scholarly journals Prescription audit of antihypertensive drugs used in stroke patients in a tertiary care teaching hospital

2021 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Bipin Shaji ◽  
Jereena George ◽  
Aishwarya Shrestha ◽  
Sharon Mary Stanly ◽  
Noah M. Bose
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Antihypertensive Agents ◽  
Channel Blockers ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Case File ◽  
Pertinent Data

Background: Stroke is considered as one of the important reasons of death and disability worldwide. A rational use of medications is needed to prevent the recurrence and the disease related complications.Methods: The current study is a prospective observational study. All stroke cases, with patients above the age of 25 and treated with antihypertensive agents were included in the study. A total of 189 patients were found suitable for inclusion in the study. Using a suitably designed data collection form, all pertinent data such as patient demographics, prescribed medicines, drug interactions and adverse drug reactions were collected from the patient’s case file, nurses’ charts, and medication charts. Prescription pattern of antihypertensive drugs were obtained. The causality of the ADR was assessed using the Naranjo causality assessment scale and reported in the institution where the study was conducted.Results: Majority of patients included in the study were in the age group of 61-70 years. The incidence of stroke in this study was more in males than in the females. Ischemic stroke (72%) was more prevalent when compared to Hemorrhagic stroke. Among the antihypertensive agents, calcium channel blockers (32%) were the most commonly prescribed class of drugs. In our audit, drug related problems were observed in 27% of the cases which included cases with improper dose (3 cases), contraindications (4 cases), major drug interactions (20 cases), and adverse drug reactions (17 cases). Most of the prescriptions were legible. Drug related problems had a great impact on the overall stroketherapy.Conclusions: The drug related problems are a relevant aspect to be considered when treating patients with stroke and it can arise irrespective of adherence to guidelines.

scholarly journals An Observational Study on Drug Utilization Pattern in Chronic Kidney Disease Patients using Anti-Hypertensive Drugs in a Tertiary Care Teaching Hospital

2021 ◽  
pp. 9-18
Author(s):  
Rajesh Hadia ◽  
Hemraj Singh Rajput ◽  
Vidhi Mehta ◽  
Pushti Shah ◽  
Arti Muley ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Channel ◽  
Drug Utilization ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Antihypertensive Agents ◽  
Channel Blockers ◽  
Utilization Pattern

Background: There is a strong relationship between Hypertension and chronic kidney disease. HTN is highly prevalent in CKD patients, contributing to high cardiovascular risk. Objectives: This study aims drug utilization pattern of Antihypertensive drugs in CKD. The objective of the study to determine the occurrence of co-morbidities, the prevalence of CKD stages in chronic kidney patients and to prepare a protocol of anti-hypertensive in CKD. Methodology: This was an observational/cross-sectional study that was carried out for six months at Dhiraj General Hospital, Vadodara. CKD patients who were prescribed antihypertensive agents were included as per study criteria. Data was collected by filling the patient medical record sheet. Results: A total of 60 CKD patients with HTN were included in the study according to inclusion and exclusion criteria. Out of 60 patients, we noticed that number of inpatients was 67% while the number of OPD patients was just 33%. Comparing gender proportionality, male represents 63% and female represents 37% were found between the age group of 18-65 years. The recorded systolic BP in mild case in the overall study population was found to be 140-159 mmHg and diastolic BP was found to be 90-99 mmHg. In moderate case systolic BP was 160-179 mmHg and diastolic BP was found to be 100-109 mmHg. In severe cases systolic BP was ≥180 mmHg and diastolic BP was found to be ≥110 mmHg. Among antihypertensive Calcium channel blockers was prescribed in 34.18% of patients and mostly recommended drug for hypertensive chronic kidney patients was furosemide which was 19.34%. Most participants were treated with multi-drug therapy. Conclusion: In Hypertensive CKD patients, calcium channel blockers and furosemide were highly recommended which do not diverge from National Kidney Foundation Kidney Disease, Outcome Quality Initiative guidelines.

scholarly journals Adverse drug reaction profile and prescription pattern of antihypertensive drug monotherapy at tertiary care hospital Nepalgunj, Nepal

2017 ◽  
Vol 7 (1) ◽  
pp. 75 ◽  
Author(s):  
Ganesh Prasad Neupane ◽  
Maya Rai
Keyword(s):  
Adverse Drug Reactions ◽  
Antihypertensive Drug ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Term Therapy ◽  
Care Hospital ◽  
Drug Reactions ◽  
Prescribing Pattern ◽  
Converting Enzyme Inhibitors ◽  
Prescription Pattern

Background: Hypertension is the leading cause of morbidity and mortality worldwide which requires long term therapy to prevent complication associated with it. As drugs are used for longer duration it is necessary to know potential undesirable effects for making the appropriate choice. Aim and objective of the study was to monitor the adverse drug reactions (ADRs) and to know prescribing pattern of antihypertensive monotherapy.Methods: The present work was an open, non-comparative, observational study conducted on seventy-three (73) hypertensive patients who were prescribed single antihypertensive drug at medical OPD of Nepalgunj Medical college by conducting patient interviews, recording the data on ADR monitoring form.Results: Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n=12), followed by diuretics (n= 6), Angiotensin converting enzyme inhibitors (n=3), β-blockers (n= 2) and Angiotensin receptor blocker (n=1). Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 10). On analysis of prescription pattern again amlodipine was most commonly prescribed antihypertensive monotherapy followed by hydrochlorothiazide.Conclusions:Amlodipine was most commonly associated with ADRs and it was also most commonly prescribed antihypertensive drugs as monotherapy. The above findings would be useful for physicians in rational prescribing. 

scholarly journals Adverse drug reactions of antihypertensive agents at tertiary care hospital in central Nepal

2017 ◽  
Vol 13 (2) ◽  
pp. 284-289 ◽  
Author(s):  
Sabita Paudel ◽  
M Sudarsana Chetty ◽  
Shankar Laudari ◽  
Nuwadatta Subedi
Keyword(s):  
Calcium Channel ◽  
Cardiovascular System ◽  
Adverse Drug Reactions ◽  
Calcium Channel Blockers ◽  
Antihypertensive Agents ◽  
Exact Nature ◽  
Channel Blockers ◽  
Care Hospital ◽  
Drug Reactions ◽  
Adrenergic Antagonist

Background & Objectives: Acute Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately.  The study was conducted with the objective to examine the incidence of different types of adverse drug reactions in drug treated hypertensive patients.Materials & Methods: Patients (n=382) who received antihypertensive agents were selected and interviewed using a standardized questionnaire. The Naranjo Algorithm, which categorizes the causality relationship into definite, probable, possible and doubtful, was used for the assessment of the exact nature of Adverse drug reaction (ADR).Results: Calcium channel blockers (CCBs) were the drug class with highest number (22 or  32.84%)  of ADRs followed by Angiotensin-converting enzyme Inhibitors (ACEI) in 17 (25.38%), Angiotensin Receptor Blockers (ARB) in 12 (17.91%), diuretics in 10 (14.92%) and beta adrenergic antagonist in six (8.95%). Cardiovascular system (40 or 59.70%) was the most affected followed by central nervous system (16 or 23.88%) and respiratory and dermatological system each in 11 (16.42%) cases. On Naranjo’s probability scale, nine (13.4%) of the ADRs were definite, 39 (58.2%) possible, 16 (23.9%) probable and three (4.5%) doubtful.      Conclusion: Calcium channel blockers were mostly associated with ADRs while Cardiovascular system was the most frequently affected. 

scholarly journals PREVALENCE OF DRUG INTERACTIONS AND ADVERSE DRUG REACTIONS IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 10 (8) ◽  
pp. 86-90
Author(s):  
Sridhar Srimath Tirumala Konduru ◽  
Nookala Pratyusha ◽  
Kowtharapu Yogitha
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions

scholarly journals Seguimento farmacoterapêutico de pacientes em tratamento com talidomida em um centro especializado em hanseníase

2017 ◽  
Vol 27 (4) ◽  
pp. 27342
Author(s):  
Rafhael Lucas Holanda de Vasconcelos ◽  
Webysten Ronny Pereira dos Santos ◽  
Allyson Martins Lopes Sousa ◽  
Laynne Hellen de Carvalho Leal ◽  
Luís Mario Rezende Júnior ◽  
...  
Keyword(s):  
Health Education ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Negative Results ◽  
Specialized Care ◽  
High Degree

***Pharmacotherapeutic follow-up of patients treated with thalidomide at a specialized leprosy center***   AIMS: To evaluate the pharmacotherapeutic follow-up of patients with type 2 leprosy reaction in treatment with thalidomide in a philanthropic center of specialized care at Teresina.   METHODS: The study was conducted at the Centro Maria Imaculada, for rehabilitation of patients with leprosy, in the city of Teresina, Piauí, Brazil. Patients of both sexes attended between september and november 2016 were included in the study. Pharmacotherapeutic follow-up was based on the Dáder Method, in the electronic base Drugdex System - Thomson Micromedex® - Interactions for analysis of drug interactions; in the classification of adverse drug reactions of Rawlins and Thompson; and the Morisky-Green test to evaluate the level of therapeutic adherence.   RESULTS: Eleven patients were followed, of whom eight were male. Three drug interactions were identified, two of which were classified as moderate risk and one in lower risk. There were 23 negative results associated with medicines, mainly quantitative insecurity and untreated health problems. In addition, 22 drug-related problems were identified, with adverse drug reactions being the most frequent occurrence. All adverse drug reactions were classified as type A or predictable. Regarding adhesion, six patients among nine who responded to the Morisky-Green test obtained a high degree of adhesion. Health education corresponded to the preponderant pharmaceutical intervention, being applied to all patients.   CONCLUSIONS: Relevant drug interactions, negative results associated with medicines, and drug-related problems were identified. Degree of adherence to thalidomide treatment was considered high. Pharmaceutical interventions were necessary, mainly focused on health education actions, which ratifies the need for constant monitoring of this group of patients.

scholarly journals Utilization pattern of antibiotics and drug related problems in the orthopedic department at a tertiary care hospital: a prospective study

2020 ◽  
Vol 10 (3) ◽  
pp. 24-30
Author(s):  
Dinesh Kumar Yadav ◽  
Kadir Alam ◽  
Anil Kumar Sah ◽  
Deependra Prasad Sarraf
Keyword(s):  
Adverse Drug Reactions ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Utilization Pattern ◽  
Orthopedic Department

Background: Antibiotics are generally prescribed for both prophylactically and to treat ongoing infections in the orthopedic department. Assessment of prescribing pattern at regular interval is essential to avoid inappropriate use of drugs. Objectives: To know the utilization pattern of antibiotics and drug related problems like adverse drug reactions (ADR) and drug-drug interactions (DDI) in hospitalized patients. Materials and Methods: A cross-sectional study was conducted among hospitalized patients using WHO Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology for one month duration in orthopedic department at a tertiary hospital. Standard data collection forms were used to collect the data. Descriptive statistics were used for analyzing the data. Results: Out of 196, most of patients (72.96%) were male and most of patients (34.69%) were from the age group 21-30 years. A total of 782 drugs were prescribed during study period and among them 262 were antibiotics. None of the drugs were prescribed in generic name. Ceftriaxone (33.58%) was the most frequently prescribed antibiotic. Average cost of drug therapy per patient was NPR 3125.7. DDD/100 bed-days were highest for Cefixime (27.9).  A total of 233 ADRs were suspected in 64 patients (32.6%). Thrombophlebitis (26.2%) was the commonest ADR. Potential DDI were found in 51 patients (26.02%). The most common interacting pairs were Cefuroxime and Rabeprazole (15 encounters). Conclusion: Generic prescribing is urgently needed for cost minimization. The prevalence rate of ADR occurrence and DDI was high. The study finding benefits the hospital policy makers to formulate and address policies for rational use of antibiotics. Keywords: Adverse Drug Reactions; Antibiotics; Cost; Drug Utilization; Drug-Drug interaction

scholarly journals A retrospective analysis of adverse drug reactions reported at a tertiary care hospital in South India

2018 ◽  
Vol 7 (7) ◽  
pp. 1257
Author(s):  
Hemavathy G. ◽  
Jeyalalitha Rathinam ◽  
Preethi A. ◽  
Divakar R.
Keyword(s):  
Retrospective Analysis ◽  
Adverse Drug Reactions ◽  
Antimicrobial Agents ◽  
Causality Assessment ◽  
Tertiary Care Hospital ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Skin Reactions

Background: Adverse drug reactions (ADRs) have a major impact on public health. Pharmacovigilance has become an integral part of pharmacotherapy. This study has been undertaken to retrospectively analyze the various adverse drug reactions and to promote the reporting of ADRs among the healthcare providers.Methods: A retrospective analysis of the reported ADRs over a period of 3 years at a tertiary care hospital, in Chennai was done. Data related to the number of adverse drug reactions, the demographic particulars, details on the drugs administered, type of ADRs, serious events and prevention strategies undertaken was analyzed. ADRs were assessed for their causality, severity, and preventability as per the standard criteria.Results: A total of 128 suspected ADRs were found to be reported over a period of 3 years. 81.25% ADRs were found to be of mild severity using the Hartwigs scale of assessment, 71.09% were classified as possible using the Naranjo’s causality assessment, the outcome of 63.28% were found to be recovering from the ADR and 41.40 % were under the probably preventable category. The most common ADRs were the skin reactions. The antimicrobial agents were found to have caused the highest number (58.59%) of ADRs followed by NSAIDs (14.84%) and the antihypertensive drugs (14.06%).Conclusions: The antimicrobial agents were associated with ADRs in majority of the patients. The commonly reported ADR s were the skin reactions.

scholarly journals Drug utilization study in patients of hypertension in tertiary care hospital

2020 ◽  
Vol 9 (8) ◽  
pp. 1275
Author(s):  
Prashant S. Mishra ◽  
U. P. Gawali ◽  
Salman H. Rizvi ◽  
Sukhmeen Kaur
Keyword(s):  
Drug Utilization ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Antihypertensive Agents ◽  
Prescribing Patterns ◽  
National Committee ◽  
Multiple Drug ◽  
Channel Blockers ◽  
Care Hospital ◽  
Converting Enzyme Inhibitors

Background: Hypertension is the most common modifiable risk factor for cardiovascular diseases, stroke and renal failure. Drug utilization research facilitates the rational use of drugs and provides an insight into the pattern of drug use. As such, the present study was conducted to assess the prescribing patterns of antihypertensive agents and to observe the disparity between the recommended and actual practices for pharmacological management of hypertension at a tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Medicine in a tertiary healthcare hospital. As per inclusion criteria, patients with hypertension visiting Medicine OPD from 1st October 2018 to 31st December 2018 were enrolled in the study.Results: A total of 390 prescriptions were collected. It was observed that majority of the study patients were female (53.84%) and were >60 years of age. Average number of drugs prescribed per prescription was 4.18. Multiple drug regimen (67.69%) was the mainstay therapy in our study. Prevalence of two drug combination was the highest (46.92%) followed by monotherapy (32.3%). Calcium channel blockers (CCBs) (amlodipine) was the most frequently prescribed class in monotherapy (19.23%). In two drug regimens, the combination of CCB with angiotensin-converting enzyme inhibitors (ACEIs) (combination of amlodipine and enalapril) was prescribed the most (28.46%) whereas prescription of combination of ACEI, beta-blocker (BB) and CCB (enalapril, atenolol and amlodipine combination) was the highest (13.84%) in three drug regimens.Conclusions: The prescription pattern of antihypertensive drugs was found to be rational and mainly in accordance with Joint National Committee VIII guidelines. All the drugs were prescribed by their generic names which suggests awareness among prescribers regarding WHO policies for generic prescribing.

scholarly journals Prescribing Pattern and Medication Related Problems in Hospitalized Diabetic Patients: A Hospital-Based Study

2021 ◽  
pp. 12-21
Author(s):  
T. S. Durga Prasad ◽  
D. Ranganayakulu ◽  
N. Devanna
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
General Medicine ◽  
World Health ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Drug Reactions ◽  
Prescribing Pattern ◽  
Prescribing Indicators

Aim: To assess the drug-related problems (DRPs) and World Health Organization (WHO) core prescribing indicators among hospitalized diabetic patients. Methodology: A prospective, observational study was made among the diabetic inpatients of the General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data pertaining to demographics, clinical variables, DRPs, and WHO prescribing indicators. Descriptive statistics like frequency, mean, and percentage were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Inferential statistics like Chi-square test was employed to test the significant association between the demographics and occurrence of DRPs. Results: A total of 199 diabetic patients were enrolled in this study. The mean age of the study participants was 55.8±11.3. The study shows the prevalence of DRPs in diabetic in-patients was 48.7%. The most commonly identified DRPs are drug interactions (53; 45.3%), adverse drug reactions (24; 20.5%), and untreated indication (21; 17.9%). Patient characteristics like, advanced age (≥60 years), presence of co-morbid condition, comprising more than 5 drugs in prescription, and stay in the hospital for more than four days are significantly associated with the development of DRPs. Findings of WHO indicators show the average number of drugs, percentage of drugs prescribed by the generic name, percentage of encounters with an antibiotic, injection, and from essential drug list have deviated from standards of WHO. Conclusion: The prevalence of DRPs in diabetic in-patients was 48.7%. Drug interactions and adverse drug reactions are the most common DRPs found in our study. Developing the drug policy guidelines focused on factors associated with DRP and WHO prescribing indicators may reduce the burden of DRPs and improves patient outcomes.

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