International Journal of Basic & Clinical Pharmacology, 2018
Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, e... more Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed...
International Journal of Basic & Clinical Pharmacology, 2020
Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescrip... more Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistic...
Background: Prescription audit is one of the methods to assess drug utilization and rationality o... more Background: Prescription audit is one of the methods to assess drug utilization and rationality of prescribing. Irrational prescribing is a worldwide problem. It is due to the faulty prescribing habits, lack of training amongst health care personnel, pressure from the pharmaceutical companies, and a lot of other reasons. Methods: The study was conducted by noting the details of patients admitted during 3 months from April to June 2015 in the Guru Gobind Singh Government Hospital, Jamnagar. Prescriptions were collected from the inpatients of medicine, surgery, obstetrics & gynecology, pediatrics, orthopedic randomly and analyzed according to the WHO core prescribing indicators. Results: Three hundred six prescriptions were analysed in which 1986 drugs were prescribed. Mean number of drugs per prescription was 6.49%. In our study, 63.34% drugs were prescribed by generic names and drugs on NLEM were 73.01%. Dosage forms used were mostly oral (69.54%). Infectious and parasitic diseases were the most common illnesses (16.01%) followed by diseases of respiratory system. The most common drug groups prescribed were GIT, antimicrobials, antihistaminics, multivitamins and minerals. The incidence of poly-pharmacy was also common with maximum number of prescriptions (26.8%) having 5 drugs per prescription. Conclusion: Prescription audit is an important measure to improve the quality of care afforded by the hospitals. Data generated on morbidity pattern coupled with current practices of treatment of these diseases provides an objective basis for preparing an NLEM. By this data we conclude that poly-pharmacy is quite common. Most of drugs were prescribed according to the NLEM 2011.
Journal of pharmacology & pharmacotherapeutics, 2012
Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as... more Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as the use of drug or device after unprotected or underprotected intercourse to prevent an unwanted pregnancy. 1.5 mg of levonorgestrel as a single dose or in two doses with 12 h apart taken within 72 h of unprotected intercourse is the current gold standard emergency contraception regimen. This method is only effective if used as soon as possible after sexual intercourse and before ovulation. A single dose of 30 mg ulipristal acetate, a novel selective progesterone receptor modulator, has recently been proposed for the emergency contraception use up to 120 h of unprotected intercourse with similar side effect profiles as levonorgestrel. Ulipristal acetate could possibly prevent pregnancy when administered in the advanced follicular phase, even if luteinizing hormone levels have already begun to rise, a time when levonorgestrel is no longer effective in inhibiting ovulation.
Journal of Clinical & Experimental Research, 2013
Hypertension frequently resists control with monotherapy, requiring two or more antihypertensive ... more Hypertension frequently resists control with monotherapy, requiring two or more antihypertensive agents in combination. Many antihypertensive fixed-dose combinations (FDCs) combine drugs with different, but complementary, mechanisms of action to improve overall efficacy and tolerability. Antihypertensive FDCs may provide significant advantages over high-dose monotherapy, such as improved efficacy in blood pressure control, reduced adverse events, improved patient compliance and lower treatment costs. Optimal blockade of the reninangiotensin-aldosterone system is a key goal of pharmacotherapy in cardiovascular as well as in renal disease. As the conversion of angiotensinogen into angiotensin I is the rate-limiting step in the synthesis of angiotensin II, it has been suggested that renin inhibitors like aliskiren may have comparable or superior clinical efficacy to angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Evidences supports that amlodipine, a calcium channel blocker is safe and effective antihypertensive agent. Various clinical trials have demonstrated the efficacy and tolerability of amlodipine in combination with ACE inhibitors and ARBs. By reviewing the clinical trials of combination of aliskiren and amlodipine in hypertensive patients, it has been found that this US FDA approved combination is effective in reducing blood pressure and having better safety profile.
Objective: The objective of this study was to determine antimicrobial drug use in newborns at a t... more Objective: The objective of this study was to determine antimicrobial drug use in newborns at a tertiary care neonatal intensive care unit, to identify educational/research priorities in neonatal drug therapy. Materials and Methods: This prospective observational study included 713 patients of neonatal sepsis over a period of 18 months. Data like name, age, sex, birth weight, gestational age, antibiotics used were recorded in the previously prepared case record form. Results: Number of patients admitted in early neonatal period was 467(65.5%) and number of patients admitted in late neonatal period was 246(34.5%). The mean age of all patients being admitted in NICU was 6.23 ± 5.86 days. The majority of neonates (92.56%) were prescribed 2 to 5 antibiotics and 29.59% of neonates were prescribed 2 antibiotics. Average number of antibiotics of all patients being admitted was 3.74 ± 1.38. Most frequently used antibiotics in decreasing frequency were: Amikacin (97.19%), ampicillin + sulbactam (60.17%), vancomycin (57.64%), ceftazidime (38.71%), cefotaxime (34.22%), ciprofloxacin (26.23%), piperacillin + tazobactam (19.07%). 73% drugs were given by generic name and 53.33% drugs were prescribed from the essential drug list. Mean length of stay in NICU of all patients being admitted was 7.59 ± 5.66 days. Conclusion: The present study provides valuable insight about the overall pattern of antimicrobial drug use profile in patients of neonatal sepsis of a tertiary care hospital. It is intended to be a step in broader evaluation of safety and efficacy of drug prescription in neonatal sepsis patients.
Background: Hypertension is one of the leading causes of cardiovascular disease. Though many clin... more Background: Hypertension is one of the leading causes of cardiovascular disease. Though many clinical guidelines published recently for the treatment of hypertension, there is substantial variation in the treatment of hypertension in different countries. Aims and objectives: To evaluate the drug utilization pattern among hypertensive patients and their adverse effects attending medicine OPD in a tertiary care teaching hospital. Materials and Methods: A prospective, observational study was conducted by Department of Pharmacology in a tertiary care teaching hospital over a period of six months. The diagnosis and line of treatment to be given was decided by the physician in charge of the Department of Medicine. All the information of ADR was recorded in CDSCO Suspected ADR reporting form. Results: Out of 600 patients, 43.83% were male and 56.17% were female. Maximum patients belonged to age group of 51-60 years (33.5%). Diabetes mellitus (40.33%) was the most common associated disease with hypertension. About half of the patients had received two antihypertensive drugs (49.50%), followed by one (33.16%) and three (15.5%) antihypertensive drugs. Enalapril was the most commonly prescribed antihypertensive drug (79.66%). 95 patients (15.83%) from the total of 600 patients developed ADR. Most common ADR was cough (18.94%) followed by headache (12.63%) and vomiting (10.52%). Enalapril was responsible for about half of the ADR (50.52%) followed by amlodipine (25.26%) and furosemide (25.26%). Conclusion: Rational utilization pattern of antihypertensive drugs was observed. However diuretics and calcium channel blockers prescribed less commonly. Most of the ADRs were probable (55.79%) and mild (30.53%).
The rapidly expanding field of psychopharmacology is challenging the traditional concepts of psyc... more The rapidly expanding field of psychopharmacology is challenging the traditional concepts of psychiatric treatment and research, and is constantly seeking new and improved drugs to treat psychiatric disorders. In this way, psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and more efficacious. [1] Although psychotropic medications have had a remarkable impact on psychiatric practice that legitimately can be called revolutionary, their utilization and consequences on real life effectiveness and safety in actual clinical practice need continuous study. [2] Drug utilization study has been defined by the World Health Organization (WHO) as "The marketing, distribution, prescription and uses of drugs in a society with special emphasis on the resulting medical and social and economical consequences." [3] The principle aim of the drug utilization research is to facilitate the rational use of the drugs. Without the knowledge of how the drugs are being prescribed, it is difficult to suggest the measures to improve prescribing habits. [4] Present study was undertaken to analyze the pattern of drug utilization of psychotropic medications in outdoor Original Article Background: Psychotropic drugs have had a remarkable impact in psychiatric practice. However, their utilization in actual clinical practice, effectiveness and safety in real life situation need continuous study. Materials and Methods: A prospective cross sectional study was carried out for 6 months. Patients of all ages and both sexes were included in the study while inpatients, referred patients and patients of epilepsy were excluded. Using World Health Organization basic drug indicators, the prescribing pattern was analyzed. Results: The numbers of psychotropic drugs prescribed per patient were 2.96. Anti-anxiety drugs (82.83%) were most frequently prescribed psychotropic drugs in various psychiatric disorders. Usage of antipsychotic drugs was in 70.15% cases. Atypical antipsychotic drugs (43.83%) were prescribed more frequently than the typical antipsychotic drugs (26.32%). Prescribing frequency of selective serotonin reuptake inhibitors (36.66%) was more than the tricyclic antidepressant (21.96%) and atypical antidepressant drugs (1.83%) in major depression. Use of mood stabilizers was restricted only to bipolar mood disorders. Central anticholinergic drug was co-prescribed in as many as 88.15% patients receiving antipsychotic drugs. Conclusion: Anti-anxiety drug (Benzodiazepine (BZD)) usage was extensive in various psychiatry disorders. Rational use of BZD requires consideration/attention to dose and duration of usage as well as drug interactions with other psychotropic drugs. Routine use of central anticholinergic drug along with atypical antipsychotic drugs also, could not be justified.
International Journal of Basic & Clinical Pharmacology, 2018
Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, e... more Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed...
International Journal of Basic & Clinical Pharmacology, 2020
Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescrip... more Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistic...
Background: Prescription audit is one of the methods to assess drug utilization and rationality o... more Background: Prescription audit is one of the methods to assess drug utilization and rationality of prescribing. Irrational prescribing is a worldwide problem. It is due to the faulty prescribing habits, lack of training amongst health care personnel, pressure from the pharmaceutical companies, and a lot of other reasons. Methods: The study was conducted by noting the details of patients admitted during 3 months from April to June 2015 in the Guru Gobind Singh Government Hospital, Jamnagar. Prescriptions were collected from the inpatients of medicine, surgery, obstetrics & gynecology, pediatrics, orthopedic randomly and analyzed according to the WHO core prescribing indicators. Results: Three hundred six prescriptions were analysed in which 1986 drugs were prescribed. Mean number of drugs per prescription was 6.49%. In our study, 63.34% drugs were prescribed by generic names and drugs on NLEM were 73.01%. Dosage forms used were mostly oral (69.54%). Infectious and parasitic diseases were the most common illnesses (16.01%) followed by diseases of respiratory system. The most common drug groups prescribed were GIT, antimicrobials, antihistaminics, multivitamins and minerals. The incidence of poly-pharmacy was also common with maximum number of prescriptions (26.8%) having 5 drugs per prescription. Conclusion: Prescription audit is an important measure to improve the quality of care afforded by the hospitals. Data generated on morbidity pattern coupled with current practices of treatment of these diseases provides an objective basis for preparing an NLEM. By this data we conclude that poly-pharmacy is quite common. Most of drugs were prescribed according to the NLEM 2011.
Journal of pharmacology & pharmacotherapeutics, 2012
Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as... more Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as the use of drug or device after unprotected or underprotected intercourse to prevent an unwanted pregnancy. 1.5 mg of levonorgestrel as a single dose or in two doses with 12 h apart taken within 72 h of unprotected intercourse is the current gold standard emergency contraception regimen. This method is only effective if used as soon as possible after sexual intercourse and before ovulation. A single dose of 30 mg ulipristal acetate, a novel selective progesterone receptor modulator, has recently been proposed for the emergency contraception use up to 120 h of unprotected intercourse with similar side effect profiles as levonorgestrel. Ulipristal acetate could possibly prevent pregnancy when administered in the advanced follicular phase, even if luteinizing hormone levels have already begun to rise, a time when levonorgestrel is no longer effective in inhibiting ovulation.
Journal of Clinical & Experimental Research, 2013
Hypertension frequently resists control with monotherapy, requiring two or more antihypertensive ... more Hypertension frequently resists control with monotherapy, requiring two or more antihypertensive agents in combination. Many antihypertensive fixed-dose combinations (FDCs) combine drugs with different, but complementary, mechanisms of action to improve overall efficacy and tolerability. Antihypertensive FDCs may provide significant advantages over high-dose monotherapy, such as improved efficacy in blood pressure control, reduced adverse events, improved patient compliance and lower treatment costs. Optimal blockade of the reninangiotensin-aldosterone system is a key goal of pharmacotherapy in cardiovascular as well as in renal disease. As the conversion of angiotensinogen into angiotensin I is the rate-limiting step in the synthesis of angiotensin II, it has been suggested that renin inhibitors like aliskiren may have comparable or superior clinical efficacy to angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Evidences supports that amlodipine, a calcium channel blocker is safe and effective antihypertensive agent. Various clinical trials have demonstrated the efficacy and tolerability of amlodipine in combination with ACE inhibitors and ARBs. By reviewing the clinical trials of combination of aliskiren and amlodipine in hypertensive patients, it has been found that this US FDA approved combination is effective in reducing blood pressure and having better safety profile.
Objective: The objective of this study was to determine antimicrobial drug use in newborns at a t... more Objective: The objective of this study was to determine antimicrobial drug use in newborns at a tertiary care neonatal intensive care unit, to identify educational/research priorities in neonatal drug therapy. Materials and Methods: This prospective observational study included 713 patients of neonatal sepsis over a period of 18 months. Data like name, age, sex, birth weight, gestational age, antibiotics used were recorded in the previously prepared case record form. Results: Number of patients admitted in early neonatal period was 467(65.5%) and number of patients admitted in late neonatal period was 246(34.5%). The mean age of all patients being admitted in NICU was 6.23 ± 5.86 days. The majority of neonates (92.56%) were prescribed 2 to 5 antibiotics and 29.59% of neonates were prescribed 2 antibiotics. Average number of antibiotics of all patients being admitted was 3.74 ± 1.38. Most frequently used antibiotics in decreasing frequency were: Amikacin (97.19%), ampicillin + sulbactam (60.17%), vancomycin (57.64%), ceftazidime (38.71%), cefotaxime (34.22%), ciprofloxacin (26.23%), piperacillin + tazobactam (19.07%). 73% drugs were given by generic name and 53.33% drugs were prescribed from the essential drug list. Mean length of stay in NICU of all patients being admitted was 7.59 ± 5.66 days. Conclusion: The present study provides valuable insight about the overall pattern of antimicrobial drug use profile in patients of neonatal sepsis of a tertiary care hospital. It is intended to be a step in broader evaluation of safety and efficacy of drug prescription in neonatal sepsis patients.
Background: Hypertension is one of the leading causes of cardiovascular disease. Though many clin... more Background: Hypertension is one of the leading causes of cardiovascular disease. Though many clinical guidelines published recently for the treatment of hypertension, there is substantial variation in the treatment of hypertension in different countries. Aims and objectives: To evaluate the drug utilization pattern among hypertensive patients and their adverse effects attending medicine OPD in a tertiary care teaching hospital. Materials and Methods: A prospective, observational study was conducted by Department of Pharmacology in a tertiary care teaching hospital over a period of six months. The diagnosis and line of treatment to be given was decided by the physician in charge of the Department of Medicine. All the information of ADR was recorded in CDSCO Suspected ADR reporting form. Results: Out of 600 patients, 43.83% were male and 56.17% were female. Maximum patients belonged to age group of 51-60 years (33.5%). Diabetes mellitus (40.33%) was the most common associated disease with hypertension. About half of the patients had received two antihypertensive drugs (49.50%), followed by one (33.16%) and three (15.5%) antihypertensive drugs. Enalapril was the most commonly prescribed antihypertensive drug (79.66%). 95 patients (15.83%) from the total of 600 patients developed ADR. Most common ADR was cough (18.94%) followed by headache (12.63%) and vomiting (10.52%). Enalapril was responsible for about half of the ADR (50.52%) followed by amlodipine (25.26%) and furosemide (25.26%). Conclusion: Rational utilization pattern of antihypertensive drugs was observed. However diuretics and calcium channel blockers prescribed less commonly. Most of the ADRs were probable (55.79%) and mild (30.53%).
The rapidly expanding field of psychopharmacology is challenging the traditional concepts of psyc... more The rapidly expanding field of psychopharmacology is challenging the traditional concepts of psychiatric treatment and research, and is constantly seeking new and improved drugs to treat psychiatric disorders. In this way, psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and more efficacious. [1] Although psychotropic medications have had a remarkable impact on psychiatric practice that legitimately can be called revolutionary, their utilization and consequences on real life effectiveness and safety in actual clinical practice need continuous study. [2] Drug utilization study has been defined by the World Health Organization (WHO) as "The marketing, distribution, prescription and uses of drugs in a society with special emphasis on the resulting medical and social and economical consequences." [3] The principle aim of the drug utilization research is to facilitate the rational use of the drugs. Without the knowledge of how the drugs are being prescribed, it is difficult to suggest the measures to improve prescribing habits. [4] Present study was undertaken to analyze the pattern of drug utilization of psychotropic medications in outdoor Original Article Background: Psychotropic drugs have had a remarkable impact in psychiatric practice. However, their utilization in actual clinical practice, effectiveness and safety in real life situation need continuous study. Materials and Methods: A prospective cross sectional study was carried out for 6 months. Patients of all ages and both sexes were included in the study while inpatients, referred patients and patients of epilepsy were excluded. Using World Health Organization basic drug indicators, the prescribing pattern was analyzed. Results: The numbers of psychotropic drugs prescribed per patient were 2.96. Anti-anxiety drugs (82.83%) were most frequently prescribed psychotropic drugs in various psychiatric disorders. Usage of antipsychotic drugs was in 70.15% cases. Atypical antipsychotic drugs (43.83%) were prescribed more frequently than the typical antipsychotic drugs (26.32%). Prescribing frequency of selective serotonin reuptake inhibitors (36.66%) was more than the tricyclic antidepressant (21.96%) and atypical antidepressant drugs (1.83%) in major depression. Use of mood stabilizers was restricted only to bipolar mood disorders. Central anticholinergic drug was co-prescribed in as many as 88.15% patients receiving antipsychotic drugs. Conclusion: Anti-anxiety drug (Benzodiazepine (BZD)) usage was extensive in various psychiatry disorders. Rational use of BZD requires consideration/attention to dose and duration of usage as well as drug interactions with other psychotropic drugs. Routine use of central anticholinergic drug along with atypical antipsychotic drugs also, could not be justified.
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