Critical Connections: Unravelling Adverse Drug Reactions and IV Incompatibility in High-Risk Medications

Background & Objectives: Adverse Drug Reactions (ADRs) and Intravenous (IV) incompatibilities are critical concerns in clinical settings as they can affect patient safety and the effectiveness of treatment. This study investigates the frequency and types of ADRs and IV incompatibilities associated with High-Risk Medications (HRMs) in a tertiary care hospital and offers recommendations for preventing these issues. Methods: A six-month prospective observational study was conducted across the General Medicine, Cardiology, and Intensive Care Unit departments of a 1000-bed teaching hospital to assess ADRs and IV incompatibilities related to HRMs. Results: Out of 97 prescriptions, 27 ADRs were identified, with heparin being the most frequent cause (51.5%), followed by insulin (47.5%) and potassium chloride (45.4%). Heparin-related ADRs primarily included hematuria (50%), decreased hemoglobin (25%), rashes (12.5%), and thrombophlebitis (12.5%). Insulin was associated with five hypoglycemic episodes. Potassium chloride caused vomiting (50%) and thrombophlebitis (50%). Additionally, 230 IV infusion errors were noted, with the most common errors being unrecorded diluent (44%), unrecorded infusion rate (32%), unrecorded concentration (23%), and four cases of IV drug incompatibilities (2%). Interpretation & Conclusion: The study underscores the necessity for improved prescribing practices and adherence to guidelines. It also suggests implementing targeted interventions and enhancing pharmacovigilance to improve patient safety and treatment effectiveness.