Prospective assessment of NSAIDS induced ADRs in orthopaedic in-patients

Abstract

Background and Objectives: nonsteroidal anti-inflammatory drugs (NSAIDs) are one among the most widely used medications to treat pain and inflammation condition. But inadvertent use of NSAIDs have resulted in gastric upset and even death. Hence to minimize such consequences and to identify the incidence of the Adverse drug reaction (ADR)s due to NSAIDs in orthopaedic in-patients to promote rational prescribing. Materials and Methods: A prospective study was done in one hundred orthopaedic in-patients of a tertiary care hospital for 3 months from June-Augest 2012. The ADRs pattern were noted with respect to age, gender and drugs involved . The causality of ADRs were assessed by Naranjo’s Algorithm. Results: Among one hundred in- patients 16% developed ADR due to NSAIDs and 1.92% due to Antimicrobial agents (AMAs). The ADRs were more in males (11%) than females (5%). Most prescribed NSAID was Diclofenac (76 %), and least was nimesulide (2%). Others were Paracetamol (16%), Ibuprofen (3%) and Etoricoxib (3%) . Out of 16 ADRs Tablet (Tab) Diclofenac accounted for maximum number {87.5%, (n=14)} of ADRs, followed by Tab. Paracetamol {12.5 % (n=2)}. Conclusion: ADR incidence rate in orthopaedic in-patient due to NSAIDs was 16%. Educating, establishment and encouragement of Pharmacovigilance system among medical and non-health professionals including medical undergraduates improve ADRs identification and to identify the drugs causing it, therefore prolonged hospitalization, treatment cost, morbidity and mortalities can be minimized. Hence, further ADRs due to particular drugs can be reduced in other patients with rational prescription.