A critical evaluation of promotional drug literatures available with prescribers at a tertiary care teaching hospital in Gujarat, India

Background: Promotional literature provided by the pharmaceutical companies is one of the important marketing strategies to prescribe. Many of these literatures do not follow ethical guidelines and contain biased and irrelevant information that may cause irrational prescribing. So we did this study with an aim to check the credibility, reliability and authenticity of the PDLs available with prescribers.Methods: Promotional drug literatures were analyzed based on various parameters and guidelines provided by world health organization. Statistical analysis was done using Microsoft Excel.Results: A total 395 promotional drug literatures were analyzed and very few of them fulfilled the ethical criteria for drug promotion. Most of them focused on providing information about generic name, brand name manufacture company name and claims about efficacy. Few of them focused on safety of drugs as less information provided about adverse reaction, precaution and drug-drug interaction. Many of them contain space occupying unnecessary pictures.Conclusions: It can be concluded that the majority of the promotional advertisements that were given to the prescribers do not follow ethical guidelines and were not able to improve rational prescribing but only have commercial benefits

A cross sectional study of various types of acute poisoning; pharmacological management and their outcome in a tertiary care hospital

Background: Acute poisoning is a common and life-threatening crisis, leading to serious complications and death of patients. Poisoning may be due to self-consumption, accidental exposure of chemical compounds, medications and poisonous animal bites/stings. Aim of current study was to investigate the pattern of drug utilization, poisoning agents and outcome in patients with acute poisoning treated at a tertiary care teaching hospital, Vadodara, Gujarat. Methods: This prospective cross-sectional study was done on patients of acute poisoning admitted in emergency department, SSG Hospital during August 2021-March 2022. Results: 400 patients were enrolled during the study, from which 262 (65.50%) were male and 138 (34.50%) were female. Mean age of patients was 30.30 ± 13.79 years. The commonest mode of poisoning observed was Suicidal (66.25%). The most common cause of poisoning was due to Pesticides (33.25%), followed by venomous animal exposures (30.75%). Death was recorded in 53 (13.25%) patients with highest number seen in suicidal poisoning (14.34%) compared to accidental poisonings (11.19%). Mainly, multivitamins (19.03%), Antimicrobials (16.65%), Proton Pump Inhibitors (15.85%) and Antiemetics (11.10%) were prescribed. Antidotes used were Atropine (4.81%), Pralidoxime (4.46%) and Anti-snake venom (2.80%). Median number of drugs per patient was 8; range: 2-25. Conclusions: Pattern and magnitude of poisoning are multidimensional and demand multi-sectoral approach for facing this problem. Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. There is a need for stringent pesticide regulation laws, counselling and training programs to reduce incidence of poisonings and deaths due to it

A drug utilization study of analgesics for management of postoperative pain in patients admitted at a tertiary care teaching hospital

Background: Postoperative pain is very common and develops naturally as a warning. After surgery, its development can be predicted and should be prevented and treated. Besides the disagreeable aspects and physiological repercussions of postoperative pain, it delays ambulation and hospital discharge. Despite the drugs and anesthetic techniques available, the prevalence of postoperative pain is still high.Methods: Pain assessment was done by BP cuff inflation method and Numerical rating scales both pre and postoperatively.Results: Complain of postoperative pain is more in female patient. Over all complain of postoperative pain was observed more in 31-45 year age group. Complain of postoperative pain was more at 18 hour time interval. Postoperative pain complains was more in patients undergoing general surgery. Postoperatively out of 310 patients 298 patients were received diclofenac only and 18 patients were received diclofenac + tramadol combination of these 112 and 13 patients complained of post-operative pain respectively.Conclusions: 112 patients from diclofenac only received group and 13 patients from diclofenac + tramadol received group complain of post operative pain. Post-operative pain control at 12 hours is sufficient but high post-operative pain scores at 18 hour of post-operative time interval suggesting needs of additional pain control. Majority of study patients received single analgesic (Diclofenac sodium)

ORAL ANTIDIABETICS AGENTS AVAILABLE IN INDIAN PHARMACEUTICAL MARKET: A PRICE VARIATION ANALYSIS

Objective: There are hundreds of brands in Indian markets for a single drug which is manufactured by various companies and thus leads to wide variation in prices for the same drug. Hence, we decide to evaluate the variation in price of different brands of the same drug available in Indian market. Methods: An analysis was done for comparing price variations among various drugs prescribed in diabetes mellitus. Indian Drug Review (IDR) (2019 Volume XXV Issue 4) and Current Index of Medical Specialties (CIMS) (July 2019–October 2019) were referred to know the maximum and minimum price in INR of drugs in all available strength and dosage forms being manufactured by different companies in India and percentage price variation was calculated. Results: Wide variation in the price of several brands of oral antidiabetics is found in Indian market. In single drug, highest price variation is found for glimepiride 1 mg tablet (1365.5%). In fixed-dose combinations (FDCs), highest price variation is found for glimepiride + metformin (2 mg + 500 mg) sustain release tablet (689.2%). Lowest price variation for FDCs was found for glimepiride + metformin (3 mg + 500 mg) tablet (4.8%). Furthermore, only few oral antidiabetic agents were included in the drug pricing control order 2013. Wide variation is seen in prices of brand and generic medicines. Conclusion: All the stakeholders should collectively make efforts to reduce price variation among the various brands so as to make them affordable and aim to improve the health status of the community