ABSTRACT
Background: Rheumatoid arthritis (RA) is a common disease that causes substantial morbidity in most patients and premature mortality in many. All the drugs used in the treatment of rheumatoid arthritis show significant toxicity and hence it is important to monitor the drugs for adverse drug reaction. This study will estimate the prescribing pattern and bring out the possible adverse drug reactions in patients with rheumatoid arthritis.Methods: This study included 200 patients with rheumatoid arthritis who fulfilled the study criteria were observed for three months. Their prescriptions were collected and analysed. The symptoms of adverse drug reaction were documented through questionnaire. The causality assessment was done by WHO-UMC assessment scale and severity by using modified Hartwig-Seigel severity assessment scale.Results: This study showed most of the patients were female (86%). Majority of them were in age group of 51-60 years. Average number of drugs per prescription was 10.57. Out of 200 patients, 2% were on single DMARD and 50.5% were on two DMARDs. 40% and 7.5% were taking three and four DMARDs respectively. A total of 450 adverse drug reactions were reported, out of which 68.4% due to steroid,12.5% due to DMARDs and 19.1 due to use of NSAIDs, DMARDs and glucocortisteroids. Chloroquine maculopathy occurred in 3 patients and elevated liver enzymes due to methotrexate in 3 patients, which necessitated DMARD withdrawal. Most patients had 1-3 ADRs. 6% of ADRs were severe and 54% belongs to probable category of causality assessment.Conclusions: Treatment of rheumatoid arthritis is mainly based on DMARDs, glucocorticosteroids and NSAIDs. So, occurrence of ADR is much common. Proper monitoring of therapy and timely modification of drugs and lifestyle can reduce the ADR occurrence.
ABSTRACT
Background: Amlodipine have been widely used drug for the treatment of Hypertension. It has many beneficial effects and less side effects. But, only very few adverse effects of Amlodipine have been documented and many were not reported. So, this study will bring out the possible adverse effect of Amlodipine.Methods: This study included 100 patients with hypertension who are taking amlodipine only. Patients who were willing to participate in the study were given a questionnaire containing demographic data and adverse drug profile of amlodipine. The symptoms of adverse drug reaction were documented. They were also asked about the other symptoms they are having, other than the questionnaire. The causality assessment was done by WHO assessment scale and severity by using modified Hartwig seigel severity assessment scale.Results: This study showed that most of the patients belong to 51-60 years age group. Mostly they were females, and many were having disease for less than a year. Most of the patients developed adverse drug reaction. Many patients had more than one adverse drug reaction. The commonest adverse effect were fatigue, palpitation, dizziness, insomnia, headache, joint pain, light-headedness, somnolence, nausea, flushing abdominal pain, tremor, leg pain, neck pain, back pain and edema. The adverse drug reaction(ADRs) mostly belongs to possible category and were mild.Conclusions: Most of the patients who were taking amlodipine had atleast one adverse drug reaction during their treatment period. It is mild, needs dose adjustment and healthy life style modification.