Adverse drug reactions among inpatients in a north Indian referral hospital.

BACKGROUND: Monitoring spontaneous adverse drug reactions is one of the epidemiological methods for assessing the safety of drugs in a hospital setting. METHODS: Data on adverse drug reactions (ADRs) were collected over a 3-year period among inpatients in a north Indian referral hospital using the spontaneous ADR monitoring system. RESULTS: A total of 317 ADRs were reported. Cutaneous reactions (38.8%) and gastrointestinal disturbances (28.4%) made up a large proportion of reported ADRs. Antimicrobial agents, including those used for antituberculosis therapy, were responsible for 47.3% of the events. Radiocontrast dyes, and antineoplastic and psychoactive agents were the other important drugs causing ADRs. No age- or sex-related differences were found in the overall rate of ADRs, though toxic epidermal necrolysis was more frequent in the elderly. CONCLUSION: The pattern of ADRs and drugs involved were largely similar to those reported in the western literature.

Adverse drug reactions to fluoroquinolones at a tertiary care hospital in northern India.

Use of fluoroquinolones has increased considerably in the last 5-6 years in our hospitals. With a view to ascertain their safety and the type of adverse drug reactions (ADRs) in our population, spontaneous reports were collected and analysed to ciprofloxacin (the most prescribed fluoroquinolone in our hospital) over a period of three and a half years. The pattern of reactions were rash in 18, severe reactions like Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in 4, gastritis and diarrhoea in 3, shivering and rigors in 2, hemorrhagic purpuric spots in 2 and oedema of eye and lids with topical application in 1 patient. Most cases recovered on stoppage of the drug and symptomatic treatment. However, one case of SJS and one of TEN proved fatal. Care needs to be exercised in their use and they do not appear to be innocuous to severe and disturbing ADRs.

Indirect excitatory actions of histamine on isolated chicken oesophagus.

The histamine-induced contraction on chicken oesophagus was antagonised non-competitively by atropine, hexamethonium, cocaine, methysergide, indomethacin, theophylline and verapamil. Physostigmine slightly potentiated the excitatory action of histamine. These results indicate that histamine excreted its excitatory action by involving a number of mechanisms as suggested in guinea pig oesophagus.

Patients' attitude towards health care at a teaching hospital in India.

Using a questionnaire, 362 patients attending the outpatients services of Internal Medicine of Nehru Hospital attached to our institution were randomly interviewed. Seventy per cent of the patients were in the 21-50 years age range; 50% came from rural and 50% from urban areas. Forty per cent travelled more than 30 Km; 72% used a public transport to reach hospital. Most patients had an income less than Rs. 1000/-. Ninety per cent had already consulted another medical practitioner earlier. The largest number of complaints related to the gastrointestinal, cardiovascular and respiratory systems. On an average 1-2 drugs were prescribed per patient; only 13% of these were available at the hospital dispensary. Most patients were willing to purchase the prescribed drugs from the market.

Distribution of 5-hydroxytryptamine and histamine in tissues of WLH chicken.

5-Hydroxytryptamine and histamine were estimated in lungs, liver, spleen and adrenals of chicken. A substantial amount of both the amines was found in all the organs. The highest level of both the amines was found in adrenals followed by spleen, lungs and liver. The level of 5-hydroxytryptamine was, however, higher than histamine in all the tissues except adrenals.