Adverse Drug Reactions Due to Cancer Chemotherapy in Females

Fakhsheena Anjum, Neelam Mallick, Sadia Shakeel, Faiza Fakhar, Qurat ul ain Arif, Zonaira Anwer


In this study, occurrence of adverse drug reactions in female patients receiving chemotherapy were analyzed. Various drugs prescribed for cancer patients for compensation of these adverse reactions were also noted. Study was conducted on 83 female cancer patients selected randomly from a recent record of six months in KIRAN (Karachi Institute of Radiology and Nuclear Medicine) hospital, Karachi, Pakistan. Only those cases were selected in which patients received at least three cycles of cancer chemotherapy. The collected reports were analyzed for patients’ data, drug details, causality, preventability and severity of adverse effects. Causality was assessed by the World Health Organization (WHO) causality assessment scale. Preventability and severity of ADRs were assessed by Naranjo's Algorithm and modified Hartwig’s and Siegel scale. Out of n=83 females, n=55 (66.26%) females were married. Majority belonged to lower socioeconomic class (n=64, 77.10%). In the 40-49 years age group 30.12% (n=25) adverse drug reactions (ADRs) were seen whereas 26.50% (n=22) ADRs in 50-59 years of age and 25.30% (n=21) ADRs in 30-39 years of age group were observed. The cases observed were of breast cancer (n=52, 62.65%), ovarian cancer (n=14, 16.86%), GI Cancer (n=8, 9.63%), and others that include head and neck cancer (n=3, 3.61%), lymphomas (n=3, 3.61%), sarcomas (n=2, 2.40%) and mass on chest wall (n=1, 1.20%). In general, the common adverse effects observed were neutropenia/pancytopenia/anemia (n=64, 77.10%), alopecia (n=51, 61.44%), nausea and vomiting (n=39, 46.98%), fatigue/anorexia (n=26, 31.32%), mouth sores (n=21, 25.30%), fever and chills (n=20, 24.09%) and diarrhea (n=12, 14.45%). According to the three scales employed for ADRs assessment {i.e. (WHO) causality assessment scale, Naranjo's Algorithm and modified Hartwig’s and Siegel scale for preventability and severity of ADRs}, the results are in close agreement with each other with respect to occurrence and severity of the ADRs. A number of ADRs are observed in various cancer patients receiving chemotherapy indicating high need of ADR monitoring and reporting. The problem of under-reporting of ADRs is a big issue and must not be overlooked


Chemotherapy, Adverse Drug Reactions, Cancer, Hartwig and Siegel Scale, WHO Causality Assessment Scale, Naranjo's Algorithm

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