Background: In this era of ongoing identification and analysis of medical errors, fluid and electrolyte management has trailed behind the medical decisions that have immediate obvious adverse consequences. This predicament may reflect a lack of understanding of the importance of considering individual volume and electrolyte abnormalities as a separate variable that can significantly alter a patient course and outcome.Objective: This study evaluated the utilization of parenteral preparations, fluids and electrolytes in two tertiary hospitals. Method:The study was a cross sectional descriptive survey which utilized the folders/medical records of patients' that visited the hospitals within January 2017 and December 2018. Data was collected using structured observational check list for parenteral utilization, patient care and health facility indicators. Data regarding parenteral utilization was obtained from sampled medical records retrospectively and filled in structured check list accordingly with careful observation. The data was checked and analyzed using the SPSS software (ver. 20.0 for Windows, Inc., Chicago, IL, USA). Descriptive statistics of frequency, percentage, mean and standard deviation was used to summarize the data. Result:The study revealed that 242 (100.0%) drugs were prescribed to various patients, including anti-microbial drugs 129(53.3%) and infusions 57 (23.6%) appearing as the most commonly prescribed medications which were found in the first two (2) drugs prescribed to patients in Chukwu Emeka Odimegwu Ojukwu University Teaching Hospital (COOUTH). Similarly, at Saint Charles Boromeo Hospital (SCBH), a total of 250 (100%) drugs were prescribed to various patients, including anti-microbial drugs 113( 45.2%), infusions 68 (27.2%) and antimalarial 16 (6.4%) appearing as the most commonly prescribed medications which were found majorly in the first three (3) drugs prescribed to patients. At COOUTH, more generic drugs 214(88.1%) were prescribed than the branded drugs 29(11.9%). Similar trend occurred at SCBH, where higher number of drugs prescribed were generic 171(70) compared to branded prescriptions 74 (30.2). Chi-square test revealed significant association (χ2 = 15.873, p = 0.001) between total dosage frequency of drugs prescribed in both hospitals. The relationship between total number of brands and generic prescription in both hospitals was significand (χ2 = 9.765, p = 0.002). Conclusion:The generic prescription practices of parenteral drugs was prevalent in the two hospitals. Parenteral preparations were frequently used in the two hospitals.

Objectives: This study aims in the identification of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) associated with vemurafenib using disproportionality analysis of the FDA database of Adverse Event Reporting System (FAERS). Methods: Data were obtained from the public release of data in FAERS. Case/ non-case method was adopted for the analysis of association between vemurafenib use and DRESS. The data mining algorithm used for the analysis was Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR). A value of ROR-1.96SE.1, PRR$2 were considered as positive signal. Results: A total of 7,869 reports for DRESS have been reported in the FDA database. Amongst which 101 reports were associated with vemurafenib. DRESS ranked 49 th among 900 vemurafenib associated adverse drug events. The mean age was 55.87 (95% CI, 52.21-59.52) and female to male ratio was 1.466:1. A positive signal was obtained with ROR: 13.10 and PRR: 13.12. Four deaths were reported and the non-death serious reports included hospitalization, lifethreatening, disability, and other serious events with 61, 11, 2 and 39 reports respectively. Linear regression analysis indicated there was a significant correlation between the PRR and time (R=0.810; p=0.027) and ROR and time (R=0.807; p=0.028). The Log Likelihood ratio for DRESS with vemurafenib was found to be 151.14 and the reporting ratio was 11.11 (Critical value-5.59). Conclusions: A positive signal was observed for vemurafenib associated DRESS, although a causal relation cannot be definitively proved. Health care professionals should be cautious about the possibility of encountering serious adverse events associated with vemurafenib and should be reported to the regulatory authorities.