Investigating the Rational Use of Injectable Analgesics in Emergency and Surgical Wards of Imam Sajjad Hospital, Ramsar

Authors

1 Pre-hospital emergency research center, Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Students Research Committee, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran

3 Professor of Clinical Pharmacy, Department of Clinical Pharmacy,Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran

4 Imam Sajjad Hospital, Mazandaran University of Medical Sciences, Ramsar, Iran

5 Associate Professor, Department of Pharmacology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Introduction: The aim of this study was the investigating rational use of opioid and non-opioid injectable analgesics in patients admitted to surgery and emergency wards of Imam Sajjad general hospital, Ramsar, Iran.
Materials and methods: This descriptive and retrospective study was performed between July to August 2016 on 1181 files of patients receiving injectable analgesics and admitted to surgery and emergency wards of Imam Sajjad general hospital. Different information including indication, dose of administered drug and duration of treatment were recorded and compared to the AHFS guideline.
Results: Among 1181 subjects, 675 patients were admitted to surgery and 506 patients to emergency wards. The main indications of injectable analgesic administration were trauma, cancer pain, chest pain and lumbar neuropathic pain, respectively. Of the 1181 patients, 568 cases received opioids, 341 cases received non-opioids and 272 cases received both opioid and non-opioids. Among the opioids, morphine was the most prescribed and among the non-opioids ketorolac was the most. Mostly encountered adverse effects were nausea and vomiting, hypotension and headache. Overall, 23.62% of the prescriptions were in accordance with guideline and 76.37% of them weren’t compatible.
Conclusion: Because of high inconsistency with guideline, it seems to need more attention on promoting medical staff information about prescription and rational use of injectable analgesic drugs.

Keywords

References

1. Motov SM, Khan AN. Problems and barriers of pain management in the emergency department: are we ever going to
get better?. Journal of Pain Research. 2009;2:5.
2. Salehifar E, Hazeghpasand R, Keyhanian S, Ala S, Ahangar N. Evaluating Pain Management among Cancer Patients
in a Chemotherapy Center. J Mazandaran Univ Med Sci. 2017; 27 (150) :89-97.
3. Hajebi G, Mortazavi A, Salamzadeh J, Moshiri K. Surveying the pattern of narcotic analgesic usage in Taleghani
hospital. Research in Medicine. 2006; 30 (4) : 291-296
4. Herfindal ET, Gourley DR. Textbook of therapeutics drug and disease management. Baltimore: Lippincott; 2000.
5. MOHAGHEGHI S, NAHVIJOU A, SEDIGHI Z. Pain control in cancer patients by opiate use. Tehran Univ Med J.
2003; 61 (2):95-102.
6. Soltani R , Vatanpour H, Shafiee f, Sadeghian N. Evaluation of Parenteral Opioid Analgesics Utilization in Patients
Hospitalized in a Referral Teaching Hospital. J Pharm Care. 2015; 3(1-2): 16-20.
7. Baghel R, Adwal SK, Singh V, Chourishi A. Prescribing pattern and drug utilization study in inpatients of
department of Orthopaedics in a rural teaching hospital of Ujjain, Madhya Pradesh, India. Intl J Bas Clin Pharmcol.
2018; 7(9):1763.
8. McEvoy GK. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 2016.
9. http://apps.who.int/medicinedocs/end/d/js487be/4.6.html.
10. Builders MI, Okonta JM and Aguwa CN. Prescription patterns of analgesics in a community hospital in Nsukka. J
Pharm Sci Res. 2011; 3 (12): 1593-1598.
11. Vatanpour H, Sufi H, Jomeh NE, Khorramnia A, Bovand T, Vatanpour S. Parenteral opioid analgesics utilization
pattern in Amir-al-Momenin hospital, Zabol-Iran. Intl J Med Res Health Sci. 2016; 5(8):112-9.
12. Shohrati M, Hosseini S M J, Rahimian S, Mastanabadi H. Evaluation of rational use of injectable analgesics after
hernia surgery and apendectomy in a teharan educational hospital. Ann Milit Health Sci Res. 2011; 9 (1):32-36.
13. Larkin GL, Peacock WF 4th, Pearl SM, Blair GA, D'Amico F. Efficacy of ketorolac tromethamine versus
meperidine in the ED treatment of acute renal colic. Am J Emerg Med. 1999 Jan; 17(1):6-10.
14. Menezes V H, Nair S, Soumya MS and Tarey SD. Prescription Pattern of Analgesic Drugs for Patients
Receiving Palliative Care in a Teaching Hospital in India. Indian J Palliat Care.2016 Jan-Mar; 22(1): 63–66.
15.Vatanpour H, Soltani M, and Sufi H. Drug Utilization Review of parenteral opioid analgesics in cardiovascular
surgery department of Shahid Modarres Hospital, Tehran. Int J Med Res Health Sci. 2016; 5(8) :181-186.
16. Zachodnik J, Andersen JH, Geisler A. Barriers in pain treatment in the emergency and surgical department. Dan
Med J. 2019 1;66(2).
17. Faponle AF, Soyannwo OA, Ajayi IO. Post-operative pain therapy: a survey of prescribing patterns and adequacy of
analgesia in Ibadan, Nigeria. Cent Afr J Med. 2001 Mar; 47(3):70-74.
Medical Journal of Mashhad university of Medical Sciences
Volume 63, Issue 2
July and August 2020
Pages 2319-2325

Files

Share

How to cite

Statistics