Cardiovascular medications use among the critically ill patients of a tertiary care hospital: a drug utilization study

ABSTRACT

In the medical intensive care unit it is often necessary to utilize extensive pharmacologic interventions and multiple intravenous medications in order to stabilize a critically ill patient. In patients diagnosed with heart disease in the intensive care unit, pharmacotherapy is the primary line of management. We evaluated the utilization pattern of cardiovascular drugs among the inpatients in the intensive care unit. The study was carried out in medical intensive care unit of a tertiary care hospital in South India. The medical records of all inpatients of the ICU were reviewed over a period of twelve months. The demographic data, clinical data, and drug details were recorded. WHO Anatomic Therapeutic Chemical classification system was used to classify drugs. Descriptive statistical analysis was carried out, and values are expressed as percentage, mean +/- SD and range. A total of 1173 cardiovascular drugs prescribed among the 728 patients were included in the study. 337 [29%] drugs were anti-hypertensives and 836 constituted the other cardiovascular drugs. Noradrenaline [CO1CA03] 220 [30%], dopamine [C01CA04] 165 [22.5%], and atorvastatin [C10AA05] 109 [15%] were commonly utilized drugs. Polytherapy among ionotropes was noticed in 145 [20%] prescriptions. Among 337 anti-hypertensive drugs prescribed, calcium channel blockers 117 [34.7%], beta-blockers 90 [20.4%] and angiotensin converting enzyme inhibitors [ACEIs] 73 [16.6%] represented the major classes. Amlodipine [C08CA01] was the single most commonly prescribed anti-hypertensive drug 110 [32.6%]. Anti-hypertensive polytherapy was noticed in 295 [40.5%] prescriptions. A wide spectrum of cardiovascular drugs was utilized from various drug classes. Polytherapy of various drug classes was noticed. Overall, the scope for improving rational use of drugs exists