International Journal of Basic & Clinical Pharmacology
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Assessment of knowledge, attitude, and practice of pharmacovigilance among healthcare workers: a cross-sectional study from North India
Full text linkBackground: Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality worldwide. Pharmacovigilance (PV) plays a crucial role in detecting, understanding, and preventing ADRs to ensure drug safety. This study aims to assess the knowledge, attitude, and practice (KAP) of pharmacovigilance among healthcare professionals, identifying barriers and areas for improvement to enhance ADR reporting.
Methods: A cross-sectional study was conducted among healthcare professionals in government and private healthcare facilities in Lucknow, Uttar Pradesh, India. A structured questionnaire was distributed via Google Forms, with 265 participants responding. Statistical analysis involved descriptive statistics, summarizing categorical variables as frequencies and percentages.
Results: Among the 265 participants, 59% were aged 20-30 years, and 66.9% were female. Educational qualifications included nursing (69.6%), MBBS (12.5%), MD/MS (9.1%), and DM/MCh (3.4%). Formal training in pharmacovigilance was reported by 45.1%. Regarding knowledge, 82% correctly identified pharmacovigilance, 68.2% knew CDSCO as the regulatory body, and 57.8% were aware of the Pharmacovigilance Programme of India (PvPI). Although 41.8% frequently encountered ADRs, only 34.4% had reported multiple ADRs, while 43.2% had never reported an ADR. The main barriers included lack of knowledge about the reporting process (49%) and time constraints (30.3%).
Conclusion: Despite awareness and a positive attitude toward pharmacovigilance, ADR reporting remains inadequate due to knowledge gaps and systemic barriers. Strengthening pharmacovigilance education, simplifying reporting mechanisms, and fostering institutional support can enhance ADR reporting practices, ultimately improving patient safety
From transient ischemic attack to peripheral vascular disease: a multifactorial case requiring steroid therapy
Full text linkA 70-year-old male from Himachal Pradesh, India, initially presented with two episodes of transient loss of consciousness and persistent temporal headache. He was diagnosed with transient ischemic attack (TIA) and temporal arteritis, which responded well to steroid therapy. One year later, he experienced weight loss and developed axillary lymphadenopathy (LAD), with histopathological and CBNAAT confirmation of extrapulmonary tuberculosis (TB). He underwent a six-month course of anti-tubercular treatment (ATT). However, six months’ post-treatment, he developed vascular claudication of the left lower limb and severe left iliac region pain, which dramatically responded to steroid therapy. Computed tomography (CT) angiography revealed peripheral vascular disease (PVD), and CT enterography showed abdominal LAD, leading to the re-initiation of ATT alongside steroids. This case underscores the importance of steroids in managing complex, multifactorial conditions and highlights the necessity of a multidisciplinary approach for optimal patient outcomes
Cost analysis of antimicrobial drugs using a common commercial drug manual: an insight into rational prescribing
Full text linkBackground: At present, there are a lot of drug industries that manufacture their own brand for a given drug molecule. A thorough knowledge of cost of different brands of the drug molecule is necessary for doctors so that they can prescribe the affordable drug brand to the patient. This can improve the compliance and therapy outcome. The aim is to analyse the cost variation of drug molecules available in market and their comparison with drugs available in Jan Ausadhi Kendra.
Methods: Cross sectional descriptive study, using current index of medical specialities (CIMS) 2023 drug manual, the relevant details of some commonly used anti-microbials were obtained. The cost ratio and the percentage cost variation of different drugs were calculated.
Results: The highest cost ratio was for tablet Fluconazole and least for tablet Atazanavir 300 mg. The maximum % cost variation was for tablet Fluconazole and least for Injection Caspofungin. Some of the costly drugs in Janaushadhi store were tablet Norfloxacin-Tinidazole, Moxifloxacin, Cefuroxime, Azithromycin and Piperacillin-Tazobactam injection respectively.
Conclusion: Since there is a wide price variation in different brands of a given same anti-microbial agent, the clinicians need to focus on the cheapest drug brands available in the drug market so that they can reduce the cost burden on patients and improve the patient compliance
Liver biomarkers of silymarin milk thistle on paracetamol induced liver toxicity in adult albino rats (Rattus norvegicus)
Full text linkBackground: Paracetamol is the most common analgesic that is readily available with or without prescription over the counter and its toxicity is due to misuse or overdose associated with liver damage. Silymarin milk thistle is an edible herb believed to have antioxidant, scavenging and regulation of glutathione contents within the cell. Aim of the study was to determine the effects of different doses of silymarin milk thistle on liver biomarkers of paracetamol induced liver toxicity among albino rats.
Methods: Twenty-four adult albino rats were randomly grouped into four groups each group consisting of six animals. Paracetamol-only group given high dose paracetamol-750 mg/kbwt and control group received water and food only. The experimental group, were divided into three subgroups with all receiving high dose paracetamol for five days and thereafter given varying doses of silymarin milk thistle. SIL-G1 given 200 mg/kbwt of silymarin milk thistle, SIL-G2 given 400 mg/kbwt of silymarin milk thistle and SIL-G3 was given 600 mg/kbwt of silymarin milk thistle. All the animals were fed with standard rodent foods and water ad libitum. After completion of 24 hours of the last drug administration, they were humanely sacrificed, serum biochemical analysis of liver biomarkers (ALP, ALT and AST) was determined.
Results: High dose of paracetamol induced liver toxicity. Upon administration of high dose of silymarin milk thistle, there was restoration of ALP, AST and ALP of all these biomarkers in relation to the control group.
Conclusions: These findings showed that high dose (600 mg/kbwt) of silymarin milk thistle was found to have restorative effects and normalized liver biomarkers of ALP, AST and ALT
Navigating medications: a prospective study on drug use in rheumatoid arthritis management
Full text linkBackground: Rheumatoid arthritis (RA) is a chronic autoimmune disease-causing joint inflammation, pain, and potential joint damage. Effective management requires a combination of pharmacologic treatments to reduce disease activity and improve patient outcomes.
Methods: This prospective study investigated drug utilization patterns, medication adherence, and their impact on RA management. Data were collected over one year from 510 RA patients visiting the orthopaedic department at Raichur Institute of Medical Sciences. Demographic details, clinical characteristics, medication regimens, adherence levels, and adverse drug reactions were recorded.
Results: Female patients, primarily aged 51-65 years, were predominantly affected by RA. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most commonly prescribed medications, with oral administration being preferred. Family history and older age were significant risk factors. Disease-modifying anti-rheumatic drugs (DMARDs), especially in combination, were preferred for managing RA. NSAID usage led to adverse effects like gastric discomfort, underscoring the need for careful monitoring.
Conclusions: This study highlights the importance of early detection, personalized treatment strategies, and the need for further research into novel therapies. It offers valuable insights into drug utilization and medication adherence, with implications for improving RA management and patient outcomes
Antibacterial prescription pattern and adverse drug reactions in childhood pneumonia
Full text linkBackground: Antibacterial drugs play an important role in the treatment of Pneumonia-a leading cause of death globally among children. To determine the class, dosing schedule, Adverse Drug Reactions (ADRs), selection criteria and World Health Organisation (WHO) prescribing indicators of antibacterials used for pneumonia.
Methods: Following the Institutional Review Board (IRB) clearance, 18 months long descriptive study was conducted among 432 paediatric patients admitted with Pneumonia in a tertiary care center. Details on antibacterial prescription with selection criteria and associated ADRs were collected. Causality, preventability and severity of ADRs were assessed. WHO prescribing indicators were calculated. Data analysed using SPSS software.
Results: Aminopenicillins (61.2%) were the major antibacterial class prescribed and the major antibacterial was Ampicillin (34.6%) with dosage regimen 32-66 mg/kg Intravenously four times daily (34.4%) with mean treatment duration 3.6±1.26 days. Major route of administration was intravenous (57%) and 99% patients received empirical treatment. The ADRs reported were Gentamicin & Ampicillin induced Hypersensitivity reactions and Vancomycin induced Redman Syndrome. WHO prescribing indicators: Average number of antibacterials per encounter 2.42, Antibacterials prescribed by generic name 96.56%, Encounters with injection 98.37%, Antibacterials from Essential Medicines List (EML) 90.9%.
Conclusions: Aminopenicillins were the major antibacterial class, Ampicillin was the major antibacterial, Inj. Ampicillin 32-66 mg/kg intravenously four times daily with mean duration 3.6±1.26 days was the commonest dosage regimen prescribed. Most antibacterials were from EML, prescribed in generic name, selected empirically and administered intravenously. Three ADRs were reported. Prescribing indicators were calculated
A prospective study to assess the usage of intravenous fluids in patients presenting to the emergency department
Full text linkBackground: Intravenous (IV) fluid therapy is a common and critical component in the emergency management of patients. However, inappropriate prescribing and management of IV fluids can result in adverse outcomes.
Methods: This was a prospective observational study involving 132 patients who received IV fluids in the ED. The type of IV fluids, indications, infusion rates and the demographic characteristics of patients were recorded and analyzed.
Results: Out of 132 patients, 80 were female and 52 were male. The most frequently used fluid was Normal Saline (NS) (81%). The primary indication for IV fluid administration was hydration (63.50%). Infusion rates were most commonly bolus infusions (86.13%).
Conclusions: The study revealed that the majority of patients were administered IV fluids for hydration, with NS being the most common fluid. Proper education on fluid management in the ED can improve patient safety and treatment outcomes
Influenza: under complications and management, mention needs to be made of secondary bacterial infection and its treatment
Full text linkThis review explains the complications and the management of influenza, focusing on their secondary bacterial infections. It outlines the types of influenza viruses, transmission, and vaccination. It outlines the different secondary infections that may arise after an influenza infection; hence, one considers the bacterial, fungal, and viral infections. It emphasizes the need for timely diagnosis and proper management, which would involve the use of antibiotics, antifungal agents, or antiviral drugs depending on the infection. It further advises on prevention techniques, which involve vaccination and proper hygiene of hands to avert the incidence of secondary infection. From the discussion above, this document has identified a wide précised account of the complications and management approaches with influenza and its complicating secondary infections
Knowledge, attitude and perception of the public towards COVID-19 vaccine in UAE
Full text linkBackground: The Corona virus pandemic spread across the globe in 2019, alarming the world due to the virus’s elevated severity and the emergence of its new strains. Vaccination became a necessity to combat the pandemic, however, there is still hesitancy among the public to accept vaccines. This study aims to assess the knowledge, attitude and perception of the public towards the COVID-19 vaccine in the UAE.
Methods: We assessed the readiness and willingness of the public to take the vaccine. Our data was collected using a cross-sectional study. The study was conducted during the period of February 2021 to May 2021 to collect data on the readiness of the population to take the COVID-19 vaccine.
Results: We received 392 responses, and two thirds (250, 63.8%) were females, non-Emirati (374, 95.4%), and with a bachelor degree (263, 67.1%). Slightly more than half (211, 53.7%) reported being frightened of the pandemic. The majority (388, 99%) of the participants know the precautionary measures, but only 313 (79.8%) are committed to the measures and 159 (40.6%) think the available vaccines are safe. There was not a dominant response by the survey participants on whether the vaccine should be compulsory or not. Long-term safety (115, 29.3%), side effects (109, 28.8%), and thinking not at a high risk were the main concerns that prevented some respondents from taking the vaccine. Around 40% of the participants took two doses of various vaccines, but similar percentage of participants do not plan taking the vaccine.
Conclusions: Government priorities should be directed toward increasing general public interest in the vaccine, as well as raising awareness regarding the general public’s concern about the pandemic and vaccination program
Assessment of antidiabetic drug utilization and prescribing trends in outpatient care at a district general hospital in central Maharashtra
Full text linkBackground: Diabetes mellitus is a growing global health challenge with substantial morbidity, particularly in low- and middle-income countries like India. Rational prescribing of antidiabetic medications is essential to optimize glycemic control and reduce complications.
Methods: A prospective observational study was conducted involving 605 diabetic patients. Prescriptions were analyzed using World Health Organization (WHO) prescribing indicators focusing on monotherapy versus combination therapy, drug classes prescribed, and adherence to essential medicines and generic prescribing.
Results: The majority of patients were males (69.4%) aged 60-69 years (38%). The average number of antidiabetic drugs per prescription was 1.7. Monotherapy was prescribed in 31.4% of cases, while 68.6% received combination therapy. Metformin was the most commonly prescribed drug (95.9%), followed by Glimepiride (47.1%). Combination therapy of Glimepiride + Metformin was the most frequent regimen (43.3%). Insulin was prescribed in 6.6% of cases, predominantly biphasic insulin. All drugs were prescribed by generic names, with 98.3% from the National List of Essential Medicines (NLEMs).
Conclusions: Metformin remains the cornerstone of antidiabetic therapy, with a clear preference for combination regimens, particularly Metformin plus Glimepiride, reflecting guideline-based practice for intensified glycemic control. The high rate of generic prescribing and use of essential medicines demonstrates adherence to rational prescribing principles. Ongoing prescription monitoring and patient-centered therapy adjustments are recommended to further optimize diabetes management