scholarly journals Knowledge, attitude and practice regarding use of fixed dose combination drugs among young prescribers a tertiary care teaching hospital in rural Bengal, India

2019 ◽  
Vol 8 (7) ◽  
pp. 1479
Author(s):  
Ananya Mandal ◽  
Sonai Mandal ◽  
Somenath Das
Keyword(s):  
Patient Compliance ◽  
Synergistic Effects ◽  
Tertiary Care ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Cross Sectional ◽  
Medical College ◽  
Prescribing Practice ◽  
Dose Combination ◽  
Graduate Trainees

Background: Use of fixed dose combination (FDCs) is a double edged sword with scope for irrational prescribing on one hand and improved pharmacotherapy and patient compliance on the other hand. Irrational FDCs are being marketed aggressively and often young prescribers including Post Graduate Trainees fall prey to the lure of FDCs. This was a Knowledge-Attitude-Practice study regarding of FDC use among the resident doctors working at a tertiary care medical college of rural Bengal.Methods: This was a cross-sectional, questionnaire based study including 50 resident doctors who were asked to fill a 10-question questionnaire on FDCs anonymously.Results: Ninety two percent of the study participants were aware of the FDCs. The most commonly perceived advantages were better patient compliance and synergistic effects. Most (96%) cited problems of titrating dosages and problems of more side effects. Only 37.6% knew about the banned FDCs. Preferred FDCs among them were antibiotics (94%), cough syrups (80%) and NSAIDs (68%). Residents of dermatology, orthopaedics, surgery and medicine most commonly prescribed FDCs. Sources of knowledge regarding FDCs were CME (92%), medical representative (76%), colleagues (72%), internet (68%), journals (48%) and textbooks (36%).Conclusions: The study showed that most participants were aware of the FDCs and also aware of the problems with irrational FDC use. Knowledge regarding banned drugs was poor as was the rationality of such combinations. More CMEs and inter department group discussions could be conducted to improve awareness and FDC prescribing practice among young prescribers.

scholarly journals Association between Compliance Level on Fixed-Dose Combination Antiretroviral Drug and CD4 Level among HIV Patients

2020 ◽  
Author(s):  
Fadhil Ilham Mustafa ◽  
◽  
Nurfitri Bustamam ◽  
Andri Pramesyanti ◽  
◽  
...  
Keyword(s):  
Significant Relationship ◽  
Fixed Dose Combination ◽  
Hiv Care ◽  
Fixed Dose ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Drug Induced ◽  
Cross Sectional ◽  
Dose Combination ◽  
Hiv Aids

Background: People living with HIV / AIDS (PLWHA) have weak immune systems and are prone to infection. Therefore, PLWHA must take antiretroviral (ARV) to maintain their immunity. This study aimed to determine the relationship between the level of adherence to taking ARV fixed-dose combination (FDC) drugs and CD4 levels of HIV patients. Subjects and Method: This was a cross-sectional study conducted at Pengayoman Cipinang Hospital, Indonesia, in 2018. Total of 91 HIV patient over 17 years of age, had or had received FDC ARV therapy for at least 1 year, and did not experience drug-induced hepatitis were enrolled in this study. The dependent variable was CD4 level. The independent variable was level of adherence to taking ARV fixed-dose combination (FDC). The data were taken from the Voluntary Counseling and Testing Poli Pengayoman Cipinang Hospital. This study used secondary data from the Overview of HIV Care and ARV Therapy. The data were analyzed using Chi-square. Results: A total of 65.93% HIV patients had a good level of medication adherence and 79.12% had an increase of CD4 levels. There was a significant relationship between adherence to taking FDC ARV drugs and CD4 levels (OR = 6.50; 95% CI = 2.15 to 19.62; p<0.001), and it was statistically significant. Conclusion: There is a significant relationship between the level of adherence to taking FDC ARV drugs and CD4 levels. Therefore, patients must receive education and support to improve adherence to taking ARV drugs. Keywords: antiretroviral, CD4, fixed-dose combination, adherence to taking medication, people with HIV / AIDS Correspondence: Fadhil Ilham Mustafa. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta. Email: [email protected]. Mobile: 081283681755. DOI: https://doi.org/10.26911/the7thicph.02.03

scholarly journals EFFECTIVENESS AND SAFETY ASSESSMENT OF FIXED DOSE COMBINATION OF NON-STEROIDAL ANTIINFLAMMATORY DRUGS PRESCRIBED FOR ORTHOPEDIC PATIENTS

2019 ◽  
pp. 70-73
Author(s):  
NILAY SOLANKI ◽  
ALPA GOR ◽  
BIRAJ PARMAR
Keyword(s):  
Adverse Effects ◽  
Tertiary Care ◽  
The Other ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Antiinflammatory Drugs ◽  
Dose Combination ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Orthopedic Patients

Objective: Many Fix Dose Combinations (FDCs) being introduced in India are usually irrational. The most pressing concern with irrational FDCs is that they expose patients to unnecessary risk of adverse drug reactions, for instance, pediatric formulations of nimesulide+paracetamol. Despite their wide clinical use, their gastro-intestinal toxicity is a major limitation. The aim of the present work was to evaluate the efficacy and safety of FDCs in non-steroidal anti-inflammatory drugs in the orthopedic department at a tertiary care teaching hospital. To study the effectiveness and safety parameters of fixed-dose combinations of Non-Steroidal Anti-inflammatory Drugs. Methods: This prospective, observational study was conducted among 150 out-patients of the orthopedic ward over a period of July 2013 to December 2013(Each combination with 50 patients). Three fixed-dose combinations utilized were paracetamol+diclofenac, paracetamol+ibuprofen and paracetamol+nimesulide. The effectiveness was analyzed by using Visual Analogue Scale (VAS) and Disease Activity Scale (DAS) and the safety criteria were analyzed by using the WHO probability scale and Naranjo scale. 150 orthopedic patients attending Out Patient Department were included. 50 participants for each of the combinations of fixed-dose combination (FDCs) of NSAIDs. Results: Out of 150 patients 33 patients developed adverse effects, and 17(51.51%) adverse effects due to the combination of Paracetmol+Nimuselide, 11(33.34%) adverse effects due to the Paracetamol+Ibuprofen and 5 (15.15%) were due to the combination of Paracetamol+Diclofenac. The maximum effectiveness (3.55±0.208) showed in the combination of paracetamol+diclofenac compared to the other two combinations. Conclusion: It was concluded from this study that the effectiveness and safety profile of PCM+DICLO is better than the other two FDCs.

scholarly journals TO STUDY THE DRUG USE PATTERN IN PRIMARY OPEN ANGLE GLAUCOMA IN A TERTIARY CARE TEACHING

2017 ◽  
Vol 10 (2) ◽  
pp. 198
Author(s):  
Deepalatha C ◽  
Leela Pratyusha Mb
Keyword(s):  
Drug Use ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Open Angle ◽  
Duration Of Treatment ◽  
Care Teaching ◽  
Dose Combination

Objective: To study the drug utilization pattern in patients suffering from primary open-angle glaucoma (POAG) in a tertiary care teaching hospital.Methods: It is a prospective study done on 50 patients of POAG (comprising of individuals belonging to any age group). This study was carried for a period of 2-month, and the data included patient’s demographic details and the drugs prescribed. Data were analyzed for drug use pattern.Results: After screening the prescriptions of patients, it was found out that out of total 50 prescriptions, 30 were males, and 20 were females. Out of50 prescriptions, prostaglandins (58%) were most commonly prescribed. β-blockers (16%) were also prescribed. Fixed dose combination constituted60% of the prescriptions. Instructions about the route, frequency, and duration of treatment were present in all prescriptions. Drugs prescribed by their generic names were 18.75% and about 81.25% of the drugs were prescribed by their brand names.Conclusions: Fixed drug combination of timolol and dorzolamide was the most frequently prescribed combination. Prescribers must be aware ofimportance of prescribing drugs with generic names.Keywords: Primary open-angle glaucoma, Intraocular pressure, Fixed dose combination.

scholarly journals KADAR SERUM GLUTAMIC OXALOACETAT TRANSAMINASE DAN SERUM GLUTAMIC PYRUVIC TRANSAMINASE PADA PASIEN TUBERKULOSIS PARU SELAMA DUA BULAN BERJALANNYA PEMBERIAN OBAT ANTI TUBERKULOSIS KOMBINASI DOSIS TETAP

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Ayu R. Pribadini Nelwan ◽  
Stella Palar ◽  
Julia C. M. Lombo
Keyword(s):  
Pulmonary Tuberculosis ◽  
Serum Levels ◽  
Fixed Dose Combination ◽  
World Health ◽  
Fixed Dose ◽  
Glutamic Pyruvic Transaminase ◽  
Cross Sectional ◽  
The World ◽  
Dose Combination ◽  
Health Organization

Abstract: Tuberculosis (TB) is still a health problem around the world. According to statistics of the World Health Organization (WHO) showed that Indonesia’s ranking were down from third to fifth in the world. However there are also challenges in the treatment of tuberculosis worldwide and in Indonesia, like treatment failure, dropping out of treatment, and inappropriate treatment. This study aimed to compare the serum levels of SGOT (AST) and SGPT (ALT) in patients with pulmonary TB during two months administration of OAT KDT. This study was a cross sectional analytic study using secondary data and blood sample from patients with pulmonary TB. The samples in this study was patients with pulmonary tuberculosis, pulmonary tuberculosis first category, pulmonary tuberculosis BTA smear (+), pulmonary tuberculosis with controlled hypertension, pulmonary tuberculosis suspected MDR, pulmonary tuberculosis with secondary infections, pulmonary tuberculosis on treatment, and pulmonary tuberculosis which dropping put of treatment. The analysis of data changes on SGOT levels before and after administration of Anti-Tuberculosis Drugs (OAT) shows that the value of zcount: 2,223 >ztable: 1,645 with a significance value of p= 0,026 < 0,05. This indicates that there is an effect of the Anti Tuberculosis Drugs (OAT) fixed-dose combination toward SGOT levels. The analysis of data changes on SGPT levels before and after administration of Anti-Tuberculosis Drugs (OAT) shows that the value of zcount: 2,045 >ztable: 1,645 with a significance value of p= 0,041 < 0,05. This indicates that there is an effect of the Anti Tuberculosis Drugs (OAT) fixed-dose combination toward SGPT levels. There are a significant correlation between serum levels of glutamic oxaloacetat transaminase and glutamic pyruvic transaminase in patients with pulmonary tuberculosis during two months administration of anti-tuberculosis medication with a fixed-dose combination and an increasing levels of SGOT and SGPT in pulmonary tuberculosis patients.     Abstrak: Penyakit Tuberkulosis (TB) masih merupakan masalah kesehatan di dunia. Menurut data statistik World Health Organization (WHO) menunjukkan Indonesia turun dari peringkat tiga menjadi peringkat kelima dunia. Namun masih terdapat pula tantangan dalam pengobatan TB di dunia dan Indonesia, antara lain kegagalan pengobatan, putus pengobatan, dan pengobatan yang tidak tepat. Penelitian ini ditujukan untuk mengetahui perbandingan kadar serum SGOT dan SGPT pada pasien TB Paru selama dua bulan pemberian OAT KDT. Penelitian ini merupakan penelitian analitik cross sectional dengan menggunakan data sekunder dan pengambilan sampel darah pada pasien TB Paru. Pada penelitian ini sampel yang digunakan adalah penderita TB Paru, TB Paru kategori 1, TB paru BTA (+), TB Paru dengan Hipertensi terkontrol, TB paru suspek MDR, TB Paru dengan infeksi sekunder, TB paru on treatment, dan TB paru putus obat. Hasil analisis data perubahan kadar SGOT sebelum dan setelah diberikan Obat Anti Tuberkulosis menunjukkan bahwa nilai zhitung: 2,223 >ztabel : 1,645 dengan nilai signifikansi p= 0,026 < 0,05. Hal ini menunjukkan bahwa terdapat pengaruh pemberian Obat Anti Tuberkulosis (OAT) kombinasi dosis tetap terhadap kadar SGOT. Hasil analisis data perubahan kadar SGPT sebelum dan setelah diberikan Obat Anti Tuberkulosis menunjukkan bahwa nilai zhitung: 2,045 >ztabel : 1,645 dengan nilai signifikansi p= 0,041 < 0,05. Hal ini menunjukkan bahwa terdapat pengaruh pemberian Obat Anti Tuberkulosis (OAT) kombinasi dosis tetap terhadap kadar SGPT. Terdapat hubungan yang signifikan antara kadar serum glutamic oxaloacetic transaminase dan serum glutamic pyruvic transaminase pada pasien tuberkulosis paru selama dua bulan berjalannya pemberian obat anti tuberkulosis kombinasi dosis tetap dan terdapat peningkatan kadar SGOT dan SGPT pada pasien tuberkulosis paru.

scholarly journals A Study of Liver Function Tests in Patients Receiving Four Drugs Regimen in Initial Two Months as Antitubercular Drugs

2013 ◽  
Vol 23 (2) ◽  
pp. 27-29
Author(s):  
Saifun Nahar Faiz ◽  
Mahmudul Haque ◽  
Kamal Hossain ◽  
ASM Towhidul Alam
Keyword(s):  
Liver Function ◽  
Prothrombin Time ◽  
Normal Subjects ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Case Group ◽  
Cross Sectional ◽  
Intensive Phase ◽  
Antitubercular Drugs ◽  
Dose Combination

Biochemical monitoring of liver function is essential because Anti Tubercular Therapy (ATT) induced hepatotoxicity can cause permanent injury to liver and death. This cross-sectional comparative study was conducted in department of Biochemistry of Chittagong Medical College during the period of July 2009- Jun 2010 to determine the association of Anti-TB treatment to alter the liver function in patients of intensive phase of tuberculosis taking Four Fixed Dose Combination of Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. A total of 100 subjects were enrolled in this study. They were divided into two groups. Group A (case) was diagnosed case of tuberculosis and had taken anti TB drugs (four Fixed dose combination) at least for fifteen days and group B (control) was consisting of normal subjects. Serum ALT, AST, Bilirubin and prothrombin time were measured. It was found, that out of 70 subjects 20% had increased level of serum ALT, 17.1% had increased level of serum AST, 20% had increased level of serum bilirubin and only 2.9% had increased level of prothrombin time in case group. Finally, determination of liver functions in patients receiving Anti TB therapy (in intensive phase) should be done irrespective of presence or absence of established risk factors, to minimize not only the incidence but also the morbidity and mortality. JCMCTA 2012 ; 23 (2): 27-29

scholarly journals Assessment of rational use of fixed dose combinations in hypertension in a tertiary care teaching hospital in north India

2018 ◽  
Vol 5 (5) ◽  
pp. 1263 ◽  
Author(s):  
Rohini Gupta ◽  
Apoorva Malhotra ◽  
Pavan Malhotra
Keyword(s):  
Tertiary Care ◽  
Drug Combinations ◽  
North India ◽  
Fixed Dose ◽  
Cross Sectional ◽  
Jammu And Kashmir ◽  
Rational Use ◽  
Dose Combination ◽  
Come Into The Market ◽  
Dual Drug

Background: Fixed-dose combination (FDC) agents could be considered as an effective therapy in chronic illnesses like hypertension, which have multifactorial etiology. At present, many FDCs have come into the market without being assessed for their efficacy, safety and rationality by the drug regulatory authorities. The objective of the present study was to assess the rational use of fixed dose drug combinations in hypertension.Methods: It was a cross-sectional observational study conducted in the cardiology outpatient department of ASCOMS and H, Sidhra, Jammu, Jammu and Kashmir from February 2016 to July 2016. In the study 92 prescriptions of hypertensive patients who were on anti-hypertensive fixed-dose drug combinations (FDCs) were recruited after thoroughly evaluated for inclusion and exclusion criteria. Data obtained includes the demographic profile of the patients, pattern of the prescribed FDCs in hypertension, evaluation of the rationality of the FDCs based upon the comprehensive seven-point criteria developed by Panda et al.Results: In the present study, about sixteen different anti-hypertensive FDCs were observed in the prescriptions of 92 patients during six-month period. It was observed that about 93.75% of FDCs were dual drug combinations. Among the dual drug combinations, most commonly used combination was Olmesartan (ARB; Angiotensin receptor blocker) + Amlodipinine (Calcium channel blocker) in 17.4% of patients. It was also observed that among the 16 different anti-hypertensive fixed dose combinations analysed, 12 FDCs (75%) were found to be rational and 4 FDCs (25%) were found to be irrational.Conclusions: In the present study it was found that 75% of the FDCs prescribed were rational and 25% were irrational. Therefore, before marketing the FDCs proper assessment of their efficacy, safety and rationality should be done.

scholarly journals PRESCRIBING PATTERN OF ANTIBIOTICS AMONG OUTDOOR PATIENTS IN MEDICINE DEPARTMENT OF TERTIARY CARE HOSPITAL IN NORTHERN INDIA

2020 ◽  
pp. 43-46
Author(s):  
SUMAN LATA ◽  
VIJAY KHAJURIA ◽  
VINEETA SAWHNEY ◽  
SANJAY SHAH
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Medicine Department ◽  
Medical College ◽  
Northern India ◽  
Dose Combination

Objective: The objective of the present study was to examine the prescribing pattern of antibiotics in the outpatient department of medicine in a tertiary care hospital. Methods: This prospective observational study was conducted in department of pharmacology in collaboration with department of medicine of Govt Medical College Kathua for a period of one month. Prescription of all patients attending medicine OPD who were prescribed antibiotics was analysed. Results: A total of 450 prescription of OPD patients were analysed. Out of these 200 prescriptions of patients had antibiotics prescribed. 98% of prescriptions had oral antibiotics and other 2% were prescribed injectable antibiotics. 70 % of prescriptions were on the single antibiotic and in 30% of prescriptions, fixed-dose combination were prescribed. Cefpodoxime antibiotic was most commonly prescribed in the cephalosporin group, followed by amoxy-clavulanic acid, azithromycin. Irrational prescribing of antibiotics was 34% and it was quite high in our study. Conclusions: Cefpodoxime was most commonly prescribed in cephalosporin group among all antibiotics. Irrational prescribing was quite high in present study. Our result calls for the urgency of refresher courses like stewardship programmes regarding antibiotic use to avoid irrational usage.

scholarly journals Off-label prescription of fixed-dose combination of tramadol and dexketoprofen in primary health care. Evidence-based or cause for concern?

2021 ◽  
Author(s):  
Montserrat Viñas-Bastart ◽  
Míriam Oms-Arias ◽  
Àfrica Pedraza-Gutiérrez ◽  
Irene Lizano-Díez ◽  
Eduardo L. Mariño ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Average Length ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Short Term Treatment ◽  
Cross Sectional ◽  
Off Label ◽  
Primary Health ◽  
Dose Combination

Abstract Background: The increase of consumption of the fixed-dose combination of tramadol/dexketoprofen in Spain and other countries is noteworthy. The authorised therapeutic indication is symptomatic short-term treatment of moderate to severe acute pain in adult patients.Objective: Describe the pattern of use of tramadol/dexketoprofen in the field of primary health care to examine potential off-label prescribing and warn about possible risks.Methods: A descriptive, cross-sectional and multicenter study carried out between March 2017 and March 2018. Total population were patients covered by the public health service in Catalonia, Spain, with an active prescription of tramadol/dexketoprofen on March 28, 2018. Target population were those patients who were prescribed tramadol/dexketoprofen over 20 day’s treatment.Results: There were 176 patients with active prescription of tramadol/dexketoprofen. All patients (100%) had a treatment duration exceeding 5 days and 72.7% (N=128) exceeding 20 days. The average length of treatment was 224±160.8 days. 35.1% of patients were treated with >2 medicines for pain concomitantly with tramadol/dexketoprofen.Conclusion: Tramadol/dexketoprofen fixed-dose combination in practice was used frequently off labelled according to the product characteristics and the literature reviewed. This study highlights potential harmful or ineffective effects of this combination since no adequate evidence exists about its off-label use.

scholarly journals Fixed dose combination products as Oro-dispersible tablets: A review

2019 ◽  
Vol 9 (2) ◽  
pp. 563-573
Author(s):  
Gothainayaki Chandrasekaran ◽  
A.N. Rajalakshmi
Keyword(s):  
Patient Compliance ◽  
Pediatric Patients ◽  
Psychiatric Patients ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Orally Disintegrating Tablets ◽  
Wide Range ◽  
Swallowing Problems ◽  
Commercial Market ◽  
Dose Combination

A fixed-dose combination (FDC) drug is a one that includes two or more active pharmaceutical ingredients (APIs) combined in a single dosage form, which is manufactured and distributed in fixed doses [1]. It increases patient compliance by reducing the no. of medications that a patient has to take especially for geriatric and pediatric patients. Orally disintegrating tablets (ODTs) are solid dosage forms containing a medicinal substance or active ingredient that rapidly disintegrates upon contact with saliva, typically within 30 s, eliminating the need for swallowing. It also increases patient compliance by reducing the swallowing problems faced by the patients especially for geriatric and pediatric patients. This review is about combining the techniques of both FDC and ODT formulations which promises to have a wide range of advantages to pediatric and geriatric populations, institutionalized and psychiatric patients, those suffering from nausea and vomiting, and individuals with lack of access to water. In spite of these advantages rarely do we find FDC-ODT products in our commercial market, this review aims at analyzing all the aspects of FDC and ODT formulations thereby forming the foundation for further studies. Keywords: Fixed-dose combinations, Orally disintegrating tablets, Patient compliance.

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