Dr. Damiani et Dp. Swanson, PHARMACIST-MANAGED MONITORING OF ADVERSE REACTIONS TO CONTRAST-MEDIA, American journal of hospital pharmacy, 51(3), 1994, pp. 358-363
A pharmacist-managed program for reporting, treating, and monitoring a
dverse drug reactions (ADRs) to contrast media is described. The radio
logy pharmacist at a 1000-bed multihospital medical center worked with
the radiology department to revise departmental policies and procedur
es for reporting ADRs to contrast media. Under the revision, an ADR re
port must be completed and forwarded to the pharmacy department and ra
diology pharmacist for review. In the radiology department itself, ADR
s must be documented in the computerized radiology information system
in two fields, the patient's radiology file and the radiology study re
port. The radiology pharmacist developed guidelines for preventing and
treating ADRs to contrast media. Boxes containing drugs specifically
indicated for the treatment of these ADRs were distributed throughout
the radiology department. The radiology pharmacist prepares a quality
improvement report each quarter. ADRs documented in the patient's radi
ology file and in the radiology study report are compared with the tot
al number of ADRs reported. The incidence of ADRs is determined and co
mpared with that for previous quarters and with published data. The tr
eatment of each reaction is evaluated for compliance with the guidelin
es, the need for follow-up, and any unusual problems. Between July 199
8 and December 1992, ADR documentation in the radiology file and in th
e radiology study report increased substantially in several divisions
of the radiology department. The rates of ADRs to contrast media remai
ned fairly constant and paralleled published rates. Compliance with th
e treatment guidelines was excellent. Pharmacist involvement led to im
proved reporting of adverse reactions to contrast media in a radiology
department and to greater awareness of measures for treating and prev
enting them.