scholarly journals DRUG UTILIZATION EVALUATION OF BENZODIAZEPINES IN A TERTIARY CARE HOSPITAL

Author(s):  
P. RAMA ◽  
R. MONISHA ◽  
SUSAN VARGHESE PAUL ◽  
VARSHA ELSA SCARIA ◽  
P. JANANI ◽  
...  

Objective: To assess the rationale use of benzodiazepines among various departments in a multi-speciality hospital. Methods: A prospective study was conducted with a sample size of 200 for a period of six months. Data was collected from patients based on inclusion and exclusion criteria. Naranjo Adverse Drug Reaction Probability Scale and Drug Interaction Probability Scale (DIPS) were used as a study tool to measure the causality of adverse drug reactions and drug interactions. Based on the dosage of various benzodiazepines DDD was calculated and compared with WHO Anatomical Therapeutic Chemical (ATC) classification Defined Daily Dose (DDD). Results: BZD’s were mostly prescribed in males (74.5%) and married patients (86.5%) were more exposed to benzodiazepines compared to others. Lorazepam (70.1%) was found to be the most commonly used drug, mainly prescribed for sedation, followed by anxiety. DDD was calculated and majority of patients had DDD in accordance with WHO standard. Based on cost analysis, Clobazam was found to be the high cost and Lorazepam being the low-cost drug. The results of drug utilization evaluation of benzodiazepines study were compiled and reported to the respected department physician and their feedback was collected. Conclusion: The study showed a rational utilization of benzodiazepines and the negative outcomes of BZDs can be reduced by providing drug-related information to the prescribers and consumers.

Author(s):  
T. Muneswar Reddy ◽  
Thammi Setty Durga Prasad ◽  
Allikesam Hemalatha ◽  
Vanam Chanukya ◽  
Bandi Lakshmi Sirisha

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.


Author(s):  
K. Padmavathi ◽  
S. A. Arun Raaj ◽  
S. Subash ◽  
C. K. Dhanapal ◽  
S. Periasamy

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.


2021 ◽  
Vol 11 (1-s) ◽  
pp. 94-101
Author(s):  
Meda Venkata Subbaiah ◽  
K Leela Prasad Babu ◽  
Dudekula Manohar ◽  
Adluru Sumalatha ◽  
Pinjari Mohammed ◽  
...  

Introduction: The utilization of HAMs is crucial in emergency and intensive care departments, as they can cause a significant amount of damage to the patient and health care members if we could not follow the standard treatment guidelines. Drug utilization evaluation/review involves a comprehensive review of the patient’s prescription and medication data before, during, and after dispensing to ensure appropriate medication decision making and positive patient outcomes. Objective: This study was taken up given finding the utilization patterns and rectifying the issues with the usage of high alert medications (HAMs) and improving their utilization. Methodology: A cross-sectional study was conducted for 6 months at a south Indian tertiary care hospital. Treatment guidelines were prepared to compare the actual drug use. Data were collected both retrospectively and prospectively by patients and care taker’s interview, medication chart review, and discussion with prescribers and applied WHO DUE indicators to evaluate utilization patterns. Results: Of 362 cases, 57.73 % were males/ and the majority geriatrics. Among all HAMs Insulin is frequently prescribed (34.5 %) and the costly drug is Enoxaparin. Generic names were used in writing prescriptions and parenteral formulations were mostly used. Around 9 ADRs were identified and managed, and a total of 133 moderate to severe Drug-Drug Interactions were found, of them, only 2 were actual. Conclusion: With this study, we conclude that the use of HAMs was found to be appropriate as per the guidelines as we observed very few DRPs with the study drugs. Keywords: HAM, DRP’s, DUE, ICU, DDD


Author(s):  
Pradeep Phadnis ◽  
Shashi Marko

Background: Adverse Drug Reactions are the recognized hazards of drug therapy and they can occur with any class of drugs. The main aim of the study was to detect and analyze Adverse Drug Reactions in inpatients of medicine department in tertiarycare hospital. The study assesses the incidence and pattern of ADRs, identifying co-morbidities, past and present illness, assess causality and the offending drugs, monitoring and documenting suspected adverse drug reactions.Methods: A prospective study was conducted over a period of 6 months. The WHO definition of an ADR was adopted. Each ADR was assessed for its causality by using WHO probability scale. The severity of each ADR was assessed by using modified Hartwig et al, and Siegel scale.Results: A total 58 ADR were reported during study period out of which 28 (48.27%) were male and 30 (51.72%) were female patients. The assessment by WHO probability scale showed that out of 58 ADR 22 (37.93%) were probable and 17 (29.31%) were possible and 6 (10.34%) were certain. Most commonly involved system was gastrointestinal system with 24 (41.37%) ADRs. Severity assessment by modified Hartwig and Siegel scale showed that 22 (37.93%) were moderate, 32 (55.17%) were mild and 4 (6.89%) were severe ADRs. No lethal effects were observed or produced.Conclusions: The study concluded that Adverse Drug Reactions are common and some of them resulted in increased health care cost due to need of some interventions and increased length of hospital stay. The health system should promote the reporting of Adverse Drug Reactions, proper documentation and periodic reporting to regional pharmacovigilance centers to ensure drug safety.


Author(s):  
ANCY SEBASTIAN ◽  
ANEESHA PK ◽  
JOSHWA AREECKAL ◽  
SONIYA DAVIS

Objective: The aim of this study is to evaluate the pattern of prescription and utilization of antidepressants (ADs) for various non-psychiatric indications in department of general medicine, cardiology, surgery, gynecology, and orthopaedic of a tertiary care teaching hospital. Methods: A prospective cross-sectional unicentric drug utilization study of inpatients was carried out in a 450 bedded tertiary care hospital. The study included 200 subjects admitted for both psychiatric and non-psychiatric illness. Pediatric patients and those with a length of stay <48 h were excluded from the study. Results: Prescriptions of 200 patients were studied in which 55% were males and 45% were females. The most widely prescribed drug is alprazolam comprising 50% of the total drug consumption and is followed by clonazepam (19.5%), amitriptyline (13.5%), diazepam (9.5%), escitalopram (3.5%), lorazepam (3%), and zolpidem (0.5%). About 36% of the drugs were prescribed in the general medicine department, and 27.5% of the prescriptions were from the cardiology department. Prescriptions from surgery, orthopedics, and gynecology were 16%, 11.5%, and 9% of the total, respectively. Conclusion: ADs were found to be potentially useful for non-psychiatric indications such as peripheral and diabetic neuropathy, gastroenterological conditions, and urological conditions. No benefit was observed in insomnia and musculoskeletal conditions except for fibromyalgia. ADs were also found to improve the treatment outcome and quality of life of patients having comorbid psychiatric conditions being treated for non-psychiatric disorders.


Author(s):  
Sesham Pushpalatha ◽  
Dheeravath Swapna ◽  
Antarvedi Moshe ◽  
Nagam Venkata Sai Jyothirmai ◽  
Tatipamula Vasundhara ◽  
...  

Studies like Drug utilization evaluation have an essential role in finding a prescription pattern of drugs prescribed in hospital for the rational use of antibiotics. An observational study conducted in a tertiary care hospital for six months among 200 patients. The study was conducted to assess prescribing pattern, the average cost of antibiotics prescribed. Also, the ten most commonly prescribed antibiotic’/ 100bed- days and ATC were calculated. Most commonly prescribed antibiotic was , followed by /. The average cost was Rs. 2742.5±25135.19 for the prescribed antibiotics. Pharmacists and physicians play a significant role in decreasing patient problems and the problems related to antibiotics by creating awareness programs related standard prescribing guidelines in the hospital, which results in a reduction of the antibiotic resistance. it is essential to carry out a drug utilization review to study the rational use of antibiotics.


2021 ◽  
Vol 14 (1) ◽  
pp. 41-45
Author(s):  
Charitha Bollavaram ◽  
Karteeka Bhukya ◽  
Shravani Komuravelli ◽  
Chandrashekar Valupadas ◽  
Sharvana Bhava Bandaru ◽  
...  

Author(s):  
V. V. Rajesham ◽  
Ch. Swethasri ◽  
E. Mamatha ◽  
Keerti Tiwari ◽  
P. Pooja Raj

Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history,drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.


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