Prescribing pattern and adverse drug reactions of cardiovascular drugs in out-patient department of a tertiary care hospital


  • Nalini R. Department of Pharmacology, Mayo Tirunelveli Medical College, Tirunelveli, Tamilnadu, India
  • Mansoora Shahiba R. Department of Pharmacology, Mayo Tirunelveli Medical College, Tirunelveli, Tamilnadu, India
  • Ezhil Ramya J. Department of Pharmacology, Mayo Tirunelveli Medical College, Tirunelveli, Tamilnadu, India
  • Kannan S. M. Department of Urology, Mayo Tirunelveli Medical College, Tirunelveli, Tamilnadu, India



Adverse drug reactions, Cardiovascular disease, Prescribing pattern


Background: The main objective of prescription pattern analysis is to assess the rationality of drug use. It has been found that cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. This study is to estimate the prescribing pattern and adverse drug reactions in patients with cardiovascular diseases.

Methods: This prospective observational study was conducted for a period of 2 months in cardiology outpatient department.100 patients who fulfilled the study criteria were observed. The central drug standard control organisation (CDSCO) reporting forms were used for the collection of adverse drug reactions. Causality assessment was done by using the World Health Organization Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre (WHO-UMC) scoring system and severity assessment by modified Hartwig and Siegel scale.

Results: The study group consists of 79% male and 21% females. Average number of drugs per prescription was 4.65. Most commonly prescribed drugs were antiplatelets (32%) followed by statins (18.27%) and the least common were calcium channel blockers (1.72%) and cardiac glycosides (0.86%). A total of 174 adverse drug reactions were reported out of which 24.7% were myalgia due to statins, 15.5% were cough due to angiotensin converting enzyme inhibitors and 14.3% were gastritis due to antiplatelets.

Conclusions: Antiplatelets, statins and angiotensin converting enzyme inhibitors dominated the prescribing pattern. Myalgia, cough, gastritis, insomnia by atorvastatin, enalapril, aspirin, beta blockers respectively were found to be the most commonly reported ADRs among the cardiovascular drugs.


Mendis S, Puska P, Norrving B. World Health Organization. Global Atlas on Cardiovascular Disease Prevention and Control (PDF). World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. 2011:3-18. ISBN 978-92-4-156437-3.

Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015.

Vijayakumar TM, Poovi G, Swaroop VSS. Prescribing patterns of fixed dose combination focus on cardiovascular drugs in outpatient department of private hospitals. J Pharmacol Toxicol. 2010;5:215-21.

WHO, Model list of essential medicines 16th list. Available at:

Mohanty BK, Aswini M, Hasamnis AA. Prescription pattern in the department of medicine of a tertiary care hospital in South India. J Clin Diagnostic Res. 2010;4:2047-51.

Al-Junid SM, Sharifa Ezat WP, Surianti S. Prescribing patterns and drug cost among cardiovascular patients in Hospital Universiti Kebangsaan Malaysia. Med J Malaysia. 2007;62:59-65.

Ranjeeta K, Idris MZ, Vidya B, Anish K, Monika A, Shivendra KS. Assessment of prescription pattern at the public health facilities of Lucknow district. Indian J Pharmacol. 2008;40:243-7.

Kanjanarat P, Winterstein AG, Johns TE, Hatton RC, Rothi RG, Segal R. Nature of preventable adverse drug events in hospitals: A literature review. Am J Health-Syst Pharm. 2003;60:1750-9. [PubMed]

Zaidenstein R, Eyal S, Efrati S, Akivison L, Koren Michowitz M, Nagornov V, et al. Adverse drug events in hospitalized patients treated with cardiovascular drugs and anticoagulants. Pharmacoepiemiol Drug Saf. 2002;11:235-8. (PubMed)

Levy M, Kewitz H, Altwein W, Hillebrand J, Eliakim M. Hospital admissions due to adverse drug reactions: a comparative study from Jerusalam and Berlin. Eur J Clin Pharmacol. 1980;17:25-31. (PubMed)

Frishman WH, Brosnan BD, Grossman M, Dasgupta D, Sun DK. Adverse dermatologic effects of cardiovascular drug therapy: part III. Cardiology Rev. 2002;10(6):337-48. (PubMed)

The use of the WHO-UMC system for standardized case causality assessment. Available at: http:// Accessed in February 2016.

Hartwig SC, Siegel J, Schneider PJ. Preventability and Severity Assessment in Reporting Adverse Drug reactions. American Journal of Hospital Pharmacy. 1992;49:2229-31.

Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: The Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000 Jul 22;356(9226):279-84.

Afroj F, Parveen F, Ara F, Iqbal M, Saha R, Rozario R. Patterns of Drug Utilization in Cardiology Department of a Tertiary Level Hospital in Bangladesh. Bangladesh J Physiol Pharmacol. 2014;28(1-2):1-4.

Singhal R, Ahmed K, Santani DD. Reporting and monitoring of adverse drug reactions with cardiac drugs. Int Res J Pharm. 2011;2:116-19.

Singh A, Dwivedi S, Gupta SK. Pattern and incidence of adverse drug reactions observed in cardiac clinic of tertiary hospital, Hakeem Abdul Hameed Centenary Hospital, Jamia Hamdard, New Delhi. Int J Basic Clin

Pharmacol. 2015;4:847-52.

Wadhwa T, El Sheikh SG, Rao PG. Monitoring and Reporting of Adverse Drug Reactions Due to Cardiovascular Drugs in Patients Admitted to a Secondary Care Hospital in Northern Emirate-a Prospective Surveillance Study. Ind J Pharm Practi. 2018 Apr;11(2):71.




How to Cite

R., N., R., M. S., J., E. R., & M., K. S. (2019). Prescribing pattern and adverse drug reactions of cardiovascular drugs in out-patient department of a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 8(4), 767–771.



Original Research Articles