Author(s):
Shazma Imam, Priti Sharma, Dinesh Kumar Mehta, Sandeep Joshi, Rina Das
Email(s):
dkmehta17@rediffmail.com
DOI:
10.5958/0974-360X.2020.00654.X
Address:
Shazma Imam1, Priti Sharma1, Dinesh Kumar Mehta1*, Sandeep Joshi2, Rina Das1
1MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana,
Ambala- Haryana (India) - 133207
2MM Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala- Haryana (India)-133207.
*Corresponding Author
Published In:
Volume - 13,
Issue - 8,
Year - 2020
ABSTRACT:
Objectives: This study aimed to explore the prescribing pattern of steroids among patients from different departments and study the most commonly prescribed corticosteroid medications and the assessment of patient knowledge about the use of corticosteroids. Methods: We conducted a prospective observational study on 120 patients receiving corticosteroids in the department of General medicine, Respiratory and Orthopedic in a tertiary care teaching hospital for the period of 6 months. Inpatients between 18-60 years receiving corticosteroid therapy were included in the study, exclusion of those patients who were under critical condition, lactating and nursing mothers and those not willing to sign on inform consent form. Key findings: The study involved 120 patients to evaluate the appropriate use of corticosteroids. The analysis of prescription was done and 24% of the prescriptions were found with drug interactions, the majority of drug interactions were minor (72%), followed by moderate (26%) and no severe interaction was found, and 76% were without interactions. Total 29(24.1%) side effects were found in the study due to corticosteroid use, hypertension was detected in 8 (28%), hyperglycemia in 7 (24%), sleep disturbance in 5 (17%), weight gain in 5 (17%) and gastrointestinal upset in 4 (14%). The use of inhaler was improved in patients from 55% to 83%. Conclusions: The study was found to be rational as the majority of interactions were minor, followed by moderate and no severe interaction was found. Greater awareness for use of corticosteroids is essential; therefore, strategies to improve drug safety, and better patients outcome. Prevention of side effects and rational prescribing can be better achieved by clinical pharmacist’s intervention in patient care.
Cite this article:
Shazma Imam, Priti Sharma, Dinesh Kumar Mehta, Sandeep Joshi, Rina Das. Corticosteroid Utilization Pattern: A Prospective study at a Tertiary Care Teaching Hospital. Research J. Pharm. and Tech. 2020; 13(8):3697-3701. doi: 10.5958/0974-360X.2020.00654.X
Cite(Electronic):
Shazma Imam, Priti Sharma, Dinesh Kumar Mehta, Sandeep Joshi, Rina Das. Corticosteroid Utilization Pattern: A Prospective study at a Tertiary Care Teaching Hospital. Research J. Pharm. and Tech. 2020; 13(8):3697-3701. doi: 10.5958/0974-360X.2020.00654.X Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2020-13-8-27
REFERENCE:
1. Kendall EC. Nobel lecture: The development of cortisone as therapeutic agent. 2013:21-25.
2. Kendall EC, Reichstein T, Hench SP. Nobel lecture: The development of cortisone as a therapeutic agent. 1950:271-280.
3. Joseph J. What is corticosteroid phobia? Contact magazine news 2013;102-115
4. Tuder RM, Petrache I. Pathogenesis of chronic obstructive pulmonary disease. J Clin Invest 2012:122(8);2749–55.
5. Mathers CD, Loncar D: Projections of global mortality and burden of disease from 2002 to 2030. PLOS Med 2006;3(11):442-8.
6. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet 2007; 370:765–73.
7. Qiu Y, Zhu J, Bandi V, Atmar RL, Hattotuwa K, Guntupalli KK, Jeffery PK. Biopsy neutrophilia, neutrophil chemokine and receptor gene expression in severe exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003;168:968–75.
8. Fujimoto K, Yasuo M, Urushibata K, Hanaoka M, Koizumi T, Kubo K. Airway inflammation during stable and acutely exacerbated chronic obstructive pulmonary disease. Eur Respir J 2005;25:640–6.
9. Hurst JR, Perera WR, Wilkinson TMA, Donaldson GC, Wedzicha JA. Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006;173:71–8.
10. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung Disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med 2017;195(5):557-82.
11. Walters JA, Tan DJ, White CJ, Gibson PG, Wood-Baker R, Walters EH. Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2014:1288.
12. Suissa S, Barnes PJ. Inhaled corticosteroids in COPD: the case against. European Respiratory Journal 2009;34:13-16.
13. Holgate S.T., Polosa R. Treatment strategies for allergy and asthma. Nat Rev Immunol 2008;8:218–30.
14. Jeffery PK. Remodeling and inflammation of bronchi in asthma and chronic obstructive pulmonary disease. Proc Am Thor Soc 2004;1:176–83.
15. Charan NB, Baile EM, Pare PD. Bronchial vascular congestion and angiogenesis. Eur Respir J 1997;10:1173–80.
16. Kumar SD, Emery MJ, Atkins ND, Danta I, Wanner A. Airway mucosal blood flow in bronchial asthma. Am J Respir Crit Care Med 1998;158:153–6.
17. Mendes ES, Campos MA, Hurtado A, Wanner A. Effect of montelukast and fluticasone propionate on airway mucosal blood flow in asthma. Am J Respir Crit Care Med 2004;169:1131–4.
18. Kanazawa H, Asai K, Hirata K, Yoshikawa J. Vascular involvement in exercise-induced airway narrowing in patients with bronchial asthma. Chest 2002;122:166–70.
19. Kanazawa H, Nomura S, Yoshikawa J. Role of microvascular permeability on physiologic differences in asthma and eosinophilic bronchitis. Am J Respir Crit Care Med 2004;169:1125–30.
20. Brown RH, Zerhouni EA, Mitzner W. Airway edema potentiates airway reactivity. J Appl Physiol 1995;79:1242–8.
21. Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014;43(2):343-73.
22. Krasselt M, Baerwald C. The current relevance and use of prednisone in rheumatoid arthritis 2014;10(5):557-71.
23. Anusreeraj RS, Prejith P, Diya S, Juliya J, Sivakumar R. A prospective study on drug utilization pattern of glucocorticoids in pulmonology department in a tertiary care teaching hospital. World journal of pharmacy and pharmaceutical science 2016;1511-7.
24. Ference JD, Last AR. Choosing topical corticosteroids. American family Physician. 2009;79(2):51-9.
25. Schweiger TA, Zdanowicz M. Systemic corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease. Am J Med 2010; 67(13):1061–9.
26. Min KH, Ree CK, Jung JY, Suh MW. Characteristics of Adverse Effects When Using High Dose Short Term Steroid Regimen. Korean J Audiol 2012;16(2):65–70.