Abstract

PHARMACO-EPIDEMIOLOGICAL STUDY OF THYROID DISORDERS IN THE DEPARTMENT OF SURGERY AT RMMCH

K. Ashwini, N. Charan, *P.Padmini, P.Mahendravarman, N. Junior Sundresh

ABSTRACT

Pharmaco-epidemiology (PCE) can be defined as the study of use and effects of drugs in large groups of general population. Adverse drug reaction is a worldwide public health problem and an important cause of death and hospitalizations in developing and developed countries. It is a common but major cause of morbidity and mortality and affect patients in the hospital and community setting causing increase in hospital stay and unnecessary economic burden. To study the pharmacoepidemiology of thyroid disorders, a non-invasive, cross-sectional, prospective, observational study was conducted in Surgery department at Rajah Muthiah Medical College Hospital. A total 22 ADR’s were reported out of 84 cases which were reported to have thyroid disorders from 1388 patients, having a prevalence of 6.05% during study period. Out of 84 patients, around 11% of the patients had family history of Thyroid disorder. Major triggering diseases like Cardiac effects, Diabetes Mellitus and co-morbidities of Thyroid disorders like Systemic Hypertension, Diabetes Mellitus were reported. Patients were affected with Hypothyroidism, Solitary Nodular Goitre, Multi Nodular Goitre, Hyperthyroidism, Thyrotoxicosis, Graves Disease with Thyrotoxicosis & Colloid Goitre. Those patients were managed with Thyroxine, Thionamides, and β-blockers simultaneously. Some of the patients were managed by either Hemithyroidectomy or Total thyroidectomy surgically. Most common side effects observed in this study were Heat Intolerance, Weight loss, Vomiting, Headache, Menstrual irregularities, Hypoglycaemia, Cold intolerance, Anemia. Categories of drugs causing ADR’s are Thionamides, Anti-Diabetics, Thyroxine, Beta-blockers, Antibiotics, Anti-asthmatics, and Corticosteroids. ADRs were monitored by using the standards, developed and designed by CDSCO. Data thus obtained were analysed by using casualty assessment. The WHO scale, Naranjo’s Algorithm score and Hartwig’s Severity Assessment Scale were used to evaluate ADRs. When causality of ADR’s was assessed by Naranjo algorithm scale and it was found to be 36% probable,41% possible, 0% definite and 25% doubtful and WHO scale certain 0%, probable 35%, possible 45%, unlikely 10%, conditional 10% and unaccessable 5% and by Hartwig’s Severity Assessment Scale mild 40.9%, moderate 27.2%, severe 31.8%. All ADR’s were not toxic reactions and they were unpredictable

Keywords: Pharmacoepidemiology, thyroid disorders, prevalence, adverse drug reactions and thyroidectomy.