Related Experiment Video

Updated: Jul 12, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Admissions to a medical intensive care unit related to adverse drug reactions

Anastasia Rivkin1

  • 1Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY 11201, USA. anastasia.rivkin@liu.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|August 29, 2007
PubMed
Abstract

Insights

Most adverse drug reactions (ADRs) leading to medical intensive care unit (MICU) admission are preventable. Bleeding from medications like NSAIDs and aspirin frequently causes these preventable ADR admissions.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Patient Safety

Background:

  • Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality.
  • Understanding the frequency, severity, and preventability of ADRs is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the frequency, severity, and preventability of adverse drug reactions (ADRs) leading to medical intensive care unit (MICU) admission.
  • To identify common causes and implicated medications for ADR-related MICU admissions.

Main Methods:

  • Prospective observational study conducted over 19 weeks in a tertiary care teaching hospital.
  • Patients admitted to the MICU due to ADRs were followed until discharge or death.
  • Causality, severity, and preventability of each ADR were assessed, along with MICU and hospital stay duration.

Main Results:

  • Out of 281 MICU admissions, 21 (7.5%) were ADR-related.
  • The majority of ADRs (86%) were preventable, with drug interactions causing 57% of cases.
  • Bleeding, particularly gastrointestinal bleeding, was the most common ADR admission diagnosis (33%), often linked to NSAIDs, aspirin, and clopidogrel.

Conclusions:

  • Preventable ADRs constitute a substantial proportion of MICU admissions.
  • Bleeding associated with nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and clopidogrel is a primary driver of ADR-related MICU admissions.
  • Interventions aimed at preventing drug interactions and minimizing risks associated with these medications could reduce ADR-related MICU admissions.

Related Concept Videos

Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Drug Toxicity: Overview01:00

Drug Toxicity: Overview

Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Pharmacovigilance01:19

Pharmacovigilance

Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...