Journal of Research in Pharmacy Practice

Abstract  Adverse drug reactions (ADRs) are one of the major causes of mortality. One of the major causes of ADR is drug–drug interactions. The purpose of this study was to evaluate the prevalence and characteristics of ADRs caused by the drug interactions in the nephrology departments. Methods: This cross-sectional prospective study was carried out in the nephrology department on 117 patients who received at least two medicines. Drug interactions were determined, and the patients were evaluated for the presence of a drug complication. Findings: A total of fifty ADRs were observed in 39 patients, whereas 26% of total ADRs (13 drug complications) were due to drug interactions. About 69% and 31% of complications were classified in terms of severity, in the category of “severe” and “moderate” complications, respectively. Warfarin had the highest contribution to major interactions (33.33%). Conclusion: ADRs, which specially occurred due to drug interactions, are particularly important for patients taking multiple medications (e.g., patient with renal insufficiency). Therefore, special attention should be paid to preventing and reducing ADRs in these patients' population.

Abstract The aim of this study was to review empirical studies examining associations between candidate genes and adverse events (AEs) from methylphenidate (MPH) use in children and adolescents. The PubMed, EMBASE, CINAHL, and Web of Science databases were searched from their inception until March 2017. We included empirically based articles on pharmacogenetic studies in 0–17-year-old patients that investigated associations between specific candidate genes, their polymorphisms, and reported AEs. We extracted information about study design, setting, type of AE reporter, studied genes and their polymorphisms, age and gender, administered doses, method of genotyping, outcome measures, and main findings. A total of nine articles reporting information about four double-blind, placebo-controlled, cross-over studies and five open-label cohort studies were eligible for inclusion. Studies were published from 2006 onward and included a total of 998 patients (3–17-year-olds) diagnosed with attention-deficit hyperactivity disorder (ADHD). Studies predominantly involved males and lasted from 1 to 12 weeks. Studies used polymerase chain reaction and single nucleotide polymorphism genotyping methodology. Reported AEs were significantly associated with the following genes: appetite reduction (CES1*G); buccal-lingual movements (T1065G); diastolic blood pressure (ADRA2A Mspl C/C-GC); emotionality (DAT1*9/9); irritability (SNAP25 T1065G); picking (DRD4*7/DRD4*4); social withdrawal (DRD4*7/DRD4*4); somatic complaints (DAT1*10/10); tics (5-HTTLRP*S/L*L/L; SNAP25 T1065G); sadness (CES1*rsl12443580); and vegetative symptoms (5-HTTLPR). In conclusion, only few MPH pediatric pharmacogenetic studies were located, and large between-study heterogeneity was found. Studies were of naturalistic design and of short duration. They included small patient samples, poorly standardized treatment regimens, and limited outcome assessments. In the future, more pharmacogenomic studies in ADHD are needed, preferably using randomized, controlled study designs and of longer duration (more than 6 months).

Abstract Objective: Adverse drug reactions (ADRs) are known as a cause of hospital admission. We 
have carried out a prospective study to characterize and assess the frequency, probability, 
preventability, and severity of ADRs, which lead to hospital admission in children.
Methods: In a prospective observational study, a cohort of children admitted to a tertiary 
pediatric hospital was randomly screened to assess ADR as the cause of admission from June 
2014 to January 2015. ADRs causing admissions were detected based on patients’ records, 
interviewing their parents, and confirmation by medical team. The probability of the ADRs 
was assessed based on WHO criteria and Naranjo tool. The preventability assessment was 
performed using Schumock and Thornton questionnaire.
Findings: Of the 658 evaluated emergency admissions, 27 were caused by an ADR giving 
an incidence of 4.1%. Among ADRs, 37.1% were estimated to be preventable. Antibiotics 
were the most common medication class which caused hospital admission.
Conclusion: Pediatric pharmacotherapy still needs evidence‑based strategies to improve 
child care including education, monitoring, planning for medications after ADR occurrence, 
and implementing preventive measures when applicable.

Abstract Objective: To assess and describe the call services delivered by drug and poison information 
call center (DPIC) of 13‑Aban pharmacy, which is closely operated by the Department of 
Clinical Pharmacy, College of Pharmacy affiliated to Tehran University of Medical Sciences.
Methods: All calls services including counseled and follow‑up calls provided by 13‑Aban 
DPIC to health care professionals and public were collected, documented, and evaluated 
in a 2 years period from July 2010 to June 2012 using the designed software. Data analysis 
was done by SPSS version 16.0.
Findings: Totally 110,310 calls services delivered during a 2 years period. Among 
healthcare professionals, pharmacists, general physicians, and nurses requested more call 
services respectively (P = 0.001). DPIC could detect 585 potential cases of adverse drug 
reactions (ADRs) and 420 cases of major drug‑drug interactions (DDIs).
Conclusion: This study by analyzing and reporting the two-years activities of one of 
the major DPICs in Iran, showed that DPICs can offer drug consultation for healthcare 
professional and public as well as detect and prevent ADRs and DDIs, and therefore can 
promote patients’ health regarding drug therapy.

Abstract
Objective: Antipsychotics have revolutionized psychiatry by allowing significant numbers 
of patients in long‑term hospital settings to be discharged and successfully maintained in the 
community. However, these medications are also associated with a range of adverse events 
ranging from mostly annoying to rarely dangerous. This study is carried out to identify the 
adverse drug reactions (ADRs) to antipsychotics and its management in psychiatric patients.
Methods: Prospective interventional study was conducted in the psychiatric unit of a tertiary 
care hospital. Patients of any age and either sex prescribed with at least one antipsychotic 
were included and monitored for ADRs.
Findings: Among the 517 patients receiving antipsychotics, a total of 289 ADRs were 
identified from 217 patients at an overall incidence rate of 41.97%. Sixty‑seven different 
kinds of ADRs were observed in the study patients. Central and peripheral nervous system 
was the most commonly affected system organ class (n = 59) and weight gain (n = 30) was 
the most commonly observed ADR. Olanzapine was most commonly implicated in reported 
ADRs(n = 92) followed by risperidone (n = 59). Of the 289 ADRs, 80% required interventions 
including cessation of drug and/or specific/symptomatic/nonpharmacological treatment.
Conclusion: This post marketing surveillance study provides a representative data of the 
ADR profile of the antipsychotics likely to be encountered in psychiatric patients in an 
Indian tertiary care hospital.