Medication utilization and concurrent administration pattern of ondansetron, pantoprazole, and acetaminophen in the emergency department

Medication utilization and concurrent administration pattern of ondansetron, pantoprazole, and acetaminophen in the emergency department: A six-month data analytics report

D V Samyuktha*

Group Clinical Pharmacist, Kauvery Hospital, Trichy, Tamil Nadu

*Correspondence

Introduction

The Emergency Department (ED) is a high-acuity clinical setting where medications are frequently prescribed to provide rapid symptomatic relief during the initial management of patients. Ondansetron, Pantoprazole, and Acetaminophen are among the commonly utilized supportive medications and are often administered either individually or in combination.

During routine prescription review, frequent concurrent prescribing of these three medications was observed across patients presenting with varied clinical conditions. This recurring prescribing pattern prompted a medication utilization analysis to characterize the frequency of concurrent administration, formulation preferences, and dual-drug combinations.

Medication utilization analysis is an important component of clinical pharmacy practice, providing insights into prescribing behaviour, recurring medication-use patterns, and opportunities for optimizing pharmacotherapy. Regular evaluation of utilization trends also supports medication stewardship programmes by identifying areas that may benefit from indication-based prescribing review and rational medication use.

The present analysis provides a descriptive overview of the utilization and concurrent administration patterns of Ondansetron, Pantoprazole, and Acetaminophen over a six-month period in the Emergency Department of the KCN unit, Kauvery hospital, Trichy. The findings establish baseline utilization data that may assist in monitoring prescribing practices, supporting quality improvement initiatives, and guiding future indication-based prescription audits.

Study description

Study period: January 2026 – June 2026

Study Setting: Emergency Department, KCN, Kauvery hospital, Trichy

Data Source: Hospital Information Software (HIS)

Medications analysed: Ondansetron, Pantoprazole, Acetaminophen

Parameters analysed

Monthly utilization
Formulation-wise utilization
Triple concurrent administration
Dual concurrent administration

Table 1. Overall Medication Utilization (January–June 2026)

Drug name	No. of pts
	Jan	Feb	Mar	Apr	May	Jun	Total
Ondansetron	Injection	278	223	279	313	370	326	1789
Ondansetron	Tablet	19	13	13	10	18	12	85
Pantoprazole	Capsule	37	35	60	47	77	77	333
	Injection	282	261	311	310	383	355	1902
	Tablet	102	94	85	81	101	98	561
Acetaminophen	Injection	208	176	194	212	277	245	1312
Acetaminophen	Tablet	27	26	27	15	23	13	131

Interpretation

Pantoprazole recorded the highest overall utilization (2,466 patients), followed by Ondansetron (1,818 patients) and Acetaminophen (1,418 patients).
Injectable formulations were the predominant dosage form for all three medications.
Oral formulations (tablets/capsules) accounted for a comparatively smaller proportion of prescriptions.
Medication utilization remained relatively stable throughout the study period, with the highest utilization observed during May.

Table 2. Concurrent Administration of Ondansetron, Pantoprazole, and Acetaminophen

Drug name	No. of pts	Common	Inj	Common
Ondansetron	1818	661	1789	630
Pantoprazole	2466		1902
Acetaminophen	1418		1312

Interpretation

A total of 661 patients received Ondansetron, Pantoprazole, and Acetaminophen concurrently during the study period.
Among these, 630 patients received all three medications as injectable formulations.
Injectable formulations accounted for approximately 95.3% of all concurrent administrations.
The findings indicate that triple-medication therapy was predominantly administered through the injectable route in the Emergency Department.

Analytics Insight

The high frequency of concurrent administration suggests a recurring prescribing pattern involving these three medications. These findings provide baseline data for monitoring medication utilization and may support future evaluation of indication-based prescribing practices.

Table 3. Dual Medication Administration Pattern

Drug name	No. of pts	Common	Injections	Common
Ondansetron	1818	1591	1789	1520
Pantoprazole	2466	1591	1902	1520
Pantoprazole	2466	855	1902	732
Acetaminophen	1418	855	1312	732
Ondansetron	1818	748	1789	728
Acetaminophen	1418	748	1312	728

Interpretation

Ondansetron + Pantoprazole

Patients receiving both medications: 1,591
Patients receiving both injectable formulations: 1,520
Most frequently prescribed dual-drug combination

Pantoprazole + Acetaminophen

Patients receiving both medications: 855
Patients receiving both injectable formulations: 732
Second most frequently prescribed combination

Ondansetron + Acetaminophen

Patients receiving both medications: 748
Patients receiving both injectable formulations: 728
Third most frequently prescribed combination

Analytics Insight

Ondansetron–Pantoprazole was the predominant dual-drug combination throughout the study period. Injectable formulations constituted the majority of all pairwise combinations, indicating a preference for parenteral administration during emergency patient management.

Clinical Pharmacology & Therapeutic Considerations

Medications	Indications	Implications of Inappropriate/Unnecessary Use
Ondansetron	Class: Selective 5HT3 receptor antagonist. - Used primarily for the prevention & treatment of nausea and vomiting, particularly CINV & PONV.	QT interval prolongation is an important consideration, particularly in patients with electrolyte abnormalities, bradyarrhythmias, HF, congenital long QT syndrome, or concomitant QT-prolonging agents.
Pantoprazole	Class: Proton pump inhibitor. - Used for acid-suppression therapy, particularly with erosive esophagitis, maintenance of healing of erosive esophagitis, and Zollinger-Ellison syndrome.	C. difficile-associated diarrhoea, hypomagnesemia, vitamin B12 deficiency, fractures, and acute interstitial nephritis are important considerations.
Acetaminophen	Class: Centrally acting analgesic & antipyretic. - Used for mild to moderate pain, moderate to severe pain as an adjunct to opioid analgesics, and reduction of fever.	Dose-related hepatotoxicity, particularly with cumulative dosing or concurrent use of other acetaminophen-containing products.

Discussion

The present analysis was undertaken following the observation of frequent concurrent prescribing of Ondansetron, Pantoprazole, and Acetaminophen during routine clinical practice in the Emergency Department. Rather than evaluating individual medication utilization alone, the analysis focused on identifying recurring patterns of simultaneous administration.

A total of 661 patients received all three medications concurrently during the six-month study period, with 630 patients receiving the combination as injectable formulations. The predominance of injectable therapy reflects the urgency associated with emergency care; however, the repeated occurrence of the same medication combination across a substantial number of patients highlights a consistent prescribing pattern that warrants periodic review.

Supportive medications are an integral component of emergency management, but empirical prescribing practices should be periodically evaluated to ensure alignment with documented clinical indications, institutional treatment protocols, and principles of rational medication use. Medication utilization analytics provides a practical approach to identifying recurring prescribing trends and supports targeted quality improvement initiatives and medication stewardship programmes.

This analysis was descriptive in nature and did not evaluate patient diagnoses, clinical outcomes, or the appropriateness of individual prescriptions. Nevertheless, it establishes baseline utilization data that may facilitate future indication-based prescription audits and diagnosis-specific evaluations.

Limitations

The analysis was based on medication utilization data retrieved from the Hospital Information System.
Clinical diagnoses, indications for prescribing, and patient outcomes were not evaluated.
The study describes prescribing patterns and does not assess the clinical appropriateness of individual prescriptions.

Conclusion

The present six-month medication utilization analysis identified a recurring pattern of concurrent prescribing of Ondansetron, Pantoprazole, and Acetaminophen in the Emergency Department. During the study period, 661 patients received all three medications simultaneously, of whom 630 patients received the combination as injectable formulations. The observed frequency of concurrent prescribing highlights the importance of periodic medication utilization reviews to monitor empirical prescribing patterns and support indication-based prescription evaluation. These findings provide baseline data for medication stewardship initiatives and continuous quality improvement aimed at promoting rational medication use in emergency care.

Medication utilization and concurrent administration pattern of ondansetron, pantoprazole, and acetaminophen in the emergency department

Medication utilization and concurrent administration pattern of ondansetron, pantoprazole, and acetaminophen in the emergency department: A six-month data analytics report

D V Samyuktha*

Nightingale Journals