A prospective assessment of polypharmacy induced drug interactions with corticosteroids

Kumar, Sumit; Thakur, Pradeep; Shah, Sangeeta

doi:10.3126/jcmc.v6i1.16651

Cited by 3 publications

(3 citation statements)

References 1 publication

(1 reference statement)

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“…In 90 prescriptions total 24 interactions were found out of which 4 (16.67%) were minor, 15 were (62.50%) moderate and 5 (20.83%) were major. Mostly moderate interactions were found in the study which was consistent with the study of Kumar S, et al 11 . who found that 80% of the interactions were moderate, 13% were major and 55.8% were contraindicated interactions subsequent the use of corticosteroids in his study.…”

Section: Discussion:-supporting

confidence: 91%

Evaluation of Corticosteroid Utilization Pattern in Tertiary Care Hospital, Dehradun.

Dabral¹

2018

IJAR

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Background: Corticosteroids are widely used as potent antiinflammatory and immunosuppressive drugs to treat a wide range of diseases. This study evaluates the rational use of corticosteroid amongst hospitalized patients. Objectives: To investigate the utilization and evaluation pattern of corticosteroids in various department of tertiary care hospital. Methodology: A prospective observational study was conducted on 90 patients receiving corticosteroids in the various departments of ShriMahantIndiresh Hospital, Dehradun, Uttarakhand. Patients receiving corticosteroid therapy were included in the study, exclusion of those patients who were of age less than 18, patients with psychiatric disease and those patients not willing to sign on inform consent form. Result: The study involved 90 patients to evaluate the appropriate use of corticosteroids. Majority of patients were of age group >60 years, followed by 41-50 years, 51-60 years, 31-40 years, 18-30 years respectively. Majority of corticosteroids were prescribed to females than males. Prednisolone was the mostly used corticosteroid (34.40%) followed by hydrocortisone (18.9%), budesonide (14.4%), methylprednisolone (11.1%), dexamethasone (11.1%), deflazacort (5.6%) and prednisone (4.4%). Total 16 ADRs were detected in the study. Total 24 drug interactions were found in 90 prescription, the majority of drug interactions were moderate 15 (62.50%) followed by major 5 (20.83%) and minor 4 (16.67%). Conclusion: There was lack of appropriate guidelines for use of corticosteroids and drug interaction reporting, which could be considered an emerging scope of pharmacy. Commonly geriatric population was more prone to diseases, for which steroids were used.

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Section: Discussion:-supporting

confidence: 91%

Evaluation of Corticosteroid Utilization Pattern in Tertiary Care Hospital, Dehradun.

Dabral¹

2018

IJAR

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“…In this study out of 200 prescriptions total 27 interactions were found out of which 7 (25.93%) were minor, 15 were (62.56%) moderate and 5 (18.52%) were major. Mostly moderate interactions were found in the study which was consistent with the study of Kumar S, et al [24]. who found that 80% of the interactions were moderate, 13% were major and 55.8% were contraindicated interactions subsequent the use of corticosteroids in his study.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of Corticosteroid Utilization Pattern in the Various Departments of a Tertiary Care Teaching Hospital, Khammam

Chowdhury¹,

Shravya²,

Prasad³

et al. 2019

SJMPS

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Corticosteroids have proved to be extremely effective in the treatment of acute inflammation and chronic inflammatory diseases. Drug utilization review (DUR) is an ongoing , systematic, criteria-based program of medicine evaluations that will help ensure appropriate medicine use. The present study aim was to evaluate the drug utilization of Corticosteroids in the various department of a tertiary care teaching hospital, Khammam. A prospective observational study was conducted to evaluate drug utilization pattern of corticosteroids. Total 249 corticosteroids were prescribed Prednisolone was prescribed in 39.5% prescription followed by hydrocortisone in 27%, budesonide in 19%, methylprednisolone in 15.5%, Dexamethasone in 9.5%, Deltazacort in 7.5%, Prednisone in 4.5% and Fluhydrocortisone in 2% respectively. 34 ADRs were detected in the study due to corticosteroid use, facial puffiness was detected in 12.50%, headache in 14.70%, Hypernatremia in 14.70%, Hyperglycemia in 17.64%, hypertension in 26.47% and osteoporosis in 14.70%. 72.6% of the drugs were prescribed from the NELM list. Clinical pharmacists interact directly with patients in several different ways. Hence, the clinical pharmacist can perform potential role in health care system in assisting physician in altering the number of medications taken, the number of doses taken, improving the patient medication adherence, detect the adverse drug reactions, drug interactions, in patient counselling, improve the health related quality of life and decreasing the health care cost of the patient.

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“…The study has shown that 1/3rd reduction in sodium excretion can affect the treatment of patient adversely for the patient treated with spironolactone for ascites or edema [11]. Another study shows that Dexamethasone, Ciprofloxacin, Tramadol, Moxifloxacin, Diclofenac, Pantoprazole and Theophylline [12]. The level of evidence provided by the online database for the given major drug interaction were majorly of poor level of evidence i.e., 71 drug interaction with level 5 evidence followed by 15 drug interactions of 3b, 10 drug interaction of 1b, 6 drug interaction of 4 and 5 drug interaction of 2b.…”

Section: Discussionmentioning

confidence: 99%

Drug Interaction Management in Critically Ill Patient

Rajput

Shah

2021

JPRI

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Drug interaction in critically ill patient is very common and affecting patients Physically, Mentally and Financially. There are various measures which has been taken to minimize this burden on patient, such as books being prepared which include various drug interaction, maintain websites and database that provides information regarding drug interactions. With the use of these website and databases the drug interaction can be managed. It is common practice that side effects of drug interaction are being managed by additional drugs, the main reason behind it could be non-availability of alternative drugs or costlier alternative. These factors remain the main cause of treatment failure in majority of patients leading to prolong. The current study was performed for the duration of 12 months, from this study it was identified that 113 types of major drug interactions commonly found in total 250 prescriptions which were evaluated and managed accordingly. Suggestions being prescribed by various sites were, avoid concomitant use of drug, use alternative therapy, and monitor closely for any adverse effect. During suggestion made by the Clinical Pharmacist, for the same drug interactions it was identified that more of drug therapy adjustment can be done then provided by the online database. The parameter on which the drug interactions management are being suggested were focused on just type of drug interaction and its effect, it does not include the actual pharmacodynamic and pharmacokinetic changes in therapy. The suggestion made by the clinical pharmacist were includes drug removal, drug dosage changes, alternative therapy, alternative route of administration, change in time interval etc. From this study it was concluded that the drug interaction management can be done at various stages of treatment with proper therapy modification by the clinical pharmacist, and if done properly it will improve the overall outcome of patient health care.

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A prospective assessment of polypharmacy induced drug interactions with corticosteroids

Cited by 3 publications

References 1 publication

Evaluation of Corticosteroid Utilization Pattern in Tertiary Care Hospital, Dehradun.

Evaluation of Corticosteroid Utilization Pattern in Tertiary Care Hospital, Dehradun.

Evaluation of Corticosteroid Utilization Pattern in the Various Departments of a Tertiary Care Teaching Hospital, Khammam

Drug Interaction Management in Critically Ill Patient

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