Utilization Profile of Gastrointestinal Medications among the Critically Ill Patients of A Tertiary Care Hospital

Pharmacotherapy in critically ill is complicated by altered physiology, presence of multi organ system failure and utilization of multiple medications. The present study assessed the utilization pattern of gastrointestinaldrugs among the inpatients of the intensive care unit. This prospective study was carried out in medical intensive care unit (ICU) of a tertiary care hospital. Case records of all inpatients of ICU were reviewed over a period of12 months. The demographic data, clinical data, and drug details were recorded. Descriptive statistics was carried out, values are expressed as percentage, mean + SD and range. Of the 728 inpatients, a total of 695 patients received gastrointestinal drugs. Male to female ratio was 1:9. The mean age was 49.21±15.84 years witha range of 18-90 years. Drugs for gastrointestinal system and drug metabolism (ATC-A) (23.3%) were most commonly utilized drug class of all the drugs prescribed in the ICU. Among the anti-peptic ulcer agents,pantoprazole (A02BC02) (87%) and ranitidine (A02BA02) (9.7%) were the frequently prescribed drugs.Metoclopramide (A03FA01) (19.5%) was the most frequent prokinetic agent and ondansetron (A04AA01) (15%) anti-emetic agents. Lactulose (A06AD11) (11.7%) was the most common laxative given while Glycopyrrolate (A03BA01) (6.3%) most frequent anti-secretory agent prescribed. Gastrointestinal drugs were the widely prescribed drug class among the critically ill prescribed both as prophylactic as well as therapeutic indications. Proton pump inhibitors were the acid suppressant therapy of choice, which require revision based on its recent findings on safety and efficacy in critically ill.