Case studies 1~4 of ADR events

Ms Chao explains how she and her colleagues analyze and resolve ADR events using case study 1. She also gives 3 more examples of ADR events.

The first case

An 86-year-old female developed extrapyramidal symptom (EPS) shortly after 0.5mL of 1mg/ml Risperidone administration on 2013/2/1. Her daughter reduced the dose of Risperidone to 0.4 mL every night without doctor’s permission on 2013/2/2, but EPS persisted. She visited the ER 2 days after the first administration.

Under the impression of subacute delirium, risperidone was discontinued on 2013/2/4. EPS finally alleviated.

Below are some of the relevant information:

She responded to Risperidone in a dose-independent manner since the change of dose on 2/2 and did not relieved EPS.

Her renal function and liver function considered as normal during initiate risperidone administration.

She quit smoking for 30 years, does not drink and has no food/drug allergies.

The pharmacists looked up Lexi-comp and found out risperidone is associated with parkinsonism and the rate of adverse reaction is around 12% to 20% in adult population, thus explaining this case.