A study to monitor adverse drug reactions in patients of chronic obstructive pulmonary disease, asthma and bronchiectasis

Background: These Diseases are chronic and often have complex pathologies which lead to polypharmacy and causes unwanted adverse drug reaction (ADRs). We conducted this study at Respiratory Medicine Department of Gandhi Medical College and associated Hamidia Hospitals, Bhopal. Aim and Objective: The objectives of the study were (i) to monitor and assess ADRs in patients of chronic obstructive pulmonary disease (COPD), Asthma, Bronchiectasis; and (ii) to assess causality of the ADR using WHO-UMC causality assessment system and Naranjo’s ADR probability scale. Materials and Methods: The present study indicates the pattern and spectrum of ADRs due to drugs used in the treatment of COPD, Asthma, Bronchiectasis. 159 patients from Respiratory Medicine, Gandhi Medical College receiving chemotherapy were enrolled in study after written informed consent of patients. Approval was obtained from institutional ethics committee. It was cross-sectional, observational study. Prescriptions were analyzed for number of drugs prescribed using a predesigned format. Any ADR observed by patient or treating physician was noted and causality was assessed by Naranjo’s algorithm and WHO-UMC scale. Results: In our study, most important causative drug was Budesonide (12.3%). Causality assessment of ADR by Naranjo’s algorithm showed 22% probable and 78% possible reactions. According to WHO-UMC scale, 81% reactions are possible, 17% are probable, and 2% are unlikely. Conclusion: To minimize this high incidence of ADRs dose individualization and therapeutic monitoring of medicine is important. In clinical practice, special precautions while prescribing these drugs with well-known potential for causing ADRs, early detection and appropriate intervention are required. This may greatly contribute to reduce the incidence, frequency, severity, morbidity, and possible mortality.

Spinal Intramedullary Tubercular abscess.

Spinal intramedullary tubercular abscess is an extremely rare entity. Only few cases are reported in literature. A Nine-year-old girl presented with pain in gluteal region and progressive paraparesis. Her chest-X-ray revealed a primary focus suggesting pulmonary Koch’s & MRI lumbosacral spine showed a ring enhancing hypointese lesion in T1w and hyperintense in T2w at L2 to L3 suggestive of epidermoid or tubercular abscess, which was confirmed at operation and subsequently by AFB staining and culture. Mycobacterium tuberculosis was seen in both staining and culture of pus. Patient improved after 2 months of ATT.