Emmanuel James currently serves as Associate Professor at the Department of Pharmacy Practice, Amrita School of Pharmacy, Health Science Campus, Kochi. He has guided 28 M. Pharm. research projects and 5 Pharm D. research projects during 2009 - 2015.


  • 1979: M. Pharm, University of Sagar (Gold Medalist)


Year Affiliation
April 2009 - Present HOD, Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham University, Kochi, Kerala
1993 - 2009 Director, Drug and Poison Information Centre, King Fahad Specialist Hospital, MOH, Saudi Arabia
1991 - 1993 Head of Clinical Pharmacy Services at King Fahad Specialist Hospital, MOH Saudi Arabia
1983 - 1991 Director of Pharmacy Services at Onaizah General Hospital, Ministry of Health, Saudi Arabia
1981 - 1983 UGC Senior Research Fellow at the Department of Pharmaceutical Sciences, University of Sagar
1979 - 1981 Worked as lecturer in University of Delhi


  • Responsible for providing drug information to the clinicians, pharmacists and other healthcare professionals with the aid of computerized data systems (eg. CD-ROMS, Medline, Micromedex, UpTodate etc).
  • Evaluation of drugs for formulary additions.
  • Identification of chemicals and drugs encountered in suspected poisoning cases and providing information regarding management of patients involved.
  • Coordinator/ Secretary of the Pharmacy and Therapeutics Committee of the hospital and member of the regional P & T Committee.
  • Coordinator of the Antibiotic Subcommittee of the hospital and one of the editors of the hospital antibiotic policy manual.
  • Coordinate and take part in drug usage evaluation in the hospital.
  • Member of the nutrition support team of the hospital.
  • Coordinator of intra-departmental and inter-departmental continuing medical education activities.
  • One of the editors of the bimonthly pharmacy newsletter ‘Pharm-Gest’.
  • Member of the departmental quality management team.
  • Coordination of adverse drug reaction reporting & evaluation in the hospital.
  • Drug dosage adjustment for patients with impaired renal function or hepatic dysfunction.
  • Individualization of dosages of drugs like vancomycin, aminoglycosides etc. by applying pharmacokinetic principles to therapeutic drug monitoring results.


Principal Investigator: Evaluation and Promotion of Rational Drug Use in Primary Health Care Centres in Gassim Region


  1. Recipient of National Merit Scholarship of India from 1971-1977.
  2. Recipient of University Grants Commission (U.G.C.), Junior Research Fellowship from 1977-1979.
  3. Recipient of U.G.C. Senior Research Fellowship from 1981-1983


Publication Type: Journal Article
Year of Publication Publication Type Title
2016 Journal Article G. Madhu S, Emmanuel James, and Venu, R. P., “Appropriateness of antibiotic usage for gastrointestinal disorders in a tertiary care hospital”, European Journal of Hospital Pharmacy, 2016.[Abstract]

Objective To assess antibiotic usage in gastrointestinal disorders with respect to appropriateness, pattern of resistance, and incidence of adverse drug reactions (ADRs).Methodology Antibiotic prescribing in the gastroenterology department of a tertiary care hospital was evaluated using the Gyssens criteria and also by assessing drug related problems (DRPs) using the Pharmaceutical Care Network Europe V.6.2. A total of 173 patients were studied prospectively by a team of clinical pharmacists. Antibiotic susceptibility was prospectively studied; in addition, retrospective data on culture and sensitivity reports of commonly isolated organisms from 1 October 2012 to 30 September 2014 were collected to determine the resistance pattern in previous years. ADRs were evaluated using the Naranjo scale.Results Antibiotic therapy was appropriate in 60% of patients and inappropriate in the remaining patients due to incorrect decision, choice, and use. A total of 184 DRPs and 30 ADRs of antibiotics were identified. In the study patients, the most commonly isolated organism was Escherichia coli (27.3%) followed by Klebsiella pneumoniae (16.7%). Both E coli and K pneumoniae exhibited 100% resistance towards cefotaxime. There was an increase in the resistance of E coli and K pneumoniae against various antibiotics tested in 2013–2014 as compared to the previous year. An empirical antibiotic policy was developed which was endorsed by the gastroenterology department.Conclusions Although antibiotic therapy was appropriate in the majority of patients, irrational use occurred due to incorrect choice, improper dosage, and improper duration of therapy. E coli and K pneumoniae isolates showed an increase in resistance towards various antibiotics tested.

More »»
2015 Journal Article R. M. George, Emmanuel James, and Vijayalakshmi, S., “Clinical pharmacist’s interventions on drug related problems in a tertiary care hospital”, International Journal of Pharmacy and Pharmaceutical Sciences, vol. 7, pp. 401-404, 2015.[Abstract]

<p>Objective: To identify various drug related problems in patients admitted to the general ward of a tertiary care hospital and to make suitable drug therapy recommendations. Methods: A prospective observational study was conducted in the Annex General ward in B Block of Amrita Institute of Medical Sciences, Kochi for a period of 6 months. All the patients admitted to the general ward on particular day of each week and who satisfied the selection criteria were included in this study. Results: During the study period, a total of 598 drug related problems were identified of which 55.51% were due to prescribing of interacting drugs followed by drug choice problems (12.71%). Three hundred and thirty two drug interactions were observed in 224 patients. Thirty nine adverse drug reactions were observed in the study patients and cardiac drugs were the main class of drugs involved. Eighty seven drug interventions were done in 224 patients. It took an average of 25-35 minutes per intervention. Out of the total 87 interventions made, 41.4% (36) were at the prescriber level followed by 30% (27) at drug administration level. 23% of drug interventions were made at the patient level. 88.5% of the interventions were accepted and 11.5% were rejected. Conclusion: This study shows the positive impact of clinical pharmacists in identification and resolution of drug related problems in a tertiary care hospital. © 2015, International Journal of Pharmacy and Pharmaceutical Sciences. All Rights Reserved.</p>

More »»
2015 Journal Article Emmanuel James and Cyriac, J. Maria, “Impact of educational interventions on the physicians for early switchover of parenteral drugs to oral therapy”, European Journal of Hospital Pharmacy, vol. 22, pp. 176-178, 2015.[Abstract]

The impact of educational interventions on physicians by clinical pharmacists for early switchover of parenteral drugs to oral therapy was evaluated prospectively in 340 patients receiving parenteral medications in a tertiary care teaching hospital. Patients switched over from parenteral to oral therapy within the appropriate time increased from 48.2% in the preintervention group to 78.8% in the postintervention group (p=0.000). Significant reduction in duration of hospital stay (p=0.005) and mean cost of therapy (p=0.021) was observed in patients in the postintervention group. The mean knowledge score obtained by physicians increased in the postintervention phase (p=0.000). Educational interventions on the physicians by clinical pharmacists and implementation of locally developed guidelines can facilitate early switchover of parenteral medications to oral therapy. This, in turn, can reduce duration of parenteral medication use, cost of drug therapy, length of hospital stay and, eventually, the total cost of treatment.

More »»
2015 Journal Article Emmanuel James, Annie, J., and Nambiar, V., “Impact of clinical pharmacist’s interventions on health outcomes in post stroke patients”, International Journal of Pharmaceutical Research, vol. 7, pp. 38 - 43, 2015.
2014 Journal Article Emmanuel James and JM, C., “Switch over from intravenous to oral therapy: A concise overview. ”, vol. 5, no. 2, pp. 83-87, 2014.[Abstract]

Majority of the patients admitted to a hospital with severe infections are initially started with intravenous medications. Short intravenous course of therapy for 2-3 days followed by oral medications for the remainder of the course is found to be beneficial to many patients. This switch over from intravenous to oral therapy is widely practiced in the case of antibiotics in many developed countries. Even though intravenous to oral therapy conversion is inappropriate for a patient who is critically ill or who has inability to absorb oral medications, every hospital will have a certain number of patients who are eligible for switch over from intravenous to oral therapy. Among the various routes of administration of medications, oral administration is considered to be the most acceptable and economical method of administration. The main obstacle limiting intravenous to oral conversion is the belief that oral medications do not achieve the same bioavailability as that of intravenous medications and that the same agent must be used both intravenously and orally. The advent of newer, more potent or broad spectrum oral agents that achieve higher and more consistent serum and tissue concentration has paved the way for the popularity of intravenous to oral medication conversion. In this review, the advantages of intravenous to oral switch over therapy, the various methods of intravenous to oral conversion, bioavailability of various oral medications for the switch over program, the patient selection criteria for conversion from parenteral to oral route and application of intravenous to oral switch over through case studies are exemplified.

More »»
2014 Journal Article Emmanuel James, Kuriakose, S., and Kumar, A., “Assessment of knowledge of epilepsy in epileptic patients attending a tertiary care centre in Kerala”, Journal of Pharmacy and Pharmaceutical Sciences , vol. 6, no. 7, pp. 64-67, 2014.[Abstract]

Patient’s knowledge of his/her disease plays a vital role in epilepsy care. Studies assessing epileptic patient’s knowledge of epilepsy have not been done in the state of Kerala, South India, which is distinguished from the rest of India by the high level of literacy and health awareness. The study results can lead to suggestions for appropriate intervention strategies for epileptic patients.

More »»
2014 Journal Article R. S, Emmanuel James, RK, P., PK, Y., and A, A., “Betainterferone therapy in relapsing and remitting multiple sclerosis-challenges in an emerging country”, International Journal of Nutrition, Pharmacology, Neurological Diseases, vol. 4, pp. 34-38, 2014.
2013 Journal Article P. M. Drisya and Emmanuel James, “Recent updates in the management of chemotherapy induced nausea and vomiting”, Asian Journal of Pharmaceutical and Clinical Research, vol. 6, pp. 5-10, 2013.[Abstract]

The leading factor that has an impact on cancer patients' quality of life and their adherence to treatment is chemotherapy induced nausea and vomiting (CINV). Better understanding of the physiology of CINV and the identification of risk factors can be beneficial in improving the treatment outcomes. A number of antiemetic agents are currently available including 5-hydroxytryptamine receptor antagonists (5HT3RAs), neurokinin receptor antagonists (NK1RAs), dopamine receptor antagonists, benzodiazepines and cannabinoids. These agents can be used in the effective management of CINV according to the various antiemetic guidelines like NCCN (National Comprehensive Cancer Network) guidelines, ASCO (American Society of Clinical Oncology) guidelines and MASCC (Multinational Association of Supportive Care in Cancer) guidelines. Even though CINV can be prevented to a great extent with these agents, some patients still experience nausea and vomiting. In order to attain the ultimate goal of complete control of CINV, more effective therapies are greatly needed. This review focuses on the pathophysiological aspects of CINV, antiemetic agents, current guidelines for management of CINV, their comparative evaluation and recent trends in management of CINV.

More »»
2013 Journal Article K. N. Anila and Emmanuel James, “Clinical pharmacist governed anticoagulation service in stroke unit of a tertiary care teaching hospital”, Asian Journal of Pharmaceutical and Clinical Research, vol. 6, pp. 147-150, 2013.[Abstract]

Many reports have documented the ability of anticoagulation management services by clinical pharmacist to help patients receiving anticoagulants especially warfarin therapy achieves better outcomes. The present prospective and interventional study was carried out in stroke inpatient department of a tertiary care teaching hospital for a period of one year. The clinical pharmacist in the anticoagulation service had taken over the responsibilities like therapeutic drug monitoring of all patients of stroke ward, warfarin dosage adjustment in direct and via telephonic calls, management of warfarin related and unrelated problems including ADR monitoring and interaction checking and sorting out it, patient knowledge assessment using a set of validated questionnaires, patient counseling, providing information leaflets etc. Clinical outcomes were measured at the end of study. The establishment of anticoagulation clinic in the hospital helped the Stroke unit in bringing their patients under targeted anticoagulation. It helped in improving patient's knowledge compliance, reducing incidence of interactions and adverse effects. A value p&lt;0.05 indicated the significant improvement in the patient's knowledge on oral anticoagulation by clinical pharmacist interventions. Thus clinic laid a foundation in building good and healthy relation between physician, pharmacist and patients.

More »»
2013 Journal Article Ra Lakshmi, Emmanuel James, and Kirthivasan, Rb, “Study on impact of clinical pharmacist's interventions in the optimal use of oral anticoagulants in stroke patients”, Indian Journal of Pharmaceutical Sciences, vol. 75, pp. 53-59, 2013.[Abstract]

Anticoagulants are very useful medications but can also lead to haemorrhagic as well as thromboembolic complications when not used correctly or without proper medical attention. Anticoagulant's complex pharmacology and pharmacokinetics contribute to its narrow margin of safety. Pharmacist's unique knowledge of pharmacology, pharmacokinetics and interactions makes them well-suited to assist patients in maintaining safe and effective anticoagulation. Successful anticoagulation therapy implies fewer incidences of therapeutic failures and bleeding complications. The anticoagulation management service staffed by clinical pharmacists is a service established to monitor and manage oral and parenteral anticoagulants. In this research work, 40 patients each were included in the intervention and the control groups. In the intervention group, patient's knowledge score on anticoagulation increased from an average of 5.6±3.2 to 13.8±0.94 (P=0.000) after clinical pharmacist's counselling, whereas in the control group there was no significant improvement in patient's baseline knowledge over the knowledge score at the end of the study (8.0±1.59 vs. 8.3±2.6) (P=0.218). In the intervention group, 73.45% of the international normalised ratio test results were within the therapeutic range, 8.45% supratherapeutic and 18.5% subtherapeutic during the 6 months data collection period. The corresponding data for the control group were 53.2 (P=0.000), 18.4 (P=0.000) and 28.4% (P=0.002), respectively. Forty four adverse drug reactions (ADRs) related to anticoagulants were identified in the intervention group as compared to 56 in the control group. These results revealed that the clinical pharmacist's involvement in the anticoagulation management improved the therapeutic outcome of patients and demonstrate the benefits of clinical pharmacist guided anticoagulation clinics in India.

More »»
2013 Journal Article A. KN and Emmanuel James, “A Study on Impact of a Clinical Pharmacist in Improving Knowledge of Cardiology Out-patients about Oral Anticoagulants”, Indian Journal of Pharmacy Practice, vol. 6, p. 31, 2013.[Abstract]

The study was conducted to find the magnitude of impact of a clinical pharmacist in improving knowledge of cardiology patients about oral anticoagulants. The interventional group received an additional care by the clinical pharmacist and was compared with a control group which received only the usual care of the physician. Patients in the intervention group were assessed for their baseline knowledge using validated questionnaire about the use of anticoagulants and counseled regarding the use of oral anticoagulants, side effects, dietary recommendations, importance of INR (International normalised ratio) tests and dose titrations, compliance and provided information booklets and contact numbers for reporting INR results and reassessed during their follow up. There was statistically significant improvement in knowledge score of patients in the intervention group as compared to control group and statistically significant increase in the number of INR's within target range for the patients in intervention group as compared to control group. The intervention group showed much better improvement in knowledge score (p<0.05) which was evident by the mean difference which had an increase of 5.864 points compared to control group's 0.907
points. The fraction of INRs within therapeutic range indicated better anticoagulation control in the intervention group compared to control group (0.632 vs 0.432). This study showed that knowledge of patients regarding oral anticoagulation therapy was insufficient before the clinical pharmacist's involvement. Counseling by a clinical pharmacist will improve the outcome of the patients taking oral anticoagulants as evidenced by the increase in the values of INRs and showed better anticoagulation control

More »»
2013 Journal Article N. Siddharthan, Prabhu, R., Pavithran, K., Emmanuel James, Priyasivakumarlal, K., Ponnachen, M., and Balachandran, N., “The safety & feasibility of high dse methotrexate based therapy for acute lymphoblastic leukemia, a single centre experience from a developing country in ASIA PACIFIC”, HAEMATOLOGY CONFERENCE (APHCON), HONK KONG, FEB, 2013.
2011 Journal Article Remya Reghu and Emmanuel James, “Epidemiological profile and treatment pattern of vitiligo in a tertiary care teaching hospital”, International Journal of Pharmacy and Pharmaceutical Sciences, vol. 3, pp. 137-141, 2011.[Abstract]

The objective of the present study was to assess the prevalence, precipitating factors, clinical features and management pattern of vitiligo patients. An observational, cross sectional descriptive study was carried out for a period of five months from a study population of 6250 outpatients who visited the dermatology department of a tertiary care hospital. The prescriptions of the individual patients were collected to assess the therapeutic management pattern. Prevalence of vitiligo was found to be 1.3%. The mean age at onset of the disease was 29.6 ± 20.6 years. 18.8% of the patients had a family history of vitiligo. Lower limbs (42.5%) followed by face (27.5%) were the most affected parts. Major precipitating factor was found to be physical trauma (18.8%). Thyroid disorder was the most common autoimmune disorder observed (21.3%). Vitiligo vulgaris was the common clinical type (53.7%) followed by focal vitiligo (18.8%), acrofacial vitiligo (13.8%), segmental vitiligo, etc. Topical tacrolimus (68.8%), topical corticosteroids (53.7%), and topical psoralen (48.8%) were the first line treatments used in the study center. Systemic steroid pulse therapy was used in progressive vitiligo patients and the noted adverse effects of the treatments were gastric irritation (11.3%) and weight gain(7.5%). Autologous melanocyte transplantation(5%), epidermal suction blister grafting (2.5%) and narrow band ultra viloet B phototherapy (27.5%) were other treatment modalities used. Similar studies covering large number of patients are needed to confirm our findings.

More »»
2011 Journal Article Sa Scaria, Emmanuel James, and Dharmaratnam, A. Db, “Epidemiology and treatment pattern of atopic dermatitis in patients attending a tertiary care teaching hospital”, International Journal of Research in Pharmaceutical Sciences, vol. 2, pp. 38-44, 2011.[Abstract]

An observational, prospective, cross sectional study was carried out on atopic dermatitis (AD) patients attending the dermatology outpatient department of Amrita Institute of Medical sciences, Kochi from January 2010 to May 2010. The study population consisted of 6250 outpatients and the entire 60 patients from all the age groups who were diagnosed to have atopic dermatitis based on the Hanifin and Rajka's diagnostic criteria and who agreed to participate in the study were included. Relevant data was obtained from patients, patients' parents and/or rela-tives by interviewing them and by individual analysis of the patient's prescription and was compiled using Micro-soft excel and descriptive statistical analysis carried out. The prevalence of AD was found to be 0.96% in the study population. Majority of the patients were in the age group of 3 to 10 years with a mean age of 13.8 ± 15.1 years and the mean age at onset was 10.6 ± 14.8years. 31.7% of the patients had "pure" AD and 68.3% suffered from a ''mixed'' type. The disease severity assessment showed that 51.7% of patients had moderate AD, followed by mild type in 30.0% of patients. Family history of atopy was seen in 56.7% of patients. Majority of the patients had ag-gravation of the disease during winter months. Most of the patients (95.0%) were prescribed topical emollients while topical steroids in 75% and short courses of systemic steroids in 25% of patients. Adverse drug reactions reported include gastric irritation in 6.7% of patients, followed by weight gain in 3.3%, folliculitis & exacerbation of eyelid dermatitis in 1.7%. It was concluded from this study that the prevalence was slightly higher than those re-ported from northern India. Only moderate and mild type of AD was found in the study population and majority of the patients could be controlled with topical emollients and topical steroids. ©JK Welfare & Pharmascope Foundation. More »»
2010 Journal Article Emmanuel James, Meenu Vijayan, K., S. V., and D., D. A., “Prevalence, clinical profile and prescribing pattern for psoriasis in a tertiary care referral hospital”, International Journal of Pharmacy & Technology , pp. 1241-52, 2010.
2010 Journal Article Emmanuel James, Unni, V. N., Deepa, A. R., and Aboobacker, S., “Evaluation of quality of life in hemodialysis and renal transplant patients”, International Journal of Pharmacy and health Sciences , pp. 77-83, 2010.[Abstract]

The study was conducted in a tertiary care hospital in Kerala to compare the quality of life between hemodialysis and transplant patients using WHOQOL-BREF scale. The study also focused on the clinical laboratory parameters of both the groups. The various immunosuppressive drug combinations prescribed for the renal transplant patients were also examined.About 50 patients each were included in both the hemodialysis and transplant groups. In the hemodialysis group, 74% were males and 26% females while in the transplant patients, 78% were males and 22% females. The patients in the hemodialysis group had a mean age of 57.32 ± 10.41 years while the transplant patients had a mean age of 36 ± 11.0 years. The mean of the serum creatinine and hemoglobin values of the hemodialysis patients were 9.68 ± 2.31 mg/dL and 9.91 ± 1.42 g/dL respectively while that of the transplant patients were 1.5 ± 0.42 mg/dL and 13.43 ± 2.11 g/dL respectively. The QOL scores in renal transplant patients in all the four domains were significantly higher (P<0.05) than that of the hemodialysis patients. The renal transplant patients were prescribed immunosuppressive drugs which have to be taken lifelong. About 36% of the transplant patients were on azathioprine + prednisolone combination. Quality of life improved after successful kidney transplant compared to dialysis. Although initially expensive, renal transplantation is a cheaper renal replacement therapy on the long run and is associated with reduced mortality. More »»

Faculty Details


Faculty Email: