DRUG USE PATTERN AND ASSESSMENT OF ADVERSE DRUG REACTIONS IN THE MANAGEMENT OF NEPHROTIC SYNDROME IN PAEDIATRICS
Priya Nair S.*, Jayakrishnan S. S. and Susan Uthup
ABSTRACT
Nephrotic syndrome is a common chronic disorder, characterized by alterations of permselectivity at the glomerular capillary wall, resulting in its inability to restrict the urinary loss of protein. The objective of the study was to find out the drug use pattern and assessment of adverse drug reaction during the management of Nephrotic syndrome in paediatrics. It was a six months prospective observational study conducted in the tertiary care setting, with 81 patients along with their caretakers attending the Paediatric Nephrology Clinic, Department of Paediatrics, SAT hospital, Govt. Medical College, Thiruvananthapuram, Kerala, India. Patients who meet the inclusion criteria are included in the study. The prescription of the patients were collected and data regarding the physician’s clinical assessment of patients, laboratory results , drug prescribed, details of patients with adverse effects, treatment taken and recovery status were entered in the prepared proforma. The study data revels that, majority of the patient population were in the age group between 5 to 10 years and showed male predominance. Mean age of onset of Nephrotic syndrome in the study population was found to be 4.1 ± 3.2 years. In the study group most of the patients were steroid responsive, steroid dependent, followed by steroid resistant. The compliance rate was found to be very high. The non-compliance reported was due to ignorance and adverse effects. The most common ADR with prednisolone was found to be increased appetite followed by behavioural and mood change. Stunting, cushing’s syndrome, osteoporosis and cataract were the other adverse effects. The most commonly occurring ADR with levimasole was extreme fatigue, followed by muscle weakness, memory loss and vasculitic rashes. Cyclophosphamide is effective among late responders and frequent relapsers. The study concluded that Childhood Nephrotic syndrome has a relatively favourable long-term prognosis. ADRs contribute significantly to patient’s morbidity and mortality and are a significant public health concern.
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