Drug utilization study of anti-hypertensive drugs and their adverse effects in patients of a tertiary care hospital

Abstract

Background: Hypertension is one of the leading causes of cardiovascular disease. Though many clinical guidelines published recently for the treatment of hypertension, there is substantial variation in the treatment of hypertension in different countries. Aims and objectives: To evaluate the drug utilization pattern among hypertensive patients and their adverse effects attending medicine OPD in a tertiary care teaching hospital. Materials and Methods: A prospective, observational study was conducted by Department of Pharmacology in a tertiary care teaching hospital over a period of six months. The diagnosis and line of treatment to be given was decided by the physician in charge of the Department of Medicine. All the information of ADR was recorded in CDSCO Suspected ADR reporting form. Results: Out of 600 patients, 43.83% were male and 56.17% were female. Maximum patients belonged to age group of 51-60 years (33.5%). Diabetes mellitus (40.33%) was the most common associated disease with hypertension. About half of the patients had received two antihypertensive drugs (49.50%), followed by one (33.16%) and three (15.5%) antihypertensive drugs. Enalapril was the most commonly prescribed antihypertensive drug (79.66%). 95 patients (15.83%) from the total of 600 patients developed ADR. Most common ADR was cough (18.94%) followed by headache (12.63%) and vomiting (10.52%). Enalapril was responsible for about half of the ADR (50.52%) followed by amlodipine (25.26%) and furosemide (25.26%). Conclusion: Rational utilization pattern of antihypertensive drugs was observed. However diuretics and calcium channel blockers prescribed less commonly. Most of the ADRs were probable (55.79%) and mild (30.53%).

The study of adverse drug reactions of antihypertensive medicines in essential hypertension patients in Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India

“…In this study, the more number of ADRs were found (43.59%) in age group of 51-60 years which was similar to the study by Solanki et al 23 It was found that elderly patients are more prone to ADRs than younger patients, most common system associated with ADRs was central nervous system; but Hussain et al, study reported cardiovascular system as the commonly affected system. 24 In our study ADRs also involved musculoskeletal system, respiratory system, gastrointestinal system, cardiovascular system and skin.…”

Comparative assessment of the pattern of anti-hypertensive drugs prescribed in medicine and cardiology outpatient department

“…Combination of CCBs and BBs were most commonly prescribed in medicine OPD, whereas combination of ACEI and BBs was preferred in cardiology OPD. Similar to our study, CCBs and BBs was most common combination used in a study conducted in other part of India, whereas, combination of ACEI with BBs was most commonly prescribed in a study conducted by Solanki et al, ARB with diuretic was the most frequently prescribed in a study conducted by Pai et al, Sivakumar et al and Pavani et al 11,12,19,29,30,26,27 Etuk (28) reported combination of ACEI and diuretic to be the most common two drug combination used. 28 CCB with diuretics 24 (30%) were most commonly prescribed in a study conducted by Konwar et al 25 When combination of three drugs were analysed, combination of CCB, ARB and diuretics was most commonly prescribed in medicine OPD whereas that of ACEI, BB and diuretics were preferred in cardiology OPD.…”

“…27 ARB, CCB and diuretics was most commonly prescribed in a study conducted by Sivakumar et al 26 α-Methyl dopa, ACEI and diuretics was preferred in Nigerian study. 28 ACEI, BB and diuretics were preferred in study conducted by Konwar et al 25 ACEI, CCB and diuretics was most commonly prescribed in study by Solanki et al Whereas, ACEI, BB and CCB was most commonly prescribed in study conducted by Khurshid et al 29,11 Thus, all the four major drugs are use in combination in various studies and it was also seen that diuretic was involved in almost all combination. Combination of CCBs, α+β Blocker, D and α-Blocker was preferred as four drug combination therapy in medicine OPD, whereas combination of CCBs, BB, ARBs and D was preferred in cardiology OPD.…”

Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

“…It is comparable to the findings of the study of Solanki et al, which reported the prescription of 74% of the drugs by their generic names. 10 Though, the number of generic drug prescriptions in our study is satisfactory, there is still scope of improvement.…”