20.500.12556/RUL-148362 Adverse drug reactions in the ambulatory internal patients at the emergency department focus on causality assessment and drug-drug interactions A non-interventional retrospective study in ambulatory patients was conducted at the emergency department of the Division of internal medicine. In 2 months, 266 suspected adverse drug reactions (ADRs) were identified in 224/3453 patients (6.5 %). In 158/3453 patients (4.6 %), an ADR was the reason for emergency department visit and in 49 patients (1.4 %), ADRs led to hospitalisation. A causality assessment algorithm was developed, which included Naranjo algorithm and levels of ADR recognition by the treating physician and the investigators. Using this algorithm, 63/266 ADRs (23.7 %) were classified as “certain”, whereas using solely the Naranjo score calculation, only 19/266 ADRs (7.1 %) were assessed as “probable” or “certain”, and the rest of ADRs (namely, 247/266 = 92.9 %) were assessed as “possible”. There were 116/266 (43.6 %) ADRs related to potential drug-drug interactions (DDIs), stated in at least one of the literature sources used. Based on the causality relationship, the rate of the clinically expressed DDIs was 19.0 %, or 12/63 “certain” ADR cases. Of these, 10 cases presented serious DDI-related ADRs. In summary, ADR causality assessment based exclusively on Naranjo algorithm demonstrated low sensitivity at an ambulatory emergency setting. Additional clinical judgment, including the opinion of the treating physician, proved necessary to avoid under-rating of the causality relationship, and enabled the determination of clinically expressed DDIs. adverse drug reactions drug interactions causality assessment emergency department ambulatory patients neželeni učinki zdravil interakcije zdravil ocena vzročnosti urgentni oddelek ambulantni bolniki zdravila neželeni učinki ambulantno zdravljenje true false true Angleški jezik Slovenski jezik Licenca Creative Commons (CC BY-NC-ND) je z ikono navedena na pristajalni strani članka (glej izvorni URL). Ta licenca je navedena tudi v zapisu za revijo Acta pharmaceutica v DOAJ (https://doaj.org/toc/1846-9558). (Datum opombe 25. 8. 2023) Članek v reviji 2023-08-18 11:40:55 2023-08-18 11:40:58 2023-08-25 14:09:42 0000-00-00 00:00:00 2023 0 0 Str. 195-210 iss. 2 Vol. 73 2023 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 615.065:616-08-056.24 1846-9558 10.2478/acph-2023-0013 139850755 10.2478_acph-2023-0013.pdf 10.2478_acph-2023-0013.pdf 1 2CD38E8AF3ACA67257B8F27ECB19CD57 8219180b6cd4c5b4aa831ff02b366dc96426fe82e04513749331d1e4f97b9f61 bc5045b6-3dab-11ee-b9d7-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=172538 https://sciendo.com/article/10.2478/acph-2023-0013 1 51bdaac5-3dab-11ee-b9d7-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=172537 Medicinska fakulteta Fakulteta za farmacijo 0 0 0