Evaluation of Prescriptions and Use of Intravenous Pantoprazole in General Wards and Intensive Care Unit of Shahid Sadoughi Hospital in Yazd

  • Seyed-Mojtaba Sohrevardi Clinical Pharmacy Department, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Alireza Vahidi Pharmacology Department, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mohammad-Hossein Mosadegh Pharmacology Department, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Arefeh Dehghani-Tafti Department of Biostatistics and Epidemiology, School of Public Health, Yazd, Iran.
  • Anita Dadollahi Student of Pharmacy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Keywords: Pantoprazole, Gastrointestinal Hemorrhage, Endoscopy

Abstract

Background: Proton pump inhibitors (PPIs) are currently the most effective agents for acid related disorders. However, studies show that 25-75% of patients receiving intravenous Pantoprazole had no appropriate justification, indicating high rate of inappropriate prescribing in hospitals. The aim of this study is to examine the appropriate use of intravenous Pantoprazole in accordance with guidelines at Shahid Sadoughi hospital.Methods: From January to April 2015, sample of 100 prescriptions who received Intravenous (IV) Pantoprazole were collected with observational and sectional model in Intensive care unit (ICU) and general wards of “Shahid Sadoughi” Hospital of Yazd, Iran. Clinical data from patient records are obtained and these data were mapped to establish clinical criteria and appropriate use of Intravenous Pantoprazole.Results: The majority (63%) of Intravenous Pantoprazole prescriptions were deemed inappropriate in terms of either indication for use, dose or duration of therapy. 51.5% of the patients were above 55 years old. Endoscopy did not performed in most of the Non UGIB (Non upper gastrointestinal bleeding) cases. Most Intravenous Pantoprazole prescriptions were ordered by junior doctors (Intern), and again this group were significantly less likely to prescribe the drug for appropriate reasons when compared with more experienced clinicians.Conclusion: This study suggests that the majority of IV PPI prescriptions in our hospital are inappropriate. Awareness of the result of this article through medical staff could result in more judicious use of intravenous pantoprazole and dose optimization. Physicians and pharmacists can work together to create solutions to inappropriate drug use.

References

Richardson P, Hawkey CJ, Stack WA. Proton pump inhibitors: pharmacology and rationale for use in gastrointestinal disorders. Drugs. 1998; 56:307-335.

Lai PS, Wong YY, Low YC, Lau HL, Chin KF, Mahadeva S. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors. PeerJ 2014; 2:145-53.

Craig DG, Thimappa R, Anand V, Sebastian S. Inappropriate utilization of intravenous proton pump inhibitors in hospital practice-a prospective study of the extent of the problem and predictive factors. QJM 2010; 103(5):327-35.

Gilaad G, Duane B, Dawn M, Remo P, Joseph R. Inappropriate Use of Intravenous Pantoprazole: Extent of the Problem and Successful Solutions. Clin Gastroenterol Hepatol 2005;3(12):1207-14.

Nalini M. Guda NM, Noonan M, Kreiner MJ, Partington S, Vakil N. Use of intravenous proton pump inhibitors in community practice: an explanation for the shortage. Am J Gastroenterol 2004; 99(7):1233-7.

Maleki N, Bashardoust B, Azami A, Tavosi Z. Acute interstitial nephritis due to pantoprazole. J Mazand Univ Med Sci 2014; 23(Suppl 2); 7-223. [In Persian].

Hoover JG, Schumaker AL, Franklin KJ. Use of intravenous proton pump inhibitors in a teaching hospital practice. Dig Dis Sci 2009; 54(9): 1974-52.

Khalili H. Setoudenia A, Jahangiri B. Pharmacology examination and board review. Bertram G. Katzvng, Susan b. Masters, Anthony c. Terror.Trans.2nd; Tehran; Arjmand publication. 2010; 87-102.

Sohrevardi SM, Shafiei A, Mirzania SH .Intravenus humunoglobulin: A drug utilization review at shahid sadoughi hospital in Yazd. J Pharm Care 2014:2(4):170-6.###

Published
2016-05-30
How to Cite
1.
Sohrevardi S-M, Vahidi A, Mosadegh M-H, Dehghani-Tafti A, Dadollahi A. Evaluation of Prescriptions and Use of Intravenous Pantoprazole in General Wards and Intensive Care Unit of Shahid Sadoughi Hospital in Yazd. J Pharm Care. 3(1-2):7-0.
Section
Original Article(s)