IDENTIFICATION OF ADVERSE DRUG REACTIONS OF ANTIDIABETIC DRUGS AMONG HOSPITALIZED ELDERLY PATIENT WITH DIABETES

Aida Udhiyati; Fita Rahmawati

doi:10.22146/farmaseutik.v20i3.80221

IDENTIFICATION OF ADVERSE DRUG REACTIONS OF ANTIDIABETIC DRUGS AMONG HOSPITALIZED ELDERLY PATIENT WITH DIABETES

https://doi.org/10.22146/farmaseutik.v20i3.80221

Aida Udhiyati⁽¹⁾, Fita Rahmawati^(2*)

(1) Universitas Gadjah Mada
(2) Universitas Gadjah Mada
(*) Corresponding Author

Abstract

The pharmacologic management of many acute and chronic conditions and the aging population have contributed to increasing medication use among elderly patients, this situation may lead to drug-related problems (DRPs) especially adverse drug reactions (ADR). This study aims to identify ADR of antidiabetic drugs among hospitalized elderly patient with diabetes. This descriptive observational study with a cross sectional design involved 98 geriatric patients at UGM Academic Hospital that admission between January to December 2021. The inclusion criteria were patients aged above 60 years, has complete medical record and patient was diagnosed with diabetes. WHO-UMC causality assessment criteria and Hartwig and Siegel’s scale was used for the assessment of causality and severity of ADRs, respectively. Number of patient who had experienced ADR were 15 (15.31%) patients with total ADR event were 15 (15.31%) ADRs. The result recorded 11 (11.22%) patients experienced ADR with causality category possible and severity category moderate, and 4 (4.09%) patients experienced ADR with causality category possible and severity category mild. Clinical manifestation of those ADR were nausea, heartburn, hypokalemia and hypoglycemia. The suspected antidiabetic drugs that caused ADR were metformin and insulin. Given pharmaceutical care among elderly with diabetes is pivotal to prevent ADR of antidiabetic drugs.

Keywords

antidiabetic drugs, adverse drug reaction, elderly, diabetes

References

Dagli RJ, Sharma A. Polypharmacy: A Global Risk Factor for Elderly People. J Int Oral Health. 2014;6(6):i-ii.

Pusdatin. Analisis Lansia Di Indonesia. Kementrian Kesehatan RI; 2017.

Fasipe OJ, Akhideno PE, Owhin OS. The observed effect of adverse drug reactions on the length of hospital stay among medical inpatients in a Nigerian University Teaching Hospital. Toxicology Research and Application. 2019;3:2397847319850451. doi:10.1177/2397847319850451

Sato I, Akazawa M. Polypharmacy and adverse drug reactions in Japanese elderly taking antihypertensives: a retrospective database study. Drug Healthc Patient Saf. 2013;5:143-150. doi:10.2147/DHPS.S45347

Lemeshow S, Jr DWH, Klar J, Lwanga SK. Adequacy of Sample Size in Health Studies. Wiley; 1990.

Jain A, Paranjape S. Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian J Endocrinol Metab. 2013;17(Suppl1):S318-S322. doi:10.4103/2230-8210.119647

Rathmann W, Haastert B, Icks A, et al. The diabetes epidemic in the elderly population in Western Europe: data from population-based studies. Gesundheitswesen. 2005;67 Suppl 1:S110-114. doi:10.1055/s-2005-858227

Nordström A, Hadrévi J, Olsson T, Franks PW, Nordström P. Higher Prevalence of Type 2 Diabetes in Men Than in Women Is Associated With Differences in Visceral Fat Mass. J Clin Endocrinol Metab. 2016;101(10):3740-3746. doi:10.1210/jc.2016-1915

Kementerian Kesehatan RI. Laporan Nasional Riskesdas 2018. Badan Penelitian dan Pengembangan Kesehatan; 2019.

Schernthaner G, Schernthaner-Reiter MH. Diabetes in the older patient: heterogeneity requires individualisation of therapeutic strategies. Diabetologia. 2018;61(7):1503-1516. doi:10.1007/s00125-018-4547-9

Bassi PU, Osakwe AI, Ogar CK, et al. Impact of comorbidity on adverse drug reaction profile in a cohort of patients treated with Artemisinin combination therapies for uncomplicated malaria in Nigeria. Pharmacol Res Perspect. 2017;5(2):e00302. doi:10.1002/prp2.302

Putra RJS, Achmad A, Rachma H. Kejadian Efek Samping Potensial Terapi Obat Anti Diabetes Pada Pasien Diabetes Melitus Berdasarkan Algoritme Naranjo. Pharmaceutical Journal of Indonesia. 2017;2(2):45-50.

Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4):R135-R146. doi:10.1530/EC-18-0109

Jiménez-Marrero S, Cainzos-Achirica M, Monterde D, et al. Real-World Epidemiology of Potassium Derangements Among Chronic Cardiovascular, Metabolic and Renal Conditions: A Population-Based Analysis. Clin Epidemiol. 2020;12:941-952.

doi:10.2147/CLEP.S253745

Coregliano-Ring L, Goia-Nishide K, Rangel ÉB. Hypokalemia in Diabetes Mellitus Setting. Medicina (Kaunas). 2022;58(3):431. doi:10.3390/medicina58030431

Muneer M, Akbar I. Acute Metabolic Emergencies in Diabetes: DKA, HHS and EDKA. Adv Exp Med Biol. 2021;1307:85-114. doi:10.1007/5584_2020_545

Gennari FJ. Hypokalemia. N Engl J Med. 1998;339(7):451-458. doi:10.1056/NEJM199808133390707

Ashraf S, Upreti P, Karki S, Khan M, Nasr R. Metformin-Associated Lactic Acidosis: A Case Report and Review. Cureus. 2022;14(4):e24220. doi:10.7759/cureus.24220

Bonnet F, Scheen A. Understanding and overcoming metformin gastrointestinal intolerance. Diabetes Obes Metab. 2017;19(4):473-481. doi:10.1111/dom.12854

Turner R, Holman R, Stratton I, et al. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). The Lancet. 1998;352:854-865.

Forslund SK, Nielsen T, Falony G. Disentangling Type 2 Diabetes and Metformin Treatment Signatures in the Human Gut Microbiota. Nature. 2015;528(7581).

Murad MH, Coto-Yglesias F, Wang AT, et al. Drug-Induced Hypoglycemia: A Systematic Review. The Journal of Clinical Endocrinology & Metabolism. 2009;94(3):741-745.

Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook 17th Edition. Lexi-Comp; 2008. Accessed October 14, 2020. https://www.amazon.com/Lexi-Comps-Information-Handbook-Armstrong-Paperback/dp/B011DCJC3E

DOI: https://doi.org/10.22146/farmaseutik.v20i3.80221