Journal of Clinical and Pharmaceutical Research

Adverse Drug Reactions in Psychiatry: An Alarming Scenario

Wed, 31 Jul 2024 00:00:00 -0400

In the world, India is the largest producer of pharmaceuticals. It is very much essential that the treatment with these drugs should be efficacious, safe and cost effective. Every year, introduction of newer drugs and the production of various pharmaceutical products were increasing. World Health Organization (WHO) realized the need for a responsible surveillance system in order to ban the noxious drugs in the market. Both in hospitalized and ambulatory patients, ADRs are the significant cause of morbidity and mortality. Around 6-15% of the hospitalized patients may experience a serious ADR and nearly 6.5% of the hospital admissions are admission due to ADR. Some of the new ADRs that can be seen with psychotropic drugs are Risperidone associated with an increased risk of stroke in elderly patients with dementia and dopamine receptor agonists (Cabergoline and Pergolide) associated with cardiac valve fibrosis. So many drugs act at more than one receptor type. Tricyclic antidepressants shows their therapeutic effect by the stimulation of monoaminergic pathways by a reduction in monoamine reuptake, but tricyclic antidepressants also show the antimuscaranic activity and this is responsible for adverse effects like retention of urine, drymouth and constipation. To avoid the noxious reactions of psychotropic drugs, pharmacovigilance plays a pivotal role in detecting the adverse drug reactions that alert the psychiatrist in their management. In developing countries like India, pharmacovigilance activities are still in initial stage and especially in case of psychotropic drugs only few reports are available on this concern. A wide range of surveillance programs on adverse drug reactions of psychotropic drugs should be emphasized, in our Indian scenario to strengthen the database.

A Study on the Prevalence of Co-morbidities among the Patients with Chronic Kidney Disease

K. Pushpavalli, S.T.P Prasuna , V. Bhavana Priya — Wed, 31 Jul 2024 00:00:00 -0400

Aim: The main aim of this study is to assess the prevalence of various co-morbidities among the patients with chronic kidney disease.

Methods: This was a prospective study conducted for a period of six months at a tertiary care hospital of East Godavari district, Andhra Pradesh. Patients with both the genders who were diagnosed with CKD with an age of above 18 years were included and patients with acute renal failure were excluded from this study.

Results: In this study, most of the study participants were observed with stage-V CKD (80.4%) followed by stage-IV CKD (12.1%). Nephropathy due to hypertension (45.1%) and diabetes (24.3%) were observed to be the most common causes among the CKD patients in this study. Hypertension associated with diabetes (29.3%) was observed to be the most common co-morbidities in this study. Loop diuretics (43.7%) and calcium channel blockers (32.1%) were observed to be the most commonly prescribed anti-hypertensive drugs among the CKD patients associated with hypertension. Short acting insulin (71%) and sulfonyl ureas (13.1%) were observed to be the most commonly prescribed anti-diabetic drugs among the CKD patients associated with diabetes.

Conclusion: Routine screening and regular check-ups along with effective management of co-morbidities in CKD require a comprehensive approach that integrates the pharmacotherapy and inter-disciplinary collaboration. Clinical pharmacists should employ evidence-based practices, monitor drug interactions and advocate for patient-centred care to enhance the quality of life of CKD patients.

Assessment of Quality of Life in Patients with Chronic Kidney Disease Undergoing Hemodialysis based on Physical, Social, Emotional and Mental Statuses

Vithanala Srinivasa Rao, Pragada Rajeswara Rao, Gummalla Akanksha — Wed, 31 Jul 2024 00:00:00 -0400

Aim: To assess the quality of life in patients with Chronic Kidney Disease (CKD) who were undergoing hemodialysis based on their physical, social, emotional and mental statuses.

Methods: This was a prospective observational study. Patients of both the genders with an age of above 35 years who were diagnosed with Chronic Kidney Disease (CKD) especially with stage III, IV, V and with a glomerular filtration rate of <30ml/min were included in this study whereas, patients with acute kidney disease were excluded from the study. In this study, SF-36 questionnaire was used for the assessment of quality of life among the patients with ESRD who is undergoing haemodialysis. The score may ranges from 0-100 and the interpretation includes higher the score indicates favorable health state and lower the score indicates more the disability. The patients were interviewed twice, with a time gap of 45 days from the date of first interview and were represented as V₀ (Day-1) and V₁(Day-45).

Results: A total of 117 subjects were recruited in this study. The mean PCS value at V₀ was observed to be 42.9 which was reduced to 40.3 at V₁ with a mean difference score of 2.6. The mean MCS value at V₀ was observed to be 49.3 which was reduced to 43.3 at V₁ with a mean difference score of 6. The PCS scores were observed to be increased among 31.6% study participants whereas it was observed to be decreased among 65%. No change in the aspect of PCS scores were observed among 3.4% study participants. The MCS scores were observed to be increased among 32.5% whereas it was observed to be decreased among 66.7%. No change in the aspect of MCS scores were observed among 0.8% study participants.

Conclusion: Based on the mean scores observed, the quality of life was slightly decreased among the study participants who were undergoing hemodialysis because of the changes in PCS & MCS at V₀and V₁. Proper patient education must be provided by the clinical pharmacists will help the patient in the better management of CKD and also regarding the health related quality of life.

A Study on the Assessment of Nutritional Attitude among the Undergraduate and Postgraduate Students at an Indian Pharmacy College

Wed, 31 Jul 2024 00:00:00 -0400

Aim: To assess the nutritional attitude among the undergraduate and postgraduate students at an Indian Pharmacy college.

Methods: A total of 173 students were participated in this study and by providing the questionnaires to the students, the data was collected in a very precise manner. The Mini Nutritional Assessment Scale consists of various questions in the aspects of screening and assessing the nutritional status of an individual. Based on the total assessment, Malnutrition Indicator Score can be classified into malnourished (< 17 points), at risk of malnutrition (17 to 23.5 points) and normal nutritional status (24 to 30 points).

Results: Among the 173 students 43 (24.9%) students were males and 130 (75.1%) students were females. The mean age of the overall study population was observed to be 20.8 years. The mean weight of the overall study population was observed to be 57.2 kg. Majority of the students were observed with height 151-160cm (43.9%) followed by 161-170cm (28.9%). Most of the study participants were observed to be having no decrease in food intake (56.7%) followed by moderate decrease in food intake (38.7%) over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties. In this study, most of the students were observed with normal nutritional status (48%) followed by at risk of malnutrition (45.1%) based upon the Malnutrition Indicator Score for assessment of nutritional status.

Conclusion: In this study most of the study participants were observed with normal nutritional status followed by at risk of malnutrition. The students who are malnourished or at risk of malnutrition should focus on taking a balanced diet with sufficient nutrition intake may help them to maintain healthy life style. Proper nutrition should be maintained by consuming more amounts of proteins compared to carbohydrates, eating fruits and vegetables regularly is very important aspect of balanced diet. Sufficient fluid intake is also required for a healthy life style. Along with these aspects regular physical activity is much more beneficial to maintain the healthy BMI which improves fitness of the human body.