Systemic adverse drug reactions: a preliminary report from the regional pharmacovigilance center, western Nepal

Present study analyzed the pattern, causality, severity and preventability of the systemic adverse drug reactions reported to the regional pharmacovigilance center during the period 14th September 2004 till 13th September 2005. Altogether the centre received 22 systemic adverse drug reactions [males 12 [54.55%], females 10 [45.45%]]. Among the total adverse drug reaction 5 [22.73%] were reported by the Department of Orthopedics. Of the 22 drugs responsible for the suspected adverse drug reaction, majority belongs to the class of Opoid analgesics [n=7, [31.82%]], followed by non steroidal anti-inflammatory drugs [n=5, [22.73%]]. Tramadol was the individual drug responsible for 6 [27.27%] adverse drug reactions and vomiting was the most common adverse drug reactions [n=6, [27.27%]]. The causality assessment revealed 7 [31.82%] of the adverse drug reaction to have a probable relationship with the suspected drugs

Can drug utilization help in promoting the more rational use of medicine? Experiences from western nepal

Drug utilization research describes the extent, nature and determinants of drug use in populations and aims to facilitate the more rational use of medicines. The departments of pharmacology and clinical pharmacy at the Manipal College of Medical Science, pokhara, Nepal are committed to promoting the more rational use of medicines. The departments run a Drug Information Center and Pharmacovigilance Center in the teaching hospital. Over the last eight years, the departments have conducted drug utilization studies in the teaching hospital and the community. A few of these were of the intervention type and drug use was studied before and after the intervention. Members of the departments are on the hospital Drug and Therapeutics Committee. Educational initiatives to improve prescribing have been carried out in a few instances. Restricting the number of brands in the hospital pharmacy and creation of a hospital drug list has been carried out. The impact of these initiatives has been studied only in a few cases. Generic prescribing was found to be low. The educational initiatives to improve prescribing had only limited success. The hospital is in the process of framing antimicrobial use guidelines for various departments. A hospital formulary is under preparation. The influence of drug utilization studies on the prescribing patterns has been low to moderate. The department of Clinical pharmacy runs a Medication Counseling Center in the hospital and teaches appropriate use of medicines to patients. The studies and initiatives to promote the more rational use of medicines should be continued and strengthened

Newer antibiotics

To combat the increasing problem of antibiotic resistance, newer antibiotics have been developed or are under development. This review focuses on the newer antibiotics, quinupristin-dalfopristin, linezolid, the newer glycopeptides, daptomycin, the cationic peptides and the newer fluoroquinolones

Dermatological adverse drug reactions due to systemic medications a review of literature

Cutaneous adverse drug reactions [ADRs] affect 2-3% of hospitalized patients. These reactions can arise as a result of immunologic or non-immunologic mechanisms. Extremes of age, female sex, previous history of ADRs and environmental factors are the major risk factors. The severity of the cutaneous ADRs may vary from a mild itching to a life threatening Stevens-Johnson syndrome [SJS]. In general, most are usually mild and respond to topical treatment. Different skin diseases and cutaneous manifestation of systemic diseases should be ruled out before diagnosing a cutaneous ADR. In order to establish the causal relationship between the offending drug and the reaction, causality assessment should be carried out. The Naranjo algorithm is widely used to determine the causality of an ADR. The cessation of the offending agent, along with the use of systemic and topical steroids, antipruritic agents and oral antihistamines may be helpful in the management. Patients with extensive skin involvement should be cared for as burns patients. High risk patients should be counseled regarding the possibility of developing a cutaneous ADR during the course of treatment and the strategies to be followed upon occurrence of a cutaneous ADR. This is a review article

Cutaneous adverse drug reactions to modern medicines and initial experiences from a spontaneous adverse drug reaction reporting program in a tertiary care teaching hospital of Western Nepal

Cutaneous adverse drug reactions [ADRs] affect 2-3% of hospitalized patients; most are usually mild and respond to topical drugs. These reactions can arise as a result of immunologic or non-immunologic mechanisms. Extremes of age, female sex, previous history of ADRs and environmental factors are the major risk factors. The Naranjo algorithm is widely used to determine the causality of an ADR. To share the authors' experience of spontaneous adverse drug reaction reporting program Nepal. During a period from September, 2004 to March, 2005, any patient who experienced a dermatological ADR were asked to report the Pharmacovigilance Cell of the Manipal Teaching Hospital, Pokhara, Nepal. Morphology of the eruption was recorded. A total of 45 cutaneous ADRs were reported during the study period. Maculopapular rash [15 reports] was the most common, followed by contact dermatitis [7 reports], fixed drug eruptions [6 reports] and erythema [4 reports]. Considering its effectiveness, the pharmacovigilance program in Manipal Teaching Hospital should be strengthened and transformed to a full-fledged active reporting program. The nationwide extension of this program would be beneficial