Palonosetron is clinically more efficacious than ondansetron in controlling CINV especially in delayed phase and overall period of emesis.

Background: Adverse drug reactions (ADR) are the leading cause of mortality and morbidity in all health care systems. Hospital based ADR monitoring and reporting programmes can throw some light upon the profile of ADRs and ways to prevent them, facilitating rational drug use. An attempt has been made in this study to analyse the seriousness, predictability, preventability, severity and outcome of ADRs occurring in a tertiary care hospital.Methods: This was a retrospective observational study based on the data collected from ADRs reported to an approved ADR monitoring centre (AMC). Data collected was evaluated for seriousness, predictability, preventability, severity and outcome using appropriate scales. Simple descriptive statistics was used for analysis.Results: The total number of ADRs reported was 300. Among this 39% reactions were serious. The commonest reason for considering as serious reaction was prolongation of hospitalization. The overall predictability was 40.4%. Total preventability was found to be 18.3%. Assessment of severity showed 55.3 %, 41.7%, 3% reactions in mild, moderate and severe grades respectively. 64.3% patients had recovered from the reaction and 30% were recovering at the time of reporting ADR. Only 0.3% ADRs caused death.Conclusions: Authors hope this study will foster the culture of reporting and analysing ADRs among health care professionals and students. The findings from the study can create awareness among health care professionals regarding the impact of ADRs on the treatment course.

Introduction: Antibiotics have a remarkable role in prolonging life, especially in underdeveloped and developing countries. Insufficient knowledge among doctors, peer pressure and patient demands, diagnostic uncertainties, lack of communication between the doctor, pharmacist and patients all implicate inappropriate antibiotic prescribing practices. Irrational antibiotic prescription can lead to antibiotic resistance, marking a global crisis. Aim: To evaluate the prescription pattern of antibiotics in the admitted patients of a tertiary care teaching hospital and assess the prescriptions' rationality. Materials and Methods: This was a retrospective record-based study done in the inpatients of Government Medical College, Manjeri, Kerala, India, for three months (1st October 2017 to 31st December 2017). Data was collected using a data collection checklist which included patient identity and demographic factors, name and route of the antibiotic prescribed, usage of multiple antibiotics, usage of prophylactic antibiotic, usage of generic names, adherence to National List of Essential Medicines (NLEM) and rational use. The data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0 and frequencies and percentages were determined for each variable. Results: Total 1,186 medical records were analysed, and 49.7% were prescribed antibiotics; 38.2% contained more than one antibiotic, and 64.8% contained parenteral antibiotics. Cefotaxime was found to be the most commonly prescribed antibiotic. An 88.3% of prescriptions were adhering to NLEM, and 29% contained generic names of antibiotics. Overall, 69 out of 589 (11.7%) were irrational prescriptions, and the use of multiple antibiotics with the same spectrum of coverage was found to be the most common reason for irrationality. Conclusion: In this study, the most drugs were prescribed from the NLEM. Cephalosporins were the most commonly used antibiotics for the inpatients in this hospital. Prescriptions with generic names of drugs were low. Irrational prescriptions contributed a minor percentage, and reserve antibiotics were too little.

Background: Pharmacovigilance is the science and activities related to detection, assessment, understanding and prevention of adverse drug reactions (ADR). The major challenge faced by the pharmacovigilance programme of India is underreporting. It is mainly due to lack of awareness, knowledge, attitude and practice among health care professionals. The main objective of this study was to assess the knowledge, attitude and practices of second professional MBBS students towards ADR reporting and to provide a session on pharmacovigilance as an intervention to increase their awareness since they are the future budding doctors.Methods: This questionnaire based study was conducted among 158 second professional MBBS students of Travancore Medical College, Kollam, Kerala. A pretest was conducted using the questionnaire followed by which a two-hours session on ADR reporting and Pharmacovigilance was given. A posttest was done with the same questionnaire. The response of the KAP questionnaire were analysed separately for pretest and posttest in percentages and based on scores and was compared.Results: Out of the158 students participated all the students successfully completed the questions of both pretest and posttest within stipulated time frame. In pretest 3 (1.9%), 101 (64%), 43 (27.1%) candidates were categorized to excellent, good and poor respectively. In posttest 155 (98.1%), 3 (1.9%) were in excellent and good category respectively. There was not even a single candidate in poor category. There was a marked increase in the knowledge and awareness of the students after the two hours intervention session on ADR reporting and pharmacovigilance which was statistically significant (p= 0.001).Conclusions: This study revealed the awareness of second professional MBBS students towards ADR reporting and Pharmacovigilance in our institution and also clearly showed the importance of early sensitization through educational interventions, which improved the KAP in pharmacovigilance in them. Educating medical students will improve the challenge of underreporting of ADRs and will increase the numbers of ADRs reported in our country.

Background: Adverse drug reactions (ADRs) are an important concern in modern therapeutics. Due to limitations in identifying ADRs during research phase, organized post marketing studies are essential. However, there are only few recent studies on this subject available in India. Hence this study was done in a tertiary care hospital in South Kerala to evaluate the profile and causality of ADRs.Methods: The details of patients who developed ADRs during the period from October 2016 to November 2017 were collected. Data collection was done using the suspected drug reactions monitoring form by CDSCO used under PvPI and a retrospective observational cross-sectional analysis was done. The profile and causality of ADRs were evaluated.Results: The total number of ADR events reported was 300. 179 ADRs were hypersensitivity reactions (Aronson Type B) and the remaining 121 reactions were Type A reactions. The individual drug class causing majority of the ADRs was antibiotics (36%). Commonest significant dose related ADR was bleeding (7%) caused by combined use of antiplatelets and anticoagulants. The organ system most affected as per SOC classification was skin and appendages (56%). Causality assessment revealed that majority (76%) belonged to “probable” category, whereas 23.6% were of “possible” type.Conclusions: The development of ADRs can significantly affect treatment course – interruption of drug therapy, use of additional drugs and prolonged hospital stay. Employing monitors dedicated to ADR detection and education of prescribers to closely monitor patients can help manage ADRs effectively.