A Rare Case of Drug-induced Vasculitis in Out-patient Department

Drug-induced vasculitis can be defined as inflammation of blood vessels triggered by a spectrum of drugs. It presents not only with a localized skin rash but also may involve the internal organ systems, including the gastrointestinal tract, kidneys, lungs, central nervous system, and joints. Here, we report the case of a 60-year-old woman who developed purpuric pruritic rashes on bilateral lower limbs and buttocks after the ingestion of sulphasalazine. The patient took the prescribed regimen for 14 days while experiencing an adverse drug reaction. At the follow-up visit, the patient was admitted and treated with methylprednisolone monotherapy with 32 mg/day for the first 3 days and after that, methylprednisolone 16 mg for the next 3 days. The rashes resolved after 6 days. Clinicians should ascertain the patient knowledge of how and when to obtain urgent care as the patient may experience ill effects after taking prescribed treatment. Timely advice may save patients’ costs of admission and treatment to manage adverse events.

A case report of Aceclofenac induced Drug induced Hypersensitivity syndrome

<p>Drug-induced hypersensitivity syndrome (DIHS) is an unusual, potentially life-threatening, multi-organ adverse drug reaction. DIHS usually develops 2-6 weeks after drug initiation. We report a case of 21 years old female with maculopapular rash associated with fever and generalised lymphadenopathy, 15 days after intake of aceclofenac. Treatment with intravenous corticosteroids, antibiotics and fluids along with cessation of the offending drug resulted in successful resolution.</p>

Completeness and accuracy of adverse drug reaction documentation in electronic medical records at a tertiary care hospital in Australia

Background: A large proportion of patients presenting to hospitals have experienced a previous adverse drug reaction (ADR). Electronic medical records (EMRs) present an opportunity to accurately document ADRs and alert clinicians against inadvertent rechallenge where there is a pre-existing reaction. However, EMR systems are imperfect and rely on the accuracy of the data entered. Objective: To ascertain the completeness of ADR documentation and the accuracy of the classification of ADRs as allergy versus intolerance in the EMR at a major metropolitan hospital in Australia. Method: Cross-sectional audit of the ADR field of the EMR for a sample of patients on four different wards over 3 weeks to ascertain the completeness of ADR documentation and the accuracy of classification of ADRs. Results: Of the 264 patients assessed, 102 (38.6%) had a total of 210 ADRs documented in the EMR. Of these, 105 (50%) were considered to have complete documentation; 63/210 (30.0%) were missing a reaction description and 88/210 (41.9%) were missing severity information. For those ADRs with a reaction description ( n = 147), 97 (66.0%) were considered to be appropriately classified as allergy or intolerance. Conclusion: Incomplete and inaccurate ADR documentation was common. These findings highlight a need for optimising ADR documentation to improve appropriate medication use in hospital. Implications: Improved EMR design and education of healthcare workers on the importance of complete and accurate documentation of reactions are needed to improve completeness and accuracy of ADR classification.

Assessment of Knowledge, Attitude, and Practice of Adverse Drug Reaction Reporting Among Community Pharmacy in Gondar Town, Ethiopia, 2021

Background: Drugs can treat diseases, reduce symptoms, and enhance patients’ health and quality of life. However, taking a drug is not always as easy as just swallowing a pill. This is because drugs have some unwanted effects. Adverse Drug Reactions (ADRs) are one of the leading causes of morbidity and mortality and contribute to excessive health care costs. Objectives: To assess knowledge, attitude, and practice of health care providers on adverse drug reporting among community pharmacists, Gondar, Ethiopia Methods: Community-based cross-sectional study designs were used from July - August 2021. The sampling method was a survey from community pharmacists. Self-administered questioner was used, and the collected data was entered into Epi-info Version 7.0 and exported to SPSS version 20 software for analysis. Result: The study included 215 community pharmacy professionals to assess the knowledge, attitudes, and practices of adverse drug reaction reporting. From a total of 215 community pharmacy professionals, 34 (15.8%) of the respondents were able to differentiate ADR from side effects and only 56(26%) respondents felt that they are adequately trained in ADR reporting. Out of 215 respondents, 78(36.3%) and 146(67.9%) knew the availability of the national reporting system and ADR reporting form in Ethiopia respectively. The study revealed that 21.4% [95% CI: 18.6-35.9] and 42.3% [95% CI: 38.2-65.9] of community pharmacists have poor knowledge and negative attitude towards ADR reporting respectively. Conclusion: Underreporting of ADR by community pharmacists was identified in this study. Training sessions to clarify the role of various community pharmacists in ADR reporting will hopefully fill the observed gap in knowledge and practices. The community pharmacy should formulate strategies to enhance the detection and reporting of ADRs.