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

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References

Ashraf, S., Upreti, P., Karki, S., Khan, M., and Nasr, R., 2022. Metformin-Associated Lactic Acidosis: A Case Report and Review. Cureus, 14: e24220.

Bassi, P.U., Osakwe, A.I., Ogar, C.K., Elagbaje, C., Nwankwo, B.B., Balogun, S.T., et al., 2017. Impact of comorbidity on adverse drug reaction profile in a cohort of patients treated with Artemisinin combination therapies for uncomplicated malaria in Nigeria. Pharmacology Research & Perspectives, 5: e00302.

Bonnet, F. and Scheen, A., 2017. Understanding and overcoming metformin gastrointestinal intolerance. Diabetes, Obesity & Metabolism, 19: 473–481.

Coregliano-Ring, L., Goia-Nishide, K., and Rangel, É.B., 2022. Hypokalemia in Diabetes Mellitus Setting. Medicina, 58: 431.

Dagli, R.J. and Sharma, A., 2014. Polypharmacy: A Global Risk Factor for Elderly People. Journal of International Oral Health : JIOH, 6: i–ii.

Fasipe, O.J., Akhideno, P.E., and Owhin, O.S., 2019. 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, 3: 2397847319850451.

Forslund, S.K., Nielsen, T., and Falony, G., 2015. Disentangling Type 2 Diabetes and Metformin Treatment Signatures in the Human Gut Microbiota. Nature, 528: .

Gennari, F.J., 1998. Hypokalemia. The New England Journal of Medicine, 339: 451–458.

Jain, A. and Paranjape, S., 2013. Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian Journal of Endocrinology and Metabolism, 17: S318–S322.

Jiménez-Marrero, S., Cainzos-Achirica, M., Monterde, D., Garcia-Eroles, L., Enjuanes, C., Yun, S., et al., 2020. Real-World Epidemiology of Potassium Derangements Among Chronic Cardiovascular, Metabolic and Renal Conditions: A Population-Based Analysis. Clinical Epidemiology, 12: 941–952.

Kardalas, E., Paschou, S.A., Anagnostis, P., Muscogiuri, G., Siasos, G., and Vryonidou, A., 2018. Hypokalemia: a clinical update. Endocrine Connections, 7: R135–R146.

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

Lacy, C.F., Armstrong, L.L., Goldman, M.P., and Lance, L.L., 2008. Drug Information Handbook 17th Edition. Lexi-Comp.

Lemeshow, S., Jr, D.W.H., Klar, J., and Lwanga, S.K., 1990. Adequacy of Sample Size in Health Studies. Wiley.

Muneer, M. and Akbar, I., 2021. Acute Metabolic Emergencies in Diabetes: DKA, HHS and EDKA. Advances in Experimental Medicine and Biology, 1307: 85–114.

Murad, M.H., Coto-Yglesias, F., Wang, A.T., Sheidaee, N., Mullan, R.J., Elamin, M.B., et al., 2009. Drug-Induced Hypoglycemia: A Systematic Review. The Journal of Clinical Endocrinology & Metabolism, 94: 741–745.

Nordström, A., Hadrévi, J., Olsson, T., Franks, P.W., and Nordström, P., 2016. Higher Prevalence of Type 2 Diabetes in Men Than in Women Is Associated With Differences in Visceral Fat Mass. The Journal of Clinical Endocrinology and Metabolism, 101: 3740–3746.

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

Putra, R.J.S., Achmad, A., and Rachma, H., 2017. Kejadian Efek Samping Potensial Terapi Obat Anti Diabetes Pada Pasien Diabetes Melitus Berdasarkan Algoritme Naranjo. Pharmaceutical Journal of Indonesia, 2: 45–50.

Rathmann, W., Haastert, B., Icks, A., Herder, C., Kolb, H., Holle, R., et al., 2005. The diabetes epidemic in the elderly population in Western Europe: data from population-based studies. Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany)), 67 Suppl 1: S110-114.

Sato, I. and Akazawa, M., 2013. Polypharmacy and adverse drug reactions in Japanese elderly taking antihypertensives: a retrospective database study. Drug, Healthcare and Patient Safety, 5: 143–150.

Schernthaner, G. and Schernthaner-Reiter, M.H., 2018. Diabetes in the older patient: heterogeneity requires individualisation of therapeutic strategies. Diabetologia, 61: 1503–1516.

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

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