Introduction: Cardiac surgery is life-saving for serious cardiovascular conditions but often leads to postoperative complications—such as metabolic, hematologic, and cardiovascular disturbances. Involving clinical pharmacist’s post-surgery provides a proactive approach to identify, manage, and prevent medication-related issues, thereby improving patient outcomes.

Aim: To evaluate clinical pharmacists’ roles in identifying and managing postoperative complications—including adverse drug reactions (ADRs), drug–drug interactions, and untreated conditions—in cardiac surgery patients, and to assess their impact on patient care.

Methodology: This prospective observational study enrolled 103 patients undergoing cardiac procedures (angiography, angioplasty, CABG, pacemaker implantation, ASD closure, valve replacement). Pharmacists collected demographics, comorbidities, medication profiles, nursing notes, and lab data. They monitored drug-related problems, assessed ADRs using Naranjo’s and WHO‑UMC tools, evaluated their severity, predictability, and preventability, and recorded all interventions.

Results:

• Complications occurred in 91 patients (88%): hyponatremia (36.6%), anemia (32.2%), hypertension (32.2%), tachycardia (14.4%), hypokalemia (14.4%), hypophosphatemia (11.1%).
• Drug-related problems identified in 39 patients (35%), including ADRs, drug–drug interactions, and untreated conditions.
• ADRs included hypoglycemia, heparin‑induced thrombocytopenia, metoprolol‑induced bradycardia, hydrochlorothiazide‑induced hyponatremia, and amlodipine‑induced edema—mostly ‘probable/possible’, mild, predictable, and preventable.
• Drug–drug interactions noted (e.g., aspirin–metformin hypoglycemia; furosemide–telmisartan hypotension; aspirin–sacubitril/valsartan hypokalemia).
• Untreated conditions: respiratory acidosis and anemia discovered.
• Pharmacist interventions included:
• Anemia: reported for transfusion or investigation.
• Electrolyte imbalances: IV supplementation of sodium, potassium, or calcium.
• Blood pressure issues: medication adjustments and fluid management.
• Heart rate abnormalities: drug modifications, ECG monitoring, pacemaker guidance.
• Wound infections: early detection led to IV vancomycin.

Conclusion: The high incidence of postoperative complications highlights the need for enhanced oversight. Clinical pharmacists played a key role in early detection and management of drug-related issues, supported physician-led decision-making, and boosted care coordination and safety. These findings align with evidence showing that pharmacist integration in perioperative care improves outcomes and reduces medication-related harm. Implementing clinical pharmacists as part of surgical teams may enhance recovery and prevent avoidable complications.

Esha Mohamed Nisarahmed, currently pursuing her Ph.D. in Pharmacy Practice at the Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bengaluru, India. She has completed both her B.Pharm and M.Pharm in Pharmacy Practice from the same institution.