ABSTRACT
Background: The gap in the knowledge of interns between brand names, generic name and indication of a drug can lead to unwanted clinical consequences. This study was conducted to assess the knowledge of interns at a tertiary care hospital regarding the generic name and indications of the routinely prescribed brand names of drugs.Methods: In this study, interns were required to write whether they prescribed the brand names mentioned in the questionnaire in the preceding six months, their generic name and the indication for their use. Results were expressed using descriptive statistics.Results: All brands except Zovobact SB was prescribed by more than 50% of interns in the preceding six months. The generic equivalents were correctly identified by good percentage of interns for Hicet (100%), Asthalin (95%), Cifran (90%) but the percentage of correct answers was low for other brands. For combination brands, correct generic names of all components were identified by more than 50% of interns for oflox TZ (93%), Septid D (68%) and Losar H (68%). The percentage of correct response for the indication of the brands was satisfactory for Hicet (100%), Asthalin (98%), Cifran (98%), Zerodol P (100%), Cyclopam (100%), oflox TZ (100%), Losar H (98%), Septid D (98%) but was inadequate for Taxim O (48%), Betaloc (33%), Valium (23%), Diamox (0%), Quadriderm (31%) and Zovobact SB (31%).Conclusions: This study identified lacunas in the knowledge of interns regarding generic equivalents and indications of brand names. Strategies to overcome the problem should be devised to ensure patient safety.
ABSTRACT
Background: Geriatric population due to the age related changes in pharmacokinetics and pharmacodynamics and the presence of comorbidities is vulnerable to drug interactions, adverse effects and high cost of therapy. This necessitates a periodic review of DU pattern in the geriatric population to ensure safe and effective treatment for them. The present study was undertaken to evaluate the DU pattern for medical conditions among the geriatric population in the Orthopaedic outpatient department (OPD) of a tertiary care hospital in Kerala.Methods: In this cross sectional observational study conducted in the Orthopaedics OPD of a tertiary care hospital, prescriptions were collected from patients attending the Orthopaedics OPD randomly over a period of 6 months. Out of these, prescriptions of male and female patients of age more than 60 years were sorted and analysed using World Health Organization drug prescribing indicators as well as additional parameters and the data was presented in the form of frequency and percentages using tables and charts.Results: A total of 800 prescriptions were collected and studied of which 76 (9.5%) belonged to patients from the geriatric population. Majority of the patients were in the age group of 61-70years (52.63%). Spondylosis (42.10%) was the most common indication for patients attending Orthopaedics OPD. Average number of drugs per prescription was 3.05 with a range between 1 and 5. Only 5.17% drugs were prescribed using generic name. Utilization from the essential drug list was 39.65%. The percentage of encounters in which an antibiotic and injection prescribed was 0% and 10.34% respectively. Of the total drugs prescribed 35% were FDCs. The most routinely prescribed drugs among the various classes were NSAIDs 34% followed by gastroprotectives (25%). The assessment of prescriptions with regard to completion and legibility was satisfactory.Conclusions: Current study pointed out deficiencies like polypharmacy, low prescribing of drugs by generic names, low prescribing of drugs from the essential drug list and higher use of FDCs. Use of antibiotics and injections was satisfactory and acceptable. Legibility and completion of prescription format was largely satisfactory. Proper strategies to rectify these deficiencies can ensure safe and effective treatment for geriatric patients.
ABSTRACT
Background: Choice between LABAs and LTRAs as add on drugs to low dose ICS in persistent asthma remains unclear due to limited data on the comparative efficacy of these two groups of drugs. The aim of this study was to compare the effects of formoterol and montelukast on lung function, when added to low dose Budesonide in persistent asthma.Methods: This was an institution based randomized open label study. 72 asthmatics satisfying selection criteria of the study were randomized to receive either inhaled budesonide and formoterol (FB group) or inhaled budesonide and oral montelukast (MB group) for 12 weeks. PEF value at end point was primary efficacy measure. Secondary efficacy measures were PEF values measured at the end of 1, 4 and 8 weeks and the end point value of FEV1.Results: Both the groups showed significant improvement in the lung function tests. However inter-group comparison showed that PEF value at end point of FB group was significantly greater than that of MB group (81.94%vs 63.82%, p<0.05). Notable observation was that the superiority of the FB group with respect to PEF values was maintained from the first week itself. FB group also had significantly better results than MB group for FEV1 (67.88% vs 64.88%, p<0.05).Conclusions: In the present study, formoterol was found to be superior to montelukast in improving lung function when added to low dose budesonide in persistent asthma.
ABSTRACT
Background: The pursuit of best and responsible use of medicines is the basis for concept and effort of Rational use of drug. RUD addresses steps in supply-use chain of drugs i.e. selection, prescribing, dispensing, monitoring and feedback. Hence periodic and continuous auditing of drug prescribing pattern is vital tool for promotion of RUD. Ophthalmology largely becoming an outpatient and day care department with almost nil Inpatient. So present study is to analyse drug prescribing pattern in Ophthalmology OPD. Methods: A prospective cross sectional study was done. Prescription were analysed for number of drugs per prescription, number of antibiotics, no of injection per prescription, Drugs from Essential Medicine List, Fixed dose Combinations. Results: A total of 176 prescriptions were analyzed the average number of drugs per prescription being 2.7 [0.78].Eye drops being the most common (81.01%) dosage form. injections were only 0.63% of all drugs. Percentage of prescription with Antibiotics were (36%) All drugs were prescribed only in brand name, none by generic name. 40.29% (940/1516) of drugs were prescribed from essential medicine list. Almost all prescriptions were having clear information on dosage form, dose, frequency and duration of treatment. Conclusion: Out of different parameters and drug prescribing indicators some are satisfactory e.g Information for patient in prescription. Some others like absence of generic name in prescription, high %age of antibiotics, lower % of drugs from EML needs attention. Conclusions: . It seems that awareness among the clinician about Rational prescribing is increasing. There is need of continuous endeavour to sensitise the clinician for rational use of drug.
ABSTRACT
Diclofenac infusion is prescribed for acute painful and inflammatory conditions in intensive care. Thrombocytopenia is a very rare adverse effect of diclofenac infusion. We report a case of thrombocytopenia due to diclofenac infusion, occurring in a 32-year-old male treated conservatively for acute appendicitis. The thrombocytopenia recovered completely with the discontinuation of the drug. The rarity, clinical importance, and the diagnostic difficulty associated with this case prompted us to report it here.