CASE STUDIES ASSESSMENT ON RATIONAL USE OF DRUGS AMONG PATIENTS WITH ISCHEMIC HEART DISEASE AT A TERTIARY HOSPITAL IN SOUTH WEST NIGERIA.

The requirement for rational use of drug (R U D) is that the right drug be used with the right dose at right interval and at right duration. These retrospective case studies were carried out at the University College Hospital (U.C.H) Ibadan to investigate factors that influence the selection of rational drug use in the treatment of ischemic heart disease among those admitted as in patients and outpatients in the hospital. Four (4) case notes of 2 male adults consisting of one in-patient and one out-patient and 2 female adults consisting of one in-patient and one outpatient from medical out-patients records were randomly selected and thoroughly studied. Patient A was prescribed 8 drugs including Isosorbid dinitrate and Metoprolol as anti-ischemic drugs. Patient B was prescribed 10 drugs including Isosorbid dinitrate and metoprolol as anti-ischemic drugs while patient C and D were prescribed the least number of drugs which was 7 with glyceryltrinitate and propranolol prescribed as antiischemic drugs for patient C and Isosorbid dinitrate with propranolol for patient D. Propranolol was later changed to Atenolol. The ECGs indicated no change in QRS but indicated depressed ST segment and T wave flattened. Although the patients were discharged and the pharmacotherapy individualized, anti-ischemics which were rationally used in the studies could be implicated by irrational use of drugs in the treatment of co-morbidities. Co-morbidities such as hypertension, obesity, diabetes and ulcer should be taken into consideration before anti-ischemics can be rationally prescribed.