Study of Prescribing Patterns for Prophylaxis and Treatment of Complications of Liver Cirrhosis in Hospitalised Patients at A Tertiary Care Teaching Hospital
Study of Prescribing Patterns for Prophylaxis and Treatment of Complications of Liver Cirrhosis
Keywords:
Cirrhosis, Prescription PatternAbstract
Introduction: Managing patients with cirrhosis can be a challenge and requires an organized and systematic approach. Adherence to available guidelines for management of cirrhosis complications and optimal treatment in actual practice is low. Aims and Objectives: To study the prescribing pattern of the drugs used for treatment of complications of liver cirrhosis on admission and on discharge and to study adverse drug reactions of drugs.Methods: Continuous, longitudinal, prospective, observational, single centre study conducted at in-patient ward of Medicine department, Civil Hospital Ahmedabad. Result: Alcohol was most common aetiology. Ascites with hepatic encephalopathy were most common combination of complications. Thirteen different drug groups were prescribed like antimicrobials, antiemetics, ulcer protective, laxatives, anti-haemorrhagics, LOLA, diuretics, blood components, minerals, vasoactive agents, beta blockers and chologogues. Most common drug group causing ADRs was diuretic and most common drug was Furosemide. Conclusion: Some deficient areas in quality of care of complications of cirrhosis patients were observed.[Malpure R NJIRM 2017; 8(3):98-104]
References
2. MokdadAA,LopezAD,ShahrazS,etal.Livercirrhosismortalityin187countriesbetween 1980 and 2010: a systematic analysis. BMC Med 2014;12:145.
3. Kanwal F, Kramer JR, Buchanan P, et al. The quality of care provided to patients with cirrhosis and ascites in the Department of Veterans Affairs. Gastroenterology 2012; 143:70-77.
4. World Health Organization. WHO model list of essential medicines (adults), 19th ed. Geneva, 2015 (www.who.int/medicines/publications/essentialmedicines/EML2015 8-May-15.pdf).
5. A Government of Gujarat. Essential Drug List of 2016-17(EDL).(https://gmscl.gujarat.gov.in/ images/ pdf/EDL-2016-2017.pdf)
6. Bedini A, Maria N, BuonoM, Bianchini M, ManciniMetal.Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome. Digestive and Liver Disease, Volume 48, Issue 10, October 2016, Pages 1142 – 1147.
7. Waghray A, Waghray N, Khallafi H, Menon K. Vaccinating Adult Patients with Cirrhosis: Trends over a Decade in the United States. Gastroenterology Research and Practice.Volume 2016 (2016).
8. Runyon BA. Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology 2013Apr.
9. PicardiA,Gentilucci U. Proton pump inhibitor prescription abuse and sepsis in cirrhosis. World J Gastrointest Pharmacol Ther. 2016 Feb 6; 7(1):1–410. Meyer, AV, Green M, Pautler H, Korenblat K, Deal E et al. Impact of Vitamin K Administration on INR Changes and Bleeding Events Among Patients With Cirrhosis. Annals of Pharmacotherapy1–5.
11. Lawate P et al. A prospective, multicentre, observational study of patients with chronic cholestatic liver diseases receiving Udilivin India: Splendid study. Int J Basic Clin Pharmacol. 2016 Dec;5(6):2621-2629
12. Amarapurkar PD, AmarapurkarDN.Management of Coagulopathy in Patients with Decompensated Liver Cirrhosis. International Journal of Hepatology.Volume 2011, Article ID 695470, 5 page.
13. Lucena MI, Andrade RJ, Tognoni G, Hidalgo R, de la Cuesta FS, Fraile JM, Cabella R, et al. Multicenter hospital study on prescribing patterns for prophylaxis and treatment of complications of cirrhosis. Eur J Clin Pharmacol 2002;58:435-440.
14. Meenu V, Anisha KA, Arjun SKS, Roshni PR. Clinical Profile and Prescribing Pattern of Cirrhosis in a Tertiary Care Hospital. Ind J of Pharmacy Practice, Vol 7, Issue 3, Jul–Sep, 2014
15. The use of the WHO-UMC system for standardised case causality assessment. Available at http//www.who-umc.org/Graphics/24734.pdf
16. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther.1981;30(2):239-45.
17. Hartwig SC, Siegel J, Schneider PJ (1992) Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 49: 2229–32.
