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Objectives: To identify and assess the various potential drug-drug interactions (pDDIs) among the patients receiving cancer chemotherapy, using the database from Lexicomp® Solutions with the ultimate goal of raising awareness among clinicians for safe medication usage. Materials and Methods: It is a prospective, cross-sectional study engaged at a tertiary care hospital in South India. Data regarding clinically prescribed drugs were obtained from the patients admitted to the oncology unit of tertiary care hospital within the time frame of 6 months (June 2018 to December 2018). Frequency and clinical relevance, the onset, and Severity of pDDIs were assessed using the database from Lexicomp® Solutions version 4.1.2. Data were analyzed using the descriptive statistics. Statistical significance was analyzed using the Mann–Whitney andChi-square tests. Pearson’s correlation coefficient was used to identify the correlation between the incidence of drug-drug interactions with age, the number of drugs prescribed, and the type of cancer. Results: A total of 895 pDDIs were seen, including 261 with chemotherapeutic drugs and 634 with supportive medication. It was observed that around 14.18% of cyclophosphamide showing interaction with Ondansetron among chemotherapeutic drugs, whereas 9.14% of lithium presenting interaction with Ondansetron among supportive therapy. A statistically significant higher interaction was noted among supportive medications provided when compared to anticancer drugs (P = 0.001). Conclusions: The majority of pDDIs observed among the patients receiving chemotherapy with supportive medications as compared to anticancer chemotherapy. There is an urgent need for special safety measures to monitor and prevent drug interactions in the oncology unit.
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Background: Psoriasis is a chronic relapsing disease necessitates long-term therapy. The disease severity, comorbidities, and access to health care determine the choice of therapy for psoriasis. The main aim of the treatment of psoriasis is to induce prolonged remission and suppress the disease as there is no cure. It is only palliative and symptomatic treatment, and the choice of treatment modality is according to the type of presentation. The various modalities of treatment available include topical therapies, systemic therapies, phototherapy, and biologics. The difference includes among clinical varieties in their presenting features, severity, natural course, and response to the treatment are responsible for variation in choice of therapy.Methods: In this descriptive study, data collected from patients diagnosed with psoriasis who were admitted in a K.S. Hegde Charitable hospital from January 2017 to January 2019 were analysed for demographic features, disease pattern and drug use pattern in patients.Results: Psoriasis vulgaris/plaque type of psoriasis was commonly observed type of psoriasis in our patients with fourth and fifth decade patients getting more affected. Diabetes was the most commonly associated comorbid disorder. The patients were treated both with systemic and topical modalities of treatment, antihistaminic and methotrexate were most commonly most commonly used systemic drug and moisturizers and glucocorticoids were used topical drugs.Conclusions: Psoriasis needs a multimodality treatment with careful monitoring for the comorbid disorder. Treatment choice is individualised depending on the severity and body parts affected.
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Background: The present study was planned to assess the knowledge, attitude and practice of healthcare providers regarding adverse drug reaction reporting and pharmacovigilance in a tertiary care hospital.Methods: The study was conducted in a tertiary care teaching hospital, it’s a observational, KAP cross-sectional questionnaire-based study. The KAP questionnaires was developed toward pharmacovigilance and ADRs and were used to assess the medical professionals.Results: Only 64% of doctors, 52% PG’s and 40% of nurses knew the correct knowledge regarding Pharmacovigilance (PhV). Regarding the attitude, all the respondents think reporting of ADR is a very necessary. 98% of doctors,80% of postgraduates and 96% of nurses have experienced ADR in the patient in their professional practice but reporting of same is very less. The factors discouraging them from reporting ADR’s was also assessed. 34% said difficult to decide whether ADR has occurred or not, 34% said lack of time, 17%- no remuneration and 15% said a single unreported case may not affect ADR database.Conclusions: This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among medical professionals, but unfortunately the actual practice of ADR reporting is still deficient among them.
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Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class.
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Background: Acne Vulgaris is the most common skin disorder of the pilosebaceous unit with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity, affecting about 80% of teenagers and has considerable psychological and social consequences and physical disability. Use of established topical and oral drugs assumes paramount importance in the treatment of acne vulgaris. Therefore, periodic auditing of prescription is necessary to increase therapeutic benefit and decrease adverse effects. Aim and objectives of the study was to evaluate the pattern of prescription and its rationale in the drug therapy of acne vulgaris. To monitor the adverse effects, if any.Methods: A prospective, hospital based, observational study. Data was collected for a period of 1 year from January 2015 to December 2015 from the outpatient records in the OPD of Dermatology at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, in a specifically designed proforma.Results: The prescription data of 346 patients were analyzed of which 45.1% were males with an average age of 21.94±0.3 years. Among the four grades of Acne Vulgaris, Grade II (53.17%) was more prevalent followed by Grade I (26.58%), Grade III (13.87%) and Grade IV (6.35%). The number of drugs prescribed for topical use was 514 of which the most commonly prescribed drugs were Benzoyl Peroxide (19.46%), a combination of Tretinoin and Clindamycin (17.12%), Tretinoin alone (12.45%), Clindamycin alone (10.51%) etc. The number of drugs prescribed for systemic use was 98 consisting of Doxycycline (55.1%), Azithromycin (34.7%), Isotretinoin (6.12%) and Erythromycin (4.08%).Conclusions: There was rationality in most of the prescriptions giving no scope for polypharmacy.
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Aim: To assess the protective effect of ethanolic leaf extract of Mussaenda erythrophylla and Aegle marmelos in ethanol induced hepatotoxicity. Methods: The ethanolic extract M. erythrophylla (ME) and A. marmelos (AM) studied for its hepatoprotective effect on alcohol induced acute liver damage on Wistar albino rats. The degree of protection was measured by using biochemical parameters such as serum glutamate oxalate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), total bilirubin (TBL), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione (GSH), and total antioxidant (TAC) levels. Results: Alcohol treated group had enhanced levels of SGPT, SGOT, total bilirubin (p <0.05) and decreased levels of GSH, SOD and GPx (p <0.05) when compared with control group. Treatment with silymarin and 200mg/kg of M. erythrophylla and A. marmelos leaf extract had significantly (p <0.01) brought down the elevated levels of SGPT, SGOT, and total bilirubin and an increase in the levels of GSH, SOD, GPx (p <0.001) and total antioxidant. (p <0.0001) Conclusion: The results showed that ethanolic extract of M. erythrophylla and A. marmelos leaves extracts possesses significant hepatoprotective activity.
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Background: Diseases of the ear, nose, and throat (ENT) constitute among the most common causes of hospital visits worldwide and account for most of the antibiotics prescribed and used. They are responsible for significant school and work absenteeism and have generated 94.6 disability-adjusted life years lost worldwide. Due to the high incidence of these diseases and the different varieties of drugs in use, it becomes imperative for us to know the present prescribing patterns, so that appropriate adjustments can be made for the benefit of patients. Methods: Over a period of 1-year, the outpatient department (OPD) records of 608 patients with ENT infections, reporting to the ENT OPD of Justice K S Hegde Charitable Hospital, Deralakatte, Mangalore, were scrutinized and the data collected in a specially designed proforma. Descriptive analysis of the data was done. Results: Of the total 608 prescriptions analyzed, 309 (50.8%) belonged to male patients and 299 (49.2%) belonged to female patients. Highest numbers of patients were in the age group of 16-25 years (29.44%). The most common diseases reported were chronic suppurative otitis media (19.24%), followed by otitis externa (13.49%) and furunculosis (9.87%). Average number of drugs per prescription was found to be 3.0. Oral antibiotics were prescribed to 540 patients (88.81%). Most common antibiotics prescribed were amoxicillin-clavulanate (53%), levofloxacin (17%), and cefixime (14%). Antihistamines were prescribed in 52.47% prescriptions, and nonsteroidal anti-inflammatory drugs were prescribed to 298 patients (49.01%). Conclusion: This study shows that the diseases were treated rationally in accordance with the standard guidelines of therapy.