Drug Utilization Patterns, Polypharmacy, And Adverse Drug Reactions Among Patients Attending A Tertiary Care Cardiac Emergency: A Prospective Observational Study

Cardiac emergencies often require multiple medications for rapid stabilization and management of complex cardiovascular conditions, increasing the potential for polypharmacy and adverse drug reactions (ADRs). The present study evaluated drug utilization patterns, polypharmacy, and ADRs among patients attending a tertiary care cardiac emergency. A prospective observational study was conducted over six months, involving 700 patients whose prescriptions and available medical records were evaluated. Demographic characteristics, clinical conditions, comorbidities, prescribed medications, polypharmacy, and ADRs were recorded. A total of 3,453 individual drug entries were documented, with an average of 4.93 recorded drug entries per evaluated encounter. Antiplatelets were the most frequently utilized drug category (730; 21.14%), followed by cardiovascular drugs (680; 19.69%) and anticoagulants (450; 13.03%). Polypharmacy was identified in 294 patients (42.0%). A total of 149 ADR events/episodes were documented, of which 85 (57.05%) were mild, 48 (32.21%) were moderate, and 16 (10.74%) were severe. Polypharmacy was significantly associated with ADR occurrence (χ²=62.983, p<0.001), with higher ADR occurrence among patients with polypharmacy than those without (35.7% vs. 10.8%; OR=4.57, 95% CI: 3.08–6.77). Age was significantly associated with both polypharmacy and ADR occurrence (p<0.001). The findings highlight the importance of medication review and pharmacovigilance, particularly among patients receiving multiple medications and older patients, to promote safer pharmacotherapy in cardiac emergency care.