ABSTRACT
Background: Analgesics are the most common class of drugs prescribed for various conditions in the orthopedics outpatient department (OPD). This study is performed for a better understanding of analgesics prescribing pattern in orthopedics and to correlate the use of selective cyclooxygenase-2 (COX-2) inhibitors, conventional non-steroidal anti-infl ammatory drugs (NSAIDs), and opioid analgesics in practice in the present scenario. Methods: The prescriptions from the OPD of Orthopedics at Dr. B. R. Ambedkar Medical College was reviewed between June 2013 and November 2013, entered in a pre-designed proforma. Pain was quantifi ed using numeric rating scale. The type of analgesics administered, whether monotherapy or combined therapy and the duration of therapy, was analyzed to obtain an overview of the current prescribing pattern. Results: A total of 300 prescriptions were analyzed. 800 drugs were prescribed with an average of 2.6 drugs per prescription. Of these, 62.3% were NSAIDs, 15.4% were opioid analgesics and 22.3% were gastroprotective agents. 61% of the NSAIDs were prescribed as monotherapy and 39% were prescribed as fi xed drug combination (FDC). The ratio of selective to non-selective NSAIDs is 1.3:1. Conclusions: The results of the present study show frequent use of selective COX-2 inhibitors, although non-selective NSAIDs topped the list of various selective NSAIDs, non-selective NSAIDs, and opioid analgesics. This suggests that gastrointestinal safety was an important concern while prescribing these drugs. Many FDCs were found to be irrational.
ABSTRACT
Background: Cutaneous adverse drug reactions (ADRs) affect 2-3% of hospitalized patients. The severity varies from mild itching to life-threatening Stevens-Johnson syndrome (SJS). Hence, this study was undertaken to emphasize the need to report ADRs. Methods: The study was carried out in the Department of Dermatology in Dr. B.R Ambedkar Medical College Hospital from June to December 2012. Naranjo’s algorithm was used to determine the causality of an ADR. Informed consent was obtained from each patient, and thorough clinical examination was conducted. All the information was carefully recorded in a pre-designed proforma. To establish the etiologic agent for a particular type of reaction, attention was paid to the drug history, temporal correlation with the drug, duration of the reaction, morphology of the reaction, associated mucosal or systemic involvement, improvement of lesions on withdrawal of the drug. Results: In the present study, all the age groups were affected with cutaneous ADRs, with a higher incidence in age group between 31 and 40 years, non-steroidal anti-inflammatory drugs (NSAIDs) (41.66%) were most commonly observed drug, followed by anti-microbials (25%) and anti-convulsants (21.66%). Fixed drug eruptions (FDE) (46.66%) most commonly observed cutaneous reaction, followed by SJS (16.66%), erythema multiformae (16.66%) most commonly observed ADRs. Conclusions: ADRs are potentially avoidable causes for seeking medical care. FDE was most common ADR and NSAIDs were most common causative agents in our study. ADRs can be prevented by avoiding polypharmacy, obtaining history of any previous skin reaction and the causative agent.