Background: Drug utilization pattern in pregnancy population provide insights regarding drug profile and interventional measures and also minimizes the inherent risk occurring due to unethical prescription.Methods: It was a prospective cross sectional study where prescription slips were collected. Further drugs were categorized according to the classification defined by US Food and drug Administration for pregnancy. Using Pre validated questionnaire the pregnant women were interviewed and parameters regarding knowledge about antenatal visit and contraception, self-medication practices were noted.Results: Among the total 365 participants, 81.4% had finish their high schooling and were in reproductive age group of 22-25. Study revealed predominant usage category- A drugs in I (95.5%), II (97.8%), III (96.4%) trimester. None of them received Category D or X drugs. Almost 100% and 98.6% in III and II trimester respectively received iron. Other drugs prescribed were calcium, anti-emetics, anti-ulcer, NSAIDS and antimicrobial. The awareness about Intra Uterine Contraceptive Devices and Oral Contraceptive Pills were 48.2% and 31.5% respectively. Unfortunately only 4.9% felt that drug use could be dangerous to foetus. 58.9% were aware about antenatal examination during pregnancy.Conclusions: Evaluation of drug utilization pattern periodically will minimize incidence of risk to foetus and mother during pregnancy.

Background: Antibiotic resistance has become a global threat in the field of medicine. Multiple causes like antibiotic abuse, irrational usage of antibiotics, over the counter availability of antibiotics etc., have been put forth as culprit leading to antibiotic resistance. The present study aims at evaluating the knowledge, attitude and behaviour of antibiotic usage and resistance among undergraduates in South Indian teaching hospital.Methods: A cross-sectional, questionnaire-based survey conducted in undergraduate MBBS students including 5th to 9th semester at Department of Pharmacology. The questionnaire comprised off: Demographic data; Knowledge including 12 questions using Four-point likert scale; Attitude and behaviours consisting of 8 questions of Yes/No type. Data were analysed in the software SPSS version 24.0. Association among categorical variable were analysed with Analysis of variance (ANOVA) followed by post hoc Bonferroni test.Results: Among 455, 382 students completed the survey instrument and the response rate was 87%. Statistically significant (p=0.002) results have been obtained for the correct responses of knowledge questionnaire. The order of “good knowledge” about antibiotic usage and resistance according to semesters are graded as VIII>VI>V. Unfortunately, there were no significant results seen with attitude and behaviour.Conclusions: The study concluded that, though there was adequate theoretical knowledge among undergraduate students however they lack in their attitude and behaviour regarding antibiotic usage and resistance. Therefore, they need to improve their attitude and behaviour over antibiotic usage and resistance.

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.

Fixed drug eruption (FDE) is an adverse drug reaction seen with various groups of drugs are antibiotics such as trimethoprim -sulphamethoxazle, pencillin, tetracyclines, non steroidal anti- inflammatory drugs like ibuprofen, aspirin etc. Doxycycline belongs to tetracycline groups of antibiotics. We herein present the case of Doxycycline induced fixed drug eruption. A 35-year - old man presented to our hospital, with a 2-day history of itching and hyperpigmentation over the chest. Patient developed skin lesion 2 days after and he started taking Doxycycline 100 mg twice a day for skin infections. Dermatological examination revealed multiple well defined hyperpigmented patches seen over the anterior aspect of the chest. Doxycycline was discontinued immediately, and the skin lesions resolved spontaneously within 2 weeks. Causality assessment by using Naranjo adverse drug reaction probability scale and WHO Uppsala monitoring scale categorize the reaction as Doxycycline was the probable cause for the adverse drug reaction. Severity assessment by using modified Hartwig and Siegel ADR severity assessment scale labelled the reaction as mild-level 2. The causative drug or drugs and cross reactants should be avoided in future to prevent recurrence of similar skin reactions.

Fluindione an oral vitamin K antagonist is associated with various hemorrhagic and immunoallergic effects. This drug is also prone to produce various drug interactions, which if not taken into consideration while prescribing, might lead to increased incidence of adverse drug reactions for the patients. We report a case of drug interaction between fluindione and cefixime leading to cutaneous bleeding manifestations and raised PT-INR. Our patient was a 59 year old lady, a known case of rheumatic heart disease and mitral valve replacement, on tablet fluindione 20 mg for past 11 years. She was prescribed tablet cefixime 200 mg two times a day for three days for treatment of upper respiratory tract infection, following which she developed cutaneous bleeding manifestations like ecchymosis and purpura in left upper and lower limbs. She also had a rise in PT-INR level to 4.2, predisposing the patient to life threatening bleeding manifestations. Hence, caution is warranted while prescribing antibiotics to patients on oral anticoagulant therapy. Antibiotics that do not cause drug interaction with the anticoagulants must be selected in these patients. Also, periodic monitoring of PT INR in patients on anticoagulants especially when a new drug is co-prescribed is essential to curb the hazards of potential adverse drug interaction.