Table 3.
Severe reactions (Hartwig scale ≥4) by reaction type and medication implicated
| Severity level | ADR type (count) | Medication implicated (count) | Admission to PICU/ HDU (if > once) |
|---|---|---|---|
| 4 |
Cardiac failure (1) |
Bisoprolol (1), Carvedilol (1)a |
HDU |
| Sedation withdrawal (1)b |
Fentanyl (1), Midazolam (1), Promethazine (1) , Chloral hydrate (1) |
PICU |
|
| Raised INR and hemorrhage (1) |
Warfarin (1) |
HDU |
|
| Pulmonary edema (1) |
Diazoxide (1) |
HDU |
|
| Respiratory depression (5) |
Fentanyl (4), Ketamine (2), Midazolam (1), |
PICU (3)c HDU (2) |
|
| Respiratory arrest (2) |
Fentanyl (2), Sevoflurane (1), Isoflurane (1), Ketamine (1) |
PICU, HDU |
|
| 5 | Peripheral neuropathy (1) | Vincristine (1) | N/A |
aBoth drugs caused significant fluid retention in this patient; bthis patient had been on sedating drugs for 10 days by the time withdrawal became clinically significant; cADR was not the only factor leading to PICU admission; other clinical factors may also have contributed. ADR adverse drug reaction, HDU high dependency unit, INR international normalized ratio, PICU pediatric ICU.