IMPACT OF EDUCATIONAL INTERVENTION ON KNOWLEDGE, ATTITUDE, AND PRACTICES OF URBAN COMMUNITY PHARMACISTS TOWARD ADVERSE DRUG REACTION REPORTING IN A SOUTH INDIAN CITY

ABSTRACTObjective: To assess the knowledge, attitude, and practices (KAP) of community pharmacists toward adverse drug reaction (ADR) reporting and alsoto evaluate the impact of the educational program on community pharmacist's knowledge and perception toward ADR reporting.Methods: A prospective cross-sectional study was carried out by administering a validated questionnaire before and after the educational programon a sample of 26 community pharmacists. The baseline score of pre-training KAP was compared with the post-training KAP. The SPSS statisticalversion 19 was used to compare the difference in the KAP of the pharmacists before and after the educational program. Frequencies and percentagewere used to measure demographic details of the participants.Results: 26 community pharmacists have participated in the study. The mean pre-training KAP score was increased from 4.30±2.02 to mean posttrainingscoreof 7.32±0.94. Afterthe educational program,92.30%(n=24)ofparticipants wereable toidentify potentialriskfactorsresponsibletocauseADRs,and 80.76% (n=21)ofparticipants wereawareof the consequenceof ADRs.Upon educational intervention73.07% (n=19)ofparticipantsdisagreewith thestatementofADR reportingin thecommunity pharmacieslead toadditional workloadandwereconfident about theirknowledgeinADR reportingand monitoring.Conclusion: The study concludes that the educational intervention has increased the KAP of the trained community pharmacists toward ADRreporting.Keywords: Community pharmacists, Adverse drug reaction reporting, Educational intervention, Knowledge, Attitude and practices.Â

DRUGS AND THERAPEUTIC INFORMATION SERVICE PROVIDED BY CLINICAL PHARMACISTS FOR AN IMPROVED PATIENT CARE: AN EXPERIENCE FROM A TERTIARY CARE TEACHING HOSPITAL

Objective: To assess the quality of drug information (DI) services provided by clinical pharmacists in a South Indian tertiary care teaching hospital.Methods: All answered DI queries by the Department of Clinical Pharmacy are documented electronically. To assess the quality of DI services, aquality assessment panel was constituted comprising the senior clinical pharmacists, and a quality assessment checklist was developed and appliedfor assessing the quality of DI services.Results: During the 12-month study period, a total of 1204 DI queries were received. The majority (48.76%) of DI queries was received during wardrounds by the clinical pharmacists and among them 61% of the queries was for better patient care. The highest numbers of queries (48%) werereceived from post-graduate medical students followed by the physicians (16%) and interns (8%). The most common DI queries were requested toknow the dosage/administration (22%), followed by cancer chemotherapy dosing (15.70%), adverse drug reactions (8%), drug use in pregnancy/lactation (7.56%), and drug-drug interactions (6.48%). The highest number of queries were from Department of Medicine (26%) followed by SurgeryDepartment (19.35%), Department of Pediatrics (15.61%) and Department of Dermatology (8.47%). The majority of the queries were answeredimmediately (64%). As per the quality assessment checklist, 64.5% queries were rated as excellent in quality followed by good (35.8%) and only 3.5%DI queries were required improvement.Conclusion: The quality of DI service was found satisfactory based on the rating.Keywords: Drug Information, Quality Assurance, Clinical Pharmacists, Medicine InformationÂ

Villagers and Illiterates are More Prone to HIV

This study aims to find out how far villagers and illiterates are aware of HIV in 104 patients both men women belonging to rural area around suryapet district. Non – co-operative and pregnant women are excluded from the study. Data collection was done in the period from December 8th to January 13th and analysed there education and occupational status and we found very interestingly more than 90% of the patients are not aware of HIV and its consequences and many of them don’t what is HIV and how can it will be prevented, many of the patients are spreading HIV to their spouse without unknowing that is sexually transmissible. Few patients don’t know that HIV will cause from undisposed needles. Interestingly whoever said they are affected due to un-disposed needles are not drug abusers they are affected due to malpractice done by RMPs who are using multiple use of single needle. And very few answered that HIV will transmitted through blood transfusion after they get affected. The people whoever effected mostly belongs to daily wage labour, farmers and truck drivers. So there is need to create awareness in villagers and illiterates to prevent further progression of disease and to prevent the transmission of disease to younger generation

DRUG INTERACTION INDUCED PHENYTOIN TOXICITY: A CASE REPORT

Phenytoin is a narrow therapeutic indexed antiepileptic drug. Many drugs competitively inhibit isoenzymes responsible for its metabolism when concurrently administered and increases the phenytoin plasma concentration leading to serious adverse effects. One such case is being reported with phenytoin toxicity due to concurrent administration of phenytoin and Isoniazid

INDUCED STEVENS-JOHNSON SYNDROME IN A HUMAN IMMUNODEFICIENCY VIRUS PATIENT: A CASE REPORT

ABSTRACTStevens-Johnson syndrome (SJS) is an acute life-threatening condition. In 95% of case reports, drugs were found to be an important cause for thedevelopment of SJS. About 100 drugs have been identified to causes of SJS. Very few reports were published on diclofenac-induced SJS. The incidencerate of SJS is approximately 1-2/1000 individuals with human immunodeficiency virus. In this case report, we present a 58-year-old female developedSJS after taking of diclofenac tablets.Keywords: Stevens-Johnson syndrome, Diclofenac, Human immunodeficiency virus patients

ASSESSMENT OF PHARMACIST MEDIATED EDUCATION ON HEALTH RELATED QUALITY OF LIFE IN TYPE 2 DIABETES MELLITUS PATIENTS IN RURAL SOUTH INDIAN POPULATION

Objective: To assess the influence of pharmacist mediated education on health-related quality of life in rural patients with type 2 diabetes mellitus. Methodology: This is a prospective, randomized interventional study approved by the institutional ethics committee. Eligible type 2 diabetic patients with written informed consent were enrolled and randomized into control and test group. Diabetic health profile-18 (DHP-18) questionnaire was administered to all patients at baseline and three subsequent follow-ups. Patients in the test group received structured education at every follow up whereas the control group patients received education only at the final follow up. SPSS software was used to evaluate the data.Results: Among the 72 patients enrolled, 35 were randomized into control group and 37 into test group. Majority of the study patients were males (65.2%) with an age range of 30 to 72 years and were from agriculture profession (34.72%) with school-level education (59.7%). The mean BMI of the study patients was 25.01. At baseline, the mean glycosylated haemoglobin (HbA1C) values of patients were 6.48±1.39% in the control group and 6.23±1.16% in the test group. During the last follow-up, a significant (p<0.05) improvement was observed in the DHP-18 scores in test group patients compared to control group patients which were supported by statistically significant (p<0.05) improvement in capillary blood glucose (CBG) values.Conclusion: Pharmacist mediated structured education has shown a positive impact on health-related quality of life in test group patients towards their disease management.Keywords: Diabetes, Therapeutic Outcome, Health-Related Quality of Life

ASSESSMENT OF PHARMACIST MEDIATED EDUCATION ON KNOWLEDGE, ATTITUDE AND PRACTICES IN TYPE 2 DIABETES MELLITUS PATIENTS IN SOUTH INDIAN RURAL POPULATION

Objective: To assess the influence of pharmacist mediated education on knowledge, attitude and practice (KAP) in rural patients with type 2 diabetes mellitus. Methodology: This is a prospective, randomized interventional study approved by the institutional ethics committee. Eligible type 2 diabetic patients with written informed consent were enrolled and randomized into control and test group. Validated and local language translated KAP questionnaire was administered to all patients at baseline and three subsequent follow-ups. Patients in the test group received structured education at every follow up whereas the control group patients received education only at the final follow up. SPSS software was used to evaluate the data.Results: Among the 72 patients enrolled, 35 were randomized into control group and 37 into test group. Majority of the study patients (65.2%) were males with an age range of 30 to 72 years and were from agricultural profession (34.72%) with school education (59.7%). The mean Body mass index (BMI) of the study patients was 25.01. At baseline, the mean glycosylated hemoglobin (HbA1C) value of patients was 6.48±1.39% in the control group and 6.23±1.16% in the test group. During the last follow-up, a significant (p<0.05) improvement was observed in KAP scores in test group patients compared to control group patients which were supported by statistically significant (p<0.05) improvement in Capillary blood glucose (CBG) values.Conclusion: Pharmacist mediated structured education has shown a positive impact on Knowledge Attitude and Practices of test group patients towards their disease management.Keywords: Diabetes, Therapeutic Outcome, Knowledge Attitude & Practice

ASSESSMENT OF PHARMACIST MEDIATED EDUCATION ON MEDICATION ADHERENCE BEHAVIOR IN TYPE 2 DIABETES MELLITUS PATIENTS IN SOUTH INDIAN RURAL POPULATION

Objective: To assess the influence of pharmacist mediated education on medication adherence behavior (MMAS-8) in rural patients with type 2 diabetes mellitus.Methods: This is a prospective, randomized interventional study approved by the institutional ethics committee. Eligible type 2 diabetic patients with written informed consent were enrolled and randomized into control and test group. The MMAS-8 questionnaire was administered to all patients at baseline and three subsequent follow-ups. Patients in the test group received structured education at every follow-up, whereas the control group patients received education only at the final follow up. SPSS software was used to evaluate the data.Results: Among the 72 patients enrolled, 35 were randomized into a control group and 37 into the test group. Majority of the study patients (65.2%) were males with an age range of 30 to 72 y and were from agriculture profession (34.72%) with school education (59.7%). The mean body mass index (BMI) of the study patients was 25.01. At baseline, the mean glycosylated hemoglobin (HbA1c) value of patients was 6.48±1.39% in the control group and 6.23±1.16% in the test group. During the last follow-up, a significant (p<0.05) improvement was observed in MMAS-8 scores in test group patients compared to control group patients which were supported by statistically significant (p<0.05) improvement in capillary blood glucose (CBG) values.Conclusion: Pharmacist mediated structured education has shown a positive impact on medication adherence behavior of test group patients towards their disease management

Formulation and Evaluation of Floating and Mucoadhesive Tablets Containing Rosiglitazone

In this present study, floating mucoadhesive tablets of Rosiglitazone were formulated to improve the gastric retention time and overall bioavailability. Different mucoadhesive polymers like HPMC K200 M, Na CMC, Carbopol 974P, Karaya gum, Chitosan and Xanthan gum were selected to formulate the tablets. Various formulations were prepared by using these polymers in different concentration. The pre-compression blend of Rosiglitazone mucoadhesive tablets were characterized with respect to angle of repose, bulk density, tapped density, carr’s index and hausner’s ratio and all the results indicated that the blend was having good flow property and hence better compression properties. The swelling studies were performed for the formulations and the results depicted that all the formulations have a good swelling index. The drug release studies depicted that the formulations release the drug in first order. So based on the results, formulation RF13 was found to be an optimized formulation. Keywords: Mucoadhesive tablets, Rosiglitazone, Bioadhesive polymers

A case report Duloxetine hydrochloride induced Paraesthesia

A 45-year-old HIV-positive female patient experienced a generalized burning sensation after the administration of one dose of duloxetine 20 mg. The patient's concurrent medications include a fixed drug combination (FDC) of Zidovudine 300 mg, Lamivudine 150 mg and Nevirapine 200 mg twice daily, which she received for five years. The patient recovered from the generalized burning sensation the next day after the withdrawal of duloxetine.  From the causal relationship assessment, we observed that neither the disease, co-morbid conditions, nor concurrent medications were responsible for the burning sensation experience in this patient. Available data from post-marketing surveillance of duloxetine suggest that to date the incidence of duloxetine-induced burning sensation of skin was reported to be 1 in 870 patients. Healthcare providers should watch for this rare but important adverse effect of duloxetine