MINI REVIEW ON: A STUDY OF ADRS IN GERIATRIC OR PEDIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL

In clinical practice, adverse drug reactions, or ADRs, pose a significant obstacle, particularly for vulnerable populations like children and the elderly. These groups are highly susceptible due to physiological differences, polypharmacy, and altered pharmacokinetics and pharmacodynamics. In tertiary care hospitals, the purpose of this review is to investigate the incidence, patterns, risk factors, and outcomes of ADRs in geriatric and pediatric patients. Multiple studies' findings indicate that ADRs significantly increase hospital admissions and morbidity. In geriatric patients, polypharmacy, comorbidities, and age-related physiological changes increase ADR risk, whereas in pediatric patients, immature organ systems and dosing errors are key contributors. Various assessment tools such as the Naranjo Scale and Hartwig Severity Scale are widely used to evaluate ADRs. Pharmacovigilance programs play a crucial role in monitoring and preventing ADRs. The review highlights the need for improved ADR reporting systems, rational prescribing, and patient-specific therapeutic approaches to minimize adverse outcomes.

• Rukmangathen R, Brahmanapalli VD. Pharmacovigilance study in geriatric patients of a tertiary care hospital. J Pharmacol Drug Res., 2021. 
• Krishna KCM, Regidi SR. A study of polypharmacy leading to ADRs in geriatric patients at tertiary care hospital. Indian J Pharm Pharmacol, 2018; 5(2):    97–100. 
• Parmar NA, Panchal V, Jadav SP. Pattern of ADRs in geriatric inpatients in a tertiary care center. Int J Basic Clin Pharmacol, 2020; 9(12): 1831– 1835.
• Rao PCV. ADRs and polypharmacy in geriatric patients: observational study. J Popul Ther Clin Pharmacol, 2023. 
• Thakur R, Verma BA, et al. Evaluation of ADRs in elderly patients: retrospective study. J Chem Health Risks., 2024.
• Devi SL, Basalingappa S. Study of ADRs among elderly patients in tertiary care hospital. Int J Basic Clin Pharmacol, 2017. 
• Kurma VR, et al. Pattern of ADRs in pediatric patients in tertiary care hospital. Int J Contemp Pediatr, 2019
• Águeda S, et al. ADRs in children admitted to tertiary care center. Pediatr Res., 2010. 
• JIPMER Study Group. Study of ADRs in pediatric patients. Indian J Pharmacol, 2011.
• Godbharle SB, Padwal SL. Study of ADRs in tertiary care hospital. Int J., 2023.
• Ankitha L, Ramesh H. Retrospective study of ADRs in tertiary care center. Int J Basic Clin Pharmacol, 2020. 
• Calicut ADR Study Group. Spontaneous ADR reporting in tertiary care hospital. Asian J PharmClin Res., 2018. 
• Pirmohamed M, et al. Adverse drug reactions as cause of hospital admission. BMJ., 2004.
• Lazarou J, et al. Incidence of ADRs in hospitalized patients. JAMA, 1998.
• Classen DC, et al. Adverse drug events in hospitalized patients. JAMA, 1997.
• Bates DW, et al. Incidence of adverse drug events. JAMA, 1995.
• Edwards IR, Aronson JK. Adverse drug reactions: definitions and classification. Lancet, 2000.
• WHO. Pharmacovigilance guidelines, 2017.
• Pharmacovigilance Programme of India (PvPI). 
• Hartwig SC, et al. Severity assessment scale for ADRs. Am J Hosp Pharm., 1992.
• Naranjo CA, et al. ADR probability scale. Clin Pharmacol Ther., 1981.
• Davies EC, et al. Adverse drug reactions in hospital patients: systematic review. PLoS One, 2009.
• Alomar MJ. Factors affecting ADRs. Saudi Pharm J., 2014.
• Routledge PA, et al. Adverse drug reactions in elderly. Br J Clin Pharmacol, 2004.
• Impicciatore P, et al. Adverse drug reactions in children. Arch Dis Child., 2001.
• Maher RL, et al. Clinical consequences of polypharmacy. Expert Opin Drug Saf., 2014.
• Onder G, et al. Polypharmacy and ADRs in elderly. J Am Geriatr Soc., 2002.
• Spinewine A, et al. Inappropriate prescribing in elderly. Lancet, 2007.