Pattern self-medication use of analgesics in Pune, Maharashtra, India.

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.

Off-label drug use in a pediatric intensive care unit.

Objective. To determine the extent and nature of off-label drug use in children admitted to a Pediatric Intensive Care Unit (PICU) Methods. This prospective exploratory study was conducted in a tertiary care hospital in a metropolitan city in India after obtaining clearance from the institutional ethics committee. Subjects admitted in PICU from February-August 2006 were enrolled in the study. In addition to the demographic data and diagnosis, details of drugs prescribed (name, dose and route and frequency of administration) were obtained from hospital records. British National Formulary 2005 was used to determine if the prescriptions were off-label and if so, they were categorized as off-label for age, indication, dosage or frequency and route of administration. Descriptive statistics was used to determine the proportion of off-label drug use. Fischer’s exact test was used to determine if there was significant difference (P<0.05) in off-label use between patients with multiple system affection and those with single system affection and between those requiring artificial ventilatory support and those not requiring it. Results. Three hundred subjects received 2237 analyzable prescriptions. Of these 1579 (70.58%) prescriptions were offlabel in nature. Off-label drug use was prevalent in all age-groups and in all systemic afflictions. The proportion of off-label drug use was not influenced by severity of illness, as judged by involvement of multiple systems or need for ventilatory support. The list of off-label drugs used included old as well as new molecules. Most commonly used drugs in PICU were also the most common off-label drugs. Conclusion. Off-label drug use is highly prevalent in PICU settings.

Off-label drug use in children.

OBJECTIVE: To determine the extent and nature of off-label drug use in children admitted to a pediatric general ward in a tertiary health care centre METHODS: Consecutive patients aged 1 mo-12 years admitted to the general wards in a tertiary care center in Mumbai over a two-month period were prospectively enrolled in the study. British National Formulary [BNF] version 2005 was used to ascertain if the drug use was "off-label". The off-label use was categorized as: administration of a greater/lesser dose, administration at a higher/lower frequency than indicated, administration for indications not described, administration of a drug not licensed for use in that age group and/ or use of alternative routes of administration. Descriptive statistics was used for calculating the off-label drug use. RESULTS: Two thousand prescriptions received by 600 subjects (M:F= 1.47:1) were analyzed. One thousand and forty-five (50.62%) prescriptions were off-label. The off-label drug use rate was 1.74+/-1.56 per patient. The maximum rate of off-label drugs was in infants (2.33/patient). 'alteration in dosage' was by far the commonest reason for off-label use; followed by 'age' and 'indication'. Furosemide (i. v.), diazepam (i.v), cefotaxime (i.v), ethambutol (tab) and prednisolone (tab) were the five commonest off-label drugs used in the study population. CONCLUSIONS: Off-label drug use was highly prevalent in general pediatric ward of a tertiary care hospital in India.