ABSTRACT
Background: Objective of current study was to find out self-medication pattern and to study awareness of ADRs to analgesics self-medication. Methods: II MBBS students collected the information of names of analgesics self-medication, dose, frequency of administration, health related problem for use of self-medication, source of information for the use of self-medication and information about ADRs. Students also educated the population about ADRs to analgesics with the help of ADR checklist. Results: Paracetamol was most commonly taken as self-medication and 39% persons reported ADRs with paracetamol. Ibuprofen, diclofenac, paracetamol and aspirin were taken less than WHO DDD for joint pain. 79% study population was ignorant about ADRs to analgesics. Headache (37%) was common health related problem for self-medication of analgesics. Conclusion: Information about problems with repeated use of analgesics like liver damage, analgesic nephropathy, gastric ulceration/bleeding should be provided by pharmacists either orally or with the help of leaflets or display board. Headache is common health related problem for the use of analgesics as self-medication. Pharmacists should take help of assistance tool to diagnosis headache like screener for migraine and guidelines for chronic headache for timely visit of self-medicating person to physician.
ABSTRACT
Background: Low therapeutic index of established antiepileptic drugs (AEDs) coupled with better understanding of the pathophysiology of seizure has encouraged the development of several novel AEDs. The conventional antiepileptics like phenytoin, phenobarbitone, valproate and carbamazepine and newer antiepileptics like levetiracetam, lamotrigine and topiramate etc. are used for epilepsy. AEDs induce potentially toxic effects over a period of time which remains undetermined over very long time. Earlier studies in this regard, states uneven results about biochemical (i.e. blood sugar level, lipid profile) and hematological (Hb%, blood cell count etc.) toxicity of AEDs. Aims: To unveil the toxic effects of AEDs when given singly or as combinations. Methods: Adult epileptics of either sex taking antiepileptic monotherapy or combination therapy for ≥ six months were enrolled. Biochemical and hematological parameters studied were compared with their age and sex matched controls, baseline and amongst groups. Statistical Analysis Used: Student’s ‘t’-test & One way ANOVA followed by posthoc Tukey HSD test for pair wise comparison; p<0.05 was considered significant. Results: Conventional antiepileptic combination therapy was found more toxic; p<0.01 for lipid profile. Combination groups showed significant reduction in Hb% (p<0.05) with no significant difference among them (p>0.05). Monotherapy and conventional combination therapy caused significant reduction in platelet count (p<0.01), but conventional combination therapy was found more toxic in this regard (p<0.05). Conclusions: Monotherapy found less toxic with no significant effects on lipid profile, Hb%, RBC count and O2 carrying capacity and less impact on platelets while combination therapy did not show any advantage over monotherapy and its use must be reserved only for refractory cases.
ABSTRACT
Background: This study was carried out in various hospitals to analyze the use of rational fixed dose combinations (FDCs) in Pune. Methods: 279 prescriptions were evaluated in this study. Information about age, sex, names of the all the drugs prescribed by doctor/ physician, diagnosis for the use of prescriptions and adverse effects were noted in the audit form from the prescriptions of the patients. Rationality of fixed dose combination is evaluated according to WHO Model List of Essential Drugs, 17th updated version, 2011. Results: 56.98 % doctor’s prescriptions in this study were containing of fixed dose combinations and out of this 10.69 % prescriptions were including two or more FDCs in their prescriptions. Only 13.20% FDCs were in accordance with WHO Model List of Essential Drugs. FDCs from antiinflammatory and antirheumatic products, vitamins, minerals, antianaemic preparations, drugs for acid related disorders, antibacterials for systemic use and cough and cold preparations were used more by private non teaching hospitals as compared to SKNMC & GH teaching hospital. 64.61 % prescriptions of private hospitals and 34.08 % prescriptions of teaching hospital were containing more than one drug. Conclusions: This study has shown that about every alternate prescription contains FDC. More than 80 % of prescribed FDCs are not in accordance with Essential Drugs List. Vitamins, minerals, antianaemic preparation FDCs should be prescribed judiciously as they are not free from ADRs. More number of drugs (poly-pharmacy) and FDCs were prescribed by non teaching private hospitals.