Analysis of drug related electrolyte disturbances in emergency medicine department
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20183938Keywords:
Adverse drug reactions, Electrolyte disturbances, Intensive care unitAbstract
Background: Electrolytes play an important role in various physiological functions of the body. Electrolyte disturbances are one of the most common problems encountered in critically ill patients. Drugs are also known to cause adverse electrolyte consequences. These drugs could be anti-hypertensive agents, hormones, antipsychotics or steroids. There is paucity of published literature on electrolyte disturbances caused by drugs. The purpose of our study was to evaluate the electrolyte disturbances caused by various drugs in critically ill patients.
Methods: Following approval of the Institutional Ethics Committee, data collection was started. Adverse Drug Reactions (ADRs) presenting as an electrolyte disturbance in emergency medicine department or occurring in hospitalized patients in the Intensive care unit (ICU) of our hospital was be collected. ADRs resulting into electrolyte disturbances were identified and analysed in detail for demographic details, types of electrolyte disturbances, seriousness, severity, causality and preventability of ADRs. Fisher's exact test was done to find out the statistical difference between the electrolyte disturbances and different drugs.
Results: Total 58 ADRs were reported as an electrolyte disturbance. Mean age of the patients affected was 52.48 years. Highest number of ADRs were observed in the age group of 61 to 70 years. Hypokalemia constituted 32 cases (55.2%) followed by hyponatremia (25.9%), hyperkalemia (6.9%), hypernatremia (6.9%), hypocalcemia (1.7%), hypomagnesemia (1.7%) and hypophosphatemia (1.7%). Insulin was associated with maximum cases of ADRs (27.6%).
Conclusions: Electrolyte disturbances constitutes a major chunk of ADRs especially in critically ill patients. The physicians must be well-versed with the dynamics of fluid-electrolyte balance.
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References
Bockenkamp B, Vyas H. Understanding and managing acute fluid and electrolyte disturbances. Current Paediatr. 2003;13(7):520-8.
Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health System Pharma. 2005 Aug 15;62(16):1663-82.
Patterson J. The Impact of Hyponatremia. Pharmacotherapy. 2011;31(5S):5S-8S.
Buckley MS, LeBlanc JM, Cawley MJ. Electrolyte disturbances associated with commonly prescribed medications in the intensive care unit. Critical Care Medicine. 2010 Jun 1;38:S253-64.
Khorasani B, Khorasani AG. Evaluating mortality rate caused by electrolyte abnormalities in patients hospitalized. Acta Medica Iranica. 2008;46(2):141-8.
Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Hospital Pharma. 1992 Jun;27(6):538.
Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Health System Pharma. 1992 Sep 1;49(9):2229-32.
Tangiisuran B, Wright J, Van der Cammen T, Rajkumar C. Adverse drug reactions in elderly: challenges in identification and improving preventative strategies. Age Ageing. 2009;38(4):358-359.
Minaker K, Rowe J. Potassium homeostasis during hyperinsulinemia: effect of insulin level, beta-blockade, and age. Am J Physiol. 1982;242(6):373-7.
Petersen K, Schluter K, Kerp L. Regulation of serum potassium during insulin-induced hypoglycemia. Diabetes. 1982;31(7):615-7.
Liamis G, Liberopoulos E, Barkas F, Elisaf M. Diabetes mellitus and electrolyte disorders. World J Clin Cases 2014;2(10):488-96.
Breathnach SM, Hintner H. Classification and mechanisms of drugs reactions. Adverse Drug Reactions Skin. 1992:14-38.
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