Comprehensive analysis of cutaneous adverse drug reactions during hospitalization: unveiling nuanced complexities and ensuring patient safety

Junaid Ahmad  Ahangar; Semira; Seema  Qayoom; Mudasir Shafi  Bhat

doi:10.69857/joapr.v12i3.462

Authors

Junaid Ahmad Ahangar Department of Pharmacology, SKIMS MCH Bemina, Srinagar, Jammu and Kashmir, India
Semira Department of Pharmacology, SKIMS MCH Bemina, Srinagar, Jammu and Kashmir, India
Seema Qayoom Department of Dermatology, SKIMS MCH Bemina, Srinagar, Jammu and Kashmir, India
Mudasir Shafi Bhat Department of Physiology, SKIMS MCH Bemina, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.69857/joapr.v12i3.462

Keywords:

Cutaneous Adverse Drug Reactions, Preventability, Causality, Non-Steroidal Anti-Inflammatory Drugs, antibiotics, antiepileptic drugs

Abstract

Background: The spectrum of cutaneous drug reactions encompasses a broad range from benign rashes to potentially life-threatening conditions. The present study aims to comprehensively investigate the frequency, type, causality, preventability, and severity of adverse drug reactions (CADRs) occurring during hospitalization. Methods: Conducted at SKIMS Medical College Hospital over a comprehensive six-month duration, this study systematically monitored the occurrence of cutaneous drug reactions. These reactions' causality, severity, and preventability assessments were meticulously conducted using established classifications such as the Wills and Brown classification, WHO criteria, Hartwig scale, and modified Schumock and Thornton scales. Result and discussion: Involving a cohort of 300 admissions, the study identified an incidence of adverse drug reactions (CADRs) at 8%. Detailed analysis revealed no significant associations between CADRs and gender, drug allergy history, or the number of drugs administered. Notably, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), particularly Dapsone, emerged as the most common drug class associated with cutaneous adverse drug reactions (CADRs), accounting for 41.67% of cases. Antibiotics, including linezolid (12.5%) and amikacin (12.5%), followed closely. Itching (37.5%), followed by red raised lesions (33.33%), emerged as the predominant reported reactions, showcasing associations with various drugs. Notably, a significant proportion of CADRs were categorized as mild (50%), with 95.83% deemed not preventable. Conclusion: The prevalence of mild reactions, particularly linked to NSAIDs and antibiotics, underscores the nuanced complexities in drug responses. The research enriches the broader comprehension of adverse drug reactions, underscoring the imperative for meticulous surveillance and scholarly inquiry to elevate patient safety.

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References

Lee A, Thomson J. Drug-induced skin reactions. In: Lee A, editor. Adverse Drug Reactions. 2nd ed. London, UK: Pharmaceutical Press; 2006: 126-155. Current Therap Res. 69, 118-29 (2008)

Chan A, Lee H, Ho C, Cham T, Lin S. Cost evaluation of adverse drug reactions in hospitalized patients in Taiwan: A prospective, descriptive, observational study. Arch Dermatol. 137, 765-70 (2001)

Bigby M. Rates of cutaneous reactions to drugs. Contact Dermatitis. 19(3), 195-201 (1988)

De Groot A, Beverdam E, Ayong C, Coenraads P, Nater J. The role of contact allergy in the spectrum of adverse effects caused by cosmetics and toiletries. Pharmacol Res. 54, 226–233 (2006)

Jose J., Rao P.G. Pattern of adverse drug reactions notified by spontaneous reporting in an Indian tertiary care teaching hospital. Am J Hosp Pharm. 49(9), 2229-32 (1992)

Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Hosp Pharm. 27(6), 538 (1992)

Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Indian J Pharmacol. 36, 292-5 (2004)

Noel M V, Sushma M, Guido S. Cutaneous adverse drug reactions in hospitalized patients in a tertiary care center. J Eur Acad Dermatol Venereol. 26(11), 1424-30 (2011)

Atzori L, Pinna A, Mantovani L, Ferreli C, Pau M, Mulargia M, et al. Cutaneous adverse drug reactions to allopurinol: 10-year observational survey of the dermatology department - Cagliari University (Italy). Pharmacoepidemiol Drug Saf. 14(8), 567–70 (2005)

Sushma M, Noel MV, Ritika MC, James J, Guido S. Cutaneous adverse cutaneous drug: a 9 year study from a South Indian Hospital. Int J Dermat. 6(2), 1-6 (2007)

Mbuagbaw J, Mbuagbaw LE, Chiabi A, Bisseck C, Nkam M. Mucocutaneous adverse drug reactions. In:A Hospital Setting in Cameroon. Indian J Pharmacol. 38(6), 429 (2006)

Chatterjee S, Ghosh A, Barbhuiya J, Dey S. Adverse cutaneous drug reactions:A one-year survey at a dermatology outpatient clinic of a tertiary care hospital. Int J Res Dermatol. 5, 231-8 (2019)

Mulla FA, Sridhar SB, Hassan GAA, Shariff A. Prospective monitoring of cutaneous adverse drug reactions in a secondary care hospital, UAE. Int J App Basic Med Res. 1(1), 50 (2011)

Nandha R, Gupta A, Hashmi A. Cutaneous adverse drug reactions in a tertiary care teaching hospital: A North Indian perspective. J Pak Assoc Dermatol. 16, 28-38 (2008)

Dubey AK, Prabhu S, Shankar PR, Subish P, Prabhu MM, Mishra, et al. Dermatological adverse drug reactions due to systemic medications. A review of literature. Oman Med J. 23(1), 21-7 (2011)

Al Raai F, Banodakar D, Epidemiological study of cutaneous adverse drug reactions in Oman. J Drugs Dermatol. 10(10), 1160-7 (2011)

Kasemsarn P, Kulthanan K, Tuchinda P, Dhana N, Jongjarearnprasert K. Cutaneous reactions to nonsteroidal anti-inflammatory drugs. J Clin Diagn Res. 6(3), 445-8 (2012)

Neupane S, Sharma SR. Adverse Drug Reactions: A 6-Month Teaching Hospital Based Study from MidWestern Nepal. IOSRJDMS. 13(7), 102-9 (2014)

Verma R, Tiwari S, Gupta CM, Verma N. Cutaneous Adverse Drug Reactions-A Study of Clinical Patterns, Causality, Severity and Preventability. IOSRJDMS.13(7):102-9 (2014)

Bharani KR, Chandel NR, Goyal CA. Dermatological Manifestations of Adverse Drug Reactions: An Observational Study from Tertiary Care Center of Central India. J Pharm Biomed Sci. 4(3), 208-14 (2014)

Son Y, Lee J, Roh J. Causality assessment of cutaneous adverse drug reactions. Ann Dermatol. 23(4), 432 (2011)

Tennis P, Stern RS. Risk of serious cutaneous disorders after initiation of use of phenytoin, carbamazepine, or sodium valproate: a record linkage study. Neurology. 49(2), 542-6 (1997)

Mani MZ, Mathew M. A study of 218 drug eruptions. Indian J Dermatol Venereol Lepr. 49, 109-17 (1983)

Puavilai S, Timpatanapong P. A prospective study of cutaneous drug reactions. J Med Assoc Thai. 72, 167-71 (1989)

Mbuagbaw J, Mbuagbaw LE, Chiabi A, Bisseck C, Nkam M. Mucocutaneous adverse drug reactions. In:A Hospital Setting in Cameroon. Int J Dermat. 6(2), 1-6 (2007)

Sudershan V, Siddiqua S, Aruna D, Manmohan, Ramesh S, Nazia Y. Cutaneous adverse drug reactions in a tertiary care hospital. Der Pharmacia Lettre. 3(6), 210-7 (2011)

Acharya L, Rao P, Ghosh S. Study and evaluation of the various cutaneous adverse drug reactions in Kasturba hospital, Manipal. Ind J Pharm Sci. 68(2), 212 (2006)

Jamunarani R, Priya M. analysis of adverse drug reaction related hospital admissions and common challenges encountered in ADR reporting in a tertiary care teaching hospital. Asian J Pharm Clin Res. 7(1), 141-3 (2014)

Sharma VK, Sethuraman G. and Kumar B. Cutaneous adverse drug reactions: clinical pattern and causative agents--a 6 year series from Chandigarh, India. J Postgrad Med. 47, 95 (2001)

Vijendra R, Pundarikaksha HP, Gopal MG, Girish K, Vasundara K, Jyothi R. A prospective study of cutaneous adverse drug reactions in a tertiary care hospital. Nat J Basic Med Sci. 3(1), 44- 51 (2012)