Sathvik Sridhar - Academia.edu (original) (raw)

Papers by Sathvik Sridhar

Research paper thumbnail of Development and validation of standardized severity rating scale to assess the consistency of drug-drug interaction severity among various drug information resources

Research in Social & Administrative Pharmacy, Aug 1, 2022

BACKGROUND The consistency in reporting the severity of drug interactions across the drug informa... more BACKGROUND The consistency in reporting the severity of drug interactions across the drug information resources is important in guiding the appropriate clinical use of drug-pairs, to minimize the associated adverse events. This necessitates the need of a standardized severity rating scale, that can accommodate the different severity ratings of the same interacting drug-pair into a reasonable severity category, that can ease the consistency assessment among different drug information resources. OBJECTIVE To develop and validate a standardized severity rating scale that can ease the consistency assessment among the various drug information resources. METHODS The definitions of various severity rating categories as documented in the eight drug information resources was consolidated to develop a standardized severity rating scale. Thus developed rating scale was validated using twenty commonly used drug-pairs. Fleiss' kappa score was used as an indicator for assessing overall consistency among various drug information resources, whereas, Cohen's kappa was used as an indicator of level of consistency between two drug information resources and between individual drug information resource and newly developed standardized severity rating scale. RESULTS The newly developed standardized severity rating scale classifies the severity of drug-drug interactions into three categories namely mild, moderate and major. The Fleiss' kappa score was improved from 0.047 to 0.176, indicating improved strength of agreement [Average pairwise agreement: 16% Vs 36.7%] among various drug information resources. The average pairwise Cohen's kappa was 0.082 [Strength of agreement: poor] in original severity ratings whereas it was improved to 0.198 [Strength of agreement: almost equal to fair] in standardized severity rating scale. CONCLUSION The newly developed standardized severity rating scale can be used as a tool to assess the consistency of severity rating categories among the various drug information resources.

Research paper thumbnail of Assessment of incidence, causality, severity, and preventability of suspected adverse drug reactions to antidepressant medications in a psychiatry outpatient setting of a secondary care hospital

Journal of Pharmacy and Bioallied Sciences, 2020

Background: Antidepressant medications are primarily used in the management of depression and var... more Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.

Research paper thumbnail of Frequency and predisposing factors for drug-induced hypoglycemia in patients with type-2 diabetes mellitus

Journal of research in pharmacy practice, 2019

Objective: Hypoglycemia is the most common complication of the treatment for diabetes mellitus. V... more Objective: Hypoglycemia is the most common complication of the treatment for diabetes mellitus. Various factors predispose an individual for drug-induced hypoglycemia. The aim of this study was to explore the relative frequency and likely predisposing factors for drug-induced hypoglycemia among type-2 diabetic patients in the United Arab Emirates (UAE). Methods: In this cross-sectional survey-based study which was conducted from February to April 2018 in two local community pharmacies in the UAE, diabetic patients underwent a structured interview on their diabetes mellitus status and management and specific open-ended questions related to hypoglycemic symptoms that they might have experienced and the occurrence of symptoms. Collected data were used to estimate the relative frequency of drug-induced hypoglycemia and to identify the probable predisposing factors and their contribution in causing hypoglycemia using relative risk, Chi-square test, and Fisher's exact test. Findings: The relative frequency of drug-induced hypoglycemia in our study was 46.25%. Patients' age of ≥65 years, duration of diabetes mellitus for more than 1 year, patients with more than one comorbid condition, and patients using more than one antidiabetic medication were predisposing for developing drug-induced hypoglycemia. Conclusion: The relative frequency of drug-induced hypoglycemia in a nontrial environment which lacks the special cares routinely provided in drug development clinical trials is high. We suggest that more attention should be paid to identify, prevent, and manage drug-induced hypoglycemia in type-2 diabetic patients who have more than 1 year of diabetes, more than one comorbidity, using more than one antidiabetic medication, and elderly.

Research paper thumbnail of A systematic scoping review of implementation of telepharmacy during COVID-19

journal of applied pharmaceutical science, 2022

Research paper thumbnail of Evaluation of potential drug-drug interactions and adverse drug reactions among chronic kidney disease patients: An experience from United Arab Emirates

Tropical Journal of Pharmaceutical Research, Jun 4, 2022

Purpose: To determine the prevalence and assessing nature of potential drug-drug interactions (pD... more Purpose: To determine the prevalence and assessing nature of potential drug-drug interactions (pDDIs) and adverse drug reactions (ADRs) among chronic kidney disease (CKD) patients. Methods: This was a prospective observational study involving adult CKD patients. Occurrence of pDDIs was evaluated using Micromedex database 2.0. Suspected ADRs during the study period were documented and assessed. Results: Overall prevalence of pDDIs was found to be 85.3 %. A total of 811 pDDIs with 225 different pairs of interacting drugs were identified. Majority of the patients had ≥ 3 pDDIs regardless of type of severity. Thirty-five ADRs were identified in 25 CKD patients. Hyperkalemia was the most-commonly suspected ADR. Logistic regression analysis revealed that age (

Research paper thumbnail of Incidence, nature and causality assessment of cutaneous adverse reactions to cosmetics: a pilot study

International Journal of Community Medicine and Public Health, Apr 27, 2019

Research paper thumbnail of Assessment of potential drug–Drug interactions in hospitalized cardiac patients of a secondary care hospital in the United Arab Emirates

Journal of research in pharmacy practice, 2019

Objective: To identify the types, severity, and documentation grades of potential drug–drug inter... more Objective: To identify the types, severity, and documentation grades of potential drug–drug interactions (pDDIs) and to identify the predictors of pDDIs among hospitalized cardiac patients. Methods: This was a cross-sectional study. All the patients who were admitted for >24 h in a cardiology ward of a general hospital of the United Arab Emirates and prescribed with cardiac medications were included. The occurrence of any pDDI between cardiac medications and other coprescribed medications was identified using Micromedex database 2.0® and graded and documented based on the severity and documentation. Findings: A total of 842 pDDIs were identified in 155 patients. The overall relevant frequency for the occurrence of pDDIs was found to be 87.74%. A total of 79 pairs of pDDIs were identified. Among identified pDDIs, 41.33% and 56.65% were major and moderate severity type, respectively, whereas 12.32% were excellent and 36.81% were good documentation grade. The majority of pDDIs were between aspirin-bisoprolol (11.64%). Patients taking more than seven drugs (odds ratio [OR] = 9.90; 95% confidence interval [CI]: 2.28–42.99), polypharmacy (OR = 3.86; 95% CI: 0.93–16.08), and number of medical conditions (OR 0.25; 95% CI: 0.09–0.68) were significant predictors of pDDIs. Conclusion: The study fosters the importance of regular and close monitoring for pDDIs among cardiac patients. Thus, multicenter interventional studies are required to determine the exact nature and types of pDDIs in the local population.

Research paper thumbnail of Intensive monitoring of adverse drug reactions to antipsychotic medications in the inpatient psychiatry department of a secondary care hospital of UAE

International journal of pharmaceutical investigation, 2018

Background: Antipsychotics are a class of medications used primarily for the treatment of psychot... more Background: Antipsychotics are a class of medications used primarily for the treatment of psychotic disorders. However, these medications are associated with potential adverse drug reactions (ADRs). Aim: To monitor the incidence and nature of ADRs in the psychiatric inpatient department of a secondary care hospital of Ras Al Khaimah, UAE. Materials and Methods: This was an observational, prospective, noninterventional study, conducted in the psychiatric inpatient setting of a secondary care hospital. Psychiatric inpatients of all age groups and both the gender, diagnosed with any psychotic disorder, and hospitalized in the psychiatry ward and managed with at least one antipsychotic medication were included in the study. The causality, severity, and preventability of ADRs were assessed using different assessment scales. Results: Out of 170 patients, 38 patients reported at least one ADR with an incidence rate of 22.3%. The most common ADRs were weight gain 15 (29.4%) due to olanzapine, followed by pseudo-parkinsonism 11 (21.6%) due to parenteral haloperidol. Schizophrenia (18, 35.3%), followed by bipolar I disorder (10, 19.6%) was the most common condition associated with ADRs. Female gender and duration of hospital stay were found to be significant (P < 0.05) predictors of occurrence of ADRs. Conclusion: A high incidence of ADRs was observed in the inpatients of psychiatry department, especially of mild nature and probably preventable types. The study highlights the importance of intensive monitoring by pharmacists to identify high ADR risk psychiatric inpatients. To reduce the ADR risk, specific and frequent monitoring for antipsychotics is recommended such as weight and extrapyramidal symptoms.

Research paper thumbnail of Assessment of the scope, completeness, and consistency of various drug information resources related to COVID-19 medications in pregnancy and lactation

BMC Pregnancy and Childbirth

Background Drug use in pregnancy and lactation is challenging. It becomes more challenging in pre... more Background Drug use in pregnancy and lactation is challenging. It becomes more challenging in pregnant and lactating women with certain critical clinical conditions such as COVID-19, because of inconsistent drug safety data. Therefore, we aimed to evaluate the various drug information resources for the scope, completeness, and consistency of the information related to COVID-19 medications in pregnancy and lactation. Methods Data related to COVID-19 medications from various drug information resources such as text references, subscription databases, and free online tools were used for the comparison. The congregated data were analyzed for scope, completeness, and consistency. Results Scope scores were highest for Portable Electronic Physician Information Database (PEPID), Up-to-date, and drugs.com compared to other resources. The overall completeness scores were higher for Micromedex and drugs.com (p < 0.05 compared to all other resources). The inter-reliability analysis for overal...

Research paper thumbnail of A Systematic Review on Sociodemographic, Financial and Psychological Factors Associated with COVID-19 Vaccine Booster Hesitancy among Adult Population

Vaccines

Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a ... more Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a sizable population expresses vaccine hesitancy. As per the World Health Organization, vaccine hesitancy is one of the top 10 hazards to global health. Vaccine hesitancy varies across countries, with India reporting the least vaccine hesitancy. Vaccine hesitancy was higher toward COVID-19 booster doses than previous shots. Therefore, identifying factors determining COVID-19 vaccine booster hesitance (VBH) is the sine qua non of a successful vaccination campaign. Methodology: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 standards. A total of 982 articles were pooled from Scopus, PubMed and Embase, while 42 articles that addressed the factors of COVID-19 VBH were finally included for further analysis. Result: We identified factors responsible for VBH and divided them into three major groups: sociodemographic, financial, and...

Research paper thumbnail of A systematic scoping review of implementation of telepharmacy during COVID-19

Journal of Applied Pharmaceutical Science

This systematic scoping review aimed to examine the literature on expanding role of telepharmacy ... more This systematic scoping review aimed to examine the literature on expanding role of telepharmacy services during the ongoing COVID-19 pandemic. Four electronic databases, PubMed, Scopus, ProQuest, and Cochrane, were searched to identify published studies that reported implementation of telepharmacy services since the start of pandemic (31st December 2019 to 31st May 2022). Twenty-eight studies met the inclusion criteria comprising 15 cross-sectional studies, 12 studies sharing experience and practice related to telepharmacy services, and one pre-post intervention study. Studies reported establishment and implementation of various novel telepharmacy models in different settings; primary, secondary, tertiary, and quaternary care hospitals, hospital and community pharmacies, and specialized care centers. Telepharmacy provided pharmaceutical care to patients with COVID-19, chronic diseases, HIV infection, cancer, cystic fibrosis, and patients on anticoagulants. Pharmaceutical care services like patient counseling services (19 studies), medication order review and medication reconciliation (15 studies), drug therapy optimization (11 studies), adverse drug reaction monitoring and management (7 studies), medication adherence assessment (5 studies), and drug-related problem monitoring (4 studies) were delivered using telepharmacy. Based on the identified evidence, telepharmacy proved beneficial in delivering a range of pharmaceutical care services to the patients during the current pandemic. However, there is a need for more rigorous evidence on the reliability, safety, and effectiveness of telepharmacy in comparison to the traditional face-to-face healthcare delivery model.

Research paper thumbnail of Assessment of incidence, causality, severity, and preventability of suspected adverse drug reactions to antidepressant medications in a psychiatry outpatient setting of a secondary care hospital

Journal of Pharmacy And Bioallied Sciences

Background: Antidepressant medications are primarily used in the management of depression and var... more Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.

Research paper thumbnail of Effect of Polymers and Permeation Enhancers in the Release of Quetiapine Fumarate Transdermal Patch through the Dialysis Membrane

Polymers

Quetiapine Fumarate is potent, and the daily therapeutic dose can be delivered easily across the ... more Quetiapine Fumarate is potent, and the daily therapeutic dose can be delivered easily across the skin with the help of permeation enhancers. Quetiapine Fumarate-loaded transdermal patches were prepared by solvent evaporation technique. Various formulation parameters, excipients, and their combinations were optimized to get thin, translucent, smooth, stable, and high permeable character patches. A total number of 10 formulations were prepared. All formulations were subjected to various physicochemical evaluations. Three different formulations were prepared and F1, F2, and F3. Various physicochemical studies were carried out and found no significant difference between the three batches. The in vitro release study showed 74.29%, 82.73%, and 77.27%, respectively, up to 24 h. From the results, F2 has been selected as an optimized formulation and evaluated for skin irritation test. The results revealed that there is no irritation produced. The stability study results showed that there is ...

Research paper thumbnail of Study on Knowledge and Attitude Related to Inherited Genetic Disorders

International Journal of Research in Pharmaceutical Sciences, 2020

Increased prevalence of inherited genetic disorders is a significant public health problem that s... more Increased prevalence of inherited genetic disorders is a significant public health problem that significantly affects the quality of life of the affected patients and their families in Arab countries. Knowledge about the disorders may empower the community by raising awareness about prevention methods and early detection to reduce the incidence of genetic disorders. This study was aimed to assess the knowledge and attitude related to inherited genetic disorders among health science university students in Ras Al Khaimah. A cross-sectional study was carried out for six months among health science university students in Ras Al Khaimah by using a validated self-administered questionnaire. A total of 359 students completed the study. The overall mean knowledge and attitude scores of the study respondents were 4.47 ± 1.81 and 5.37 ± 2.32, respectively. One hundred and six (29.5%) respondents had adequate knowledge, and a majority (74.65%) of the respondents showed a positive attitude towa...

Research paper thumbnail of Study and Evaluation of the Different Types of Poisoning CasesEncountered in a Secondary Care Hospital in Ras Al Khaimah

Objectives: To assess the type, clinical characteristic, management and outcome of different pois... more Objectives: To assess the type, clinical characteristic, management and outcome of different poisoning cases in a secondary care hospital in Ras Al Khaimah. Methods: This was a prospective observational study conducted from October 2017 to May 2018 in a secondary care hospital in Ras Al Khaimah. Patient case notes related to admissions due to poisoning were identified and reviewed by the study investigator. Various details such as patient demographic characteristics, type, clinical characteristics and management of poisoning were entered in a suitably designed data collection form. The collected data was analyzed based on poison severity score and snakebite severity scale Results: A total of 75 cases were recorded during the study period. There was a predominance of males [42 (56%)] compared females [33 (44%)]. The intention of poisoning was suicidal in majority of the cases [46 (61.3%)]. A total of 41 cases were recorded to be due to pharmaceutical agents, out of which paracetamol ...

Research paper thumbnail of Use of phosphate binders in end-stage renal disease: An experience from a secondary care hospital in United Arab Emirates

Journal of Pharmacy And Bioallied Sciences, 2019

Objective: Hyperphosphatemia in end-stage renal disease (ESRD) is associated with many serious pa... more Objective: Hyperphosphatemia in end-stage renal disease (ESRD) is associated with many serious patient-level consequences including cardiovascular events and mortality. The purpose of this study was to investigate the use of phosphate binders in ESRD patients on maintenance hemodialysis. Materials and Methods: The study was a prospective observational cohort study including adult ESRD patients undergoing hemodialysis at a secondary hospital in United Arab Emirates. Patient characteristics were compared as per type of phosphate binder used. Bivariate and multivariate multinomial logistic regression analyses were carried out to determine variables that were independently associated with use of different phosphate binders. Results: Phosphate binders used at our study site were sevelamer, calcium carbonate, and a combination of sevelamer and calcium carbonate. Bivariate multinomial logistic regression analysis revealed that serum phosphorous (odds ratio [OR]: 0.14, 95% confidence interval [CI]: 0.04–1.09, P = 0.047; OR: 0.10, 95% CI: 0.03–0.89, P = 0.042), calcium (OR: 0.11, 95% CI: 0.02–0.86, P = 0.041; OR: 0.22, 95% CI: 0.01–0.96, P = 0.012), and calcium–phosphorous product (OR: 0.20, 95% CI: 0.06–0.64, P = 0.008; OR: 0.16, 95% CI: 0.05–0.54, P = 0.003) levels were significantly lower in patients on sevelamer per se as well as in patients on combination therapy, respectively when compared to calcium carbonate per se. Multivariate multinomial logistic regression analysis revealed that in sevelamer and combination groups, cardiovascular diseases (OR: 0.12, 95% CI: 0.02–0.65, P = 0.022; OR: 0.10, 95% CI: 0.01–0.88, P = 0.038) were significantly lesser compared to calcium carbonate group after being adjusted for other variables in the model. Conclusion: We observed that hyperphosphatemia and related events in our study population were better controlled by sevelamer per se and combination therapy than calcium carbonate per se. Further large scale, multicenter studies are required to confirm and establish these findings.

Research paper thumbnail of Assessment of General Public Knowledge, Perception and Practice Regarding Safety Measures and Poisoning Risks of Household Products (Awarded for best oral presentation)

Research paper thumbnail of Attitudes and Perceptions of Pharmacy Students of Ras Al Khaimah towards Problem Based Learning

Journal of Advanced Pharmacy Education Research, Jul 1, 2013

Research paper thumbnail of Intensive Monitoring of Adverse Drug Reactions in HIV Patients: A Hospital-Based Study in Italy

Research paper thumbnail of Amphotericin B Induced Thrombophlebitis: A Case Report

Journal of Young Pharmacists, 2021

Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old m... more Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old man developed pain and skin swelling over right forearm at the intravenous access site during amphotericin B administration treatment given for mucormycosis, the post-operative of sinuses. After 4 hours of affected period, amphotericin B was administration. A well revealed thrombophlebitis of the right forearm was noted. The systemic reaction was assessed based on the naranjo algorithm and was found to be probable. The safety profile of amphotericin B and its adverse effects must be monitored on long term treatment usage.

Research paper thumbnail of Development and validation of standardized severity rating scale to assess the consistency of drug-drug interaction severity among various drug information resources

Research in Social & Administrative Pharmacy, Aug 1, 2022

BACKGROUND The consistency in reporting the severity of drug interactions across the drug informa... more BACKGROUND The consistency in reporting the severity of drug interactions across the drug information resources is important in guiding the appropriate clinical use of drug-pairs, to minimize the associated adverse events. This necessitates the need of a standardized severity rating scale, that can accommodate the different severity ratings of the same interacting drug-pair into a reasonable severity category, that can ease the consistency assessment among different drug information resources. OBJECTIVE To develop and validate a standardized severity rating scale that can ease the consistency assessment among the various drug information resources. METHODS The definitions of various severity rating categories as documented in the eight drug information resources was consolidated to develop a standardized severity rating scale. Thus developed rating scale was validated using twenty commonly used drug-pairs. Fleiss' kappa score was used as an indicator for assessing overall consistency among various drug information resources, whereas, Cohen's kappa was used as an indicator of level of consistency between two drug information resources and between individual drug information resource and newly developed standardized severity rating scale. RESULTS The newly developed standardized severity rating scale classifies the severity of drug-drug interactions into three categories namely mild, moderate and major. The Fleiss' kappa score was improved from 0.047 to 0.176, indicating improved strength of agreement [Average pairwise agreement: 16% Vs 36.7%] among various drug information resources. The average pairwise Cohen's kappa was 0.082 [Strength of agreement: poor] in original severity ratings whereas it was improved to 0.198 [Strength of agreement: almost equal to fair] in standardized severity rating scale. CONCLUSION The newly developed standardized severity rating scale can be used as a tool to assess the consistency of severity rating categories among the various drug information resources.

Research paper thumbnail of Assessment of incidence, causality, severity, and preventability of suspected adverse drug reactions to antidepressant medications in a psychiatry outpatient setting of a secondary care hospital

Journal of Pharmacy and Bioallied Sciences, 2020

Background: Antidepressant medications are primarily used in the management of depression and var... more Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.

Research paper thumbnail of Frequency and predisposing factors for drug-induced hypoglycemia in patients with type-2 diabetes mellitus

Journal of research in pharmacy practice, 2019

Objective: Hypoglycemia is the most common complication of the treatment for diabetes mellitus. V... more Objective: Hypoglycemia is the most common complication of the treatment for diabetes mellitus. Various factors predispose an individual for drug-induced hypoglycemia. The aim of this study was to explore the relative frequency and likely predisposing factors for drug-induced hypoglycemia among type-2 diabetic patients in the United Arab Emirates (UAE). Methods: In this cross-sectional survey-based study which was conducted from February to April 2018 in two local community pharmacies in the UAE, diabetic patients underwent a structured interview on their diabetes mellitus status and management and specific open-ended questions related to hypoglycemic symptoms that they might have experienced and the occurrence of symptoms. Collected data were used to estimate the relative frequency of drug-induced hypoglycemia and to identify the probable predisposing factors and their contribution in causing hypoglycemia using relative risk, Chi-square test, and Fisher's exact test. Findings: The relative frequency of drug-induced hypoglycemia in our study was 46.25%. Patients' age of ≥65 years, duration of diabetes mellitus for more than 1 year, patients with more than one comorbid condition, and patients using more than one antidiabetic medication were predisposing for developing drug-induced hypoglycemia. Conclusion: The relative frequency of drug-induced hypoglycemia in a nontrial environment which lacks the special cares routinely provided in drug development clinical trials is high. We suggest that more attention should be paid to identify, prevent, and manage drug-induced hypoglycemia in type-2 diabetic patients who have more than 1 year of diabetes, more than one comorbidity, using more than one antidiabetic medication, and elderly.

Research paper thumbnail of A systematic scoping review of implementation of telepharmacy during COVID-19

journal of applied pharmaceutical science, 2022

Research paper thumbnail of Evaluation of potential drug-drug interactions and adverse drug reactions among chronic kidney disease patients: An experience from United Arab Emirates

Tropical Journal of Pharmaceutical Research, Jun 4, 2022

Purpose: To determine the prevalence and assessing nature of potential drug-drug interactions (pD... more Purpose: To determine the prevalence and assessing nature of potential drug-drug interactions (pDDIs) and adverse drug reactions (ADRs) among chronic kidney disease (CKD) patients. Methods: This was a prospective observational study involving adult CKD patients. Occurrence of pDDIs was evaluated using Micromedex database 2.0. Suspected ADRs during the study period were documented and assessed. Results: Overall prevalence of pDDIs was found to be 85.3 %. A total of 811 pDDIs with 225 different pairs of interacting drugs were identified. Majority of the patients had ≥ 3 pDDIs regardless of type of severity. Thirty-five ADRs were identified in 25 CKD patients. Hyperkalemia was the most-commonly suspected ADR. Logistic regression analysis revealed that age (

Research paper thumbnail of Incidence, nature and causality assessment of cutaneous adverse reactions to cosmetics: a pilot study

International Journal of Community Medicine and Public Health, Apr 27, 2019

Research paper thumbnail of Assessment of potential drug–Drug interactions in hospitalized cardiac patients of a secondary care hospital in the United Arab Emirates

Journal of research in pharmacy practice, 2019

Objective: To identify the types, severity, and documentation grades of potential drug–drug inter... more Objective: To identify the types, severity, and documentation grades of potential drug–drug interactions (pDDIs) and to identify the predictors of pDDIs among hospitalized cardiac patients. Methods: This was a cross-sectional study. All the patients who were admitted for >24 h in a cardiology ward of a general hospital of the United Arab Emirates and prescribed with cardiac medications were included. The occurrence of any pDDI between cardiac medications and other coprescribed medications was identified using Micromedex database 2.0® and graded and documented based on the severity and documentation. Findings: A total of 842 pDDIs were identified in 155 patients. The overall relevant frequency for the occurrence of pDDIs was found to be 87.74%. A total of 79 pairs of pDDIs were identified. Among identified pDDIs, 41.33% and 56.65% were major and moderate severity type, respectively, whereas 12.32% were excellent and 36.81% were good documentation grade. The majority of pDDIs were between aspirin-bisoprolol (11.64%). Patients taking more than seven drugs (odds ratio [OR] = 9.90; 95% confidence interval [CI]: 2.28–42.99), polypharmacy (OR = 3.86; 95% CI: 0.93–16.08), and number of medical conditions (OR 0.25; 95% CI: 0.09–0.68) were significant predictors of pDDIs. Conclusion: The study fosters the importance of regular and close monitoring for pDDIs among cardiac patients. Thus, multicenter interventional studies are required to determine the exact nature and types of pDDIs in the local population.

Research paper thumbnail of Intensive monitoring of adverse drug reactions to antipsychotic medications in the inpatient psychiatry department of a secondary care hospital of UAE

International journal of pharmaceutical investigation, 2018

Background: Antipsychotics are a class of medications used primarily for the treatment of psychot... more Background: Antipsychotics are a class of medications used primarily for the treatment of psychotic disorders. However, these medications are associated with potential adverse drug reactions (ADRs). Aim: To monitor the incidence and nature of ADRs in the psychiatric inpatient department of a secondary care hospital of Ras Al Khaimah, UAE. Materials and Methods: This was an observational, prospective, noninterventional study, conducted in the psychiatric inpatient setting of a secondary care hospital. Psychiatric inpatients of all age groups and both the gender, diagnosed with any psychotic disorder, and hospitalized in the psychiatry ward and managed with at least one antipsychotic medication were included in the study. The causality, severity, and preventability of ADRs were assessed using different assessment scales. Results: Out of 170 patients, 38 patients reported at least one ADR with an incidence rate of 22.3%. The most common ADRs were weight gain 15 (29.4%) due to olanzapine, followed by pseudo-parkinsonism 11 (21.6%) due to parenteral haloperidol. Schizophrenia (18, 35.3%), followed by bipolar I disorder (10, 19.6%) was the most common condition associated with ADRs. Female gender and duration of hospital stay were found to be significant (P < 0.05) predictors of occurrence of ADRs. Conclusion: A high incidence of ADRs was observed in the inpatients of psychiatry department, especially of mild nature and probably preventable types. The study highlights the importance of intensive monitoring by pharmacists to identify high ADR risk psychiatric inpatients. To reduce the ADR risk, specific and frequent monitoring for antipsychotics is recommended such as weight and extrapyramidal symptoms.

Research paper thumbnail of Assessment of the scope, completeness, and consistency of various drug information resources related to COVID-19 medications in pregnancy and lactation

BMC Pregnancy and Childbirth

Background Drug use in pregnancy and lactation is challenging. It becomes more challenging in pre... more Background Drug use in pregnancy and lactation is challenging. It becomes more challenging in pregnant and lactating women with certain critical clinical conditions such as COVID-19, because of inconsistent drug safety data. Therefore, we aimed to evaluate the various drug information resources for the scope, completeness, and consistency of the information related to COVID-19 medications in pregnancy and lactation. Methods Data related to COVID-19 medications from various drug information resources such as text references, subscription databases, and free online tools were used for the comparison. The congregated data were analyzed for scope, completeness, and consistency. Results Scope scores were highest for Portable Electronic Physician Information Database (PEPID), Up-to-date, and drugs.com compared to other resources. The overall completeness scores were higher for Micromedex and drugs.com (p < 0.05 compared to all other resources). The inter-reliability analysis for overal...

Research paper thumbnail of A Systematic Review on Sociodemographic, Financial and Psychological Factors Associated with COVID-19 Vaccine Booster Hesitancy among Adult Population

Vaccines

Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a ... more Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a sizable population expresses vaccine hesitancy. As per the World Health Organization, vaccine hesitancy is one of the top 10 hazards to global health. Vaccine hesitancy varies across countries, with India reporting the least vaccine hesitancy. Vaccine hesitancy was higher toward COVID-19 booster doses than previous shots. Therefore, identifying factors determining COVID-19 vaccine booster hesitance (VBH) is the sine qua non of a successful vaccination campaign. Methodology: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 standards. A total of 982 articles were pooled from Scopus, PubMed and Embase, while 42 articles that addressed the factors of COVID-19 VBH were finally included for further analysis. Result: We identified factors responsible for VBH and divided them into three major groups: sociodemographic, financial, and...

Research paper thumbnail of A systematic scoping review of implementation of telepharmacy during COVID-19

Journal of Applied Pharmaceutical Science

This systematic scoping review aimed to examine the literature on expanding role of telepharmacy ... more This systematic scoping review aimed to examine the literature on expanding role of telepharmacy services during the ongoing COVID-19 pandemic. Four electronic databases, PubMed, Scopus, ProQuest, and Cochrane, were searched to identify published studies that reported implementation of telepharmacy services since the start of pandemic (31st December 2019 to 31st May 2022). Twenty-eight studies met the inclusion criteria comprising 15 cross-sectional studies, 12 studies sharing experience and practice related to telepharmacy services, and one pre-post intervention study. Studies reported establishment and implementation of various novel telepharmacy models in different settings; primary, secondary, tertiary, and quaternary care hospitals, hospital and community pharmacies, and specialized care centers. Telepharmacy provided pharmaceutical care to patients with COVID-19, chronic diseases, HIV infection, cancer, cystic fibrosis, and patients on anticoagulants. Pharmaceutical care services like patient counseling services (19 studies), medication order review and medication reconciliation (15 studies), drug therapy optimization (11 studies), adverse drug reaction monitoring and management (7 studies), medication adherence assessment (5 studies), and drug-related problem monitoring (4 studies) were delivered using telepharmacy. Based on the identified evidence, telepharmacy proved beneficial in delivering a range of pharmaceutical care services to the patients during the current pandemic. However, there is a need for more rigorous evidence on the reliability, safety, and effectiveness of telepharmacy in comparison to the traditional face-to-face healthcare delivery model.

Research paper thumbnail of Assessment of incidence, causality, severity, and preventability of suspected adverse drug reactions to antidepressant medications in a psychiatry outpatient setting of a secondary care hospital

Journal of Pharmacy And Bioallied Sciences

Background: Antidepressant medications are primarily used in the management of depression and var... more Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.

Research paper thumbnail of Effect of Polymers and Permeation Enhancers in the Release of Quetiapine Fumarate Transdermal Patch through the Dialysis Membrane

Polymers

Quetiapine Fumarate is potent, and the daily therapeutic dose can be delivered easily across the ... more Quetiapine Fumarate is potent, and the daily therapeutic dose can be delivered easily across the skin with the help of permeation enhancers. Quetiapine Fumarate-loaded transdermal patches were prepared by solvent evaporation technique. Various formulation parameters, excipients, and their combinations were optimized to get thin, translucent, smooth, stable, and high permeable character patches. A total number of 10 formulations were prepared. All formulations were subjected to various physicochemical evaluations. Three different formulations were prepared and F1, F2, and F3. Various physicochemical studies were carried out and found no significant difference between the three batches. The in vitro release study showed 74.29%, 82.73%, and 77.27%, respectively, up to 24 h. From the results, F2 has been selected as an optimized formulation and evaluated for skin irritation test. The results revealed that there is no irritation produced. The stability study results showed that there is ...

Research paper thumbnail of Study on Knowledge and Attitude Related to Inherited Genetic Disorders

International Journal of Research in Pharmaceutical Sciences, 2020

Increased prevalence of inherited genetic disorders is a significant public health problem that s... more Increased prevalence of inherited genetic disorders is a significant public health problem that significantly affects the quality of life of the affected patients and their families in Arab countries. Knowledge about the disorders may empower the community by raising awareness about prevention methods and early detection to reduce the incidence of genetic disorders. This study was aimed to assess the knowledge and attitude related to inherited genetic disorders among health science university students in Ras Al Khaimah. A cross-sectional study was carried out for six months among health science university students in Ras Al Khaimah by using a validated self-administered questionnaire. A total of 359 students completed the study. The overall mean knowledge and attitude scores of the study respondents were 4.47 ± 1.81 and 5.37 ± 2.32, respectively. One hundred and six (29.5%) respondents had adequate knowledge, and a majority (74.65%) of the respondents showed a positive attitude towa...

Research paper thumbnail of Study and Evaluation of the Different Types of Poisoning CasesEncountered in a Secondary Care Hospital in Ras Al Khaimah

Objectives: To assess the type, clinical characteristic, management and outcome of different pois... more Objectives: To assess the type, clinical characteristic, management and outcome of different poisoning cases in a secondary care hospital in Ras Al Khaimah. Methods: This was a prospective observational study conducted from October 2017 to May 2018 in a secondary care hospital in Ras Al Khaimah. Patient case notes related to admissions due to poisoning were identified and reviewed by the study investigator. Various details such as patient demographic characteristics, type, clinical characteristics and management of poisoning were entered in a suitably designed data collection form. The collected data was analyzed based on poison severity score and snakebite severity scale Results: A total of 75 cases were recorded during the study period. There was a predominance of males [42 (56%)] compared females [33 (44%)]. The intention of poisoning was suicidal in majority of the cases [46 (61.3%)]. A total of 41 cases were recorded to be due to pharmaceutical agents, out of which paracetamol ...

Research paper thumbnail of Use of phosphate binders in end-stage renal disease: An experience from a secondary care hospital in United Arab Emirates

Journal of Pharmacy And Bioallied Sciences, 2019

Objective: Hyperphosphatemia in end-stage renal disease (ESRD) is associated with many serious pa... more Objective: Hyperphosphatemia in end-stage renal disease (ESRD) is associated with many serious patient-level consequences including cardiovascular events and mortality. The purpose of this study was to investigate the use of phosphate binders in ESRD patients on maintenance hemodialysis. Materials and Methods: The study was a prospective observational cohort study including adult ESRD patients undergoing hemodialysis at a secondary hospital in United Arab Emirates. Patient characteristics were compared as per type of phosphate binder used. Bivariate and multivariate multinomial logistic regression analyses were carried out to determine variables that were independently associated with use of different phosphate binders. Results: Phosphate binders used at our study site were sevelamer, calcium carbonate, and a combination of sevelamer and calcium carbonate. Bivariate multinomial logistic regression analysis revealed that serum phosphorous (odds ratio [OR]: 0.14, 95% confidence interval [CI]: 0.04–1.09, P = 0.047; OR: 0.10, 95% CI: 0.03–0.89, P = 0.042), calcium (OR: 0.11, 95% CI: 0.02–0.86, P = 0.041; OR: 0.22, 95% CI: 0.01–0.96, P = 0.012), and calcium–phosphorous product (OR: 0.20, 95% CI: 0.06–0.64, P = 0.008; OR: 0.16, 95% CI: 0.05–0.54, P = 0.003) levels were significantly lower in patients on sevelamer per se as well as in patients on combination therapy, respectively when compared to calcium carbonate per se. Multivariate multinomial logistic regression analysis revealed that in sevelamer and combination groups, cardiovascular diseases (OR: 0.12, 95% CI: 0.02–0.65, P = 0.022; OR: 0.10, 95% CI: 0.01–0.88, P = 0.038) were significantly lesser compared to calcium carbonate group after being adjusted for other variables in the model. Conclusion: We observed that hyperphosphatemia and related events in our study population were better controlled by sevelamer per se and combination therapy than calcium carbonate per se. Further large scale, multicenter studies are required to confirm and establish these findings.

Research paper thumbnail of Assessment of General Public Knowledge, Perception and Practice Regarding Safety Measures and Poisoning Risks of Household Products (Awarded for best oral presentation)

Research paper thumbnail of Attitudes and Perceptions of Pharmacy Students of Ras Al Khaimah towards Problem Based Learning

Journal of Advanced Pharmacy Education Research, Jul 1, 2013

Research paper thumbnail of Intensive Monitoring of Adverse Drug Reactions in HIV Patients: A Hospital-Based Study in Italy

Research paper thumbnail of Amphotericin B Induced Thrombophlebitis: A Case Report

Journal of Young Pharmacists, 2021

Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old m... more Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old man developed pain and skin swelling over right forearm at the intravenous access site during amphotericin B administration treatment given for mucormycosis, the post-operative of sinuses. After 4 hours of affected period, amphotericin B was administration. A well revealed thrombophlebitis of the right forearm was noted. The systemic reaction was assessed based on the naranjo algorithm and was found to be probable. The safety profile of amphotericin B and its adverse effects must be monitored on long term treatment usage.