International Journal of Basic & Clinical Pharmacology
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Breaking the blisters: a comprehensive guide to treating bullous pemphigoid
Get PDFIn adapting the treatment plan, the severity of the disease in correlation with the patient should be put onto consideration. Recent RCTs demonstrated adjuvant treatment with doxycycline, dapsone, and immunosuppressants for the treatment of bullous pemphigoid is of advantage and safe in terms of diminished total steroid dose and mortality. The British association of dermatologists has produced dermatologists’ guidelines. These provide evidence-based treatment recommendations with respect to candidness, and offer a summary on, among others, epidemiological features, diagnosis, and research. The evidence on which the guidelines rest was retrieved from Medline, Embase, the Cochrane Library, literature searches, and the authors' 10 years of experience treating patients with bullous pemphigoid in general and special clinics. However, it should be noted that findings from the literature should be interpreted with great care as only six randomized controlled trials with small patient groups are available.
Fluoroquinolone-nitro imidazole fixed-dose combination medication-induced fixed drug eruption with positive re-challenge
Get PDFFluoroquinolone-nitroimidazole fixed-dose combinations, such as ofloxacin-ornidazole and norfloxacin-tinidazole, are widely prescribed for gastrointestinal infections. However, fixed drug eruptions (FDEs) associated with these combinations are underreported. A 32-year-old female developed generalized itching and painful ulcerative lesions on the buccal mucosa shortly after taking an ofloxacin-ornidazole tablet. Upon discontinuation and substitution with norfloxacin-tinidazole by a physician, her symptoms worsened, indicating a positive rechallenge. Dermatological evaluation led to withdrawal of the drug and initiation of antihistamines and topical analgesics, resulting in symptom resolution. Her clinical course, including lesion recurrence at the same site upon re-exposure, confirmed the diagnosis of FDE, a delayed-type hypersensitivity reaction mediated by CD8+ T cells. Causality assessment using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale classified the reaction as certain. This case highlights the need for thorough drug history taking and the importance of avoiding re-prescription of drugs from the same pharmacological class in patients with suspected drug allergies.
Formulation and nutritional evaluation of galactagogue-based nutritional health mixes to support lactation
Get PDFBackground: Human breast milk is a rich source of essential nutrients and also contains protective elements such as antibodies and immune factors, along with hormones, growth factors, enzymes, and other bioactive compounds, which are designed for easy digestion and optimal absorption, ensuring the best possible growth and development of infants. However, dysgalactia or insufficient milk production, often linked to inadequate intake of calories and essential nutrients necessary for milk production, is a common hindrance to breastfeeding. In this context, the current study was planned to design and develop different variations of finger millet and oats-based galactagogue health mixes with the intent to encourage milk synthesis.
Methods: Four galactagogue health mixes, namely GHM-R1, GHM-R2, GHM-O1 and GHM-O2 based on finger millet (25 and 50%) and oats (25 and 50%) with nuts and seeds, were developed. Foxnut flour-based health mix was used as a control. A descriptive sensory score card was used for sensory analysis. AOAC methods were used to analyse proximate and dietary fibre. Calcium and iron were analysed using standard protocols.
Results: Among the developed galactagogue health mixes, the sensory quality of GHM-R1 (25% popped finger millet) was found to be highly acceptable with a score of 8.45. GHM-R2 (50% popped finger millet) reported the highest calcium content, 328 mg/100 gm.
Conclusions: There lies great scope in scientifically evaluating the traditional knowledge systems based galactagogues for the mechanism, efficacy, dose, and safety.
Landiolol in supraventricular tachycardia: an updated review of clinical applications
Get PDFSupraventricular tachycardia (SVT) is a prevalent cardiac arrhythmia requiring rapid and effective intervention. Landiolol, a highly selective, ultra-short acting, beta-1 adrenergic receptor blocker, has recently received FDA approval for short-term ventricular rate control in adults with SVT, including atrial fibrillation and atrial flutter. Its rapid onset and hemodynamic stability make it a valuable addition to acute cardiac care. Data from clinical trials, systematic reviews, and real-world studies were analyzed to evaluate landiolol’s role in SVT management. It effectively controls the ventricular rate in SVT. The drug exhibited a favourable safety profile and is better suited for rate control rather than arrhythmia termination when compared to adenosine. Its utility in managing perioperative atrial fibrillation, critically ill patients, and those with respiratory conditions makes it a valuable therapeutic option. Future research should explore its role in Indian demographics to optimize its clinical use
Optimized corticosteroid therapy for respiratory disorders and role of stewardship: a narrative review
Get PDFCorticosteroids are considered the cornerstone in the treatment of respiratory diseases, especially asthma, chronic obstructive pulmonary disease (COPD) and other inflammatory airway diseases. Corticosteroids have established themselves as drugs of choice in modern respiratory practice due to their well-documented role in suppressing airway inflammation and improving pulmonary function. It’s obvious that inappropriate or prolong use of corticosteroids leads to significant adverse events, including osteoporosis, metabolic dysfunction, adrenal suppression, and infection risk. These challenges require an urgent need for optimized, evidence-based practices that balance efficacy with safety. Corticosteroid stewardship programs have emerged as a structured framework to tackle inappropriate prescribing, with the aim of fostering responsible, patient-centered use. The multidisciplinary collaboration, audit and feedback systems, digital prescribing dashboards, biomarker-guided strategies all make up part of the various elements included in the corticosteroid stewardship initiatives to ensure that such therapy is used in a rational and consistent manner. Advances in precision medicine have also extended to include the use of blood eosinophil counts and molecular biomarkers that clinicians can exploit to provide personalized corticosteroid therapy, thereby increasing therapeutic benefit while minimizing unnecessary exposure. The article provides a traditional review of the current evidence, emerging practice, and implementation models underlying the optimization of corticosteroid therapy in respiratory medicine. Also outlines how such stewardship programs can improve prescribing behaviors, mitigate adverse outcomes, and embed quality improvement processes across healthcare systems. Innovations in the integration of digital health, clinician education, and patient engagement in reshaping corticosteroid usage in both hospital and community settings are discussed
Assessing anticancer drug utilization patterns through WHO prescribing indicators at a specialized cancer hospital in Peshawar
Get PDFBackground: Efficient utilization of anticancer agents is crucial for effective malignancy treatment and cost management. WHO Prescribing Indicators provide a standardized measure for assessing drug usage. This study aimed to evaluate anticancer drug utilization patterns in a specialized oncology hospital using these indicators.
Methods: A cross-sectional analysis involved reviewing medical records of anticancer drug prescriptions at a designated cancer treatment facility. Key WHO prescribing indicators, including drug per prescription average, proportions of anticancer drugs and generics usage, were assessed.
Results: Analysis of 900 prescriptions revealed an average of 8.36 drugs per prescription, with 2.27 being anticancer drugs and 4.93 adjuvants. Notably, 71% of medications were prescribed generically 85% were on the Essential Medicines List. Opportunities for enhancing efficiency, like promoting generic drugs and reducing injectable anticancer agents, were identified.
Conclusions: This study highlights the value of WHO Prescribing Indicators in analysing anticancer drug utilization trends. Addressing prescribing deficiencies can refine treatment protocols, promote judicious pharmaceutical use and elevate patient care standards. Future efforts should focus on targeted strategies to rectify these shortcomings, emphasizing ongoing research and quality improvement in oncologic pharmacotherapy
Knowledge, attitude and practice towards self-medication among pharmacy students in tertiary care hospital
Get PDFBackground: Self-medication, which is when the public treats health problems on their own without consulting a doctor, is very common. The objective of this study is to analyze pharmacy students' self-medication practices, attitudes, and knowledge in a tertiary care hospital.
Methods: Data will be collected from the B. Pharmacy, M. Pharmacy and Pharm. D with their consent by request to them to complete the questionnaire (self-administrated).
Results: A total of 339 responses from participants were prospectively collected and documented. The participant characteristics such as demographic information (age, gender, and education) was collected.
Conclusions: Insufficient understanding regarding appropriate self-medication exists, yet changes can be made in this situation with the existing positive attitude of the respondents. Seminars and workshops can be utilised to effectively distribute knowledge to students, while implementing robust policies to curb the increasing trend
Role of immunotherapy in cancer management
Get PDFCancer remains one of the leading causes of mortality worldwide accounting for nearly 20 million new cases and 10 million deaths, prompting continuous research for more effective treatments. In recent years’ immunotherapy has transformed the landscape of cancer treatment, with significant breakthroughs promising more targeted and durable outcomes. Unlike standard treatments, such as surgery, chemotherapy, and radiation, which directly target cancer cells, immunotherapy aims to boost or replace the immune system's natural ability to fight cancer. Since it is a new mode of therapy most of the practicing doctors are unaware of the details about it. In this context, we conducted a narrative review based on available literature. This article explores the historical background and evolution of immunotherapy, the mechanisms of various immunotherapeutic plans, recent advancements, future directions, and challenges in this field. Our paper focused on, checkpoint inhibitors, chimeric antigen receptor T (CAR-T) cell therapy, oncolytic virus therapy, and cancer vaccines. As the field continues to evolve, collaboration among researchers, clinicians, and patients is essential to drive these advancements and improve outcomes in cancer care
A review on physicochemical properties and pharmacological activity present in Erythrina variegata plant leaves
Get PDFThe morphology, pharmacological activity, and phytochemical screening of Erythrina variegata are the briefly outline in the study. A substitute term for E. variegata is also known as Erythrina indica. The plant is capable of reaching an average height of between fifty and sixty feet. Many phytoconstituents, which includes alkaloid substance, tannins, flavonoids, and other resin, protein, saponins and glycosides, have been identified. Terpenoids, triterpenoids, steroids, and phenols are a few examples of secondary metabolites. According to Soxhlet techniques, there are five unique solvent system: methanol, hexane, ethyl acetate, dichloromethane, chloroform, and aqueous solution. Various parts of this plant have been used in traditional medicinal for their analgesic, nervine-calming, antiseptic, antacid antiepileptic, anti-asthmatic, and anti-inflammatory properties. E. variegata plant parts of leaves are used to treat infections produced by bacteria that inhibit or eradicate Pseudomonas and Escherichia (E. coli) bacteria. Its further block both grammeme-positive and grammeme- negative bacteria. E. variegata leaf bark is the main treatment for various diseases in medical systems like siddha (Ayurveda), Unani medicine, and Homoeopathy.
An algorithmic approach to pharmacoeconomic analyses
Get PDFPharmacoeconomics is defined as the description and analysis of costs of drug therapy to health care systems and society. There are various methods used, such as cost-minimization (CMA), cost-effectiveness (CEA), cost-utility (CUA) and cost-benefit analyses (CBA). Others include willingness-to-pay (WTP) and incremental net benefit (INB) analysis. However, there is lack of knowledge in the proper application of these in a coordinated fashion. The aim is to create an algorithm for health-care professionals in deciding appropriate treatment in a pharmacoeconomic perspective when multiple treatment options are available, ensuring safe and effective health-care services within limited resources. For this we reviewed various literature on pharmacoeconomics and compiled various analytical methods being used, along with their pros and cons, including when they can be applied and not. We used all this information to prepare the algorithm which goes as follows. Step 1: for the given patient condition, find the minimum effectiveness of treatment required and list out the health interventions which can provide it along with their costs, benefits and utility. Step 2: conduct INB analysis using WTP method to rule out those which the patient cannot afford. Step 3: among others, conduct CUA followed by CBA, CEA and CMA in this order. Step 4: the treatment option which doesn’t get ruled out at the end of these steps should be considered. If sufficient data is available (which is an important limitation), this algorithm can serve as a powerful tool in optimizing health-care interventions, at least in selective health-care setups