Cost effectiveness analysis of anti-hypertensive drugs used for chronic kidney disease patients

Cost effectiveness analysis branch of pharmacoeconomics is a technique used to aid in decision making between alternatives. A prospective observational study would be conducted in the nephrology department at O.P, Patients with CKD with hypertension, with or deprived of diabetes are included in the study. Patients with drug-induced renal disease or unknown cause. Pregnant women with chronic kidney disease are excluded from the study. The research was conducted in150 patients in which common are men. The mean age of the research people was found to be 51.2 ±7. 02. .It was observed that calcium channel blockers 127 (84.6%), diuretics 51 (34%), α agonists 33 (22%), β blockers 21 (14%), α blockers 17 (11.3%), α+β blockers 10 (6.6%), Angiotensin receptor blockers 3 (2%) and angiotensin-converting enzyme inhibitors 1 (0.6%) were the numerous antihypertensive drugs given to the study people. Incremental Cost-Effectiveness Ratio was assessed, and it was observed that Rs.31.80 was extra required while using diuretics than Calcium Channel Blockers for achieving respective maintenance value. The major classes of antihypertensive drugs prescribed in all of them are CCB+α agonist was found most effective CCB+ Diuretics were the second most effective. Incremental Cost-Effectiveness Ratio was calculated, and it was found that Rs.4.40 was Extra needed to attaining essential upkeep of blood pressure. Pharmacoeconomic study shows that Calcium channel blockers were the utmost cost-effective antihypertensive in CKD patients when linked to other antihypertensive drugs. In two-drug combination therapy, CCB+α agonist was found most effective.

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Cardiotoxicity with antihypertensive drugs (literature review) Part 1. Calcium channel blockers and beta-blockers

Medical alphabet ◽

10.33667/2078-5631-2021-25-12-19 ◽

2021 ◽

pp. 12-19

Author(s):

A. N. Esaulenko ◽

A. Yu. Moiseeva ◽

A. A. Ivannikov ◽

I. V. Bratischev ◽

Kh. G. Alidzhanova

Keyword(s):

Calcium Channel ◽

Calcium Channel Blockers ◽

Antihypertensive Drugs ◽

Beta Blockers ◽

Research Literature ◽

Channel Blockers ◽

Distinctive Features ◽

Experimental Pharmacology ◽

Myocardial Insufficiency ◽

Β Blockers

The effect of hypotensive drugs overdose on cardiovascular system is poorly studied; it should undergo clinical, experimental pharmacology and toxicology together with cardiology. There is too little information about cardiotoxicity of beta-blockers (β-blockers) and calcium channel blockers (CCB) in existing research literature. Intoxication from these groups of drugs causes similar severe hemodynamic abnormalities and myocardial insufficiency, however pathophysiological mechanisms of these abnormalities are not thoroughly studied. The review highlights how difficult it is to identify toxic level and distinctive features of clinical evidence of intoxication. Methods of diagnosis as well as β-blockers and CCB overdose treatment are discussed.

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The safety of antihypertensive drugs. Retrospective analysis of adverse reactions based on a regional database

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-2-216-228 ◽

2021 ◽

Vol 27 (2) ◽

pp. 216-228

Author(s):

A. V. Matveev ◽

A. E. Krasheninnikov ◽

A. V. Ushakov ◽

E. A. Egorova ◽

A. G. Dormidor

Keyword(s):

Calcium Channel ◽

Retrospective Analysis ◽

Calcium Channel Blockers ◽

Adverse Reactions ◽

Antihypertensive Drugs ◽

Channel Blockers ◽

Drug Reactions ◽

Life Threatening ◽

Β Blockers ◽

Design And Methods

Objective. To analyze adverse drug reactions (ADR) occuring in patients taking antihypertensive drugs (AHD).Design and methods. We have analyzed 459 cases of ADR caused by AHD and recorded in the regional database (register) called ARCADe (Adverse Reactions in Crimea, Autonomic Database) during 2011–2018 years.Results. Out of all ADR, 304 cases (3,9 4,4 4,9 % of the total number of cases) were associated with AHD affecting renin-angiotensin-aldosterone system,101 (1,2 1,5 1,8 %) — with calcium channel blockers, and 54 cases (0,6 0,8 1,0 %) — with β-blockers. In the majority of cases, the ADRs were attributed to Enalapril (85 cases) and Amlodipine (76 cases). The analysis of the outcomes showed that serious reactions (life-threatening conditions, hospitalization, and disability) occurred in 72 cases. The remaining 387 ADRs were not considered serious. The majority of reported ADRs were unavoidable reactions of mild severity.

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

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i35b31893 ◽

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.

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DRUG UTILIZATION BASED ADRS MONITORING OF ANTIHYPERTENSIVE AGENTS PRESCRIBED IN AL-QUWAYIYAH GENERAL HOSPITAL, SAUDI ARABIA

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2018v10i3.15296 ◽

2018 ◽

Vol 10 (3) ◽

pp. 22

Author(s):

Md Salahuddin Ansari ◽

Faisal Al-otaibi

Keyword(s):

Saudi Arabia ◽

Calcium Channel ◽

General Hospital ◽

Drug Utilization ◽

Calcium Channel Blockers ◽

Antihypertensive Drugs ◽

Antihypertensive Agents ◽

Channel Blockers ◽

Hypertensive Patients ◽

Patient Interviews

Objective: To monitor drug utilization based adverse drug reactions (ADRs) of antihypertensive agents prescribed in Al-Quwayiyah general hospital, Saudi Arabia.Methods: An open, non-comparative, observational study was conducted on hypertensive patients attending the medicine outpatient department of Al-Quwayyah general hospital, Al-Quwayyah, Saudi arabia. Data were collected by conducting patient interviews. Data were captured for adverse drug reaction monitoring based on Narinjo scale and WHO format.Results: 25 ADRs were observed out of 212 hypertensive patients. Incidence was found to be higher in patients more than 40 y age, and females experienced more ADRs (n = 16, 7.54%) than males, 9 (4.62%). Combination therapy was associated with more number of ADRs (64.0%) as against monotherapy (36.0%). Calcium channel blockers were found to be the most frequently associated drugs with ADRs (n = 8), followed by diuretics (n = 6), and β-blockers (n = 5). Among individual drugs, amlodipine was found to be the commonest drug associated with ADRs (n = 8), followed by torasemide (n = 4). ADRs associated with the central nervous system was found to be the most frequent (48.0%) followed by musculoskeletal complaints (20.0%) and respiratory system disorders (16.0%).Conclusion: ADRs were experienced by taking the antihypertensive drugs prescribed in Al-Quwayyah general hospital, Saudi arabia. The findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with ADRs.

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Comparison between the antiproteinuric effects of the calcium channel blockers benidipine and cilnidipine in combination with angiotensin receptor blockers in hypertensive patients with chronic kidney disease

Expert Opinion on Investigational Drugs ◽

10.1517/13543784.2010.505918 ◽

2010 ◽

Vol 19 (9) ◽

pp. 1027-1037 ◽

Cited By ~ 8

Author(s):

Masanori Abe ◽

Kazuyoshi Okada ◽

Noriaki Maruyama ◽

Shiro Matsumoto ◽

Takashi Maruyama ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Calcium Channel ◽

Calcium Channel Blockers ◽

Angiotensin Receptor Blockers ◽

Channel Blockers ◽

Angiotensin Receptor ◽

Hypertensive Patients ◽

Receptor Blockers

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β-Blockers and Calcium Channel Blockers as Antiarrhythmic Drugs

Cardiac Electrophysiology ◽

10.1016/b0-7216-0323-8/50103-2 ◽

2004 ◽

pp. 918-931 ◽

Cited By ~ 2

Author(s):

Bramah N. Singh

Keyword(s):

Calcium Channel ◽

Calcium Channel Blockers ◽

Antiarrhythmic Drugs ◽

Channel Blockers ◽

Β Blockers

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Atrial Fibrillation Screen, Management, and Guideline‐Recommended Therapy in the Rural Primary Care Setting: A Cross‐Sectional Study and Cost‐Effectiveness Analysis of eHealth Tools to Support All Stages of Screening

Journal of the American Heart Association ◽

10.1161/jaha.120.017080 ◽

2020 ◽

Vol 9 (18) ◽

Cited By ~ 1

Author(s):

Jessica Orchard ◽

Jialin Li ◽

Ben Freedman ◽

Ruth Webster ◽

Glenn Salkeld ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cost Effectiveness ◽

Incremental Cost ◽

Oral Anticoagulant ◽

Population Based ◽

Incremental Cost Effectiveness Ratio ◽

Anticoagulant Treatment ◽

Cost Effectiveness Ratio ◽

Oral Anticoagulant Treatment ◽

Effectiveness Analysis

BACKGROUND Internationally, most atrial fibrillation (AF) management guidelines recommend opportunistic screening for AF in people ≥65 years of age and oral anticoagulant treatment for those at high stroke risk (CHA₂DS₂‐VA≥2). However, gaps remain in screening and treatment. METHODS AND RESULTS General practitioners/nurses at practices in rural Australia (n=8) screened eligible patients (≥65 years of age without AF) using a smartphone ECG during practice visits. eHealth tools included electronic prompts, guideline‐based electronic decision support, and regular data reports. Clinical audit tools extracted de‐identified data. Results were compared with an earlier study in metropolitan practices (n=8) and nonrandomized control practices (n=69). Cost‐effectiveness analysis compared population‐based screening with no screening and included screening, treatment, and hospitalization costs for stroke and serious bleeding events. Patients (n=3103, 34%) were screened (mean age, 75.1±6.8 years; 47% men) and 36 (1.2%) new AF cases were confirmed (mean age, 77.0 years; 64% men; mean CHA₂DS₂‐VA, 3.2). Oral anticoagulant treatment rates for patients with CHA₂DS₂‐VA≥2 were 82% (screen detected) versus 74% (preexisting AF)( P =NS), similar to metropolitan and nonrandomized control practices. The incremental cost‐effectiveness ratio for population‐based screening was AU$16 578 per quality‐adjusted life year gained and AU$84 383 per stroke prevented compared with no screening. National implementation would prevent 147 strokes per year. Increasing the proportion screened to 75% would prevent 177 additional strokes per year. CONCLUSIONS An AF screening program in rural practices, supported by eHealth tools, screened 34% of eligible patients and was cost‐effective. Oral anticoagulant treatment rates were relatively high at baseline, trending upward during the study. Increasing the proportion screened would prevent many more strokes with minimal incremental cost‐effectiveness ratio change. eHealth tools, including data reports, may be a valuable addition to future programs. REGISTRATION URL: https://www.anzctr.org.au . Unique identifier: ACTRN12618000004268.

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