Drug utilization pattern and adverse drug reaction monitoring in the cardiac emergency of a tertiary care teaching hospital: An observational study

Abstract: BACKGROUND: The cardiac emergency stands critical for careful medication evaluation because it is a setting that requires very low margin of error and intensive monitoring. Polypharmacy is employed as a strategy to address acute cardiac emergencies, wherein medications with varying levels of adverse effects are concurrently provided. The presence of drug interaction presents a compelling argument for the necessity of conducting a thorough medication assessment in a cardiac healthcare setting. METHODOLOGY: A prospective observational study was undertaken on 500 cardiac emergency patients at tertiary care teaching center, in Delhi. Assessments included demographics, comorbidities, cardiovascular emergencies, polypharmacy, and adverse reactions. Prescriptions were also assessed for the World Health Organization rational therapeutic prescribing parameters. RESULTS: Among 500 patients, 44.6% had a family history of coronary artery disease and 38.8% of patients presented with comorbidity. The most common comorbidity encountered was hypertension (17.2%) trailed by diabetes with hypertension (12%). The predominant cardiac emergency observed was myocardial infarction, accounting for 86.4% of cases. Polypharmacy was found in 60% of prescriptions. A total of 2470 drugs were prescribed out of which only 171 drugs were prescribed by their generic name. 60% of drugs constituted from drugs acting on the blood, whereas drugs acting on the cardiovascular system constituted 17.6%. 40% of the patients developed mucosal bleed and 23% developed epistaxis. CONCLUSION: Most of the findings of this study align with established pharmacological strategies for managing cardiovascular emergencies. Pantoprazole was the most frequently prescribed drug. Drugs were prescribed by their brand names in most of the prescriptions which was found to be in contrast to prescription guidelines.