C. Dhandapani, K.S.G. Arulkumaran, P. Asha
In this study we evaluate the utilization of corticosteroids which includes the monitoring of corticosteroid induced adverse effects and analyzing the prescribing habits of corticosteroids. This was a prospective, observational study carried out in 138 patients, for a period of six months. The main clinical adverse effects attributable to corticosteroids were assessed in patients. The relevant datas were collected from patient treatment chart, laboratory investigations, through patient interview and compared with baseline status. The risk factors for steroid induced adverse effects were identified using statistical analysis. BMI of the patients (p=0.019), route of administration (p=0.0001) and dose of steroids (p=0.0001) were showed a positive relationship with the incidence of adverse effects. Prescribing pattern of corticosteroids and the interactions caused by steroids were also analyzed. Out of the total study population 75 were monitored for steroid induced adverse effects.39% showed adverse effects and 61% were free from adverse effects.72.4% experienced single adverse effects, while 27.5% experienced multiple adverse effects. Hyperglycemia was the most frequent adverse effect (62%) observed. Among multiple ADRs hyperglycemia along with hypokalemia was found in more number of patients (6.8%). All patients who received Methylprednisolone experienced adverse effects while Dexamethasone produced adverse effects were found in 90.9%. Among in-patients, most of them were prescribed with Dexamethasone (55%) and in out- patients 41% were treated with Budesonide. Out of total population most of the patients were treated with inhalational steroids (50%) followed by oral (27.11%).Interaction of steroid with co-administered drugs were found mostly in in-patients (83.3%) and only 16.6% was found in out-patients. Till now, effective treatment guidelines for corticosteroids are not available. Even though we can’t completely eliminate the occurrence of ADRs, definitely we can minimize it. Further studies are needed for implementing standard Guidelines in corticosteroid therapy.
