Table 4 Drug classes commonly implicated in serious ADRs and the associated ADR manifestations
From: Serious adverse drug reactions at two children’s hospitals in South Africa
Drug class | Serious ADRs |
|---|---|
Systemic antibacterials (J01), implicated in 12 serious ADRs | • Diarrhoea with amoxicillin (2 cases) and with clarithromycin (1 case), prolonging the admissions • Urticaria with phenoxymethylpenicillin (1 case) and with ceftriaxone (1 case), causing the admissions • Maculo-papular rash with flucloxacillin, prolonging the admission • Respiratory arrest with intravenous benzathine benzylpenicillin (medication error), fatal • Red-man syndrome with vancomycin, near-fatal • Thrombocytopaenia with amoxicillin, causing the admission • Agranulocytosis with co-trimoxazole (and zidovudine), causing the admission • Bicytopaenia with ceftriaxone, co-trimoxazole (and ganciclovir), prolonging the admission • Metabolic acidosis with amikacin (and paracetamol), causing the admission |
Systemic corticosteroids (H02), implicated in 6 serious ADRs | • Lower respiratory tract infection with prednisone, causing the admission • Upper respiratory tract infection with prednisone, causing the admission • Pneumocystis jirovecii pneumonia with prednisone and methylprednisolone, prolonging the admission • Salmonellosis with prednisone (and mycophenolic acid), prolonging the admission • Pancreatitis with prednisone and methylprednisolone, prolonging the admission • Sepsis with methylprednisolone (and mycophenolic acid and tacrolimus), prolonging the admission |
Psycholeptics (N05), implicated in 4 serious ADRs | • Respiratory depression with chlorpromazine, lorazepam and diazepam (and phenobarbital), near-fatal • Respiratory depression with diazepam (and morphine and phenobarbital), near-fatal • Apnoea with midazolam, near-fatal • Delirium with clozapine, causing the admission |
Immunosuppressants (L04), implicated in 4 serious ADRs | • Macrocytic anaemia with mycophenolic acid and tacrolimus, causing the admission • Neutropaenic sepsis with tacrolimus, prolonging the admission • Sepsis with mycophenolic acid and tacrolimus (and methylprednisolone), prolonging the admission • Salmonellosis with mycophenolic acid (and prednisone), prolonging the admission |
Direct-acting antivirals (J05), implicated in 4 serious ADRs | • Agranulocytosis with zidovudine (and co-trimoxazole), causing the admission • Diarrhoea with lopinavir-ritonavir, prolonging the admission • Increased transaminases with efavirenz, prolonging the admission • Bicytopaenia with ganciclovir (and ceftriaxone and co-trimoxazole), prolonging the admission |
Analgesics (N02), implicated in 3 serious ADRs | • Respiratory depression with morphine (and diazepam and phenobarbital), near-fatal • Metabolic acidosis with paracetamol (and amikacin), causing the admission • Increased paracetamol plasma concentration, prolonging the admission |