The Drug Regimen Prescribed for Sickle Cell Patients Attending a Clinic in Kumasi, Ghana, in a Period of One Year
Affiliation(s)
1 Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2 Department of Child Health, College of Health Sciences, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3 Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
1 Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 2 Department of Child Health, College of Health Sciences, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3 Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
ABSTRACT
Objective: In order to manage the varied pathophysiological features of sickle cell disease (SCD), an array of drugs has to be used. The specific drugs used, however, depend on the locality. This study was aimed at finding out the drug regimen prescribed by clinicians to sickle cell disease patients who attended a Sickle Cell Clinic in Kumasi, Ghana. Method: The setting for the study is the Sickle Cell Clinic at the Komfo Anokye Teaching Hospital, Ghana, and a questionnaire was used as the study instrument. Information on drug prescription on each day of clinic visit was extracted from the medical records of the patients. Results: The drugs prescribed were “routine drugs” for SCD patients, analgesics, narcotics, anti-malarials, antibiotics, haematinics and miscellaneous drugs. The top ten commonly prescribed drugs were folic acid, diclofenac, ibuprofen, B-complex, routine drugs, artesunate/amodiaquin, paracetamol, penicillin V, amoxiclav and zincovit. Conclusion: Within the year, the drugs prescribed included those that could prevent vitamin and zinc deficiency due to continuing haemolysis, those that could mitigate the pain and inflammation from vaso-occlusion and reperfusion injury, as well as antibiotics to combat infections. Being a malarial-endemic region, prophylaxis with daraprim and symptomatic malaria fever therapy were common practices. This study has thus shown that the well-being of SCD patients in our typical tropical terrain, depends on haematinic vitamin/mineral supplements, anti-malarials, analgesics-anti-inflammatory, antipyretics and antibiotics.
Objective: In order to manage the varied pathophysiological features of sickle cell disease (SCD), an array of drugs has to be used. The specific drugs used, however, depend on the locality. This study was aimed at finding out the drug regimen prescribed by clinicians to sickle cell disease patients who attended a Sickle Cell Clinic in Kumasi, Ghana. Method: The setting for the study is the Sickle Cell Clinic at the Komfo Anokye Teaching Hospital, Ghana, and a questionnaire was used as the study instrument. Information on drug prescription on each day of clinic visit was extracted from the medical records of the patients. Results: The drugs prescribed were “routine drugs” for SCD patients, analgesics, narcotics, anti-malarials, antibiotics, haematinics and miscellaneous drugs. The top ten commonly prescribed drugs were folic acid, diclofenac, ibuprofen, B-complex, routine drugs, artesunate/amodiaquin, paracetamol, penicillin V, amoxiclav and zincovit. Conclusion: Within the year, the drugs prescribed included those that could prevent vitamin and zinc deficiency due to continuing haemolysis, those that could mitigate the pain and inflammation from vaso-occlusion and reperfusion injury, as well as antibiotics to combat infections. Being a malarial-endemic region, prophylaxis with daraprim and symptomatic malaria fever therapy were common practices. This study has thus shown that the well-being of SCD patients in our typical tropical terrain, depends on haematinic vitamin/mineral supplements, anti-malarials, analgesics-anti-inflammatory, antipyretics and antibiotics.
Cite this paper
Nsiah, K. , Osei-Akoto, A. and Ansong, D. (2014) The Drug Regimen Prescribed for Sickle Cell Patients Attending a Clinic in Kumasi, Ghana, in a Period of One Year. Open Journal of Blood Diseases, 4, 50-57. doi: 10.4236/ojbd.2014.44007.
Nsiah, K. , Osei-Akoto, A. and Ansong, D. (2014) The Drug Regimen Prescribed for Sickle Cell Patients Attending a Clinic in Kumasi, Ghana, in a Period of One Year. Open Journal of Blood Diseases, 4, 50-57. doi: 10.4236/ojbd.2014.44007.
References
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http://dx.doi.org/10.1016/j.blre.2004.04.002 [2] Dampier, C. and Setty, B.N.Y. (2004) Vaso-Constriction in Children with Sickle Cell Disease: Clinical Characteristics and Biologic Correlations. Journal of Pediatric Hematology/Oncology, 29, 785-790. [3] Benjamin, L.J. (2001) The Nature and Management of Acute Pain Episode in Sickle Cell Disease. In: Forget, B.G., Higgs, D., Nagel, R.L. and Steinberg, M.H., Eds., Diseases of Hemoglobin, Cambridge University Press, Cambridge, 671-710. [4] de Franceschi, L., Finco, G., Vassanelli, A., Zaia, B., Ischia, S. and Corrocher, R. (2004) A Pilot Study on the Efficacy of Ketorolac plus Tramadol Infusion Combined with Erythrocytapheresis in the Management of Acute Severe Vaso-Occlusive Crises and Sickle Cell Pain. Haematologica, 489, 1389-1391. [5] Krisnamoorthy, P., Alyaarubi, S., Abish, A., Gale, M., Abuquerque, P. and Jabado, N. (2006) Primary Hyperparathyroidism Mimicking Vaso-Occlusive Crises in Sickle Cell Disease. Journal of Pediatrics, 118, e537-e539.
http://dx.doi.org/10.1542/peds.2006-0337 [6] Aliyu, Z.K., Tumblin, A.R. and Kato, G.J. (2006) Current Therapy of Sickle Cell Disease. Haematologica, 91, 7-10. [7] Jison, M.L., Munson, P.J., Barb, J.F., Suffredini, A.F., Talwar, S., Logun, C., Raghavachori, N., Beigel, J.H., Danner, R.L. and Gladwin, M.T. (2004) Blood Mononuclear Cell Gene Expression Profiles Characterize the Oxidant, Hemolytic, and Inflammatory Stress in the Expression of Sickle Cell Disease. Blood, 104, 270-280.
http://dx.doi.org/10.1182/blood-2003-08-2760 [8] Hankins, J. and Aygun, B. (2009) Pharmacotherapy in Sickle Cell Disease—State of the Art and Future Prospects. British Journal of Haematology, 145, 296-308.
http://dx.doi.org/10.1111/j.1365-2141.2009.07602.x [9] Payan, D.G. and Katzung, B.G. (1992) Nonsteroidal Anti-Inflammatory Drugs: Nonopioid Analgesics; Drugs Used in Gout. In: Katzung, B.G., Ed., Basic and Clinical Pharmacology, 6th Edition, Appleton and Lange, Norwalk, Connecticut, 535-557. [10] Gringauz, A. (1997) Introduction to Medicinal Chemistry. Wiley-VCH, New York, 144,205,235,251,265-266. [11] Lindenbaum, J. and Klipstein, F.A. (1963) Folic Acid Deficiency in Sickle Cell Disease. New England Journal of Medicine, 269, 875-882.
http://dx.doi.org/10.1056/NEJM196310242691701 [12] Lindenbaum, J. (1997) Workshop on Human Folate Requirements Folic Acid Biochemistry and Physiology in Relation to Human Nutritional Requirement. National Academy of Sciences, Washington DC, 256-276. [13] Yardurmian, A. and Crawley, C. (2001) Sickle Cell Disease. Clinical Medicine, 1, 441-451.
http://dx.doi.org/10.7861/clinmedicine.1-6-441 [14] Sadarangani, M., Makani, J., Komba, A.N., Ajala-Agbo, T., Newton, C.R., Marsh, K. and Williams, T.N. (2009) An Observational Study of Children in Kilifi, Kenya. British Journal of Haematology, 146, 675-682.
http://dx.doi.org/10.1111/j.1365-2141.2009.07771.x [15] Prasad, A.S. (1993) Clinical Spectrum of Human Zinc Deficiency. In: Prasad, A.S., Ed., Biochemistry of Zinc, Plenum, New York, 219-258.
http://dx.doi.org/10.1007/978-1-4757-9444-1_11 [16] Prasad, A.S. (1997) [Editorial] Malnutrition in Sickle Cell Disease Patients. American Journal of Clinical Nutrition, 66, 423-424. [17] Lambright-Eckker, J.A. and Stimmel-Fair, J.M. (1996) Pharmacology Essentials. WB Saunders Company, Philadelphia, 179,207. [18] World Health Organisation (2003) The Africa Malaria Report.
http://www.afro.who.int [19] Konotey-Ahulu, F.I.D (1991) The Sickle Disease Patient. Macmillan, London.
[1] Bonds, D.R. (2003) Three Decades of Innovation in the Management of Sickle Cell Disease: The Road to Understanding the Sickle Cell Disease Phenotype. Blood Reviews, 19, 99-110.
http://dx.doi.org/10.1016/j.blre.2004.04.002 [2] Dampier, C. and Setty, B.N.Y. (2004) Vaso-Constriction in Children with Sickle Cell Disease: Clinical Characteristics and Biologic Correlations. Journal of Pediatric Hematology/Oncology, 29, 785-790. [3] Benjamin, L.J. (2001) The Nature and Management of Acute Pain Episode in Sickle Cell Disease. In: Forget, B.G., Higgs, D., Nagel, R.L. and Steinberg, M.H., Eds., Diseases of Hemoglobin, Cambridge University Press, Cambridge, 671-710. [4] de Franceschi, L., Finco, G., Vassanelli, A., Zaia, B., Ischia, S. and Corrocher, R. (2004) A Pilot Study on the Efficacy of Ketorolac plus Tramadol Infusion Combined with Erythrocytapheresis in the Management of Acute Severe Vaso-Occlusive Crises and Sickle Cell Pain. Haematologica, 489, 1389-1391. [5] Krisnamoorthy, P., Alyaarubi, S., Abish, A., Gale, M., Abuquerque, P. and Jabado, N. (2006) Primary Hyperparathyroidism Mimicking Vaso-Occlusive Crises in Sickle Cell Disease. Journal of Pediatrics, 118, e537-e539.
http://dx.doi.org/10.1542/peds.2006-0337 [6] Aliyu, Z.K., Tumblin, A.R. and Kato, G.J. (2006) Current Therapy of Sickle Cell Disease. Haematologica, 91, 7-10. [7] Jison, M.L., Munson, P.J., Barb, J.F., Suffredini, A.F., Talwar, S., Logun, C., Raghavachori, N., Beigel, J.H., Danner, R.L. and Gladwin, M.T. (2004) Blood Mononuclear Cell Gene Expression Profiles Characterize the Oxidant, Hemolytic, and Inflammatory Stress in the Expression of Sickle Cell Disease. Blood, 104, 270-280.
http://dx.doi.org/10.1182/blood-2003-08-2760 [8] Hankins, J. and Aygun, B. (2009) Pharmacotherapy in Sickle Cell Disease—State of the Art and Future Prospects. British Journal of Haematology, 145, 296-308.
http://dx.doi.org/10.1111/j.1365-2141.2009.07602.x [9] Payan, D.G. and Katzung, B.G. (1992) Nonsteroidal Anti-Inflammatory Drugs: Nonopioid Analgesics; Drugs Used in Gout. In: Katzung, B.G., Ed., Basic and Clinical Pharmacology, 6th Edition, Appleton and Lange, Norwalk, Connecticut, 535-557. [10] Gringauz, A. (1997) Introduction to Medicinal Chemistry. Wiley-VCH, New York, 144,205,235,251,265-266. [11] Lindenbaum, J. and Klipstein, F.A. (1963) Folic Acid Deficiency in Sickle Cell Disease. New England Journal of Medicine, 269, 875-882.
http://dx.doi.org/10.1056/NEJM196310242691701 [12] Lindenbaum, J. (1997) Workshop on Human Folate Requirements Folic Acid Biochemistry and Physiology in Relation to Human Nutritional Requirement. National Academy of Sciences, Washington DC, 256-276. [13] Yardurmian, A. and Crawley, C. (2001) Sickle Cell Disease. Clinical Medicine, 1, 441-451.
http://dx.doi.org/10.7861/clinmedicine.1-6-441 [14] Sadarangani, M., Makani, J., Komba, A.N., Ajala-Agbo, T., Newton, C.R., Marsh, K. and Williams, T.N. (2009) An Observational Study of Children in Kilifi, Kenya. British Journal of Haematology, 146, 675-682.
http://dx.doi.org/10.1111/j.1365-2141.2009.07771.x [15] Prasad, A.S. (1993) Clinical Spectrum of Human Zinc Deficiency. In: Prasad, A.S., Ed., Biochemistry of Zinc, Plenum, New York, 219-258.
http://dx.doi.org/10.1007/978-1-4757-9444-1_11 [16] Prasad, A.S. (1997) [Editorial] Malnutrition in Sickle Cell Disease Patients. American Journal of Clinical Nutrition, 66, 423-424. [17] Lambright-Eckker, J.A. and Stimmel-Fair, J.M. (1996) Pharmacology Essentials. WB Saunders Company, Philadelphia, 179,207. [18] World Health Organisation (2003) The Africa Malaria Report.
http://www.afro.who.int [19] Konotey-Ahulu, F.I.D (1991) The Sickle Disease Patient. Macmillan, London.