Study of Drug Utilization Pattern of Glucocorticosteroid Drugs with ...

Ankit P - Study of Drug Utilization Pattern of Glucocorticosteroid Drugs with Special Emphasis on their Immediate Adverse Effects in a Tertiary Care Teaching Rural HospitalSrNo.Table 6: Adverse Drug Reaction (ADR) of steroid observed in patients.Name of Adverse Drug Reaction Observed in Patients Percent (%)Adverse Drug Reaction from Short Course of Steroid1 Insomnia 25 25.02 Psychosis 1 1.03 Heart Failure 2 2.04 Peptic Ulcer 1 1.05 Hyperglycemia 3 3.0Adverse Drug Reaction from Longer Course of Steroid1 Cushing Syndrome 4 4.02 Fragile Skin And Purple Striae 1 1.03 Ecchymoses 0 0.04 Susceptibility To Infection 0 0.05 Delayed Healing Of Wounds &Surgical Incision 0 0.06 Muscular Weakness 45 45.07 Osteoporosis 1 1.08 Osteonecrosis 0 0.09 Mild Euphoria 0 0.010 Hypomania Or Depression 1 1.011 Hypertension 1 1.012 Glaucoma 0 0.013 Posterior Subcapsular Cataract 2 2.014 Acute Adrenal Insufficiency 0 0.015 Malaise 0 0.063% of patients developed glucocorticoid-type skinchanges and abnormal fat deposition. This wasconsidered the most distressing effect by the patients andwas most frequently seen in women and youngerpatients. Neuropsychiatric disorders, including irritability,anxiety, depression, euphoria, hyperactivity, and manicepisodes, were reported in 52.5%. Skin disorders wereseen in 46.2% of patients, more frequently in women and39% of women described menstrual disorders. Musclecramps and proximal muscle weakness were reported by32.5% and 15% of patients, respectively. New-onset3hypertension developed in 8.7% of patients.In a prospective cohort study of 2108 patients withinflammatory polyarthritis from a community-basedregister at Mayo Clinic, the incidence of hospitalizationfor infection was more than 2.5 times that of the generalpopulation. Use of glucocorticoids was identified as an4independent risk factor for hospitalization for infection.The incidence of various glucocorticoid-associatedadverse events was identified in a large population-basedstudy of over 3 million members of a national managedcare organization, 6517 long-term glucocorticoid users5(>60 days).The adverse event with the greatest prevalence wasweight gain, experienced by 80% of patients in thehighest quartile of glucocorticoid use. Skinbruising/thinning and sleep disturbance were the nextmost commonly reported adverse events. Cataracts (15%overall) and fractures (12% overall) were reported less6frequently but were still common.In our study, most frequent adverse drug reactionobserved were muscular weakness and insomnia. Butthese come under possible category, because samesymptoms are very common in elderly group of patientsdue to co-morbid conditions.CONCLUSIONIn the study, use of glucocorticoid drugs were appropriateand according to standard guideline and current protocolof prescribing glucocorticoid drugs. Obviously, lessnumber of adverse drug reaction were observed.However, there is over prescribing of the drugs to theIndian Journal of Pharmacy Practice Volume 3 Issue 4 Oct - Dec, 2010 22