Intern’s knowledge of clinical pharmacology and therapeutics at Puducherry: a cross-sectional study

Background: Internship is the intermediate period between under-graduation and general practice. The dexterity of health professional relies upon prescribing practices. Clinical pharmacology and therapeutics (CPT) is a crucial discipline for interns to acquire safe and rational prescription of drugs. Cultivating sound knowledge about CPT during under graduation is, henceforth, mandatory.Aims and objectives:To assess whether the undergraduate CPT teaching and internship training had prepared interns adequately for safe and rational prescription.To assess the awareness and reporting of adverse drug reaction (ADR).Methods: 110 interns were enrolled after obtaining informed written consent. A structured questionnaire was given to them including basic demographic information, undergraduate CPT teaching, experience of ADR and any deficiency in the under-graduate CPT teaching.Results: Response rate was 91 % in which 53 were males and 47 females. 81 considered themselves aware of CPT. 56% & 57% interns were able to prescribe drug safely and rationally respectively. Without supervision, they were confident to prescribe antacids (93%), vitamins and minerals (90%), NSAIDS (85%), antihistamines (82%), antibiotics (75%), antiemetics (62%) and antiasthmatics (52%). Only 22% had reported ADR and opined that it could lead to hospitalization (51%), prolonged hospital stay (33%), morbidity (16%) and death (21%). According to interns, the topics where more emphasis needed were ADR, dosage calculation, pediatric and emergency medicine and therapeutic drug monitoring during undergraduate CPT teaching.Conclusion: CPT teaching should be improved at undergraduate level for safe and rational prescribing including ADR monitoring, ADR reporting and dosage calculation

Chlorpromazine induced ocular myasthenia gravis

Drug induced bilateral ptosis is a very rare adverse drug reaction. Here we report a case of ten year old male child with chlorpromazine induced bilateral ptosis due to ocular myasthenia

Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators – A cross-sectional study

Aim: World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. It is critical that the rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. In this study, we aim to assess the prescription pattern and prescribing behavior of physicians using the WHO-recommended core prescribing indicators at a teaching hospital in South India. Materials and Methods: A prospective, descriptive cross-sectional study was conducted in the general medicine outpatient department of a tertiary care hospital for a period of 1 month in June 2019. A total of 600 prescriptions were sampled based on the WHO “How to investigate drug use in health facilities” document recommendation. The WHO guidelines and methods were observed to ensure data reliability. Descriptive statistical analyses such as frequencies, percentages, mean, and standard deviation were used to present the data. Results: The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 2.38 ± 1.1 and only 796 (55.4%) of the drugs were prescribed by generic name. Whereas, the percentage of encounters prescribed with an antibiotic 44 (7.3%) and an injection 63 (10.5%) was less than the ideal recommendations as per WHO and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines. Conclusion: This study on prescription pattern audit done using the WHO core prescribing indicators highlights that prescriptions encountered with antibiotic and injection use were in accordance with the WHO recommendations