A clinical study of morphological patterns of cutaneous adverse drug reaction and its causality assessment in tertiary care hospital of central India

Background: Adverse reactions to drugs are as old as drug. Cutaneous adverse drug reactions are the most common type of drug reaction. Most cutaneous adverse drug reactions are important as they are frequently the reason for discontinuation of drug therapy. Looking to this matter the study was undertaken.Method: It was an observational study conducted at NKP Salve Institute of Medical Science & Research Centre, Nagpur Maharashtra. A total number of 80 patients having cutaneous adverse drug reaction were evaluated. All the patients were assessed for cutaneous adverse drug reaction during the study period and the information was carefully recorded in standard Adverse drug reaction (ADR) form and Naranjo’s algorithm was used for causality assessment of adverse drug reaction.Result: The maximum study subjects were in the age group of 41-50 years (32-50%) followed by the age group of 31-40 years (25%) followed by other age groups. In study group male to female ratio was 11.5:8.5. Majority of cutaneous adverse drug reactions comprise of fixed drug eruption which is 45%. Most of the cutaneous ADR’s were caused by antibiotics (42.5%) followed by Non-steroidal anti-inflammatory drugs (NSAIDS) (20%). The study subjects were in probable causality assessment of Naranjo’s scale i.e. 82.5% followed by definite in (12.5%) and possible (5%).Conclusion: The fixed drug eruption was the most common cutaneous adverse drug reaction and most of these drugs eruptions were caused by antimicrobial agents. The study provided the base line information about the prevalence of cutaneous adverse drug reaction and their morphological distribution amongst different age group, gender and the causative drug

Polypharmacy and cost analysis in patients suffering from type 2 diabetes mellitus with associated comorbidities

Background: Diabetes mellitus is a common health problem worldwide, associated with several co-morbidities. It requires longer therapy, and is crippling in terms of cost management. The objective of this study was to evaluate co-morbidities in patients suffering from type 2 diabetes and concomitant medications used along with antidiabetic drugs, also analyzing individually cost of drug therapy.Methods: It is an observational, cross sectional study. The study was conducted at outpatient department, Medicine at a tertiary care hospital. Prescriptions of patients attending the clinic, suffering from type 2 diabetes were analyzed for antidiabetic drugs and other concomitant medications for associated co-morbidities. Their age, sex, number of medications and their costs were noted.Results: Out of 60 patients evaluated, 36 (60%) were males and 24 (40%) were females. Hypertension in 54 (90%) of the patients and hyperlipidaemia in 23 (38.33%) are the important comorbidities. Metformin was most commonly prescribed antidiabetic drug in this study in 41 (68%), followed by glimepiride 18 (30%), tenegliptin 10 (16.67%), voglibose in 6 (10%) and others. Mean cost of drug therapy to a person was INR 1408.8 per month and INR 16905.6 per annum.Conclusions: Hypertension 54 (90%) and hyperlipidaemia 23 (38.33%) were the most common associated comorbidities. Metformin and glimepiride were the most common antidiabetic drugs used. Antihypertensive and hypolipidemics were commonly prescribed concomitant medications. Mean cost of drug therapy per person was INR 1408.8 per month and INR 16905.6 per annum

Antihypertensive agents in systemic hypertension associated with Type 2 diabetes in a tertiary care hospital

Background: Hypertension and diabetes mellitus are both chronic disorders and when they occur as co-morbidities create havoc by presenting with a plethora of morbidity and mortality. Both require drug treatment over a long period of time, which calls for stringent analysis of prescribing trends of the same.Objectives: The present study was intended to analyze prescribing pattern and establish prescribing trends of anti-hypertensive drugs (AHD) in hypertensive diabetic patients.Methods: The present study was a record based, randomized, non-interventional study of 2 years duration conducted at a tertiary care hospital of central India. Prescriptions from 400 case records of hypertensive diabetics were obtained from the medical record section. Demographic details, blood pressure, and AHDs prescribed were systematically entered in pre-validated case record form. All data were thoroughly analyzed for fallacies and appropriateness.Results: Among 400 patients, 221 were males, and 179 were females. Monotherapy was used in 366 (91.5%) patients while combination therapy was used in 34 (8.5%) patients. Most commonly used combination was angiotensin converting enzyme inhibitor (ACEI)+calcium channel blocker (CCB), while in monotherapy CCB≥ACEI>beta blocker>diuretic>angiotensin II receptor blocker were most commonly prescribed.Conclusion: The present study represents trend and attitude of physicians in prescribing AHDs. On comparing with Joint National Committee 7 guidelines, the majority of the cases deviated from the guidelines, mostly in a choice of AHDs and Fixed dose combination

Study of prescription patterns of antihypertensive agents in preeclampsia patients: Central India study

Background: The main objective of this study was to evaluate prescription patterns of antihypertensives in preeclampsia patients at a tertiary care hospital in Central India.Methods: The study belongs to retrospective observational type. he study was conducted by department of Pharmacology in association of department of Obstetrics & Gynaecology department at Nkp Salve Institute of Medical Sciences & Research Centre, Lata Mangeshkar Hospital, Nagpur. Permission from Institute Ethics Committee was taken for studying the prescribing patterns of drugs. The study was conducted for a period of 6 months. Inclusion and Exclusion criteria were added.Results: The maximum number patients seen in age groups 36-41 (28.6%). The main drug prescribed in our study was Labetalol followed by methyldopa. In our study most of the patients were of moderate and mild type corresponding to 48% and 32% respectively and only 20% of patients belong to severe cases. In our study highest number of patients was seen in second gravida i.e. 33.33%.Conclusions: Labetalol was the most common anti hypertensive prescribed in pre eclampsia patients. Rationale prescribing of drugs were done