Assessment of adverse drug reactions and intravenous incompatibilities in a tertiary care teaching hospital

Background: Adverse drug reactions (ADRs) and intravenous (i.v.) incompatibilities are significant concerns in clinical practice due to their potential to compromise patient safety and treatment efficacy. This study aimed to evaluate the prevalence, types, and consequences of ADRs and i.v. incompatibilities in prescriptions from tertiary care hospitals. The study also aimed to identify the most frequently implicated drugs and conditions associated with these issues and suggest recommendations for improving prescribing practices. Methods: A prospective observational study was conducted over one year in a tertiary care hospital. Data were collected from 1000 patients across various age groups and genders in tertiary care settings. Detailed demographic information, prescribing patterns of high-risk medications, department-specific distribution, i.v. incompatibilities, and specific ADRs were analyzed. The assessment criteria included adherence to STGs, identification of deviations, and analysis of potential consequences. Results: The study revealed a significant prevalence of unacceptable deviations from standard treatment guidelines, particularly with medications such as pantoprazole and rabeprazole with domperidone. High-risk medications like anticoagulants, antiplatelets, insulin, chemotherapeutic agents, opioids, and corticosteroids were frequently prescribed, with notable department-specific variations. I.v. incompatibilities were common with chemotherapeutic agents and insulin, while specific ADRs were associated with chemotherapeutic agents, insulin, anticoagulants, and corticosteroids. Conclusions: The findings highlight the need for improved prescribing practices and strict adherence to guidelines, especially for high-risk medications. Implementation of targeted interventions, enhanced training for healthcare providers, utilization of electronic systems, robust pharmacovigilance programs, patient education, and department-specific protocols are recommended to enhance patient safety and treatment outcomes in tertiary care settings.