Life Threatening Drug Reactions Amongst Medical in-Patients

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Abstract
The present report gives information on life threatening effects of drugs as seen in a group of 2580 consecutive medical inpatients in 2 Scottish hospitals, who participated in a drug surveillance program. Life threatening adverse reactions to drugs were reported in 28 instances (1.1/100 patients and approximately 2/1000 drug orders). Such reactions were significantly more common in patients with recognized malignancy (5 of 201 = 2.5%) than in those without this diagnosis (23 of 2379 = 1.0%). Life-threatening reactions are relatively uncommon in this population and the group at greatest risk is also the group who stand to gain most from energetic treatment (those receiving chemotherapy for cancer). A reduction in the frequency of life-threatening events could be obtained most readily by stricter use of potassium supplements and potassium retaining diuretics such as spironolactone which are known to carry substantial risks of producing hyperkalemia.

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