Background: There exists a treatment dilemma regarding the optimal and effective use of therapeutic drugs (hydroxychloroquine/chloroquine/azithromycin) for COVID-19. Furthermore, with changing guidelines, the data on drug utilization patterns across India are limited. Hence, this study was conducted to assess the prescription pattern and drug utilization trends in COVID-19 patients with the aim to study the drug utilization pattern in patients affected with COVID-19 in a dedicated COVID-19 hospital. Aims and Objectives: The objectives of the study are as follows: (1) To study drug utilization patterns according to the severity of the disease. (2) To study the prevalence of adverse drug reactions (ADRs). Materials and Methods: Data were collected retrospectively from 100 medical records of patients ≥18 years irrespective of sex admitted in the COVID ward and ICU of a dedicated COVID hospital from May to August 2020. Pregnant and lactating women were excluded from the study. ADRs reported were also analyzed. Results: About 71% were mild in this study, 18% were moderate, and 11% were severe COVID-19 patients. Overall, the most common drugs prescribed were multivitamins, followed by pantoprazole, paracetamol, and azithromycin. Hydroxychloroquine was prescribed in 22%, favipiravir in 7%, and remdesivir in 3% of cases. The majority of moderate COVID patients received injectables piperacillin-tazobactam, methylprednisolone, and enoxaparin. The mean number of medications, duration of admission, and number of days on oxygen were higher and significant in moderate compared to mild and severe COVID patients. Overall, ADRs were encountered in 9% of cases. Conclusion: The prescribed pattern of drugs was by the national standard guidelines. Multivitamins, followed by pantoprazole, paracetamol, and azithromycin dominated the prescription pattern. Polypharmacy was encountered, which needs to be addressed for the rational use of drugs.
Background: Psychotropic medications, used at normal therapeutic or maintenance doses, have been associated with Adverse drug reactions (ADRs). Multiple studies have noted the high burden of ADRs caused by psychiatric medications. Hence, reporting of likely ADRs is warranted as pharmacovigilance data will help health care professionals to provide reliable, balanced information for the effective assessment of the risk/benefit profile of medicines. Methodology: Necessary approval from the Institutional Ethics Committee will be obtained before initiating the study. It is a prospective, observational, single centre pilot study. 30 patients attending the Psychiatry OPD in MGM Hospital, Kamothe, and experiencing ADRs were enrolled in the study. Results: People who experienced an ADR had a median age of 43±16.23 yrs. A total of 35 ADRs were noted in 30 patients on psychiatric medications. Therapeutic Failure (57%) was observed to be the most common ADR followed by gastric reflux (22%). Benzodiazepines (19%) and SSRIs (17%) seems to be the most common class of drugs, while Trihexyphenydyl (14%) was noted to be the most common drug, causing ADRs. Conclusion: Therapeutic Failure (57%) was observed to be the most common ADR and benzodiazepines (19%) seems to be the most common drug class causing ADR. Under reporting of ADRs is an issue that arises from the lack of awareness amongst patients as well as healthcare professionals. Hence, pharmacovigilance in psychiatry units alerts the physicians and protects the patients from ADRs that can be avoided.
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