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Citation
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Beauchamp GA, Amaducci A, Greenberg MR, Meyers M, Cook M, Cannon RD, Katz KD, Finkelstein Y. J. Med. Toxicol. 2019; ePub(ePub): ePub. |
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Affiliation
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Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. |
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Abstract
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INTRODUCTION: Adverse drug events/reactions (ADE/ADR) cost more than $30 billion annually and are among the leading causes of death in the USA. Little is known about patients treated at the bedside for ADE/ADR by medical toxicologists.
METHODS: We conducted a retrospective study of ADE/ADR cases reported to the Toxicology Investigators Consortium (ToxIC) registry between January 1, 2010, and December 31, 2016. Clinical and demographic data were collected including age, sex, circumstances surrounding exposure, suspected offending substance, clinical manifestations, treatment, disposition, and outcome.
RESULTS: Among 51,440 ToxIC cases during this time period, 673 ADE/ADR cases were reported (337 females). By age, ADE/ADR were seen most commonly among adults aged 19-65 years (442/673, 65.7% of ADE/ADR) and older adults aged 65-89 years (134/673, 19.9% of ADE/ADR). Two hundred twenty-two out of 673 (33%) consults for ADE/ADR were seen in the emergency department (ED); 181/673 (26.9%) were seen in the hospital ward; and 160/673 (23.8%) were seen in the intensive care unit (ICU). The most commonly reported sign for ADE/ADR was tachycardia 51/673 (7.6%), followed by bradycardia 49/673 (7.3%). Most commonly reported agents associated with ADE/ADR were as follows: 97/673 (14.4%) due to cardiovascular medications, 76/673 (11.3%) due to antipsychotic medications, and 61/673 (9.1%) due to antidepressants. Four hundred twenty-nine out of 673 (63.7%) ADE/ADR were reported as due to a single agent, and 212/673 (31.5%) were reported as due to multiple agents.
CONCLUSIONS: 4.2% of cases managed at the bedside by a consulting toxicologist and reported to the ToxIC registry between 2010 and 2016 had ADE/ADR as the reason for consultation. Agents most commonly involved in ADE/ADR included cardiovascular medications, antipsychotic medications, and antidepressants.
Language: en |