Aim:Drug–drug interactions (DDIs) are one of the major but preventable cause of adverse drug reaction. Study of prevalence and prediction of DDIs will make the physician easier to provide better patient care and mitigate patient's harm. Hence, the study was planned to evaluate the potential DDIs among medication prescribed to hypertensive patients in our hospital.Materials and Methods:A prospective, cross-sectional study was conducted among the hypertensive patients in medicine (outpatient/inpatient) department over the period of three months in a tertiary care hospital. Adult hypertensive patients of either sex with comorbidities were included in the study. The prescriptions were collected and analyzed for DDI using Medscape interaction checker. Data were analyzed using SPSS (version 16.0) software and expressed in percentage. Pearson's correlation and regression analysis were done.Results:Among 125 patients, 48% were exposed to at least one DDI. Totally 123 DDI were identified and majority of them were significant (85.36%). No serious interactions were identified. Pharmacodynamic and pharmacokinetic drug interactions were found to be 37.39% and 28.76%, respectively. Logistic regression analysis showed advanced male gender and polypharmacy was associated with increased risk of DDI. About 51 interacting pairs of DDI were identified and most frequently occurring pair was amlodipine with atenolol. Aspirin was found to have commonly involved in DDI with enalapril, atenolol, frusemide, spironolactone, carvedilol, and metoprolol.Conclusion:The study highlighted that patients with hypertension are particularly vulnerable to DDI. The comorbidities, advanced age, and polypharmacy are the important factors associated with the occurrence of DDI.
Introduction: Osteoarthritis (OA) often called wear and tear arthritis is a chronic progressive musculoskeletal joint disease with multifactorial aetiology, affecting millions of people around the world. It is one of the leading causes of morbidity, having major impact on Quality of Life (QoL) of the patient with substantial economic and social burden. OA can have a negative impact on health related QoL and psychological well-being of the individual. Aim: To evaluate the prescribing trends of drugs in the management of OA in a tertiary care teaching hospital and to assess the effect of pharmacotherapy on QoL of OA patients in terms of subjective and functional status using Western Ontario and McMaster Universities Arthritis index scale (WOMAC)-modified Centre for Rheumatic Disease (CRD) Pune version OA patients. Materials and Methods: Prospective observational study conducted among the OA patients in Orthopaedic Department over the period of one year between November 2014-December 2015. Adult patients of either gender diagnosed with OA for minimum period of three months were enrolled for the study. Out of 285 eligible patients, drug therapy of 256 patients’ data were analysed and they were given treatment by the treating orthopaedician. All the patients were asked to personally complete the WOMAC index scale during their first visit. They were followed-up for one month of pharmacotherapy in order to assess change in the WOMAC index scale. Data were analysed using Statistical Package for the Social Sciences (SPSS) software 16.0 version. The p-value <0.05 was considered statistically significant. Results: Among 256 patients who completed the study, the most frequently prescribed drug class was NSAIDs (82.1%). Acelofenac with Paracetamol combination (117) and Diclofenac monotherapy (44) were most commonly prescribed. Statistically significant reduction in the WOMAC (pain, stiffness and physical function) score was observed in the follow-up visit when compared to first visit (p<0.0001) after one month of pharmacotherapy in patients taking Diclofenac and Aceclofenac with Paracetamol combination. Conclusion: This study highlighted the significant improvement in QoL and significant reduction in WOMAC scores with Aceclofenac-Paracetamol combination and Diclofenac monotherapy in OA patients.
Angioedema is a rare adverse reaction of carbamazepine, which causes localized tissue edema in submucosal and subcutaneous tissue mediated by histamine, serotonin, and kinins (bradykinin). We report a case of 34-year-old female who developed angioedema, 24 h after administration of carbamazepine for treating bipolar disorder. Patient's symptoms responded rapidly with antihistamine therapy and with the withdrawal of carbamazepine, the offending drug. Carbamazepine-induced angioedema is a life-threatening reaction which requires immediate treatment and monitoring in order to avoid morbidity and mortality.
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