Abstract
Objective: To evaluate medication use pattern and adverse drug reactions (ADRs) among stroke patients admitted in Neurology department of a multi-speciality hospital.Methods: A prospective observational study was carried out for a period of 6 mo, in a 750 bedded multi-speciality hospital in Bangalore. The clinical pharmacist analysed the medication use pattern and occurrence of ADRs in stroke patients.Results: Out of 100 patients, 75% had an ischemic stroke and 25% had a hemorrhagic stroke. The incidence of stroke was found to be higher in males (66%) compared to females (34%). Most of the patients were of the age group>60 y (52%). The common risk factors for stroke were hypertension (31%), diabetes (24%), and dyslipidemia (21%). The average number of drugs prescribed per patient was 7.67±3.1. The most common class of drugs prescribed were antihypertensives (14.3%), neuroprotectors (14.1%), antiplatelets (11.5%) and antihyperlipidemic (10.4%). Aspirin monotherapy was more prevalent in this study. Only 4 patients received thrombolytics. During the study, a total of 18 ADRs were reported from 14 patients (18%). Amlodipine (16.6%) and fondaparinux (11%) were the more frequent to cause ADRs. The most common reactions were bleeding (33.3%), pedal edema (16.6%) and headache (11.1%).Conclusion: The study helps to identify drug utilization pattern and in addition to monitor adverse drug reactions among stroke patients. The study also emphasises the need for creating awareness regarding early recognition of stroke symptoms, which helps to prevent the occurrence of stroke.
Highlights
According to World Health Organization (WHO), “stroke is a clinical syndrome characterized by rapidly developing clinical symptoms and/or signs of focal, and at times global, loss of cerebral function, with symptoms lasting more than 24 h or leading to death, with no apparent cause other than that of vascular origin [Hatano, 1976]
It was observed that 75% (n=75) patients had an ischemic stroke and 25% (n=25) had a hemorrhagic stroke
Two large pivotal clinical trials have shown that there is no significant benefit in stroke patients. These results focuses on the need of demonstrating the rationality behind IV citicoline use [20]
Summary
According to World Health Organization (WHO), “stroke is a clinical syndrome characterized by rapidly developing clinical symptoms and/or signs of focal, and at times global (applied to patients in deep coma and those with subarachnoid hemorrhage), loss of cerebral function, with symptoms lasting more than 24 h or leading to death, with no apparent cause other than that of vascular origin [Hatano, 1976].Ischemic stroke is accountable for 85% of cases. According to World Health Organization (WHO), “stroke is a clinical syndrome characterized by rapidly developing clinical symptoms and/or signs of focal, and at times global (applied to patients in deep coma and those with subarachnoid hemorrhage), loss of cerebral function, with symptoms lasting more than 24 h or leading to death, with no apparent cause other than that of vascular origin [Hatano, 1976]. 15 % of the stroke cases belongs to hemorrhagic stroke, which results due to rupture of a weakened blood vessel leading to compression of the surrounding brain tissue [1]. According to the Indian epidemiological data, the incidence rate of stroke is considered to be 102-152 per 100000 persons. Indians are having a higher risk of developing stroke, which may be due to the high prevalence of risks factors such as obesity, smoking, hypertension, high cholesterol, alcohol consumption and diabetes [3]
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