Background: A wide range of medications are now available for the treatment of asthma, and selection of optimal treatment is essential. Aims and Objective: To evaluate the drug-prescribing trend of antiasthmatic drug in a tertiary-care hospital. Materials and Methods: The prescription data from 130 patients with asthmapatients were studied using a prescription auditing pro forma. Data were recorded from the patients attending the outpatient department of Hi-Tech Medical College and Hospital from February to July 2014. Verbal consent was taken from the patients before filling the pro forma. Results: During the study, 130 patients were monitored but only 100 prescriptions were included for data analysis as per the inclusion and exclusion criteria. Demographic analysis of data revealed that there were 66% men and 34% women in the study. The study showed that maximum patients with asthma belonged to 30-40 years age group. The results of this study showed that most of the patients received combination therapy as compared with individual therapy. Majority of the patients received combination therapy of beta 2 agonists and glucocorticoids via inhalational routes; 34% of the prescribed drugs are from the essential drug lists. Average drugs per prescription were 5.16, and 54% of the patients received more than four drugs. About 60% drugs were given by inhalation route, followed by oral route (38%). Conclusion: There is need to encourage the physician to use the treatment guidelines while managing patients with asthma. In conclusion, National Asthma Education program would benefit as an initial step to improve asthma knowledge and increase awareness in the medical community on current treatment practice.
Drug induced lupus is an autoimmune condition secondary to drug exposure which leads to development of systemic lupus erythematosus (SLE). However, labelling the culprit drug needs a prudent insight into the pharmacological plausibility of each of the offending drugs in suspicion. Here we present a report where allergen immunotherapy was suspected to cause SLE and a deeper clinico-pharmacological evaluation cleared the air.
We assessed the association between polypharmacy and cardiovascular autonomic function among community-dwelling elderly patients having chronic diseases. Three hundred and twenty-one patients from an urban municipality area of Kolkata, India were studied in August 2022. The anticholinergic burden and cardiac autonomic function (Valsalva ratio, orthostatic hypotension, change in diastolic blood pressure after an isometric exercise, and heart rate variability during expiration and inspiration) were evaluated. Binary logistic regression analysis was performed to find out the association of polypharmacy and total anticholinergic burden with cardiac autonomic neuropathy. A total of 305 patients (age, 68.9 ± 3.4; 65.9% male) were included. Of these patients, 81 (26.6%) were on polypharmacy. Out of these 81 patients, 42 patients were on ninety-eight potential inappropriate medications. The anticholinergic burden and the proportion of patients with cardiac autonomic neuropathy were significantly higher among patients who were on polypharmacy than those who were not (8.1 ± 2.3 vs. 2.3 ± 0.9; p = 0.03 and 56.8% vs. 44.6%; p = 0.01). The presence of polypharmacy and a total anticholinergic burden of > 3 was significantly associated with cardiac autonomic neuropathy (aOR, 2.66; 95% CI, 0.91–3.98 and aOR, 2.51; 95% CI, 0.99–3.52, respectively). Thus, polypharmacy was significantly associated with cardiac autonomic neuropathy among community-dwelling elderly patients.
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