Adverse effects of neuromuscular blocking agents based on yellow card reporting in the U.K.: are there differences between males and females?
Abstract
Background: Adverse drug reactions (ADRs) are known to occur during anaesthesia; in the U.K. such ADRs may be reported through the Yellow Card Scheme (YCS). Our aim was to determine the demographics of ADRs to neuromuscular blocking drugs without formal causality assessment. Methods: A retrospective analysis of ADRs to seven neuromuscular blocking drugs reported via the YCS during a greater than 30‐year period was performed. Sex and age were analysed in order to identify at risk groups. Results: Of 998 reports, 969 included gender. Non‐allergic suspected reactions occurred with almost the same frequency as those with an allergic component. The majority occurred in females 676 (70%), and significant sex differences were measured between drugs. Males were more likely to have suffered an ADR to atracurium (p = 0.01) whilst females experienced more ADRs to suxamethonium (p = 0.01). ADRs proved fatal in 81 (9%) of the 950 reports for single drugs. Mortality following suxamethonium was significantly higher in males at 22% compared with 9% females (p < 0.001). More women than men were reported to have allergic reactions, 73% (362/499) compared with 27% (137/499) respectively. The female:male ratio for ADRs was reversed for subjects < 10 years compared with peak ADR reports during the decade from 31–40 years. Conclusions: Sex differences in mortality exist in this analysis. The unexpected high frequency of non‐allergic ADRs suggests that morbidity and mortality from reactions to established drugs is twice that expected from allergic reactions alone. Standards and guidance for the reporting of ADRs warrant urgent development. Copyright © 2006 John Wiley & Sons, Ltd.
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Zolpidem shows slower drug metabolization and high secondary effects in women, increasing their health risks compared with men.
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From Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare (2020) · cites this paper as [36]
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Self-citation
- Authors
- Light, K. P., Lovell, A. T., Butt, H., Fauvel, N. J., & Holdcroft, A.
- Affiliations
- Chelsea and Westminster Hospital (GB)
- University of Bristol (GB)
- Corresponding author
- Holdcroft, Anita
- Venue
- Pharmacoepidemiology and Drug Safety
- Publisher
- Wiley
- Published
- 2006-01-04
- Volume
- 15
- Issue
- 3
- Pages
- 151-160
- ISSN
- 1053-8569 (ISSN-L)
- 1099-1557
- OpenAlex
- W2131093315
- Cited by
- 72
- References
- 19
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2022: 4 · 2021: 8 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 7 · 2013: 3 · 2012: 1
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacoepidemiology and Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- neuromuscular blocking agents, adverse drug reactions, Yellow Card Scheme, sex differences, atracurium, succinylcholine, allergic reactions, drug safety reporting, anesthesia, mortality
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anaphylaxis, Atracurium, Child, Child, Preschool, Neuromuscular Nondepolarizing Agents, Drug Hypersensitivity, Female, United Kingdom, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mortality, Neuromuscular Depolarizing Agents, Pancuronium, Risk Factors, Succinylcholine, Vecuronium Bromide, Adverse Drug Reaction Reporting Systems, Age Distribution, Sex Distribution, Pharmacoepidemiology, Risk Assessment
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