scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY ON THE ASSESSMENT OF POTENTIAL DRUG-DRUG INTERACTIONS AND MANAGEMENT OF POST-COMPLICATIONS IN STROKE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

Author(s):  
MAHE NAAZ SULTANA ◽  
SABA YOUNUS QURESHI ◽  
IQRA FATIMA ◽  
WAJIDA JABEEN ◽  
MOHAMMED OBAID

Objective: The objective of the study is to determine the occurrence, frequency, and severity of significant drug-drug interactions in stroke patients, with an emphasis on post complications and their symptomatic management. Methods: A prospective observational study was carried out for 6 mo at Osmania General Hospital, a Tertiary Care Teaching Hospital. The prescriptions taken by stroke patients throughout their hospital stay were analyzed for possible interactions using-Micromedex-2 (Thomson Reuters) × 2.0. Results: A total of 130 prescriptions was analyzed in the study in which 141 drug-drug interactions were found with a male predominance of 85.4%. The majority of interactions were of moderate severity (74.46%) and pharmacokinetics (67.37%) in nature. Among the clinical consequences, decreased atorvastatin efficacy (49.10%) was found to be the highest. The class of drugs most commonly involved in drug-drug interactions was found to be anti-epileptics and statins. 60.15% of the study population were identified with one complication, among which seizures account for 15% of patients. All the complications allied with the condition were treated with drug classes in the study population. Conclusion: This study highlighted the exigency for screening prescriptions of cerebrovascular accident patients for potential drug-drug interactions (pDDIs). Brain edema and seizure were the most accountable complications identified in the study population. The early detection of these problems can improve stroke outcomes and can reduce the mortality or disability rate.

Author(s):  
TALHA JABEEN ◽  
MOHD ABDUL KHADER ◽  
A. V. KISHORE BABU ◽  
A. SRINIVASA RAO

Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population. Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used. Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared. Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.


Author(s):  
Vandana Badar ◽  
Vidisha Parulekar ◽  
Priti Garate

Objectives: The objectives of the study were as follows: (1) To study the prescription patterns in Respiratory tract infections (RTI) in indoor patients in pediatric wards. (2) To check the rationality of treatment according to Modified Kunin’s rationality criteria. (3)To analyze the data of RTI by Anatomical Therapeutic Chemical classification.Methods: It was a non-interventional, prospective, observational study which was conducted in indoor pediatric patients in a tertiary care teaching hospital in India. Data were analyzed and evaluated according to the WHO rational use of drugs guidelines.Study sample: The study sample was 174.Study duration: The study duration was August 15, 2016–September 15, 2016.Results: Males (63.79%) were more as compared to females (36.20%), and the highest number of cases was seen in infants (62.06%). Acute bronchiolitis (54.02%) was highest in the incidence followed by Wheeze Associated Lower Respiratory Tract Infection (WALRI) (30.45%). The average duration of patient stay in hospital was 4.71 days whereas 93.33% were polytherapy and mostly prescribed antibiotic was amoxicillin-clavulanic acid in acute bronchiolitis and WALRI. Salbutamol (40.84%) and Ipratropium Bromide (39.43%) were the commonly prescribed respiratory medicines. Oral route (42.27%) was the most common route of administration. 56.11% drugs were prescribed by generic name.Conclusion: Standard treatment guidelines for the treatment of RTI need to be urgently developed and strictly implemented.


Author(s):  
Binu K. M. ◽  
Jenil Johny ◽  
Doddayya Hiremath

Background: The endocrine disorders such as diabetes mellitus, hypothyroidism and hyperthyroidism along with world’s ageing population has increased the burden of health care systems. The present study aimed to assess the prescribing pattern of drugs in endocrine disease like diabetes and thyroid disorder and to evaluate the drug use in given healthcare against programmed criteria and standards.Methods: A prospective observational study was conducted in 220 patients over six months in a tertiary care teaching hospital. Patients who are diagnosed with endocrine disorder in various (general medicine, surgery and Orthopedics) inpatient departments of study hospital.Results: A prospective observational study was carried out by reviewing prescriptions of 220 patients with lifestyle disorders such as, DM (120), hyperthyroidism (50) and hypothyroidism (50). In diabetes, most of the patients were prescribed with biguanides 75 (47.17%) followed by sulfonylureas 56 (35.22%), alpha-glycosidase inhibitors 20 (12.58%), dipeptidyl peptidase 4 inhibitors 5 (3.14%), meglitinides 2 (1.26%) and thiazolidinediones 1 (0.63%). Most of the prescription containing insulin Actrapid and insulin Mixtard 14 (82.35%) followed by insulin Actrapid and insulin NPH 2 (11.76%), insulin Mixtard and insulin Glargine 1 (5.89%). In hypothyroidism most of the patients were prescribed with propylthiouracil 28 (56%) followed by methimazole 26 (44%). Levothyroxine is the best choice of drug for hypothyroid disorder.Conclusions: Our study found that treatment and management of endocrine disorders were not rational. There is a need of clinical pharmacist involvement for a better patient care in these disorders.


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