24-09-2012, 01:54 PM
DRUG INTERACTION IN POLY PRESCRIPTIONS; EVALUATION AND MANAGEMENT
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ABSTRACT
Drug Interaction is increasing day by day leading to the major manifestations of Health care issues. According to “WHO” Drug Interaction was estimated to be from 6.2 % to 6.7 % per year. According to the “Journal of the American Medical Association” (JAMA 1996) reported that 108,000 American died in hospital and 2.2 million American had reaction to “FDA” permitted medication. To overcome for this scenario there are numerous sources of in sequence which accessible to Prescriber, Pharmacist and User about the Drug Interaction. In 2009, in the UK, drugs are gradually more obtainable over the counter and on-line devoid of prescription. Additionally, close at hand is widespread use of numerous herbal medicines from relatively under-regulated suppliers and the constituents of such products are often not known. This clinical reality of the widespread use of potent medicines – be they allopathic or traditional showed us the need for a practical hands-on guide that aims to be a compact, succinct and accessible source of Information for practitioners, prescribers and the public about adverse drug-Interactions. In this Cross Sectional Study total 300 Prescriptions were collected after analysis 250 informed consent have filled. Rest in 50 prescriptions the prescribing pattern errors have found including consent displeasure. In 250 prescriptions 70 is interacted and 180 is non-interacted or safe, without any significance level. The statically data have given below and graph demonstrates the interaction in all clinic, Government and private sectors hospitals. In this study poly prescription evaluation in primary, secondary and tertiary care hospitals. The percentage of interacted and non-interacted prescription is 28% in the city of Karachi, Pakistan. Female genders were more susceptible for interaction due to various causes about 17.6% and Male about 10.4% out of 28%.The major significance level is about 4% in Major Interaction, Moderate is about 13.6% and Minor is about 14.8%. Most Interaction Found in Cardiovascular is about 11.6% along with it 2.0 % interaction in Angina and 1.2% in Arrthymias.
INTRODUCTION
Drug Interaction refers to an adverse drug response which is produced by the co-administration and effects the action of a drug so the response of the drug may be augmented or decreased, and sometimes produces their own response (National Prescribing Services et. al). According to National Prescribing service interaction may be in between drugs, between drug and food, and between drug and herb etc .Some drug interactions are accidental or taken place due to the abuse, unawareness and therapeutic relationship of the vigorous components and the pertinent substance involve. Numerous of interaction occurs because of the alterations in metabolism (Elizabeth et al). Additionally enzymes are characteristically activated all the way through meeting of nuclear receptors. For Evaluation and Management of Drug interaction, in 1948 National war Formulary published but slowly and surely its effectiveness reduced but in1976 British National Formulary was discontinued again. After 1976, again in BNF born in 1981 after a long lasting effort, slowly and gradually the BNF improved.
MATERIAL AND METHOD
Study Protocol Design: This is cross sectional study, in which collection of prescriptions on especially design formulated shown to the end of the thesis, including all age groups at different tertiary care hospitals including Government and Private sectors of Karachi with no duration of time limit and Evaluate through Statistical Parameters. The hospital selection was done keeping in view the patients of different economic classes i.e. higher/lower. Prescriptions from the different hospitals, clinics and general practitioners have been collected. The Prescriptions have been categorized according to Diagnosis, Sex, Age, And No. of drug prescribed. After categorization critically, prescription have been evaluated on the basis of the of drugs which have been prescribed by the prescriber, during all the producer, the patient counseling has already been made and suggested advised in the patients regarding the outcomes of the drugs which have been prescribed by the concern consultant. The concern prescriber have also been contacted and try to convince regarding the errors of the prescriptions.
CONCLUSION
The result that have been evaluated clearly shows the pattern of prescribing practices f the General Practitioners of different Private or Public Hospital, Clinics in Karachi. Accumulative result shows that there are 28% interaction Drug-drug interaction, if focused on other interaction type such as herb and food etc surely have find out the interaction and can correct just by different conversation tools. In the opinion of other healthcare professionals like Pharmacist are alarming. The mortality rate of their interaction could not evaluate due to the patient non-compliance. Only Drug interaction in poly prescription in the above mention rate is shocking and need to address by giving a proper knowledge to the General practitioners or to advice them to be in touch this latest development in the field of medicine. Table and Graphical information shows that the citizens of Karachi are not taking the proper medication in case of different element and need to be address by the Government levels and other steps and minimize to eradicate this interaction or to minimize the Percentage of interaction to an appropriate level for reducing the mortality rate.