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General Practice 5e. Drugs of Choice CIMS Publishing year To get the free app, enter mobile phone number. We also observed some gross qualitative variation regarding drug information given in different sources. Conclusion: Variation exists in the quantity and quality of information available on indications about drugs available in various sources.
Necessary steps need to be taken to harmonize drug information available across various sources so as to provide reliable and uniform drug information thereby promoting rational drug use.
There are various sources of information which are utilized by treating physicians for accessing relevant drug information such as their indications, ADRs, contraindications, and special precautions.
Drug information is usually sourced from National Formularies e. It has been observed that there is variation in the quantity and quality of information mentioned in different drug information sources and a single credible benchmark is lacking.
Such variation not only deprives the medical fraternity from accessing reliable drug information but can also promote off-label and irrational drug use leading to increased incidence of adverse reactions and possible treatment failure.
These drugs were chosen on the basis of prescription pattern in the hospital.
Two senior residents D. Clinical Pharmacology students and one PhD student collected and analyzed the PIs of the selected drugs. The following parameters were assessed. The number of drugs out of the selected 50, whose indication information was missing in different sources. Total number of indications given in different sources, in respect of these 50 drugs. Average number of indications per drug mentioned in different sources. After doing the above assessments, we did a subset analysis in respect of: Only those drugs whose indications were given in CDSCO website list.
In the next step, we compared only those drugs whose indications were mentioned in all the four sources. We also looked upon gross qualitative differences existing across various sources of drug information used in this study.
To find the difference between different sources, data were statistically analyzed by applying Friedman Test using Graph Pad Instat trial version software.
Only MIMS contained information about all the 50 drugs. The number of indications per drug was variable in all these four sources. The details of this information are given in Table 1.
NFI was excluded from this analysis as this source had information of only about 24 of these 40 drugs. ADRs of each drug were compared among the various drug information sources. Parameters assessed were: i number of drugs out of the 44 drugs studied that were not mentioned at all in various sources, ii average number of ADRs mentioned for all drugs in various sources, iii total ADRs of prototype drugs from each antihypertensive group, iv serious ADRs of the prototype drugs mentioned, and v qualitative analysis of serious ADRs among different sources.
Pharmacology textbooks  ,  provided ADRs of drug groups as a whole and not of individual drugs. Medicine textbook  mentioned various drug therapies and regimens and did not deal with the details of drugs like ADRs in detail.
Therefore, data from these textbook sources of information were not included in the final analysis. Figure 1: Number of drugs studied per group.
The maximum number of antihypertensive drugs was mentioned in DT 36 out of 44 studied , it being deficient in only 8 drugs. None of these sources of information was complete in providing wholesome information regarding ADRs of antihypertensive drugs and there was variability in description [Table 1]. Table 2: Comparison of serious adverse drug reactions of prototype antihypertensive drugs Click here to view Qualitative analysis Serious ADRs were analyzed in these sources of information.
Data were incomplete in all sources of information; NFI does not mention all the drugs and is silent on few of the serious ADRs. DT does not mention all the drugs and is silent on most of the serious ADRs.
Table 3: Variability in mentioning serious cardiovascular adverse drug reactions of antihypertensive drugs Click here to view NFI seems the best source as far as serious ADRs information is concerned; however, a few serious ADRs were not mentioned even in NFI. DT reported serious ADRs for only a few of the drugs overall, most of which are cardiovascular events.