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Background: Adverse Drug Reactions (ADRs) present significant challenges in healthcare, necessitating vigilant monitoring and analysis to enhance medication safety protocols. This retrospective study aimed to analyse ADRs reported at an Adverse Drug Reactions Monitoring Centre (AMC) to understand prevalence, patterns, and characteristics of ADRs.

Methods: Retrospective data from January to December 2023 were collected from the AMC at Vaishampayan Memorial Medical College, Solapur. A total of 282 ADR reports were analysed for frequency, severity, implicated medications, patient demographics, and associated clinical factors. Causality assessment was performed using the WHO-UMC scale.

Results: The majority of ADRs were associated with the oral route of drug administration (79.43%), and most were categorized as minor severity (68.44%) and probable causality (91.84%). Common ADR symptoms included vomiting (9.55%) and rash (9.22%). Antimicrobial agents were the most suspected drugs causing ADRs (17.38%). The study revealed discrepancies in ADR reporting patterns and highlighted the importance of pharmacovigilance in capturing and addressing ADR occurrences. Strategies to improve ADR reporting and enhance medication safety protocols are warranted to optimize patient care.

Conclusion: Our study provides valuable insights into the prevalence, patterns, and characteristics of ADRs, emphasizing the need for continued surveillance and reporting to promote patient safety and improve healthcare outcomes.

Background

The cosmetics business is one of the most profitable and advanced global trade sectors, and academic and industrial investments have expanded to provide high-quality products to the right consumers. Thus, this cross-sectional survey assessed Iranian pharmacists and pharmacy technicians' cosmetic product knowledge, attitudes, and behaviors.

Methods

Demographics were the first questionnaire section after eligibility and consent. Ten questions test knowledge in the second phase. The third portion has nine pharmacist cosmetic product attitudes questions. We used five-point Likert spectrum scaling. The final component of the questionnaire includes a pharmacist practice checklist. This fulfilled 12 pharmacists' obligations. PT demographics, knowledge, and attitude were measured using an eight-, five-, and eight-item questionnaire. A cosmetic sales checklist with eight practice items was devised to evaluate PTs. Pharmacists and PTs were evaluated for scientific advice on exfoliating lotion and anti-stain sunscreen use, skin type, history, and brand presentation. Using a 95% confidence interval, binary logistic regression found significant relationships between categorical dependent and independent variables. Pearson correlation measured knowledge-performance linearity.

Results

The study included 325 pharmacists and 324 PTs. The average knowledge score for pharmacists was 6.38 ± 1.95, while their practice score was 6.35 ± 1.92 out of 10. The overall knowledge score for PTs was 2.8 ± 0.92 out of 5. Results indicate a strong association between pharmacist and PT knowledge and cosmeceutical performance (r= +0.635 and +0.564, respectively, P < 0.001).

Conclusion 

This study indicates a strong correlation between knowledge and performance in community pharmacists and PTs.

Background: Rational utilization of parenteral iron with meticulous calculated doses will promote appropriate utilization of healthcare resources. The aim is to study utilization of intravenous Iron Sucrose at patient level and hospital level. Methods: This prospective-observational study was conducted over 6 months. Case-records of 125 indoor patients were reviewed for intravenous (IV) Iron Sucrose prescription and patient details and treatment details for patients were procured. Results: 125 patient records were divided in (Antenatal care and Non Antenatal care) ANC and Non ANC groups; and their Mean age was 36(S.D ± 16) years. IV Iron Sucrose was prescribed the most in anemic pregnant patients 41(32.8%) followed by severely debilitated patients on other injectable drugs 37(6%). The Total administered dose was more than the Standard calculated dose in an alarming 84(67.2%) of the patients. Utilisation of IV iron sucrose in Defined Daily Dose per 100 bed days (DDD/100 bed days) was found to be 0.42 in total patients whereas it was 0.59 in ANC and 0.36 in Non ANC groups. Conclusion: This research highlighted that overutilization and administering more than the required dose of IV iron sucrose, could be effectively tackled by calculation of its standard dose by Ganzoni’s formula. Studying the monthly trends and comparing utilization of parenteral iron with the help of DDD/100 bed days by hospitals can help in comparing utilization and also assist for budgetary preparedness of hospitals. There is also a dire need to formulate universally accepted guidelines for the use of parenteral iron in general adult population.

Background: Tocilizumab (TCZ), a monoclonal antibody against interleukin-6 (IL-6), was recommended for treatment of Covid-19 patients with a risk of cytokine storm but showed variable effect on outcome. The aim was to assess the association of outcome following tocilizumab administration with various physiological, pathological and pharmacological factor in Covid- 19 patients

Methods: Retrospective observational study from June 2020 to July 2020. All indoor Covid positive patients who received tocilizumab were included and relevant information was captured in the case record form. Data was analyzed to the study association of various physiological factors, comorbidities, severity of disease, laboratory parameters and co-administered drugs with the outcome following tocilizumab administration.

Results: Total 25 patients received tocilizumab during study period. Older age group (p=0.001), high NEWS score, hypertension (OR: 3.62; p=0.05) and hydroxychloroquine(HCQ) administration (OP=6.66; p=0.009) showed significant association with a worst outcome. Hypertension and hydroxychloroquine usage was analyzed after adjustment with NEWS score using MH adjusted analysis, which revealed a trend of worst outcome in HCQ recipients but the association was not significant with hypertension. High pre-treatment IL-6 (death 570.11+498.76; discharge110.31+ 49.68; p: 0.0011); high post-treatment ferritin level (death 1756.5+ 1622.03; discharge 711.71+ 421.23; p: 0.019) as well as post-tocilizumab rise in ferritin level was associated with worst outcome (p= 0.029).

Conclusion: Participants having higher cytokine level/or high NEWS score were unlikely to benefit from tocilizumab. Increased in ferritin level even after tocilizumab appeared to be an indicator of failure of treatment.

Background: Migraine is the second most common cause of headache, various methods have been mentioned for the treatment of migraine, including herbal medicine. Iaraj Fiqra is a combination of Aloe, saffron, cinnamon, mustalci, balsam incense and asaroon and claim to be effective in migraine. The present study aims to compare the effect of Iaraj Fiqra and placebo tablets on migraine headache.

Methods: In this randomized, controlled trial, patients with migraine (based on the International Headache Society definition) received Iaraj Fiqra (500mg/daily) or placebo tablets for two months. Headache characteristics were measured using the Migraine Disability Assessment (MIDAS) and Headache Impact Test-6 (HIT-6).

Results: Iaraj Fiqra reduced significantly the frequency (P=0.007), the severity (P=0.000) and the duration (P=0.000) of attacks compared to placebo. MIDAS and HIT-6 scores were significantly reduced in the drug group other than the placebo group (P=0.014 and P=0.000 respectively). Analgesic use also reduced. No significant difference was observed between the two groups in term of side effects (P=0.23).

Conclusion: This study showed that Iaraj Fiqra had significant effects on reducing headache characteristics and analgesic use and given its limited side effects, it is recommended for the treatment of migraine.

J Pharm Care 2024; 12(1): ?.

Background: Globally, with the increasing orthopaedic admissions, the management modalities have also been evolving. With the focus mainly on reducing hospital stay and improving quality of life, pharmacotherapy is a keystone in management. Thus, the present study was undertaken to assess the drug utilization in orthopaedic inpatients.

Methods: This is a cross sectional, observational study. Data was collected from prescriptions of 200 patients admitted in the Orthopaedic ward and evaluated for WHO Drug Use Indicators and potential drug-drug interactions (pDDI) and prescription pattern was noted. Adverse Drug Reactions (ADR) were noted and assessed.

Results: A total of 2046 drugs were prescribed in 200 prescriptions. Average number of drugs per prescription is 10.23. Antimicrobials (25.76%) was the most common class of drug prescribed followed by supplements (20.28%) and analgesics (16.13%). 79.42% drugs were prescribed by generic name, 82.06% were from the NLEM and 99.9% drugs were from hospital pharmacy. Antibiotics prescribed were as per WHO AWaRe guidelines. ADR noted in 4 patients with drug being discontinued in one case. pDDI were seen in 98% prescriptions with 95.8% being Pharmacokinetic interactions.

Conclusion: Current study provides insight into the drug utilisation pattern, highlighting the extensive use of antibiotics and analgesics in orthopaedic inpatients. Adherence to WHO guidelines helps reduce antibiotic resistance and promotes better patient care.

For safe and effective therapy of respiratory disorders in children, delivering the medication at the site of disease i.e. directly into the respiratory tract via aerosolized medication is critical. But, the anatomical and physiological differences in the respiratory tract of infants/children and adults make the delivery of aerosolized medication complicated. This review article will give an overview of the delivery of inhaled medication in children and discuss the pharmacological and specific clinically relevant aspects of medication delivery using nebulizers, pressurized metered dose inhalers (MDIs), and dry powder inhalers (DPIs) in children.

Background: The incidence and prevalence of diseases are increasing, which has resulted in a huge increase in the use of medications. However, when they were no longer required/remained unused due to various reasons, they had to be disposed of. Since the drugs are chemicals, their expiration date indicates the amount of time that the product is anticipated to remain stable. Consumption of expired drug can result in efficacy loss, safety concerns, potency loss.

Methods: This cross-sectional questionnaire-based study evaluated knowledge, attitude and practice of drug disposal among healthcare professionals especially junior residents in tertiary health care centre. The data were collected through a google form and expressed in percentage.

Results: Out of 200, a total of 133 participants have completed the survey, which includes 42% males and 58% females. A total of (97.7%) participants were aware that improper disposal of unused and expired medicines affects the environment and health. However, (97%) of the respondents answered that the drug take back programmes should be included in the communities.                                                                                  

Conclusion: Majority of the study participants reported that they have unused medications at home, and throwing them in the household garbage is the most common method of getting rid of them. It is important to educate people on the correct way to dispose of unused and expired medications, and a drug take-back program in communities could be the solution to this issue.

Drugs Controller General of India (DCGI) in April 2022 approved the emergency use authorisation of Corbevax and Covaxin COVID 19 vaccines in children. Corbevax is a protein subunit COVID 19 vaccine developed by Texas Children's Hospital.  Third nerve palsy is rarely reported following protein sub- unit COVID vaccines. We report a case of a 13-year-old male who presented to a tertiary care hospital with complaints of   giddiness, headache, diplopia and drooping of left eye within one hour of receiving Corbevax vaccine in school. He was subsequently diagnosed with third nerve palsy and treated with corticosteroids and lubricant eye drops. He recovered fully and was discharged after four days. Causality assessment as per World Health Organization (WHO) guidelines for the causality assessment of Adverse Events Following Immunization (AEFI) was consistent. Protein sub unit vaccines can rarely cause third nerve palsy.