ABSTRACT
Background: Hypertension is a major non-communicable disease and a large proportion of patients are not treated adequately even though several antihypertensive drugs and various guidelines are available. Aims and Objectives: The aim of the study was to study the treatment pattern and effectiveness of the antihypertensive drugs by estimating the blood pressure (BP) control achieved based on Joint National Committee (JNC) 8 guidelines for the treatment of hypertension. Materials and Methods: In this observational study, 92 patients with primary hypertension diagnosed since 1 1/2 years were included in the study. BP at the time of diagnosis and on subsequent follow-up visits and details of antihypertensive drugs prescribed during each visit were recorded, until target BP was achieved or till the end of the study period. Wilcoxon Signed Rank test and Mann–Whitney U test were used for analyzing the dependent and independent groups, respectively. Results: Mean age of patients was 57.50 years and 54.3% of them were females. Majority received single drug (80.43%) compared to combination therapy (19.57%). Most frequently prescribed antihypertensive drug group was angiotensin receptor blockers (47.75%) followed by calcium channel blockers (41.44%) and most commonly prescribed individual drugs were losartan and amlodipine (both 25.22%). Seventy-three (79.30%) patients attained their target BP and the average time taken for the adequate control of BP was 5.67 (S.D ± 2.674) weeks. Conclusion: JNC 8 guidelines were found to be effective in this study population.
ABSTRACT
Background: Proton pump inhibitors (PPI) are most commonly prescribed medications in the world which are highly effective drugs in treatment of upper gastrointestinal disorders, but there are concerns regarding its long term use. Aim and Objective: To assess the pattern of reported adverse drug reactions (ADR) in patients with long term use of PPI and to estimate the frequency of adverse drug effects. Materials and Methods: A study conducted as an observational study among 100 consecutive patients who attended the medical-gastro inpatient and outpatient department on treatment with PPI for more than 4 months, according to inclusion and exclusion criteria. After attaining the written informed consent, data regarding patient’s demographic details, occupational status, addictions, co-morbidities, and lab investigations were recorded in pre-prepared proforma after interviewing the patient and referring the case sheet. Details including PPI used and per day dose of the drug with any ADR developed were noted. Data collected were analyzed using appropriate statistical method. Categorical variables are expressed as frequency (percentage) and continuous variables as mean (standard deviation). Chi-square test was used to find out the association between PPI and ADR. Results: Out of 100 study participants, 57% case reported ADR which included 19 cases (33.3%) of hypomagnesemia, 8 cases (14%) each of hypocalcemia, and hyperkalemia, 7 cases (12.3%) of anemia, and 5 cases (8.9%) of acute kidney injury. Out of the 57 reported adverse events, 29 (50.9%) were caused by Rabeprazole followed by 18 (31.6%) by Pantoprazole, then Esomeprazole: 8 (14%), and least by Omeprazole (3.5%). Conclusion: Long-term use of PPI can lead to various ADR which requires the withdrawal of drug. Since PPIs are easily available without prescriptions, self-medication with PPIs are increasing alarmingly. With every antibiotic one PPI is always prescribed, as a result, there is irrational use of PPIs which is of concern and requires attention. These adverse events could be reduced by preventing self-medication of long duration and reducing the irrational prescribing of PPIs. Doctors should be sensitized about the ADRs. The patient should be educated about the long-term adverse effects of PPIs.