Drug-related events in an emergency department of a tertiary health care facility in South- South Nigeria

Abstract

Background: Drug-related adverse events refer to any injury from a medical intervention relating to a drug. This study identified suspected drug-related events presenting to the accident and emergency (A&E) unit of a teaching hospital.

Methods: The adult admission registers of the A&E unit of the University of Benin Teaching Hospital, Benin-City, Nigeria were retrospectively reviewed over a four-year period (January 2015 –December 2018). Patients with diagnosis that may indicate a drug-related event were included in the study.

Results: A total of 24510 new patients were seen over the 4- year period, with 648(2.6%) presenting with a drug-related event (DRE). There were 353 (54.5%) males, and the mean age (SD) was 48.9(20.4) years. Main DRE identified were adverse drug reactions (n=465, 71.8%) and of these, Non-steroidal antiinflammatory drugs (NSAIDs)-induced upper gastrointestinal bleeding (n=145, 31.2%), drug-induced hypoglycaemia (n=79, 21.5%), herbal medicines related events(n=27, 4.2%), were the commonest. Other DREs were substance abuse/misuse (n=105, 16.2 %), causing substance (notably cannabis) - induced mental and behavioural disorders (n=60, 9.3%), and
lastly poisoning (n=78, 12%) which were mostly intentional poisoning (notably organophosphates) (n=43, 6.6%).

Conclusions: Drug-related events constitute a significant burden on the emergency system. Upper gastrointestinal bleeding following use of NSAIDs, drug induced hypoglycaemia, organophosphate poisoning were found to be notable life threatening causes of emergency admissions. require multifaceted public health interventional strategies to mitigate the burden.

Keywords: drug-related medical emergencies; adverse drug reactions; poisoning; anti-inflammatory agents non-steroidal; Nigeria