ABSTRACT
Background: Drugs that are dispensed against a valid prescription issued to a patient by a registered medical practitioner are known as 損rescription-only drugs�. In India, they have been regulated under schedule H, H1, G, and X of the Drugs and Rules (1945). The drugs which are not included in the list of 損rescription-only drugs� are considered to be over-the-counter drugs (OTC). There is no provision for an OTC drug schedule in the Drugs and Cosmetics Rules 1945, and these drugs have higher chances of misuse or abuse. This study was undertaken to assess the knowledge, attitudes and practice among medical interns about OTC drugs in a tertiary care hospital in India.Methods: This was a cross-sectional study, which was conducted at Kempegowda Institute of Medical Sciences and Research Center, Bangalore, Karnataka, India, from March 2018 to September 2018. A pre-validated questionnaire consisting of 24 questions to assess the knowledge, attitude, and practice was administered to 80 medical interns chosen by simple randomization, out of which 14 questions were related to knowledge, 6 related to attitude and 4 related to the practice. The participants were provided 30 minutes to complete the questionnaire. The data recorded were analyzed using Microsoft Excel.Results: There were some gaps in the knowledge, attitude and practice among the medical interns about OTC medications.Conclusions: There is a need for special emphasis on the MBBS curriculum about the use of OTC drugs.
ABSTRACT
Ibuprofen is a NSAID belonging to the class of propionic acid derivatives which is widely used for its analgesic, antipyretic and anti-inflammatory action. Well-known adverse effects of ibuprofen include gastric irritability leading to nausea and vomiting as well as allergic manifestations such as urticaria and skin rashes. Severe ADRs include renal papillary necrosis, SJS/TEN, and thrombotic events leading to myocardial infarction and stroke. Authors present a case of exfoliative dermatitis in an 11-month-old infant possibly due to ibuprofen. An 11-month-old infant was prescribed syrup ibuprofen by a local medical practitioner for unclear reasons. Three days after ibuprofen therapy, the infant developed erythematous, crusting exfoliative lesions predominantly over the face with a few lesions over the lower abdomen. Subsequently, the infant was admitted to Kempegowda Institute of Medical Sciences and Research Center Hospital, Bangalore. A diagnosis of drug-induced exfoliative dermatitis was made after ruling out other causes. Treatment was initiated with intravenous and topical dexamethasone along with saline compressions and amoxicillin + clavulanic acid for secondary bacterial infection as well as topical emollient cream applied over the affected areas. The lesions improved significantly with the above management and the infant recovered enough to be discharged from the hospital after 3 days. The reaction was assessed to be “possible” as per Naranjo and WHO-UMC causality assessment scales, “moderately severe” on modified Hartwig’s severity assessment scale and “not preventable” according to Schumock and Thornton criteria. Severe and serious reactions such as exfoliative dermatitis can be caused by commonly used drugs like ibuprofen.
ABSTRACT
he advance directive is a statement of an individual’s preference for future treatment. The concept initially evolved in the context of end-of-life treatment decision making. Subsequently, in some countries, advance directives have been promoted in the care and treatment of people with serious mental disorders. They have recently been endorsed by the United Nations Convention for the Rights of Persons with Disability. In India, the legal framework related to the care of persons with mental illness is currently being reappraised, and significant changes are being contemplated. Thus, this is an appropriate time to review the existing evidence on psychiatric advance directives and examine the potential challenges involved in making them legally binding.