Studies on the Epidemiology of Adverse Drug Reactions

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Abstract
Nine hundred patients hospitalized on a semi-private medical ward in a teaching hospital were surveyed over one year for adverse drug reactions. Reactions were detected in 10.8% of the patients and 1.7% were admitted specifically because of a reaction. Most of the reactions were pharmacologically mediated toxic and side reactions. Less than 20% were allergic reactions. Two deaths were attributed to adverse drug reactions. Reactions were common in those patients receiving the largest number of drugs. These patients were more severely ill than patients receiving fewer drugs for the mortality rate was higher and the duration of hospitalization longer in patients receiving many drugs. Neither the clinical diagnoses, specific types of drugs administered, nor drug combinations could entirely explain the increased rate of adverse reactions in these patients. The overall rate of adverse reactions was increased in patients with abnormal renal function. Reactions to sedatives and tranquilizers were common in patients with abnormal liver function. Infections, primarily pneumonias, predisposed patients to adverse reactions. Allergic reactions were common in patients with infections. A topic disease did not predispose patients to adverse reactions, although a history of a prior drug reaction did. Interestingly, allergic reactions were common in patients with gastrointestinal disease. Most of these allergic reactions were to orally administered drugs. There was a wide variability in rates of reaction to specific drugs, and considerable diversity in type and severity of reactions.