Analysis of drug promotional literatures in a tertiary care hospital: a cross sectional study

Background: Large numbers of new drugs are introduced into the market every day and pharmaceutical companies are in the business of development and selling of new drug. There are different modes of drug promotion which include visual aids, leave behind leaflets and audio visuals. Drug Promotional Literatures (DPL’s) claim to provide vital and accurate information regarding the drug. To ensure rational use of drugs a set of standards laid by the WHO for ethical drug promotion.Methods: A cross sectional observational study was performed in Department of Pharmacology at a tertiary care teaching hospital of Navi Mumbai. A total of 100 drug promotional literatures were randomly collected from different outpatient departments and were evaluated by using WHO guidelines.Results: None of drug promotional literature fulfilled all WHO criteria. Generic name, Brand name, active ingredients were mentioned in all. The problem causing ingredient was not mentioned in any of the cases. Safety information was not complete, adverse drug reactions were mentioned in only 45% of the cases, contraindications and drug interactions were mentioned in 39% of the cases. Manufacturer details including name and address of manufacturer was mentioned in 67% of the DPL’s. References were mentioned in 80% of the literature out of which 84% were from journal articles.Conclusions: None of the DPL’s satisfied all the WHO criteria. Incomplete information may lead to irrational prescription of drugs. Therefore, more strict regulations need to be implemented and physicians must critically evaluate DPL’s before considering the same for prescribing.

Study of antibiotic prescription pattern in PICU of a tertiary care hospital

Background: Infectious disease is one of the importance causes of mortality and morbidity in India, therefore pattern of use of antibiotics requires separate study as they differ from adult, Therefore the aim of our study is to observe the antibiotic prescription in the tertiary care hospital.Methods: A prospective observational study was carried out in the children admitted in PICU. The study was started after obtaining the approval from Institutional Ethics Committee. Written informed consent was obtained from a parent or legal guardian of participants.Results: There were 50 patients were enrolled. The maximum antibiotics were prescribed from cephalosporin class (42; 40.38%) which included ceftriaxone, cefixime, cefotaxim, cefpodoxime. The majority of cephalosporins were prescribed in miscellaneous cases followed by respiratory tract infections, gastrointestinal tract, Central nervous tract infections and nil in CVS cases, secondly higher number of antibiotics prescribed was metronidazole and from Aminopenicillin class which includes amoxiclav and ampicillin and another beta lactamase which includes ureidopenicilin and carbepenem. The majority of aminopenicillin were prescribed in miscellaneous group infections followed by respiratory tract infections.Conclusions: From this study, it can conclude that commonly antibiotic were from 3rd generation cephalosporins followed by metronidazole and other ? lactamase inhibitor and all of the antibiotics were prescribed as per the national guidelines.

Drug utilization study in ophthalmology in OPD patients at a tertiary care teaching hospital

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs.

Study of drug utilization and antimicrobial prescription pattern of indoor paediatrics cases in tertiary care hospital

Background: Infectious disease represent a major cause of mortality and morbidity in India. Pattern of use of antibiotics need to be studied separately as they vary from adult, however there is limited data is available, Therefore the aim of our study is to observe the drug utilization and antimicrobial prescription pattern and drug utilization in department of pediatrics at our tertiary care hospital.Methods: This was a prospective observational study carried out among indoor patients admitted to paediatric ward after obtaining approval by Institutional Ethics Committee. Written informed consent obtained from a parent or legal guardian of participants.Results: 100 patients were enrolled. The maximum number of antibiotics were prescribed from cephalosporin class (75; 43.6%) out of which ceftriaxone (42;56%), Cefixime (20;26.6%), cefotaxim (11;14.6%), cefpodoxime (3;4%), cefazolin (1;1.33%). The majority of cephalosporins were prescribed in Gastrointestinal tract infections (60.66%) followed by respiratory (27.2%) and least in cvs (2.66%), secondly higher group of antimicrobial prescribed was from Aminopenicillin class accounting of (36; 21.9%) which includes amoxiclav (35;97.2%), ampicillin (1;2.7%) and other beta lactamase (3;1.7%) consisting meropenem (2;66.7%), piperacillin with tazobatcam (1;33.3%). The majority of aminopenicillin were prescribed in respiratory tracts infections and very less in other systems. Miscellaneous drugs used in respiratory conditions were bronchodilator, systemic steroid and nasal decongestant; in CNS disorders antiepileptic and diuretics; in cardiovascular disease NSAID, inotropic, antihypertensive, diuretics; in genitourinary tract infections alkalizing agent and steroid and in GIT disorders minerals, rehydration fluids, antispasmodic probiotic were used.Conclusions: We conclude that commonly prescribed drugs were from 3rd generation cephalosporins followed from extended spectrum penicillin with ? lactmase inhibitor. Majority of the antimicrobials are used empirically.

Rabeprazole plus domperidone: the answer for gastro-oesophageal reflux disease.

To study and document the efficacy and tolerability of rabeprazole and domperidone in the treatment of patients suffering from gastro-oesophageal reflux disease (GERD), an open, prospective, non-comparative study was carried out among 50 adult patients of either sex attending gastroenterology OPD of a leading, tertiary-care teaching hospital in Mumbai with the clinical diagnosis of GERD. One capsule of rabeprazole and domperidone was swallowed in empty stomach each day for up to 4 weeks by the patients. Rabeprazole and domperidone provided significant and remarkable improvement in symptoms of GERD. Although, the improvement was observed at first follow-up visit (within 2 weeks), continuing treatment for 4 weeks provided additional gains. Almost all patients tolerated the drug well. Most patients (94%) had excellent or good relief as assessed by their physician whilst 86% of patients rated treatment with rabeprazole and domperidone as good or excellent. Rabeprazole and domperidone not only provided desired relief of symptoms of GERD but also is very well tolerated. This combination may also improve the quality of life of patients suffering from GERD.

Efficacy and safety of losartan-amplodipine combination--an Indian postmarketing surveillance experience.

The present study was conducted among 719 patients enrolled by 109 doctors to evaluate the efficacy and tolerability of the combination of losartan potassium and amlodipine besylate in Indian patients with mild to moderate hypertension. Out of them 11 patients were dropped out. Of these 708 patients 643 patients received once daily dosage of the combination whereas 10 patients received 1/2 daily, 13 patients received 1 1/2 daily and 42 patients received 1 twice daily dosage of the combination. The mean SBP in the study was 172.89 +/- 19.18 mm Hg baseline. After the 10-day treatment, the mean SBP had significant reduction ie, 13.1% from basal and at the end of day 20 of the treatment, the reduction was 19.13% from the baseline which was significant. Similarly mean DBP was 105.42 +/- 10.85 mm Hg at baseline. After treatment, the mean DBP had significant reduction. After 10- day treatment, there was 12.7% reduction from the baseline and at the end of the treatment ie, after day 20, the reduction was 17.70% from basal, which was significant. Global evaluation of efficacy was done by the physicians; 93.8% of the cases had excellent to good response and 4.9% patients had fair response. Details of any adverse event reported or noted during the treatment with the combination were recorded in the appropriate section of the case record form, whether considered treatment related or not, as reported by the patients. The severity of an adverse event was graded on a 3-point scale as mild, moderate and severe. The most common side-effects reported were oedema of feet (5.08%), ankle oedema (1.98%). Remaining adverse events included some cardiovascular events such as palpitations, gastro-intestinal events such as constipation, miscellaneous events, muscular pain, weakness, generalised swelling, etc. CNS events included giddiness, headache, insomnia, etc.