Medication error drug reactions

Meanwhile, these chemicals—like chemical agents encountered at work or in hobbies or as pollutants in air, water, soil, or food—can also cause harm. Sometimes the known mechanisms of action permit us to predict the nature of toxicity to be expected. A meta-analysis of prospective studies from U.S. hospitals indicates that 6.7% of in-patients have serious adverse drug reactions 0.3% have fatal reactions (Lazarou et al., 1998). In fact, estimates of 40,000 to 100,000 deaths per year attributed to errors in medical care, primarily due to adverse reactions to pharmaceuticals, make this phenomenon a major cause of death in the United States (Meyer, 2000). A tremendous... 

Monitoring and taking action to prevent adverse drug reactions and medication errors... 

Safety reporting A proposed revamping of safety reporting requirements aims to enhance the FDA s ability to monitor and improve the safe use of drugs and biologies. In 2003, the FDA published a proposed rule. The rule, if enacted, would improve the quality and consistency of safety reports, require the submission of all suspected serious reactions for blood and blood products, and require reports on important potential medication errors. 

The Institute of Medicine reported in January 2000 that between 44 000 and 98 000 deaths occur annually from medical errors and that an estimated 7000 deaths occur due to adverse drug reactions, which was in excess of the 6000 deaths that occurred annually from workplace injuries.3... 

A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while medication is in the control of a healthcare professional/ patient/ or consumer (6). Not all medication errors reach the patient. These are often referred to as "near misses." They are not usually considered to be ADEs only because no harm was done. Preventable ADEs are a subset of medication errors that cause harm to a patient (7). Figure 26.1 depicts the relationship between ADES/ medication errorS/ and adverse drug reactions (8). Because adverse drug reactions are generally unexpected/ they are not presently considered to be a reflection of medication use quality in a classic sense. However/ as genetic variances become a more prominent consideration in drug selection and monitoring/ it may be possible to predict and avoid some of the reactions that have been previously unexpected. This offers an opportunity to improve the quality of medication use. 

American Society of Health-System Pharmacists. Suggested definitions and relationships among medication misadventures, medication errors, adverse drug events, and adverse drug reactions. Am J Health-Syst Pharm 1998 55 165-6. 

American Society of Health-System Pharmacists. Suggested Definitions and Relationships Among Medication Misadventures, Medication Errors, Adverse Drug Events and Adverse Drug Reactions. Am. J. Health-Syst. Pharm. 1998, 55, 165-166. 

Adverse drug reaction/medication error tracking and reporting. 

The pharmacist should be actively involved in the organization s performance improvement activities.Aspects of care that can be monitored include, but are not limited to, patient satisfaction, unscheduled admissions, medication errors, adverse drug reactions, infection control-related issues (e.g., line infections), unscheduled deliveries, and so on. 

The incidence of serious and fatal adverse drug reactions (ADRs) in U.S. hospitals is high. An estimated 2 million hospitalized patients have serious ADRs each year, and about 100,000 suffer fatal ADRs. If this estimate is correct, then more people die annually from medication errors than from highway accidents, breast cancer, or AIDS. 

Studies of medication errors, as we have seen, assess whether a dmg was prescribed and administered correctly there may or may not have been any actual or potential harm to the patient. Studies of adverse drug events, in contrast, focus on the harm, which may or may not have been caused by an error. For instance, if a patient suffers an allergic reaction which could not have been predicted then this is unfortunate, but not an error. If their medical record specifies the allergy and they are still given the drug, then it certainly can be classed as an error, although investigation may reveal a quite complex net of causes. 

---