ADRs in high-risk pregnancy
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ADRs in high-risk pregnancy Magnesium sulphate is the drug most frequently associated with adverse drug reactions (ADRs) in women with high-risk pregnancy in Brazil, according to findings of a study published in the European Journal of Clinical Pharmacy. ADRs were investigated in 607 women with high-risk pregnancies admitted to an obstetric intensive care unit (ICU) in Brazil between June 2016 and December 2017. Patients were excluded if they were admitted to the ICU for non-obstetric conditions, stayed in the ICU for less than 24h, or were readmitted to the ICU. The overall incidence of ADRs was 27.2%. No severe ADRs were reported but 29.7% of ADRs were of moderate severity. The incidence of ADRs was highest in patients receiving magnesium sulphate (44.5%), and was much lower for all other drugs, including vancomycin (14.3%), meropenem (9.2%), cefalexin (5.3%), azithromycin (4.5%), methyldopa (2.6%), mineral oil (1.4%), insulin (1.1%), ferrous sulphate (0.5%) and captopril (0.3%). ADRs reported in patients receiving magnesium sulphate included somnolence (68.6%), absent patellar reflex (21.6%) and hypotension (9.8%). All four cases of methyldopa-related ADRs were somnolence. Moderate hypoglycaemia was reported in one patient receiving insulin, and mild diarrhoea was reported in patients receiving azithromycin, cefalexin, meropenem, ferrous sulphate and vancomycin (one case each). Multivariate analysis found that higher BP (adjusted odds ratio [aOR] 1.02), higher haemoglobin level (aOR 1.21) and lower body temperature (aOR 0.71) significantly increased the risk of ADRs. Considering its therapeutic importance in preeclampsia/eclampsia and for foetal neuroprotection, the benefits of magnesium sulphate to the mother and foetus outweigh its risks, even though its use is associated with significant ADR, said the investigators. Xavier da Costa T, et al. Incidence of Adverse Drug Reactions in High-Risk Pregnancy: A Prospective Cohort Study in Obstetric Intensive Care. European Journal of Clinical Pharmacy : 25 Nov 2019. Available from: URL: https:// 803438847 doi.org/10.1007/s00228-019-02789-9
0114-9954/19/1782-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 7 Dec 2019 No. 1782
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