A Prospective Observational Studies on Drug Utilization Evaluation and Rational Use of Corticosteroids in Tertiary Care Hospital

  • Syeda Masarrath Unissa Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India
  • Sana Kareem Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India
  • Sumaiya Faheem Ahmed Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India
  • Syed Imran Ul Haq Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India
  • S Ahmedullah Hussaini Quadri Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Abstract

Background: Corticosteroids are widely prescribed Drugs in Hospitals, forming a part of standard treatment of modern medicine for a wide range of diseases, associated with inflammation and immune activation. Apart from beneficial effects they also produce number of adverse effects. In the present study, Prospective Observational studies on DUE (Drug utilization evaluation) and rationality of Corticosteroids has been Performed.


Objectives: To Investigate the Drug utilization evaluation, Prescription pattern and Rationality of corticosteroids in various department of tertiary care teaching hospital.


Methodology: A prospective observational study was conducted on 100 patients receiving corticosteroids in the various departments of Osmania general Hospital, Hyderabad. Patients prescribed corticosteroids therapy was included in the study. Exclusion of those patients with age less than 18, psychiatric disease, pregnant women and patients not willing to sign on consent form.


Result: This study included 100 Patients out of which 68 were Male and 32 were female. In Age wise distribution, 15  Patients prescribed with corticosteroid in age group 18-28 years, 20  patients in 29- 38 years, 12 in 32-48 years, 16  in 49-58 years, 22 in 59-68 years, 11  in 69-78 years and 4  in above 80 years. This data showed that commonly male populations are more prone to diseases. As per the demographic data our finding shows that Budesonide was the most frequent prescribed corticosteroid (31.75%) followed by Hydrocortisone (26.19%), Dexamethasone (15.08%), Prednisolone 13.49%, Betamethasone (7.94%), Methyl prednisolone (5.56%).


Out of 100 prescriptions total 10 ADRs and 25 Drug interactions were detected in this study. The majority of drug interactions were minor 24 followed by major 1.


Conclusion: The Prescription pattern of corticosteroids was found to be rational as there is no Major drug interaction. Commonly geriatric population was more prone to diseases, for which steroids were used. Hence close observation is required to ensure safety, effectiveness and well-balanced therapeutic management with corticosteroids, both patients and prescribers should be more aware of the appropriate dose, dosage regimen, Drug - Drug interactions, ADRs and overall guidelines for corticosteroids prescribing.


Keywords: Corticosteroids, Drug utilization evaluation, Prescription pattern.

Keywords: Corticosteroids, Drug utilization evaluation, Prescription pattern

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Author Biographies

Syeda Masarrath Unissa, Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Sana Kareem, Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Sumaiya Faheem Ahmed, Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Syed Imran Ul Haq, Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

S Ahmedullah Hussaini Quadri, Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

Dept. of Pharmacy Practice. MESCO College of Pharmacy, Hyderabad, Telangana, India

References

1. Kang, J.-S., & Lee, M.-H. Overview of Therapeutic Drug Monitoring. The Korean Journal of Internal Medicine, 2009; 24(1):1. doi:10.3904/kjim.2009.24.1.1
2. Gross AS, Blackwell Science Ltd Br J Clin Pharmacol, 2001 ; 52:5S–10S
3. Schoretsanitis G et al. (April 2018). "TDM in psychiatry and neurology: A comprehensive summary of the consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology, update 2017; a tool for clinicians". World Journal of Biological Psychiatry. 19 (3): 162–174.
4. Marshall WJ, Bangert SK. Clinical Chemistry, 6th Edition. Edinburgh, London: Mosby Elsevier. 2008. ISBN 978-0723434559
5. Hallworth M, in Clinical Biochemistry: Metabolic and Clinical Aspects (Third Edition), 2014, Pages 767-786
6. Ramamoorthy S, Cidlowski JA, Corticosteroids-Mechanisms of Action in Health and Disease Rheum Dis Clin North Am. 2016; 42(1): 15–31
7. William Ericson-Neilsen, MD, Alan David Kaye, MD, PhD Steroids: Pharmacology, Complications, and Practice Delivery Issues. Academic Division of Ochsner Clinic Foundation the Ochsner Journal 2014; 14:203–207.
8. Safiya Shaikh et al., Applications of Steroid in Clinical Practice: A Review. International Scholarly Research Network ISRN Anaesthesiology 2012, Article ID 985495, 11 pages.
9. Liu et al A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy, Allergy, Asthma & Clinical Immunology 2013, 9:30
10. National Institute for Health and Clinical Excellence (NICE): Clinical Knowledge Summaries: Corticosteroids - Oral. NICE; 2012. [http://www.cks.nhs. uk/corticosteroids_oral], Accessed February 20, 2013.
11. Singh N, Rieder MJ, Tucker MJ: Mechanisms of glucocorticoid-mediated antiinflammatory and immunosuppressive action. Paed Perinatal Drug Ther 2004, 6:107–115.
12. Newton R, Leigh R, Giembycz MA: Pharmacological strategies for improving the efficacy and therapeutic ratio of glucocorticoids in inflammatory lung diseases. Pharmacol Ther 2010, 125:286–327.
13. Coutinho AE, Chapman KE: The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol 2011, 335:2–13.
14. Croxtall JD, van Hal PT, Choudhury Q, Gilroy DW, Flower RJ: Different glucocorticoids vary in their genomic and non-genomic mechanism of action in A549 cells. Br J Pharmacol 2002, 135:511–519.
15. Smoak KA, Cidlowski JA: Mechanisms of glucocorticoid receptor signaling during inflammation. Mech Ageing Dev 2004, 125:697–706.
16. Stellato C: Post-transcriptional and nongenomic effects of glucocorticoids. Proc Am Thorac Soc 2004, 1:255–263.
17. Furst DE, Saag KG: Determinants of glucocorticoid dosing, Up To Date 2012; 2013. http://www.uptodate.com/contents/determinants-of glucocorticoiddosing?source=search_result&search=glucocorticoid&selectedTitle=4~150.
18. Deshmukh CT: Minimizing side effects of systemic corticosteroids in children. Indian J Dermatol Venereol Leprol 2007, 73:218–221.
19. Da Silva JA, Jacobs JW, Kirwan JR, Boers M, Saag KG, Inês LB, de Koning EJ, Buttgereit F, Cutolo M, Capell H, Rau R, Bijlsma JW: Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data. Ann Rheum Dis 2006, 65:285–293.
20. Weinstein RS, Jilka RL, Parfitt AM, Manolagas SC: Inhibition of osteoblastogenesis and promotion of apoptosis of osteoblasts and osteocytes by glucocorticoids. Potential mechanisms of their deleterious effects on bone. J Clin Invest 1998, 102:274–282.
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1.
Unissa SM, Kareem S, Ahmed SF, Ul Haq SI, Quadri SAH. A Prospective Observational Studies on Drug Utilization Evaluation and Rational Use of Corticosteroids in Tertiary Care Hospital. JDDT [Internet]. 15Oct.2020 [cited 21Oct.2020];10(5-s):119-26. Available from: http://jddtonline.info/index.php/jddt/article/view/4352