Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 6 Articles
The aim of current study was to assess the pattern of adverse drug reactions (ADRs) in patients receiving antiretroviral (ARV) therapy. A prospective observational study was conducted for 6 months from March to August 2018 at ART Centre, Sri Venkateswara Ram Narayan Ruia Government General Hospital (SVRRGGH) and Tirupati. This is a tertiary care teaching hospital. The study had taken the institution ethical committee approval. Data were evaluated for patient demographics, laboratory data, ART regimen and type of ADRs. CDSCO forms were used to record the ADRs. Causality, severity and preventability of ADRs were assessed by suitable scales. Out of 216 ADRs identified, majority were females (54.35%) followed by males (46.65%). The most common regimens which caused ADRs were Tenofovir + Lamivudine + Efavirenz (55.55%) and Zidovudine + Lamivudine + Nevirapine (45.45%). Majority of ADRs fall between 31-40 years (35.64%) followed by 20-30 years (27.31%) of age. Most of the ADRs were related to CNS abnormality like abnormal dreams (27.31%), followed by lipodystrophy (26.38%), anaemia (23.14%), diarrhoea (12.96%), skin rash (9.25%), renal abnormalities (0.46%) and myopathy (0.46%). On evaluation of NARANJO’S causality of ADRs, majority were found to be probable (99.7%). The modified Hartwig and Siegel’s severity assessment scale showed that most of the ADRs were mild (64.42%). The modified Schumock and Thornton preventability scale showed that 50.92% ADRs were probably preventable. Adverse drug reactions of Antiretroviral are frequent and could be life threatening in short and long terms. Regular follow up of patients receiving the triple therapies by using assessment scales, early detection of ADRs to improve the medication adherence and to prevent permanent harm to the patients....
Polycystic ovary syndrome is an ovarian disorder producing multiple cysts filled with serous fluid that produces excess number of androgens dominantly testosterone and estrogens. Polycystic ovarian syndrome (PCOS) women are associated with hyperandrogenism, oligomenorrhea, infertility, hirsutism, hyperinsulinaemia (type 2 diabetes) and rarely virilism. In our study, a total of 83 patients were selected that were diagnosed with PCOS, out of which 47 (56.63%) were in the age group of 15-25 years. 61 (73.49%) respondents were receiving metformin for the period of 1-6 months whereas 26 (31.33%) respondents received the same drug for the time period of 7-12 months. The duration of treatment strictly based on the age factor and life of the disorder. Patients fall in the age group of 15-25 years have abnormal number of follicles 28 (32.53%) and 19 (22.89%) respondents have abnormal number of follicles having age in between of 26-35. Metformin is not an effective first line treatment in non-obese women with polycystic ovarian syndrome. Among 83 non-obese and non-diabetic women only 27 women got benefit but no ovulation occurred from metformin therapy while other 57 women did not get any beneficial clinical effect. It is, therefore, concluded from the result that metformin should only be referred as first line therapy or synergistic agent in obese women who have hyperinsulinaemia but not in non-insulin resistant patients....
Patient counselling and addressing drug-related problems are the\npharmacistâ??s key activities to ensure the safe and effective use of medicines. This study aimed\nto describe the dispensing practice of prescribed medicines in daily community pharmacy practice\nand to identify factors influencing counselling provision; Methods: An observational study was\nconducted in community pharmacies in Basel, Switzerland. One master student in pharmacy\nperformed non-participatory observations for one day at each of the participating community\npharmacies. Patient characteristics, counselling content, additional activities, and pharmaceutical\ninterventions were documented on a structured checklist; Results: 556 prescription encounters (PE) in\n18 participating community pharmacies were observed (269 first prescriptions; 287 refill prescriptions).\nPatients were regular customers (n = 523, 94.1%) and 53.8 ± 23.4 years old. Counselling was provided\nto 367 (66.0%) customers on 2.9 ± 3.1 themes per PE. Factors influencing counselling were dispensing\nby the pharmacist, new customer, customer who did not refuse counselling, customer with a first\nprescription, with a prescription resulting in a pharmaceutical intervention, and a prescription filled\nby carers. During 144 PEs, 203 interventions were documented. Pharmacists proposed few additional\nactivities and performed no cognitive pharmaceutical service; Conclusions: Our study quantified\ncounselling and additional services at the dispensing of prescribed medicines and identified\ninfluencing factors on counselling provision at the patient, prescription, and pharmacy level....
Background: In the United States (U.S.), large price increases for selected generic drugs have elicited public\noutrage. Recent legislative proposals aim to increase price transparency and identify outlier drug â??price spikes.â? It is\nunknown how many and what types of products would be highlighted by such efforts.\nMethods: IQVIA Health Incorporatedâ??s National Sales Perspectivesâ?¢ provided sales, use and price data for all generic\nprescription products (unique molecule-manufacturer-formulation combinations) sold in the U.S. We estimated\nannual prescription price levels and changes between 2013 and 2014. We identify drugs with annual prescription\nprice increases in excess of the medical consumer price index (CPI), and in excess of 15% or 20%, per legislative\nproposals. We reported annualized inflation-adjusted mean, standard deviation (SD), median, and 95th percentile\nprescription price increases and percentage of products exceeding the growth in the medical CPI. We fitted logistic\nregression models to identify characteristics of drugs associated with each category of price increase.\nResults: We analyzed data for 6,182 generic products. The mean inflation-adjusted price increase among all generic\nproducts was 38% (SD 1,053%), the median, 2%; the 95th percentile, 135%; and the mean price level, $29.69 (SD\n$378.44). Approximately half of all products experienced price increases in excess of the growth in the medical CPI;\n28% had price increases greater than 15% and 23% had price increases greater than 20%. Drugs exceeding outlier\nthresholds exhibited lower baseline price levels than the mean price level observed among all generic drugs. The\nmost consistent characteristic predicting whether a product would exceed â??price spikeâ? thresholds proposed in\nlegislation is the being supplied by only one manufacturer.\nConclusions: â??Price spikesâ? among generic drugs in 2014 were more common than newspaper stories and legislative\nhearings suggest. While the cross-sectional association between an indicator of being sold by only a single manufacturer\nand the probability of meeting specific price growth thresholds is suggestive of an economically intuitive causal story,\nfuture work should delve more deeply into whether decreases in generic competition explain the dramatic price\nincreases that have captured the publicâ??s attention in recent years....
The PHARMINE (â??Pharmacy Education in Europeâ?) project studied pharmacy practice and\neducation in the European Union (EU) member states. The work was carried out using an electronic\nsurvey sent to chosen pharmacy representatives. The surveys of the individual member states are now\nbeing published as reference documents. This paper presents the results of the PHARMINE survey\non pharmacy practice and education in Slovenia. In the light of this, we examine the harmonisation\nof practice and education in Slovenia with EU norms....
In modern medicine antibiotics are the most commonly prescribed medicines among all the medications. Antibiotics are useful to treat various types of infections ranging from smaller discomforts like respiratory tract infections to life threatening infections like meningitis and septicemia. According to the World Health Organization (WHO) as per report of situational analysis of antibiotic use and resistance shows, in Asian countries India is a one of the highest that deals with infectious diseases. Patients who are identified to be less than 15 years of age, but whose weight exceeds 36 kg may still be considered as pediatric. For calculating the child dose from adult dose, the weight of the child must be considered. Our results shows Mean age of study subjects was calculated as 22.06 months with a standard deviation 19.52. Most (118; 53.63%) of the subjects are between the age group of 13 months and 5 years, followed by 1M – 12M (98; 44.54%) and 6 Years-13 years (4; 1.81%). Most of the study subjects belongs to female (118; 53.6%) followed by male (102; 46.4%). Most (120; 43.16%) of the children are suffering with URTI. Viral fever (50; 17.98%) was second leading infectious disease in children which is more in 1M to 12 months. More than 1/10th of population suffered for dysentery (34; 12.2%) and rhinitis (30; 10.79%). Children are diagnosed rarely with acute GE (12; 4.31%), LRTI (12; 4.31%), malaria (8; 2.87%), enteric fever (4; 1.43%), ear pain (4; 1.43%), conjunctivitis (2; 0.71%) and varicella (2; 0.71%)....
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