Study of prescription pattern and adverse drug reactions of antineoplastic drugs in patients with breast cancer in a tertiary care teaching hospital

To study current prescription pattern of drugs and adverse drug reactions (ADRs) in patients of carcinoma breast.

This observational, cross-sectional study was carried out in Radiotherapy department of a tertiary care teaching hospital for a period of two months. Patients diagnosed with breast carcinoma and attending Radiotherapy department for chemotherapy were included. Prescriptions were analysed and details of drugs prescribed were recorded. Patients were enquired about occurrence of any ADRs and details were recorded. Preventability and severity of ADRs were assessed by modified Schumock and Thornton scale and modified Hartwig and Siegel scale respectively.

A total of 70 patients were included in the study. Cyclophosphamide was the most commonly used chemotherapeutic agent (77.14%), followed by Doxorubicin (68.57%) and 5-FU (44.29%). Most commonly prescribed regimen was Cyclophosphamide + 5FU + Doxorubicin followed by Cyclophosphamide + Doxorubicin. Nausea was the most commonly reported ADR followed by alopecia, vomiting and blackening of nails. Maximum ADRs were reported with Cyclophosphamide + Doxorubicin + 5 FU combination followed by Cyclophosphamide + Doxorubicin combination. Out of the total ADRs 60.11% belonged to the category of “definitely preventable” while 74.15% of ADRs were of less severity categorized as “mild level 1” severity.

Cyclophosphamide was the most commonly prescribed drug. Highest incidence of ADRs was observed with Cyclophosphamide + Doxorubicin + 5 FU. Inspite of prophylactic antiemetic treatment majority of patients had nausea and vomiting which indicates that more vigorous measures to prevent emesis need to be undertaken since these ADRs of antineoplastic drugs are usually preventable.