Drug Utilization Study and Monitoring of Adverse Events of Anti-cancer Drugs in a Tertiary Care Hospital of Bihar

Abstract

Chemotherapy is one of the integral components in the management of carcinomas. Significant variation in the response rate of individual anticancer drugs, availability of different regimens, and intolerability of combination regimens necessitate observation and evaluation of cancer chemotherapy. It has been found that the ADR profile of cancer chemotherapeutics is very less reported and the situation is even worse in India. Present study was conducted to delineate the various drugs used in carcinomas to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs, to assess prevalence of various carcinomas and to assess adverse events. This was an observational and prospective study in which chemotherapy prescriptions and data regarding adverse event (patients complain, clinician report, laboratory data) were collected from out-patient department of Medical Oncology. Their prescriptions were collected and they were screened for adverse events of grade 1-4 of CTC version 5. Descriptive analysis was done to analyse and compare the results. Most of the patients were of age group 46-60 (39.08). Gall bladder cancer was mostly found in age group 61-70. Hodgkin’s lymphoma and germ cell tumour were mostly found in younger patient. Cisplatin (15.13%), Gemcitabine (13.38%) and Carboplatin (11.40%) were mostly prescribed drugs. 20.56% of all adverse event were haematological. Most of the grade 3 adverse events were haematological. More recent developments in the availability of anticancer drugs which include molecular-targeted therapy such as targeting the proteins with abnormal expression inside the cancer cells should be utilized judiciously. Nevertheless, an early detection of these ADRs may help in minimizing the damage by either modifying the dose or changing the offending agent.