International Journal of Basic & Clinical Pharmacology
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Evaluation of the mechanism of action of Aegle marmelos in a murine model of 3% dextran sulphate sodium induced acute colitis
Full text linkBackground: An earlier study by us in a murine model of dextran sulphate sodium (DSS) induced acute colitis showed that aqueous extract of unripe fruit of Aegle marmelos (780 mg/kg/day) was comparable with Sulfasalazine. In this study we evaluated the same extract for anti-inflammatory, anti-oxidant, and prebiotic activity in the same model.
Methods: 48 adult swiss albino mice (>6 weeks age) of either sex (18-25 grams) were divided into four groups (n=12/) i.e., normal control (distilled water-10 ml/kg/day), Disease control (Distilled water-10 ml/kg/day), Positive Control (Sulfasalazine-100 mg/kg/day) and Test drug (A. marmelos-780 mg/kg/day). The drug/vehicle was administered orally for 14 days from day 1 through day 14. Acute colitis was induced by adding 3% DSS in drinking water from day 8 to 14 in all groups except normal control. The animals were euthanized on day 15, each group were divided into two batches (n=6). One batches were used to estimate colonic myeloperoxidase (MPO) and TNF-α. The other batch was used to cultivate lactobacilli and aerobic microbiota from colonic contents, three animals from this batch were also used to estimate colonic MPO and TNF-α.
Results: Mice administered A. marmelos, and sulfasalazine showed significantly higher colon lengths, colon weight/ length ratios, colonic TNF-α and MPO levels, and both were significantly better than disease control. Lactobacilli and aerobic bacteria counts were significantly higher in A. marmelos group compared to the disease control and were comparable to normal control. However, sulfasalazine showed no improvement in the colonic microbiota counts.
Conclusions: A. marmelos showed anti-inflammatory, anti-oxidant, and prebiotic activity
Evaluation of anxiolytic effect of aqueous extract of Garcinia indica seeds using open field test
Full text linkBackground: Anxiety is a common psychiatric condition frequently encountered in medical practice. While benzodiazepines like Diazepam are widely used as anxiolytics, they come with long-term adverse effects. Garcinia indica (Kokum), a natural herb, is believed to have anxiolytic properties without these drawbacks. This study aimed to evaluate its anxiolytic potential as a safer alternative.
Method: Wistar albino rats (n=32) were divided into four groups (8 per group) and administered orally with distilled water (0.5 ml), Diazepam (1 mg/kg), Garcinia indica (1.75 gm/kg), and Garcinia indica (3.5 gm/kg), respectively. Anxiety was assessed using the open field test, measuring parameters like the number of lines crossed, central square entries, rearing, grooming, immobility, and urination. Data were analyzed using one-way ANOVA followed by Tukey’s test.
Results: Both doses of Garcinia indica and Diazepam significantly increased central square crossings and improved behavior such as rearing, grooming, and immobility. However, Garcinia indica did not significantly affect urination or number of lines crossed compared to the control. Diazepam significantly reduced number of lines crossed compared to Garcinia indica (3.5 gm/kg).
Conclusion: Garcinia indica demonstrated significant anxiolytic effects comparable to Diazepam, suggesting its potential as a safer alternative for anxiety management
Frequency and management of non pain symptoms, in cancer patients receiving palliative care: a prospective, observational and cross-sectional study in a tertiary care institute
Full text linkBackground: Cancer is the second most common cause of death caused by non-communicable diseases around the world, causing serious stress in both patients and caregivers including physical, psychological, social, and economic problems. Advanced cancer patients often experience a range of debilitating non-pain symptoms that significantly impact their quality of life. These symptoms can be due to the disease itself or the side effects of treatment. Effective management of these symptoms is crucial for palliative care (PC). The main aim of this study was to identify the frequency and management strategies of common non-pain symptoms in patients with cancer admitted to the oncology ward and inpatient PC patients, receiving PC.
Methods: A prospective, observational study was conducted involving 100 patients, admitted to the oncology ward and inpatient PC patients, receiving PC. Structured interviews and questionnaires were used to collect data on non-pain symptoms experienced. The frequency of symptoms was analyzed using specific statistical methods and the effectiveness of various management approaches was evaluated.
Results: The majority of the admitted patients were poly-symptomatic. The two most prevalent non-pain symptoms reported were lack of appetite (52%) and fatigue (51%) followed by nausea and vomiting, insomnia, constipation, shortness of breath, and anxiety. Ondansetron is the most common antiemetic and hydrocortisone is the most common steroid prescribed in the study population.
Conclusions: In the findings of our survey significant prevalence of non-pain symptoms among cancer patients was seen, with fairly controlled symptoms after the management. This emphasizes the need for a comprehensive assessment of symptoms and routine monitoring of symptom management strategies in cancer patients
Efficacy and safety of Amrith Noni Arthoplus in osteoarthritis: a double-blinded, randomized clinical trial
Full text linkBackground: Osteoarthritis (OA) is a chronic, degenerative joint disorder marked by pain, inflammation, and impaired mobility, significantly affecting quality of life. Current treatments often provide limited relief and may have adverse effects with long-term use. This study aimed to evaluate the efficacy and safety of Amrith Noni Arthoplus in individuals with OA through a double-blinded, randomized clinical trial.
Methods: This double-blind, randomized, placebo-controlled study evaluated the efficacy and safety of Amrith Noni Arthoplus, an herbal formulation containing Morinda citrifolia (Noni) as the primary ingredient, in 40 patients with osteoarthritis (OA). Efficacy was evaluated using the visual analog scale (VAS) for pain intensity, 6-minute walk test, stair climb test, physician and subject global assessments (PGA/SGA), serum biomarkers (hs-CRP, calcium, phosphorus, magnesium, vitamin D3), and bone mineral density (BMD) via DEXA scans. Safety was assessed through vital signs, haematology, liver and kidney function tests, and adverse event monitoring.
Results: The active group demonstrated significant improvements in pain intensity (33.82% reduction in VAS scores, p<0.0001), physical function (14.17% increase in walking distance, p<0.0001), and stair climb time (12.75% reduction, p<0.0001) compared to the placebo group. Serum biomarkers, including hs-CRP (31.33% reduction, p<0.0001) and bone health markers (calcium, phosphorus, magnesium, vitamin D3), showed significant improvements. BMD increased by 25.48% in the active group (p<0.0001), while the placebo group experienced an 18.10% decline (p=0.002). No adverse events were reported, and all safety parameters remained within normal limits.
Conclusions: Amrith Noni Arthoplus significantly alleviates OA symptoms, improves physical function, and enhances bone health, demonstrating its potential as a safe and effective complementary therapy for OA management
Adverse drug reactions to antitubercular therapy in osteoarticular tuberculosis: a retrospective observational study from a tertiary care center
Full text linkBackground: Osteoarticular tuberculosis (OATB) is a challenging form of extrapulmonary tuberculosis (TB) that often requires long-term multidrug regimens. Antitubercular therapy (ATT) can lead to significant adverse drug reactions (ADRs), potentially affecting patient adherence and outcomes. Objectives were to assess the types and frequencies of ATT-induced ADRs in patients treated for osteoarticular TB.
Methods: This retrospective observational study included 27 patients diagnosed with OATB, who were treated at Dr. RPGMC Tanda. Patient records and telephone interviews were used to collect data on ADRs. Descriptive statistics were used for analyses.
Results: Of 27 patients, 13 (48.1 %) experienced ADRs. GI symptoms were the most common (18.5%), followed by dermatological (11.1%) and neurological (11.1%) side effects. One case each of hepatotoxicity with liver failure and epistaxis, and two cases of ocular symptoms were recorded.
Conclusions: Nearly half of the patients developed ADRs to ATT. Regular monitoring and early intervention are essential to improve treatment compliance and patient safety.
A study on drug utilization, evaluation and monitoring of adverse drug reactions in the cardiology department of a tertiary care hospital
Full text linkBackground: Cardiovascular diseases require complex pharmacotherapy, increasing the risk of Adverse Drug Reactions (ADRs). Monitoring drug utilization and ADRs is essential to enhance patient safety.
Methods: A prospective observational study was conducted over 3 months (April 2025-June 2025) in the Cardiology Department of a tertiary care hospital. Fifty inpatients aged ≥18 years were monitored for ADRs. Causality was assessed using the Naranjo Scale and WHO-UMC criteria; severity was evaluated using the Hartwig Scale.
Results: A total of 50 ADRs were reported, with hematological (36%), gastrointestinal (24%), and cardiovascular (16%) systems most affected. Anticoagulants, antiplatelets, diuretics, RAAS inhibitors, and SGLT2 inhibitors were commonly implicated. Most ADRs were moderate (50%), with 62% categorized as probable. No fatalities occurred; 66% of patients recovered fully.
Conclusions: ADRs are common among cardiology inpatients, with polypharmacy and comorbidities as key risk factors. Regular pharmacovigilance, patient monitoring, and individualized therapy are essential to minimize ADR-related complications.
In vitro evaluation of antifungal property of ethanolic extract of Syzygium aqueum fruit in leucorrhoea using zone of inhibition
Full text linkBackground: Leucorrhoea, characterized by abnormal vaginal discharge, is commonly associated with Candida albicans infection. Conventional antifungal agents face resistance, creating the need for plant-based alternatives. Syzygium aqueum (water apple) is known to possess antimicrobial activity.
Methods: Ethanolic extract of Syzygium aqueum fruit was prepared by cold maceration. Antifungal activity was evaluated against Candida albicans using agar well diffusion on potato dextrose agar medium. Extract concentrations (10, 5, 2.5, 1.25 mg/ml) were tested. DMSO served as negative control, and ketoconazole (50 mg/ml) as positive control. Zones of inhibition were measured after incubation at 37°C for 24 hours.
Results: Extract exhibited concentration-dependent antifungal activity with maximum inhibition zone of 20 mm at 10 mg/ml, while ketoconazole showed 31 mm inhibition.
Conclusions: Syzygium aqueum demonstrated moderate antifungal efficacy against Candida albicans, supporting its potential as a natural antifungal option in leucorrhoea management
Echoes of adversity with Voriconazole: a retrospective study
Full text linkBackground: Voriconazole is widely used in managing invasive fungal diseases, but its adverse drug reactions, pose significant clinical challenges. This retrospective observational study aimed to evaluate the frequency, severity, and risk factors of ADRs associated with voriconazole treatment in patients in a tertiary care hospital, focusing on demographic characteristics, co-morbidities, route of administration, and trough drug levels.
Methods: Data of 95 patients who received voriconazole between 2020 and 2025 were retrieved from electronic medical record. Demographic details, treatment indication, comorbidities, mode of administration, and trough plasma concentrations were collected. ADRs were categorized by system organ class, assessed for severity using modified Hartwig -Siegel scale, and causality was determined using the WHO-UMC system. Statistical analysis employed chi-
square tests for categorical variables and Mann–Whitney U tests for trough level comparisons, with p<0.05 considered significant.
Results: ADRs occurred in 58 patients (61.1%), hepatobiliary were most frequent (44%). Male patients had a higher ADR rate (54.5%), and those with type 2 diabetes mellitus showed a significantly higher incidence (p=0.008). Cardiovascular comorbidities and thyroid disorders were also significantly associated with ADRs. The intravenous route showed a higher incidence of ADRs compared to oral route. Most reactions were moderately severe (56.8%). A statistically significant relationship was observed between higher trough concentrations and the occurrence of transaminitis.
Conclusion: Voriconazole therapy showed a high rate of moderate ADRs, primarily hepatobiliary. Intravenous route and comorbidities-diabetes, cardiovascular disease, and thyroid disorders-were significant risk factors requiring vigilant monitoring
Emerging insights into the use of dexamethasone for high-altitude illness: bridging basic pharmacology and clinical practice
Full text linkAcute mountain sickness (AMS) and its severe forms high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE) result from hypobaric hypoxia that triggers vascular leak, inflammation, and metabolic stress. Among preventive agents, acetazolamide remains conventional, but dexamethasone has emerged as the most potent pharmacologic safeguard due to its rapid and multi-level protective mechanisms. Acting through both genomic and non-genomic pathways, dexamethasone suppresses NF-κB and HIF-1α signalling, reinforces endothelial barrier integrity, reduces cytokine-driven edema, and enhances mitochondrial energy efficiency, collectively restoring vascular and metabolic stability under hypoxic stress. Evidence from randomized trials and meta-analyses demonstrates a 60-70% reduction in AMS incidence and accelerated recovery in HACE and HAPE with dexamethasone therapy. Multi-omics analyses further reveal that the drug reprograms over a thousand genes involved in immune, oxidative, and metabolic regulation, underscoring its system-wide impact. Recent advances including inhaled, transdermal, and depot formulations, as well as pharmacogenomic-guided dosing are transforming dexamethasone from a symptom-relief drug to a precision altitude pharmacology agent. Its unmatched combination of anti-inflammatory, anti-edematous, and metabolic-stabilizing actions firmly establishes dexamethasone as the most comprehensive and mechanistically validated therapy for both prevention and treatment of high-altitude illness
Beyond folate antagonism: the unique pharmacological blueprint of methotrexate
Full text linkMethotrexate (MTX) possesses a uniquely complex pharmacological profile characterized by nonlinear pharmacokinetics, saturable absorption, transporter-dependent distribution, and intracellular polyglutamation, all of which contribute to substantial interindividual variability in therapeutic response and toxicity. This review summarizes current evidence on MTX absorption kinetics, dose-dependent oral bioavailability, and the role of renal and hepatic pathways in systemic clearance. Special emphasis is placed on the formation and accumulation of MTX polyglutamates (MTX-PGs), which act as long-acting intracellular metabolites that enhance therapeutic duration but may also increase the risk of adverse effects when present at higher concentrations. Genetic polymorphisms in key enzymes and transporters, including RFC1, FPGS, GGH, and members of the SLCO and ABC transporter families, significantly influence MTX disposition, efficacy, and toxicity, underscoring the expanding role of pharmacogenomics in individualized therapy. The review also highlights the relevance of routine laboratory monitoring, emerging biomarkers, and clinical dosing strategies, including split dosing and subcutaneous administration to optimize outcomes across oncology and autoimmune settings. By integrating current pharmacokinetic, pharmacodynamic, and pharmacogenomic insights, this work provides a comprehensive understanding of MTX’s therapeutic behaviour and supports the need for personalized approaches to maximize efficacy while minimizing adverse effects