SUMMARY

Rationalization of pharmacotherapy is intended to maximize the effectiveness, minimize the

risks and costs. This thesis report is to evaluate the extent up to which rationalization of
pharmacotherapy in various gastrointestinal & hepatic diseases have been followed in our health
care system. Three diseases cirrhosis, ascities and peptic ulcer disease have been selected for the
project because of high prevalence ratio and then comparison of prescribed and standard therapy,
drug related problems and their management has been done.

This study was performed considering 20 cases comprised of three diseases. Suitable Performa
was designed and required information were collected. The data was collected in the following
table’s i.e. patient profile data table containing necessary information about the patient. Table for
dosage form, disease, drug class, identified drug related problems and for dosage related
problems.

In 7 cirrhosis disease cases pharmacotherapy given at hospital it was according to STG (standard
treatment guidelines), where as In 7 cases of cirrhosis total 26 drug related problems were
identified. Out of which the major drug related problems were cost related problem 16(68% of
all DRPs), Problems requiring dose adjustment in hepatic impairment 3 (12% of DRPs),
excessive dosage 2(8% of DRPs), Untreated conditions reported 2(8% of DRPs) and Problem
regarding improper route of drug administration reported 1(4% of DRPs).

In ascites 7 reported cases pharmacotherapy given at hospital it was according to STG (standard
treatment guidelines).Among 7 reported cases of Ascites total 29 drug related problems were
identified. The major drug related problem were cost related problem 13(46% of DRPs),
Problems requiring dose adjustment in hepatic impairment 3(10 % of DRPs), excessive dosage
problems 3(10% of DRPs), untreated conditions 2(7% of DRPs), drug interactions reported
1(3% of DRPs) and Miscellaneous problems 7(24% of DRPs).

In peptic ulcer disease 6 reported cases 3 cases have been treated with standard pharmacotherapy
whereas in 3 cases the dose variation was noted. Among 6 patients of peptic ulcer disease total
38 drug related problems were identified. The most common drug related problem were cost

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related problem 22(57% of DRP), problems requiring dose adjustment in hepatic impairment
3(8% of DRP) and excessive dosage 3(8% of DRP), Drug interaction 3(8% of DRP). Improper
drug selection 1(3% of DRP), non compliance 2(5% of DRP) and miscellaneous 4(11% of
DRP).

Strategies should be made for the increasing awareness and improved understanding of the
nature of problem & by rectifying the problem, making the interventions & monitoring of the
drug related problems. This can be done by improvement of skills for DRPs identification and
management accordingly. As in reported three main diseases main drug related problem
identified was cost related problem so patient socioeconomic status should be considered before
prescribing the drugs in order to promote rationalized drug therapy.

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