TABLE 10.
Classification of potentially preventable DRAs related to treatment safety (N = 50).
| Categories of preventable DRAs related to treatment safety | No. | Medication involved |
|---|---|---|
| OVERUSE | ||
| Drug without an indication | 4 | low-dose acetylsalicylic acid (3), levodopa |
| UNDERUSE | ||
| Omission of an indicated drug | 3 | omission of gastric acid suppressants despite prior gastritis or gastrointestinal ulcer naproxen, ibuprofen, ibuprofen (+rivaroxaban) |
| MISUSE | ||
| Wrong drug | 13 | nimesulide, furosemide |
| • inappropriate according to guidelines | ||
| • contraindication or precaution for a certain condition with increased risk of toxicity | diclofenac (2), meloxicam (2), ibuprofen (2), nimesulide, amiodarone, bisoprolol, dosulepin, doxazosin | |
| Wrong dose | 9 | glimepiride, tramadol |
| • the dose was too high | ||
| • the dose was not adapted to the patient characteristics (age, renal function, weight) | diclofenac, tiapride, nadroparin | |
| • the dose was given too frequently | metoprolol | |
| • accidentally ingesting a toxic amount of drug | tramadol + zolpidem, tiapride, insulin | |
| Inappropriate monitoring | 11 | amiodarone (+bisoprolol), verapamil, digoxin (+nebivolol) |
| • symptoms of bradycardia, heart rate | ||
| • symptoms of bleeding, INR | warfarin (5) | |
| • blood glucose | insulin (2) | |
| • blood potassium | potassium chloride | |
| Drug-drug interactions | 1 | haloperidol (+morphine, fentanyl) |
| OTHER | ||
| Inappropriate lifestyle measures | 9 | glimepiride, insulin |
| • food intake | ||
| • fluid intake | furosemide (2), digoxin, amiloride (+telmisartan), perindopril | |
| • smoking | hormonal contraceptives | |
| • heavy episodic alcohol consumption | warfarin | |
DRA, Drug-related hospital admission; INR, International Normalized Ratio.