Utilization profile of gastrointestinal medications among the critically ill patients in a tertiary care hospital

ABSTRACT

Pharmacotherapy in critically ill is complicated by altered physiology, presence of multi organ system failure and utilization of multiple medications. The present study assessed the utilization pattern of gastrointestinal drugs among the inpatients of the intensive care unit. The study was carried out in medical intensive care unit [ICU] 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, values are expressed as percentage, mean +/- SD and range. Of the 728 inpatients of the ICU, a total of 695 patients received gastrointestinal drugs. Male to female ratio was 19. The mean and standard deviation [SD] for age was 49.21 +/- 15.84 years with a range of 18-90 years. The mean length of stay in the medical ICU was 7.4 +/- 4.3 days. Drugs for gastrointestinal system and drug metabolism [ATC-A] [23.3%] were most commonly utilized drug class of all the drugs prescribed in the ICU. Among the anti-peptic ulcer agents, pantoprazole [A02BC02] 607 [87%] followed by ranitidine [A02BA02] 68 [9.7%] were the frequently prescribed drugs. Metoclopramide [A03FA01] 136 [19.5%] and ondansetron [A04AA01] 105 [15%] were the frequently utilized anti-emetic agents. Lactulose [A06AD11] 82 [11.7%] was the most common laxative given while Glycopyrrolate [A03BA01] 44 [6.3%] was the most frequent anti-secretory agent prescribed. Gastrointestinal drugs were the widely prescribed drug class among the critically ill prescribed both as prophylactic as well as therapeutic indications