International Journal of Basic & Clinical Pharmacology
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Antibacterial drug utilization study in patient of sepsis due to Staphylococcus aureus
Get PDFBackground: Sepsis is the most common and highly fatal clinical syndrome due to infection. Gram-positive organisms as a cause of sepsis have increased in frequency over time more common than gram-negative infections. S. aureus bacteremia (SAB) is one of the most prevalent and difficult to treat infections associated with significant morbidity and mortality. Aim was to study antibacterial drug utility, sensitivity and resistance pattern of antibacterial drugs in S. aureus infective septic patient in medicine department.
Methods: A prospective observational study was done in medicine department of SSG hospital, Vadodara over a period of 9 months.
Results: Total 50 S. aureus were tested for their sensitivity and resistance pattern towards ten antibacterial agents in microbiology department by disc diffusion method. The antibiogram of S. aureus indicated widespread resistance antibacterial agent ranging from a minimum resistant to vancomycin (4%) to a maximum of 90% against penicillin G. Total 142 antibacterial agents were prescribed in 50 patients. Metronidazole, ceftriaxone and piptaz were the most frequently prescribed antibacterial agents with DDD/1000 patient days 2.44, 3.55 and 2.62 respectively. 30 out of 50 patients needed a change in antibacterial agents during their course of treatment either due to antibacterial agent failure or after culture sensitivity report. 60% of the patients were prescribed ≥3 antibacterial agents at any point of time during treatment. Mean DOT/LOT was 2.22±0.84.
Conclusions: There is a need of antibacterial agent usage guidelines and restriction policies for the rational prescribing of antibacterial agent in critically ill patients
Drug utilization pattern of antidepressant used in depression disorder in psychiatric department in Northern India: a prospective observational study
Get PDFBackground: Due to its large economic impact, severe impairment, suffering, and relatively high lifetime prevalence, depression is becoming a major health concern worldwide, its treatment involved different strategies consisting of supportive and drug therapy This work was done to evaluate the prescribing practices in treatment of depression.
Methods: A prospective observational study was undertaken at the IIMS&R hospital, department of psychiatry. A total of 100 prescriptions written for patients with depressive disorders were examined along with the patients file and progress report to access the pattern of drug therapy, demographic information of patients, comorbidities, the number and types of medications given were also evaluated.
Result: Among the prescriptions, 6 different class of drugs were prescribed out of which 61.26% are selective serotonin receptor inhibitors (SSRIs), 10 different individual antidepressant drugs were prescribed, escitalopram was highest 58.4% (n=83) and paroxetine 2.8% (n=4) as the least, mirtazapine 11.9% (n=17), sertraline 7% (n=10), amitriptyline 6.33% (n=9), duloxetine 6.33% (n=9), escitalopram+ clonazepam 5.6% (n=8) gabapentin+ nortriptyline 1.4% (n=2) and most of patient were within age group of 26-35 years, there is an average of 2 antidepressant drugs per prescription.
Conclusions: The current study reveals important highlights on the current drug treatment pattern in the treatment of depressive disorder, including the most commonly prescribed drug, average number of drugs per prescription and the demographic distribution of patients with depressive disorder which is important for the healthcare professionals to enhance drug therapy, encourage effective healthcare delivery and improve quality in treatment of depression
Steroidal and gonadotropin hormone profile studies of a classical ayurvedic preparation of “Saraguna Balijarita Makardhwaja” after chronic administration to male Sprague-Dawley rats
Get PDFBackground: Saraguna Balijarita Makardhwaja (SGM) is an Ayurvedic preparation used as a traditional antipyretic in the rural population. This research work was designed to get an overview of steroidal and gonadotropin hormone profiles after chronic administration of this drug.
Methods: The acute pharmacological test of SGM recorded no death or any signs of effectivity even at the highest dose of 4000 mg/kg body weight. For chronic pharmacological evaluation, sixteen healthy Sprague-Dawley male rats were randomly divided into two groups, one group was a control group and the other was an experimental group. The experimental group was assigned to receive the drug at a dose of 400 mg/kg of body weight orally. After 28 days of treatment, blood samples were collected for biochemical tests.
Results: The research showed the following effects on the steroidal and gonadotropin hormone profile. In this study, serum circulating level of dehydroepiandrosterone sulfate (DHEA-S), testosterone level, progesterone, 17-beta-estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured to determine safety profile study of SGM after chronic administration. There were no significant differences in any parameters which is suggesting that SGM has no effect of the steroidal and hormone profile.
Conclusions: According to studies, SGM has no harmful effect on the steroid and hormone profiles after chronic treatment. Further studies are needed to establish the safety aspects of SGM
Antihypertensive drug prescription patterns and their impact on blood pressure outcomes in a tertiary care teaching hospital
Get PDFBackground: The guidelines from the Joint National Committee (JNC-8) emphasize the importance of rapid blood pressure (BP) control to reduce morbidity and mortality. The success of hypertension treatment depends on various factors, with irrational prescription being strongly linked to poor BP control. This study aimed to evaluate the patterns of antihypertensive drug prescriptions among patients in a tertiary care teaching hospital.
Methods: A hospital-based observational study was conducted in 2018, including all hypertensive patients on medication. Their prescription patterns were analyzed.
Results: The study analyzed prescriptions from 240 hypertensive patients. The mean ages for male and female patients were 56.68±15.32 and 62.29±12.65 years, respectively. Physicians commonly prescribed monotherapy (34.60%) followed by two-drug (18.40%), three-drug (11.80%), and four-drug combinations (3.00%). The most frequent two-drug combination was ACE inhibitors + diuretics (4.40%), followed by angiotensin receptor blockers (ARBs) + diuretics (3.60%) and calcium channel blockers (CCBs) + ACE inhibitors (2.60%). Adherence to JNC 8 guidelines was 19.3% for pre-hypertension, 88.70% for stage 1 hypertension, and 73.29% for stage 2 hypertension.
Conclusions: Monotherapies were the most commonly prescribed regimens. Twice-daily dosing and monthly appointments were associated with lower incidences of uncontrolled BP. However, complete adherence to standard guidelines was not observed in all cases, especially in patients with comorbid conditions
Assessment of antimicrobial activity of Meliponula ferrugica in pathogenic wound samples
Get PDFBackground: Honey is a naturally occurring sweet material that bees make from nectar from flowers, secretions from plant parts, or excretions from plants that suck insects from plant parts. Honey’s antibacterial and antifungal qualities are widely known, and it has been used to heal burns, surgical wounds, and decubitus ulcers. Honey instantly sterilizes wounds affected by Staphylococcus aureus. The honey’s ability to fight bacteria can be ascertained by the nectar’s origin. Many antibiotic resistances among the bacteria that cause infections in humans have directly evolved as a result of the use of antibiotics in clinical practice.
Methods: This study found that Bergey’s manual of determinative bacteriology can be used to identify Pseudomonas aeruginosa and Staphylococcus aureus. According to the study’s findings, honey has a capacity to neutralise Pseudomonas aeruginosa and Staphylococcus aureus that have been isolated from infected wounds. Honey’s antibacterial characteristics account for a significant portion of its antibacterial activity.
Results: Staphylococcus aureus and Pseudomonas aeruginosa were both susceptible to the antibacterial activity of the honey sample. Pseudomonas aeruginosa exhibited lower activity compared to Staphylococcus aureus.
Conclusions: The results of this investigation show that Bergey’s handbook of determinative bacteriology can be used to identify Staphylococcus aureus and Pseudomonas aeruginosa. According to the study’s findings, honey has the ability to neutralise Pseudomonas aeruginosa and Staphylococcus aureus that have been isolated from infected wounds
Cost variation analysis of disease modifying anti rheumatic drugs in Indian market
Get PDFBackground: Rheumatoid arthritis (RA) is a chronic inflammatory disease with systemic complications, necessitating treatment to manage inflammation and prevent joint damage. In India, significant cost discrepancies exist among branded formulations of generic drugs, posing a financial burden on patients and impacting treatment adherence. This study focuses on cost differences of disease modifying anti rheumatic drugs (DMARDs) among Indian brands and advocating strict adherence to drug price control order (DPCO) rules and suggests scheduling non-scheduled drugs under DPCO.
Methods: This observational study analysed the cost of 6 oral DMARDs across 16 tablet formulations using data from National Pharmaceutical Pricing Authority (NPPA) and DPCO ceiling prices 2024. Number of brands per formulation, cost ratios, percentage variations, and DPCO price violations was analysed. Statistical analysis was performed using Microsoft Excel Office 2021, and Zotero was utilized for managing references.
Results: This study highlights significant price variations among DMARDs in the Indian market, with methotrexate 2.5mg exhibiting the highest cost ratio (1:3.63) and percentage cost variation (263.6%). Azathioprine 50mg has the most brands available (23), while sulfasalazine 500mg, sulfasalazine 1000mg, and tofacitinib 11mg are among the formulations with the fewest brands (3 each). Notably, sulfasalazine 500mg and hydroxychloroquine 200mg showed the most frequent instances of pricing violations above DPCO recommendations.
Conclusions: Strict regulation for price control and monitoring should be implemented since the DPCO has not yet achieved its goal of enforcing price ceilings, and non-scheduled drugs should be included under DPCO regulations effectively to enhance adherence to RA therapy
Knowledge, attitude and practices regarding travel medicine among health care workers in a tertiary care centre
Get PDFBackground: International travel whether for business, work or other reasons is increasing very rapidly. Along with this the risk for travel related illness has also increased exponentially as a very few travellers seek pre and post travel advice and our health care workers can play an important role in this field. To access the current knowledge, attitude, practice of travel medicine among health care workers.
Methods: The participants were briefed about the purpose of the study prior to its commencement. The questionnaire was framed in 2 sections. Section I covered the demographic profile while section II pertained to knowledge, attitude and practice. The questions were developed focusing on the domains that were already used in similar published literature. A Google form link was sent to the participants and they were given a time span of 2 days to completely fill the Google Form.
Results: Nearly all the participants had a fair knowledge regarding travel medicine (52.1%), associated diseases with it (68.6%) and the most common medicines to be prescribed during travel (65.3%). But (71.9%) were still unaware about the recommended guidelines related to travel medicine. A great number of participants (90%) were of the impression to create awareness among HCWs about presentation of illness in travellers. Most of the HCWs (72.7%) were aware of the issues that needed to be addressed in pre-travel consultation which could help to reduce the risk of illness and injury during travel. Most of HCWs (81%) were of the belief to encompass training related to travel medicine to be incorporated in medical curriculum.
Conclusion: HCWs has fair knowledge and positive attitude and practices with more trainings in the form of workshops and CMEs on Travel Medicine
Comparative study of efficacy and safety of erythropoietin and darbepoetin for treatment of anemia in chronic kidney disease patients: a comparative, observational and prospective study
Get PDFBackground: Anemia is a common prognosis of chronic kidney disease (CKD). It is predominantly managed with erythropoietin and darbepoetin. The objective of this study was to compare the efficacy and safety of erythropoietin injection versus darbepoetin for treating renal anemia amongst patient with CKD.
Methods: Patients of either gender diagnosed with anemia due to CKD, irrespective of dialysis who had haemoglobin less than 12g/dl were included in the study. Comparison of efficacy and safety of erythropoietin and darbepoetin was done based on the laboratory values of hemoglobin (Hb), red blood cells (RBCs), haematocrit (PCV) and adverse events respectively.
Results: A total of 108 patients met the inclusion criteria; 54 of them were treated with erythropoietin and 54 were treated with darbepoetin. The changes in Hb, RBCs and PCV in the group of patients who were on erythropoietin were 1.16, 0.49 and 3.76 respectively. Similarly, the changes in Hb, RBCs and PCV in the group of patients who were on Darbepoetin were 1.19, 0.42 and 3.52 respectively. The differences in the changes of Hb, RBCs and PCV in the both groups of patients were 0.04, 0.07 and 0.24 respectively. A total of 4 adverse events (HTN, vomiting, headache and joint pain) were reported by 24 (44.44%) patients of erythropoietin group and a total of 1 adverse event (HTN) was reported by 19 (35.19%) patients of darbepoetin group.
Conclusion: Both erythropoietin and darbepoetin were found to be equally effective and safe for the treatment of anemia in CKD patients
Effectiveness and safety of daily versus alternate-day rosuvastatin dose in dyslipidemic patients: a prospective, randomized and open-label study
Get PDFBackground: Dyslipidemia is considered to be an important risk factor for development of atherosclerotic cardiovascular disease (ASCVD). Statins, also called HMG CoA reductase inhibitors are considered to the most effective lipid lowering agents. This study assessed the effectiveness and safety of daily versus alternate day dosing regimens of rosuvastatin in dyslipidemia patients.
Methods: This study was conducted for a period of 12 weeks. Study subjects comprised patients of either sex in age group 18-65 years diagnosed with dyslipidemia and a total of 90 subjects completed study who were randomly distributed to three groups, A (rosuvastatin 10 mg daily), B (rosuvastatin 10 mg on alternate days) and C (rosuvastatin 20 mg on alternate days).
Results: Rosuvastain significantly lowered total cholesterol, low density lipoprotein-cholesterol and triglycerides in all groups (p<0.001). High density lipoprotein-cholesterol increased, but non-significantly (p>0.05). Intergroup differences were not statistically significant. Group A reported slightly more adverse events than group B and group C.
Conclusions: Alternate-day rosuvastatin therapy showed effectiveness statistically similar to the daily dose therapy in dyslipidemic individuals. It also exhibited fewer side effects, suggesting it could be a feasible approach for managing dyslipidemia, providing a more economical and potentially safer alternative to daily administration
General anaesthesia for laparoscopic umbilical hernia repair in a patient with pseudocholinesterase deficiency: a case report
Get PDFPseudocholinesterase deficiency is a condition that causes prolonged muscle weakness when succinylcholine or mivacurium is used as a neuromuscular blocking agent. It can be either inherited or acquired. The practice of not using these two muscle relaxant agents may suggest that PED is not a significant problem for general anesthesia. This case report describes the successful discharge of a patient with a preexisting diagnosis of PED who underwent laparoscopic umbilical hernia repair under GA with neuromuscular monitoring without complications