The objective of this survey is to monitor the different Adverse Drug Reactions experienced by the patients treated with antidiabetics, antianginals and antibiotics from different hospitals. Adverse Drug Reaction profile or ADR was done mainly for monitoring the expected, unexpected side effects of a medication or combinations of medications. ADR profiling was done by healthcare professionals of different hospitals and clinical centers. ADR Profiling aimed to identify and quantify the risks associated with the use of drugs dispensed in a hospital setting. In this survey the ADR profiling was done with the help of hospital pharmacists from different Government and Private Hospitals across Kolkata, West Bengal. This survey only focused on the ADR Profile of antidiabetics, antianginals and Antibiotics. Some observed side effects of the report included antidiabetics having weight gain, nausea, vomiting. Antianginals showed symptoms of dizziness, fatigue, and headache. Whileside effects of antibiotic drugs included skin rash, itching and other allergic reactions. A comprehensive compilation of the work has been reported for guidance of healthcare professionals with an aim to encourage rational drug therapy and rational use of these categories of drugs and take appropriate remedial measures to improve quality of life of patients.
All toxic and unintended responses to a medicine related to any dose level are considered as adverse drug reactions.
Globally adverse drug reactions (ADRs) make a great impact on human health. Introducing a systematic approach could resolve these problems. Formalized monitoring was developed to diagnose and take action as a strategy to respond against these problems. Every year new kinds of drugs emerges which come with their own ADRs. Sometimes these ADRs could be minor at the other it could be life-threatening. So monitoring the ADRs is an important duty of the regulatory authorities.
It is crucial that hospitals and other organizations take advantage of these tools which can help improve how medicines are managed. ADRs has been developed with the help of healthcare professionals to help hospital staff take a structured approach to the monitoring of medicines, identifying any ADRs and then making changes to improve a patient's health and wellbeing.
Antidiabetics are those agents which help to lower the high blood glucose level.
Diabetes is not a single disease. Rather, it is a combination of syndromes characterized by elevated blood glucose attributed to a relative or absolute deficiency of glucose.
Type 1 diabetes — It is the most common type, characterized by an absolute deficiency of insulin due to destruction of
Type 2 diabetes – It is characterized by a lack of insulin sensitivity of target organs. In type 2 diabetes, the pancreas sustains some
Antidiabetic drugs do not cure diabetes;rather they help diabetics to keep their blood glucose level under control resulting in lower risk of complications. Type 1 diabetes patients daily need insulin injections to maintain health. Whereas in type 1 diabetes patients exogenous insulin is administered to substitute for absent insulin secretion.
Oral anti-diabetic drugs are useful in the treatment of patients with type 2 diabetes that is not controlled with diet. Patients with chronic state of disease may require a combination of oral drugs with or without insulin to control hyperglycemia.
Sulfonylureas stimulate release of insulin from the
Glinides bind to a distinct site on the
Metformin is the most commonly used Biguanides. It works by reducing the rate of hepatic gluconeogenesis. Metformin also slows intestinal absorption of sugars and improves peripheral glucose uptake and utilization.
The TZDs lower insulin resistance by acting as agonist for the peroxisome proliferator-activated receptor-γ(PPARγ), a nuclear hormone receptor. Activation of PPARγ regulates the transcription of some insulin responsive genes, resulting in increased insulin sensitivity in adipose tissue, liver and skeletal muscle.
Located in the intestinal brush border, α-Glucosidase enzymes break down carbohydrates into glucose and other simple sugars that can be absorbed.
These drugs inhibit the enzyme DPP-4 which is responsible for the inactivation of incretin hormone such as GLP-1. Prolonging the activity of incretin hormones increases insulin release in response to meals and reduces inadequate secretion of glucagon.
Antianginal drugs are those that prevent, abort or terminate attacks of angina pectoris.Angina pectoris or angina is a pain syndrome due to induction of an adverse oxygen supply or demand situation in a portion of the myocardium. Metabolites that accumulate due to myocardial ischemia elicit the pain. Angina pectoris has different patterns -
Classical angina is one of them. Classical angina is the most common form of angina and therefore known as angina pectoris. It is usually characterized by a short-lasting burning, heavy or squeezing feeling in the chest.
Another pattern is unstable angina. In this chest pain frequency increases, the intensity and duration are precipitated by progressively less effort.
Prinzmetal angina is an uncommon pattern of episodic angina, which occurs at rest due to coronary artery spasm.
Drugs used in angina exploit two main strategies, one being reduction of oxygen demand and another one is increase of oxygen delivery to the myocardium.
The organic nitrate agents are prodrugs that are sources of nitric oxide(NO). NO activates the soluble isoform of cGMP. In turn, cGMP promotes the dephosphorylation of the myosin light chain and the reduction of cytosolic Ca2+ and leads to the relaxation of smooth muscle cells in a broad range of tissues. Some examples of nitrates are Glyceryl trinitrate, Isosorbide dinitrate, Isosorbide mononitrate.
The
The calcium channel blockers (CCB) decrease intracellular availability of Ca2+ by blocking its entry and thus allow blood vessels to relax.
In ischemia calcium influx increases due to membrane depolarization that produceshypoxia. The CCB protect tissue by blocking the entrance of calcium into cardiac and smooth muscle cells of the coronary and systemic arterial beds and decreases the smooth muscle tone and vascular resistance, afterload.
Ranolazine inhibits the late phase of sodium current (INa), improving the oxygen supply and demand equation. Inhibition of late INa reduces intracellular sodium and calcium overload, thereby improving diastolic function.
Antibiotics are those drugs, which prevent infection caused by bacteria in human beings by either killing the bacteria or making it difficult to grow or multiply.
Antibiotics can be classified by their spectrum of activity -
Narrow-spectrum agents (e.g., penicillin G) affect primarily gram-positive bacteria.
Broad-spectrum antibiotics, such as tetracyclines and cephalosporin, affect both gram-positive and some gram-negative bacteria.
An extended-spectrum antibiotic is chemically modified so that it acts on additional types of bacteria, belonging to gram-negative.
Antibiotics work through a range of mechanisms of action. Maximum of them inhibit bacterial cell wall synthesis, and they are referred to as β-lactam antibiotics.
Other antibiotics, such as the aminoglycosides, chloramphenicol, erythromycin, and clindamycin, work by inhibiting protein synthesis in bacteria.
The antibiotics that are selectively toxic bind to or inhibit the function of the proteins of bacteria. They prevent the synthesis of new proteins and new bacterial cells.
Some other antibiotics bind to membrane phospholipids of the bacterial cell and interfere with selective barrier function of cell membrane. This causes leakage of essential macromolecules from the cell and death of the cell.
Some antibiotics, such as the sulfonamides, are competitive inhibitors of folic acid (folate) synthesis that is essential for synthesis of nucleic acids. Sulfonamides are able to inhibit folic acid synthesis because of structural similarity to para-aminobenzoic acid, an intermediate compound that is enzymatically converted to folic acid. The structural similarity of these compounds results in competition between sulfonamide and para-aminobenzoic acid for the enzyme responsible for converting the intermediate to folic acid.
The survey was conducted as verbal interview of the healthcare staff of the hospital and the response were documented as a report. The healthcare personnel were asked about different drugs that are used by the patients in the hospital. The survey was performed on a weekly basis. It took nearly 6 months to complete the survey. The location where the survey was performed is given below;
Nil Ratan Sircar Medical College and Hospital (138, Acharya Jagadish Chandra Bose Rd, Sealdah, Raja Bazar, Kolkata, West Bengal- 700014)
RS V Hospital (40, Deshpran Sasmal Rd, Tollygunge Phari, Tollygunge, Kolkata, West Bengal- 700033)
VIP APEX Medical Centre Pvt. Ltd. (Sachindralal Sarani, Joramandir H/1, 16, VIP Rd, Kolkata, West Bengal- 700059)
The format used for data collection is given below:-
Serial Number
Drug Name (Brand Name/Generic Name
Manufacturer
Dose used
Route of Administration
Use
Frequency
Side effects
The survey was conducted over a period of 6 months in three different hospitals across Kolkata, West Bengal. The results are presented in
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Metformin |
Stadmed Pvt Ltd. |
500, 1000mg |
Oral |
To prevent and treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
2 |
Glimepiride |
Luxmi Pharmaceutical Works |
1, 2mg |
Oral |
To treat type 2 diabetes |
Twice daily |
Hypoglycemia, dizziness, weight gain |
|
3 |
Pioglitazone |
Caplet Healthcare Pvt Ltd. |
15mg |
Oral |
To treat type 2 diabetes |
Once daily |
weight gain, difficulty in urination |
|
4 |
Galvus 50 |
Novartis India Pvt Ltd. |
50mg |
Oral |
To treat type 2 diabetes |
Once daily, twice daily |
Headache, cough, constipation |
|
5 |
Teneligliptin |
Precise Chemipharma Pvt Ltd. |
20mg |
Oral |
To treat type 2 diabetes |
Once daily |
Hypoglycemia, skin rash, loss of appetite |
|
6 |
Voglibose |
Bymaa Laboratories Pvt Ltd. |
0.3mg |
Oral |
To treat diabetes mellitus by lowering postprandial blood glucose level |
Twice daily |
Hypoglycemia, abdominal distension |
|
7 |
Regular Human Insulin |
Novo Nordisk India Pvt Ltd. |
40IU/ml |
Sub-cutaneous |
To reduce high blood sugar level in patients with diabetes |
Once daily |
Hypoglycemia, weight gain |
|
8 |
Lantus |
Sanofi India Ltd. |
100IU/ml |
Sub-cutaneous |
To reduce high blood sugar level in patients with diabetes |
Once daily |
Headache, weakness |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Glyceryl trinitrate |
Salud Care India Pvt Ltd. |
2.6mg |
Oral |
To treat angina |
Twice daily |
Itching, numbness, swelling |
|
2 |
Isosorbide dinitrate |
Unicare India Ltd. |
5mg |
Oral |
To prevent chest pain caused by angina |
Twice daily |
Headache, temporary redness of face |
|
3 |
Atenolol |
Stadmed Pvt Ltd. |
50mg |
Oral |
It can be used to prevent chest pain caused by angina. |
Once daily |
Tiredness, hypotension. |
|
4 |
Propranolol |
Olcare Laboratories |
10, 20, 40mg |
Oral |
Helps to prevent chest pain caused by angina |
Once daily, twice daily |
Dizziness, tiredness, difficulty in sleeping |
|
5 |
Metoprolol |
Mascot Health Series Pvt Ltd. |
25, 50mg |
Oral |
To treat high blood pressure and it helps to prevent anginal pain |
Once daily |
Hypotension, tiredness, dizziness |
|
6 |
Amlodipine |
Tropical Laboratories |
5, 10mg |
Oral |
To treat high blood pressure and to treat certain types of angina |
Once daily |
Headache, nausea, stomach upset |
|
7 |
Ranolazine |
Jackson Laboratory Pvt Ltd. |
500mg |
Oral |
To treat chronic angina |
Twice daily |
Difficulty in breathing |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Amoxicillin and potassium clavulanate |
Rivpra Formulation Pvt Ltd. |
Amoxicillin (500mg) + potassium clavulanate (125mg) |
Oral |
To treat bacterial infections |
Thrice a day |
Diarrhoea, vomiting, indigestion |
|
2 |
Azithromycin |
Gluconate Health Limited |
500mg |
Oral |
To treat bacterial infections |
Once daily |
Diarrhoea, vomiting, stomach upset |
|
3 |
Cefpodoxime |
ZEE Laboratories Limited |
200mg |
Oral |
To treat bronchitis, pneumonia, gonorrhea |
Twice daily |
Sore throat, skin rash |
|
4 |
Cefixime 100 DT |
MenrikBiomerge Pvt Ltd. |
100mg |
Oral |
To treat variety of bacterial infections |
Twice daily |
Diarrhoea, stomach pain |
|
5 |
Cefixime |
Bharat Parenterals Ltd. |
200mg |
Oral |
Used to treat bronchitis, gonorrhoea |
Twice daily |
Diarrhoea, stomach pain, nausea |
|
6 |
Ciprofloxacin |
Diamond Drugs Pvt Ltd. |
500mg |
Oral |
To treat chest, ear, eye infections |
Twice daily |
Diarrhoea, nausea, dizziness |
|
7 |
Levofloxacin |
Pacific Bioengineering Pvt Ltd. |
500mg |
Oral |
To treat pneumonia, kidney infections |
Once daily |
Diarrhoea, nausea, tendon Problems |
|
8 |
Linezolide |
CI Laboratories |
600mg |
Oral |
To treat pneumonia, skin infections |
Twice daily |
Diarrhoea, rash |
|
9 |
Ofloxacin |
Diamond Drugs Pvt Ltd. |
200mg |
Oral |
To treat bacterial infections |
Twice daily |
Diarrhoea, stomach upset, nausea |
|
10 |
Clarithromycin |
CI Laboratories |
50mg |
Oral |
To treat pneumonia, bronchitis |
Twice daily, thrice a day |
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Glyciphage SR |
Franco Indian Pharmaceuticals Pvt Ltd. |
Metformin (500, 1000mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
2 |
Amaryl |
Sanofi India Ltd. |
Glimepiride (1, 2mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Dizziness, weight gain |
|
3 |
Pioz |
USV Ltd. |
Pioglitazone (15 mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Difficulty in urination, weight gain |
|
4 |
Galvus 50 |
Novartis India Pvt Ltd. |
Vildagliptine (50mg) |
Oral |
To treat type 2 diabetes |
Once daily, twice daily |
Headache, cough, constipation |
|
5 |
Tegliptin |
Alkem Laboratories Ltd. |
Teneligliptine (20mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Hypoglycemic, skin rash, loss of appetite |
|
6 |
Volibo |
Sun Pharmaceutical Industries Ltd. |
Voglibose (0.3mg) |
Oral |
To treat diabetes mellitus by lowering post-prandial blood glucose level |
Once daily, twice daily, thrice a day |
Diarrhoea |
|
7 |
Human Actrapid |
Novo Nordisk India Pvt Ltd. |
Insulin 40IU/ml |
Subcutaneous |
To reduce high blood sugar level in patients with diabetes |
Once daily |
Hypoglycemia, weight gain |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Imdur |
Astra Zeneca |
Isosorbide mononitrate (15, 30mg) |
Oral |
To prevent chest pain caused by angina |
Twice daily |
Headache and temporary redness of face |
|
2 |
Sorbitate 5 |
ABBOTT |
Isosorbide dinitrate (5, 10mg) |
Oral |
To prevent chest pain caused by angina |
Twice daily, thrice a day |
Tiredness, hypotension |
|
3 |
Dilzem 30 |
Torrent Pharmaceuticals Ltd. |
Diltiazem (30mg) |
Oral |
To prevent anginal pain |
Once daily |
Headache, constipation, dizziness, fatigue |
|
4 |
Nicardia Retard 20 |
JB Chemicals and Pharmaceuticals Ltd. |
nifedipine (20mg) |
Oral |
To treat and prevent angina |
Twice daily |
Dizziness, edema, fatigue |
|
5 |
Calaptin 120 SR |
ABBOTT |
Verapamil (120mg) |
Oral |
To treat high blood pressure and severe angina |
Once daily, twice daily |
Constipation, dizziness, nausea |
|
6 |
Aten |
ZydusCadila |
Atenolol (25, 50mg) |
Oral |
It helps to treat high blood pressure, chest pain |
Twice daily |
Fatigue, nausea, diarrhea |
|
7 |
Inderal |
ABBOTT |
Propanolol (10, 20 and 40mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Once daily, twice daily |
Tiredness, weakness, diarrhea |
|
8 |
Met XL 25 |
Ajanta Pharma Ltd. |
Metoprolol (25mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Twice daily |
Fatigue, headache, slow heart rate |
|
9 |
Stamlo 5 |
Dr Reddy's Laboratories Ltd. |
Amlodipine (5mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Once daily |
Headache, fatigue, nausea |
|
10 |
Nikoran 5 |
Torrent Pharmaceuticals Ltd. |
Nicorandil (5mg) |
Oral |
To prevent and treat heart related chest pain |
Twice daily |
Headache, nausea, vomiting |
|
11 |
Ranozex 500 |
Sun Pharmaceutical Industries Ltd. |
Ranolazine (500mg) |
Oral |
Used for the management of angian |
Twice daily |
Headache, constipation, dizziness |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Augmentin 625 |
Glaxo Smith Kline Pharmaceuticals Ltd. |
Amoxicillin (500mg) + potassium clavulanate (125mg) |
Oral |
To treat bacterial infections |
Thrice a day |
Diarrhoea, vomiting, indigestion |
|
2 |
Azithral 500 |
Alembic Pharmaceuticals Ltd. |
Azithromycin (500mg) |
Oral |
To treat bacterial infections |
Once daily |
Diarrhoea, vomiting, stomach upset |
|
3 |
Doxcef CV 200 |
Lupin Ltd. |
Cefpodoxime (200mg) |
Oral |
Used to treat bronchitis, gonorrhoea |
Twice daily |
Diarrhoea, nausea, stomach pain |
|
4 |
Cifran 500 |
Sun Pharmaceutical Industries Ltd. |
Ciprofloxacin (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, throat, skin infection. |
Twice daily |
Diarrhoea, nausea |
|
5 |
Loxof 500 |
Pfizer Ltd. |
Levofloxacin (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, throat infection. |
Once daily |
Diarrhoea, nausea, constipation |
|
6 |
Dalacin C |
Pfizer Ltd. |
Clindamycin (300mg) |
Oral |
It is used to treat varriety of bacterial infections |
Twice daily |
Diarrhoea, vomiting, nausea |
|
7 |
Lizolid 600 |
IntegracePvt Ltd. |
Linezolide (600mg) |
Oral |
To treat pneumonia, skin infections |
Twice daily |
Vomiting, headache, nausea |
|
8 |
Zanocin |
Sun Pharmaceutical Industries Ltd. |
Ofloxacin (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Diarrhoea, nausea |
|
9 |
Claribid 500 |
ABBOTT |
Clarithromycin (500mg) |
Oral |
To treat bacterial infections |
Twice daily, thrice a day |
Diarrhoea, headache, abdominal pain |
|
10 |
Taxim O 200 |
Alkem Laboratories Ltd. |
Cefixime (200mg) |
Oral |
To treat pneumonia, gonorrhoea |
Twice daily |
Diarrhoea, nausea, stomach pain |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Trajenta 5 |
Boehringer-Ingelheim |
Linagliptine (5mg) |
Oral |
Helps to control blood sugar level |
Once daily |
Cough, vomting, Diarrhoea |
|
2 |
Ondero 5 |
Lupin Ltd. |
Linagliptine (5mg) |
Oral |
Helps to control blood sugar level |
Once daily |
Cough, vomting, Diarrhoea |
|
3 |
Trajenta DUO |
Boehringer-Ingelheim |
Metformin (500) + Linagliptin (2.5mg) |
Oral |
Plays a vital role in controlling blood sugar level. |
Twice daily |
Hypoglycemia, nausea, vomiting |
|
4 |
Ondero Met |
Lupin Ltd. |
Metformin (500) + Linagliptin (2.5mg) |
Oral |
Plays a vital role in controlling blood sugar level |
Twice daily |
Hypoglycemia, nausea, vomiting |
|
5 |
Glyciphage SR |
Franco Indian Pharmaceuticals Pvt Ltd. |
Metformin (500, 1000mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
6 |
Glycomet 500 SR |
USV Ltd. |
Metformin (500mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
7 |
Gluconorm SR 500 |
Lupin Ltd. |
Metformin (500mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
8 |
Metsmall 500 Tablet SR |
Dr Reddy's Laboratories Ltd. |
Metformin (500mg) |
Oral |
To treat type 2 diabetes |
Twice daily |
Nausea, vomiting, stomach upset |
|
9 |
Glyciphage PG 2 |
Franco Indian Pharmaceuticals Pvt Ltd. |
Glimepiride (2mg) + Metformin (500) + Pioglitazone (15mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Hypoglycemia, dizziness, headache |
|
10 |
Gemer 1 |
Sun Pharmaceutical Industries Ltd. |
Glimepiride (1mg) + Metformin (500mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Hypoglycemia, nausea, vomiting |
|
11 |
Glycomet GP 1 |
USV Ltd. |
Glimepiride (1mg) + Metformin (500mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Hypoglycemia, nausea, vomiting |
|
12 |
Galvus 50 |
Novartis India Ltd. |
Vildagliptin (50mg) |
Oral |
To treat type 2 diabetes |
Once daily, twice daily |
Dizziness, headache, nausea |
|
13 |
Galvus Met |
Novartis India Ltd. |
Metformin (500) + vildagliptin (50mg) |
Oral |
To treat type 2 diabetes mellitus |
Once daily, twice daily |
Hypoglycemia, headache, nausea |
|
14 |
Zita Met Plus |
Glenmark Pharmaceuticals Ltd. |
Metformin (500mg) + Teneligliptin (20mg) |
Oral |
To treat type 2 diabetes mellitus |
Once daily |
Hypoglycemia, headache, nausea |
|
15 |
Tenglyn |
ZydusMedica |
Teneligliptin (20mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Constipation, stomach ache, nausea |
|
16 |
Dynaglipt 20 |
Mankind Pharma Ltd. |
Teneligliptin (20mg) |
Oral |
To treat type 2 diabetes |
Once daily |
Constipation, stomach ache, nausea |
|
17 |
Jardiance 10 |
Boehringer-Ingelheim |
Empagliflozin (10mg) |
Oral |
It helps control the high blood sugar levels seen in diabetes |
Once daily |
Nausea, frequent urge to urinate |
|
18 |
Volibo |
Sun Pharmaceutical Industries Ltd. |
Voglibose (0.2mg) |
Oral |
To treat diabetes mellitus by lowering post-prandial blood glucose level |
Once daily |
Hypoglycemia, weight gain |
|
19 |
Pioz 15 |
USV Ltd. |
Pioglitazone (15mg) |
Oral |
To treat type 2 diabetes mellitus |
Once daily |
Hypoglycemia, edema |
|
20 |
Lantus |
Sanofi India Ltd. |
Insulin glargine (100IU) |
Subcutaneous |
To treat types 1 and 2 diabetes mellitus. |
Once daily |
Hypoglycemia, high blood pressure |
|
21 |
Basugine |
Lupin Ltd. |
Insulin glargine (100IU) |
Subcutaneous |
To treat types 1 and 2 diabetes mellitus |
Once daily |
Hypoglycemia, high blood pressure |
|
22 |
Novomix 30 |
Novo Nordisk India Pvt Ltd. |
Insulin aspart (30%) + Insulin aspart protamine (70%) |
Subcutaneous |
To treat types 1 and 2 diabetes mellitus |
Once daily |
Hypoglycemia |
|
23 |
Human Actrapid |
Novo Nordisk India Pvt Ltd. |
Human Insulin (40IU/ml) |
Subcutaneous |
To treat types 1 and 2 diabetes mellitus |
Once daily |
Hypoglycemia |
|
24 |
Human Mixtard 70/30 |
Novo Nordisk India Pvt Ltd. |
Insulin isophane (70%) + Human insulin(30%) |
Subcutaneous |
To treat types 1 and 2 diabetes mellitus |
Once daily |
Hypoglycemia |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Nitrolong 2.6 Tablet CR |
Mankind Pharma Ltd. |
Nitroglycerin (2.6)mg |
Oral |
To treat angina |
Twice daily |
Itching, numbness, swelling |
|
2 |
Sorbitate |
ABBOTT |
Isosorbide dinitrate (5mg) |
Oral |
To prevent chest pain caused by angina |
Twice daily |
Dizziness, headache, nausea |
|
3 |
Monotrate 10 |
Sun Pharmaceutical Industries Ltd. |
Isosorbide monotrate (10mg) |
Oral |
To prevent chest pain caused by angina |
Twice daily |
Headache, dizziness |
|
4 |
Depin 5 |
ZydusCadila |
Nifedipine (5mg) |
Oral |
To treat heart pain caused by angina |
Twice daily |
Dizziness, fatigue |
|
5 |
Nicardia 5 |
JB Chemicals and Pharmaceuticals Ltd. |
Nifedipine (5mg) |
Oral |
To treat heart pain caused by angina |
Twice daily |
Dizziness, fatigue |
|
6 |
Aten |
ZydusCadila |
Atenolol (25,50mg) |
Oral |
It helps to treat high blood pressure, chest pain |
Twice daily |
Fatigue, nausea, dizziness |
|
7 |
Tenolol |
Ipcalaboratories Ltd. |
Atenolol (25,50mg) |
Oral |
It helps to treat high blood pressure, chest pain |
Twice daily |
Fatigue, nausea, dizziness |
|
8 |
Betaloc 25 |
Astra Zeneca |
Atenolol (25mg) |
Oral |
It helps to treat high blood pressure, chest pain |
Twice daily |
Fatigue, nausea, dizziness |
|
9 |
Inderal 40 |
ABBOTT |
Propranolol (40mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Once daily, twice daily |
Dizziness, tiredness |
|
10 |
Stamlo 5 |
Dr Reddy's Laboratories Ltd. |
Amlodipine (5mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Twice daily |
Headache, fatigue, nausea |
|
11 |
Amlodac 5 |
ZydusCadila |
Amlodipine (5mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Twice daily |
Headache, fatigue, nausea |
|
12 |
Amlokind 5 |
Mankind Pharma Ltd. |
Amlodipine (5mg) |
Oral |
To treat high blood pressure and heart related chest pain |
Twice daily |
Headache, fatigue, nausea |
|
13 |
Ranozex Tablet ER |
Sun Pharmaceutical Industries |
Ranolazine (500mg) |
Oral |
Used for the management of angina |
Twice daily |
Nausea, vomiting, headache |
|
14 |
Ranolaz Tablet SR |
Torrent Pharmaceuticals Ltd. |
Ranolazine (500mg) |
Oral |
Used for the management of angina |
Twice daily |
Nausea, vomiting, headache |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1 |
Faronem 200 |
Sun Pharmaceutical Industries Ltd. |
Faropenem (200mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Thrice a day |
Diarrhoea, nausea, rash |
|
2 |
Duonem 300 ER |
ZydusCadila |
Faropenem (300mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Thrice a day |
Diarrhoea, nausea, rash |
|
3 |
Lizolid 600 |
IntegracePvt Ltd. |
Linezolide (600mg) |
Oral |
To treat pneumonia, skin infections |
Twice daily |
Vomiting, headache, nausea |
|
4 |
Linokem 600 |
Alkem Laboratories Ltd. |
Linezolide (600mg) |
Oral |
To treat pneumonia, skin infections |
Twice daily |
Vomiting, headache, nausea |
|
5 |
Lizoforce 600 |
Mankind Pharma Ltd. |
Linezolide (600mg) |
Oral |
To treat pneumonia, skin infections |
Twice daily |
Vomiting, headache, nausea |
|
6 |
Lizokef |
Macloeds Pharmaceuticals Pvt Ltd. |
Cefixime (200mg) + Linezolide (600mg) |
Oral |
To treat pneumonia, skin infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
7 |
Augmentin 625 |
Glaxo SmithKline Pharmaceuticals Ltd. |
Amoxicillin (500mg) + potassium clavulanate (125mg) |
Oral |
To treat bacterial infections |
Thrice a day |
Diarrhoea, nausea, vomiting |
|
8 |
Clavam 625 |
Alkem Laboratories Ltd. |
Amoxicillin (500mg) + potassium clavulanate (125mg) |
Oral |
To treat bacterial infections |
Thrice a day |
Diarrhoea, nausea, vomiting |
|
9 |
Augpen 625 BID |
Zuventus Healthcare Ltd. |
Amoxicillin (500mg) + potassium clavulanate (125mg) |
Oral |
To treat bacterial infections |
Thrice a day |
Diarrhoea, nausea, vomiting |
|
10 |
Clarimin 500 |
United Biotech Pvt Ltd. |
Clarithromycin (500mg) |
Oral |
To treat bacterial infections |
Twice daily |
Diarrhoea, headache, nausea |
|
11 |
Cetil 500 |
Lupin Ltd. |
Cefuroxime (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, and throat infection. |
Twice daily |
Diarrhoea, nausea, vomiting |
|
12 |
Zocef 500 |
Alkem Laboratories Ltd. |
Cefuroxime (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, and throat infection. |
Twice daily |
Diarrhoea, nausea, vomiting |
|
13 |
Pulmocef 500 |
Micro Labs Ltd. |
Cefuroxime (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, and throat infection. |
Twice daily |
Diarrhoea, nausea, vomiting |
|
14 |
Forcef 500 |
Aristo Pharmaceuticals Pvt Ltd. |
Cefuroxime (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, and throat infection. |
Twice daily |
Diarrhoea, nausea, vomiting |
|
15 |
Xoxe 500 |
Corona Remedies Pvt Ltd. |
Cefuroxime (500mg) |
Oral |
It is used in the treatment of the urinary tract, nose, and throat infection. |
Twice daily |
Diarrhoea, nausea, vomiting |
|
16 |
Taxim O 200 |
Alkem Laboratories Ltd. |
Cefixime (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Nausea, stomach pain, indigestion |
|
17 |
Monocef O 200 |
Aristo Pharmaceuticals Pvt Ltd. |
Cefpodoxime (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Diarrhoea, nausea, rash |
|
18 |
Cepodem 200 |
Sun Pharmaceutical Industries Ltd. |
Cefpodoxime (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Diarrhoea, nausea, rash |
|
19 |
Moxicip |
Cipla Ltd. |
Moxifloxacin (400mg) |
Oral |
To treat ear, eye infections |
Once daily |
Eye discomfort, dry eye |
|
20 |
Moxam 400 |
Alkem Laboratories Ltd. |
Moxifloxacin (400mg) |
Oral |
To treat ear, eye infections |
Once daily |
Eye discomfort, dry eye |
|
21 |
Moxif 400 |
Torrent Pharmaceuticals Ltd. |
Moxifloxacin (400mg) |
Oral |
To treat ear, eye infections |
Once daily |
Eye discomfort, dry eye |
|
22 |
Loxof 500 |
Sun Pharmaceutical Industries Ltd. |
Levofloxacin (500mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Once daily |
Diarrhoea, nausea, headache |
|
23 |
Glevo 500 |
Glenmark Pharmaceuticals Ltd. |
Levofloxacin (500mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Once daily |
Diarrhoea, nausea, headache |
|
24 |
Leon 500 |
Dr Reddy's Laboratories Ltd. |
Levofloxacin (500mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Once daily |
Diarrhoea, nausea, headache |
|
25 |
Alivo 500 |
Avail Healthcare |
Levofloxacin (500mg) |
Oral |
Used in the treatment of lungs and urinary tract infections |
Once daily |
Diarrhoea, nausea, headache |
|
26 |
Zanocin 200 |
Sun Pharmaceutical Industries Ltd. |
Ofloxacin (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Nausea, headache, diarrhoea |
|
27 |
Oflox 200 |
Cipla Ltd. |
Ofloxacin (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Nausea, headache, diarrhoea |
|
28 |
OF 200 |
JB Chemicals and Pharmaceuticals Ltd. |
Ofloxacin (200mg) |
Oral |
To treat bacterial infections |
Twice daily |
Nausea, headache, diarrhea |
|
29 |
Azithral 500 |
Alembic Pharmaceuticals Ltd. |
Azithromycin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
30 |
Azee 500 |
Cipla Ltd. |
Azithromycin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
31 |
Azimax 50 |
Cipla Ltd. |
Azithromycin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
32 |
Azibact 500 |
Ipca laboratories Ltd. |
Azithromycin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
33 |
Zithium 500 |
Alkem Laboratories Ltd. |
Azithromycin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Once daily |
Diarrhoea, nausea, vomiting |
|
34 |
Mox 500 |
Sun Pharmaceutical Industries Ltd. |
Amoxicillin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Twice daily, thrice in a day |
Rash, vomiting, stomach pain |
|
35 |
Wymox 500 |
Pfizer |
Amoxicillin (500mg) |
Oral |
To treat a wide variety of bacterial infections |
Twice daily, thrice in a day |
Rash, vomiting, stomach pain |
This survey was mainly performed to record different ADRs of antidiabetics, antianginals and antibiotics which are available in the Government hospital or in the private hospitals in West Bengal.
In this survey the healthcare staffs in the hospital were interviewed about different aspects of the drugs that are administered to the patients. The different aspects being drug name either brand name or generic name, their manufacturers, how much dose is given to the patients, drug's route of administration, their uses, their frequency of administration and the drug's side effects. This information was recorded in the given table:
In accordance with the hospital administration with the medical ethics (taken in consideration) the personal information or any other information like the name, sex, age, height, weight etc. about the patient were kept confidential in this survey.
ADRs were recorded by interviewing the healthcare professionals of the hospital whenever possible but no contact with the patients was made.
At that time when the survey was conducted there were 8 antidiabetics, 7 antianginals and 10 types of antibiotics given to the patients in NRS Medical College and Hospital. The same time admitted patients in RSV Hospital were given 7 antidiabetics, 11 antianginals and 10 types of antibiotics. On the other hand VIP APEX Medical Centre was giving patients 24 antidiabetics, 14 antianginals and 35 types of antibiotics respectively including same class of drugs with different manufacturers.
Patients who were being treated with Antidiabetic drugs reported rapid weight gain with nausea, vomiting and with a minor number of patients complains about hypoglycemia or low blood sugar level. There are also some other non-serious side effects like loss of appetite, weakness and headache were found in the patients.
Patients who were being administered antianginals showed symptoms of dizziness, fatigue, headache, and nausea. Some minor cases of serious ADRs like heavy breathing or low blood pressure were also observed in the patients.
Antibiotics were being used in a variety of diseases thus they also produce different kinds of ADRs. People after administering antibiotics reported cases of headache, nausea, vomiting, constipation, itching, skin rash and other allergic reactions, indigestion, stomach upset, stomach pain, abdominal pain. Some serious cases of diarrhea were also seen. The observed side effects in the survey were near about the same on every hospital with a minor number of the data may be different.
The main purpose of this survey was to record different ADRs of antidiabetics, antianginals and antibiotics. Every class of drug has its own unique actions and unique side effects. If the drug in question has been properly profiled or monitored then the potential risks associated with the side effect of the drug can be kept at minimal or the serious life-threatening effects may be minimized. In case of antidiabetics rapid weight gain, nausea, vomiting is seen with some other minor side effects. Antianginals produce fatigue, dizziness, and headache. On the other hand antibiotics produce a range of side effects like constipation, diarrhea, nausea, vomiting etc. Monitoring these kinds of ADRs and maintaining this information is very important for the rational treatment of the patient. If pre examined information is available then the treatment will be quick, safe and responsive with minimal risk incidents.