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Background: The emergency department represents an important platform for conducting drug utilization studies as patients present with a wide spectrum of diseases in acute form. An irrational prescription adversely affects the prognosis and recovery of patients. Hence, the objective of our study was to evaluate the drug utilization pattern and to determine the rationality of prescription using WHO prescribing indicators in emergency medicine ward. Methods: After obtaining Institutional Ethical Committee approval, a prospective observational study was conducted over 2 months. The case records of 150 patients admitted to the emergency medicine ward, with a hospital stay of more than 24hrs were reviewed to analyze the prescription pattern during the initial 48hrs of admission. Case records of patients irrespective of age, sex and diagnosis were included in the study. Descriptive statistics were used to analyze the results (SPSS version 20).Results: A total of 1014 drugs were prescribed from 150 case records with a mean age of 47±18 years. An average of 6.76 drugs was prescribed per prescription; percentage of encounters with at least an antimicrobial was 115 (76.66%). Injections were prescribed in all patients (100%) and only 416 (41.02%) drugs were prescribed by generic name and 657 (64.79%) drugs abided to the WHO essential drug list. Majority of patients received antiulcerogenic drugs followed by antimicrobials. Conclusions: There was a tendency of polypharmacy with overuse of PPIs and antimicrobials. There is need to rationalize the drug therapy in terms of increasing prescription of drugs from essential drug list by generic name.

Background: Poly-pharmacy being most common in chronic kidney disease patients (CKD). The present study was carried out to analyse current prescribing trends in the management of CKD patients and to compare it with WHO Core Indicators. Methods: A prospective observational study was carried out for three months (15th July 2019 – 15th October 2019) after Institutional Ethics Committee approval at a tertiary care hospital. Patients diagnosed with CKD by treating Nephrologist were included and their prescriptions (OPD card) were analysed to study the prescribing patterns. Results: A total of 60 cases were analysed during the study, of which 73.3% were males and 26.7% were females. The common comorbidities were hypertension (36.6%), diabetes (36.6%), other cardiovascular diseases (26.6%), anaemia (3.33%), Ca Cervix (1.67%), osteoarthritis (6.67%). Among drugs Antihypertensive drugs (40.9%) were the most commonly used drugs, followed by, Anti-diabetic drugs, calcium salts and multi-vitamins (19.7%), oral iron supplements and erythropoietin (13.4%) and ulcer protective (6.1%). Conclusions: Polypharmacy being followed in these CKD patients were necessary for multiple conditions of patient, supplemental drugs decreased adverse effects on initial drug and they yielded synergistic effects. Maximum numbers of drugs were prescribed from anti-diabetic, antihypertensive, supplemental drugs and other cardiovascular class of drugs. The principle of rational prescribing was followed. The right choice of drugs and in appropriate doses will reduce the incidence of nephrotoxicity and ultimately result better clinical outcomes.

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