Table 1.
Rationale for the use of triggers
Triggers | Rationales for use |
---|---|
Haematological alterations | Anemia, leucopoenia, and thrombocytopoenia are adverse reactions of various drugs |
Biochemical alterations | Hyponatraemia, hypokalaemia, elevated BUN and creatinine are common events with various drugs |
Cardiac alterations | Tachycardia is common, for example, with β-adrenergic agents, which can cause other arrhythmias; bradycardia may occur with β-blockers |
Antihistamines | Indicator of allergic reaction |
Corticoids | Potential indicator of allergic reaction |
Allergic reactions | Frequently reported adverse events |
Non-programmed endotracheal intubation | Potential indicator of respiratory depression, common, for example, with benzodiazepines |
Level of consciousness degradations | Common with benzodiazepines, anticonvulsants |
Drug interactions | For example, hypotension and lethargy caused by concomitant administration of sedatives and anticonvulsants |
Antiseizures prescription | Potential indicative of unexpected seizure, when using medications that may lead to changes in electrolytes and seizures, like amphotericin B |
Drug intolerance | For example, vomiting and diarrhoea, frequent events with various medications, such as antibiotics |
Non-programmed suspension of drug | Indicative of intolerance or adverse reaction |
Fever | Adverse event of drugs such as amphotericin B |
Sudden death | Already reported with drug combinations containing dipyrone |
Serum level alteration | for monitored drugs such as vancomycin and phenobarbital, with a narrow therapeutic range and potentially toxic at high levels |
Aminophylline/adrenaline prescription | Potential indicators of severe allergic reactions |
Antidotes prescription | For example, the use of flumazenil may indicate adverse events due to the use of benzodiazepines |
Others | Adverse events discovered in the review of medical records, and that does not fit in any trigger, being the trigger the event itself |
BUN, blood urea nitrogen.