Pattern of adverse drug reaction related queries received by the drug information centre of a tertiary care teaching hospital

Accurate information about safety of drugs is very essential for health care professionals in identifying, preventing and managing Adverse Drug Reactions [ADRs], thereby ensuring safe use of medications. The objective of the present study was to assess the pattern of drug information [DI] queries related to ADRs received by the Drug Information Center [DIC] of a tertiary care teaching hospital. Retrospective evaluation of the DI queries received in the DIC over a period of three and a half years [January 2002- July 2005] was done for various parameters such as purpose and type of query, characteristics of the drugs and reactions involved, and references used. Out of 2312 DI queries received, 600 [25.9%] were related to ADRs. Majority of the queries were from the department of medicine [80.5%] and was received during ward rounds [76%]. In most of the queries, the information was sought for better patient care [66.3%] and the enquirer wanted the information immediately [59.5%]. The category of ADR queries most commonly asked was regarding identification of an ADR [54.3%]. Considering the reaction characteristics, the organ system most commonly involved in the queries was nervous system [14.7%] and the reaction was fever and skin rash [14%]. Most of the queries were on uncommon reactions. Drug class most commonly involved in the queries were antibacterials for systemic use [18.6%] and the most frequently involved drug was phenytoin [35%]. MICROMEDEX system was used as the reference in answering most [57.1%] of the queries. Information on ADRs is among the most sought information on drugs by the health care professionals. Evaluation of pattern of these queries could reveal opportunities for educational and other interventions in promoting safer drug use in a health care setting. DICs could play a major role in promoting drug safety and it needs to be well equipped to respond to these needs

Continuous ambulatory peritoneal dialysis: Indian scenario.

Chronic peritoneal dialysis (CPD) has been initiated as a treatment modality for chronic renal failure patients in the Indian subcontinent since 1990. Over a period of 9 years both continuous ambulatory peritoneal dialysis (CAPD) and continuous cyclic peritoneal dialysis (CCPD) have emerged as accepted forms of renal replacement therapy in our country. Although there were government restrictions on import of dialysis fluid until 1993, the availability of locally manufactured fluid in collapsible bags had facilitated the expansion of the programme to the far corners of the country and in neighbouring countries. Initially majority (78%) of the patients who were started on this programme were diabetics with other comorbid conditions who were drop-outs from haemodialysis and unfit for transplantation. Both CAPD and CCPD have been used for all age groups and for men and women. Majority of the patients do 3 x 2 l exchanges a day on CAPD; 8-10 l using a cycler at night those who are onCCPD. Peritonitis rate was 1 episode every 18 patient months. With the introduction of new connection and disposable sets the incidence of peritonitis is dropping down. The major cause of drop-out is cardiovascular death followed by peritonitis. Malnutrition is a major problem in both CAPD and haemodialysis patients. The programme has been expanded and there are over one thousand patients on this treatment in the country. The introduction of CPD had a major impact on the treatment of renal failure in India.

Continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) was used as renal replacement therapy in 55 patients for 666 patient months. Thirty five patients had Type II diabetes. They ranged in age from 1-83 years. Majority of the patients were above 50 years of age who could not be transplanted due to various comorbid conditions. The incidence of peritonitis was 1 episode every 20 patient months. Twenty five patients dropped out during the observation period. The major cause of drop-out was death due to underlying coronary artery disease. Three patients underwent renal transplantation.