Medication Safety: Prevention of Adverse Drug Events

  • Spring 2018

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An adverse drug event can happen after a patient receives any medication and the severity can range from minor (e.g., nausea, foggy feeling) to severe (e.g., hallucinations).  An allergy to a medication (e.g., rash, swelling of airways) is different than an adverse drug event and is less predictable than an adverse effect from a medication.

Pharmacists carefully review all patients’ medication history after they are admitted to the hospital as a practice to prevent adverse drug events. This review process includes gathering information about their current medications, allergies to medications, previous reactions to medications and immunization history.

“Reviewing the medications and discussing the medications with the patient is an opportunity for us to identify any past and potential adverse medication events,” said Steve Timmerman, director of pharmacy at Brookings Health System.

When an adverse event happens, nurses note what side effect(s) the patient has and work with the pharmacists to try and determine if a medication may have caused the problem.

“The nurses, from the pharmacy stand point, are our eyes and ears on what’s going on because they have the direct patient contact,” said Timmerman. 

Reactions may appear as a result of a number of different things: wrong dosage, not tolerating the 
current medications, an allergy, or interaction with another medication.

Luckily, there’s a screening tool in place that helps determine what the side effects come from. The screening tool takes a health care provider through questions like: what time did the event happen, when was the medication given, etc. to reveal a step by step timeline creating a true cause and effect. 

If the patient takes multiple medications at the time of their reaction, and the reaction was non-life threatening, patients may receive a rechallenge of the new medication to see if the same reaction develops. If it does, the new medication takes fault. If it doesn’t, then the reaction likely resulted from something else. 

The time that healthcare providers take to sort through adverse effects and allergies is worthwhile as it can help guide decisions on future medication use. If a patient gets nausea from an oral medication then they may be able to tolerate an IV medication. Therefore, it is important that the adverse effect of nausea is not inappropriately labeled as an allergy in a profile. If a patient has an allergy to a medication then it changes the decision about the use of alternative forms of the medication or medications that are similar to the one listed in a record/profile.

To learn more about the prevention and care of adverse drug events at Brookings Health System visit: www.brookingshealth.org/Pharmacy