International Journal of Basic & Clinical Pharmacology
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A questionnaire-based study on the knowledge, attitude, and the practice of ecopharmacology among the healthcare professionals in Amaltas Medical College and Hospital, Dewas, Madhya Pradesh
Get PDFBackground: Ecopharmacology which deals with the health hazards posed by discarded or used medicinal products in the environment, is a globally emerging issue. There are guidelines for pharmaceutical waste management (like GMP and FDA guidelines) for the manufacturing units, pharmacists and consumers. However, it is uncertain whether consumers are aware of it. Before beginning the process of creating awareness, it is first necessary to assess the existing knowledge of the issue in the community. This study was planned to assess the knowledge, attitude and practice (KAP) of ecopharmacology in the medical personnel and students in our institute.
Methods: It was a questionnaire based cross-sectional observational study. Study population included MBBS students, nursing students and resident doctors. Total 500 consenting participants were enrolled and subjected to a structured KAP questionnaire and data was expressed in percentage. Questionnaire consisted of 20 questions out of which 3 were open ended and remaining closed ended.
Results: Present study result showed that 73% respondents had heard of term ecopharmacology and majority (98%) felt that it was their responsibility to protect environment from pharmaceutical waste. Responses from 83% of participants indicated that they were worried about the excess medicines at their homes. 87% of participants threw it in garbage bin, but (58%) were unsure whether their drug disposing method was safe and 25% knew it was unsafe. Most respondents (94%) felt that there should be guidelines for safe disposal of expired/unused drug and were enthusiastic about participating in campaign for this issue. Medical personnel also suggested some solutions to deal with this problem.
Conclusions: Awareness and concern regarding the problem is high however in absence of knowledge of methods of safe disposal of unused drug, it is not transforming into safe disposal practices
The impact of anti-tumor necrosis factor alpha drugs on lipid profile of patients with rheumatoid arthritis or seronegative spondyloarthropathy
Get PDFBackground: Inflammatory arthritis is associated with abnormal levels of lipoprotein. The cause is considered to be inflammation. Recently, the use of biologic drugs in the treatment of inflammatory arthritis, especially rheumatoid arthritis (RA) and seronegative spondyloarthropathy, has increased. There are different results of the effect of these drugs on fat profile. Evaluate the impact of anti-tumor necrosis factor (TNF) alpha drugs on lipid profile of patients with RA or seronegative spondyloarthritis.
Methods: In this cross-sectional descriptive study, 50 patients with rheumatoid arthritis or seronegative spondyloarthritis, who were candidates for TNF alpha treatment, were included in the study. After obtaining written consent, a checklist was completed for all patients including demographic information such as age, sex, height, weight, place of residence, level of education, type of disease, and lipid profile test results including total cholesterol, triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were recorded. Then the patients were treated and evaluated for fat profile after 3, 6, 9 months after receiving the relevant treatment regimen. The test results were recorded in checklists. After completing the study, the data were entered into the statistical package for the social sciences (SPSS) 24 software and analyzed.
Results: The mean age of patients was 46.38±14.33 years. 54% of patients were female. 54% of patients had rheumatoid arthritis. 62% of patients were treated with Sinora. The results of this study showed that serum triglyceride levels increased during the study period and this increase was statistically significant but the trend of changes in serum cholesterol, HDL and LDL levels was not statistically significant. However, serum LDL levels measured in the ninth month increased significantly compared to the initial measurement.
Conclusions: Results showed that there was a significant relationship between lipid profile changes and anti-TNF alpha consumption. Although decreased inflammation appears but other mechanisms may be involved in dyslipidemia
Knowledge, attitude, and practice of ‘P-drug concept’ among postgraduate residents and interns in a tertiary care teaching hospital in Maharashtra
Get PDFBackground: A P-drug is a clinician’s personal or preferred or priority choice drug. The study aims to evaluate the knowledge, awareness, and practice of P-drug, which helps postgraduates to prescribe medicines rationally. The objective of this study is to assess the knowledge, attitude, and practice of the P-drug concept among postgraduate students at a tertiary care teaching hospital.
Methods: The study is a prospective, cross-sectional pre-validated questionnaire-based study conducted in the tertiary care teaching hospital. A total of 300 postgraduates, interns and consultants from Tertiary care teaching hospital from Maharashtra were enrolled and instructed to fill the questionnaire. These filled forms were collected, and data was analyzed.
Results: Out of 300 members, 233 filled the questionnaire, and these forms are evaluated. About 49.7% among them are aware of P-drug, 43.4% are aware of P-treatment, 28.4% are not including fixed-dose combinations in their P-drug list, 42% are aware of the advantages of prescribing P-drug, and 48.4% felt that teaching programs are needed for preparing P-drug list.
Conclusions: The P-drug concept is requisite for improving the quality of health care and practicing rational use of medicine. As only a few studies have been conducted on the P-drug idea in this institute, the institutional teaching review board should run teaching programs regarding the P-drug concept
Dissolution rates of various brands of proton pump inhibitors in combination with domperidone: an in vitro study
Get PDFBackground: Drug solubility, bioavailability, and dissolution rates are important in establishing in vivo efficacy. Eight brands of domperidone proton pump inhibitor combination drugs were compared to enable physicians to take an informed decision regarding the dissolution rates of various domperidone-PPI combinations available in the Indian market to allow identification and prescription of the drug with better bioavailability.
Methods: The in vitro dissolution rate of a combination of domperidone-PPI drugs was measured using the United States Pharmacopeia dissolution paddle apparatus. Each flask of the dissolving testing apparatus contained one tablet and 900 mL of the media, which was dissolved in pure water with 1% Tween® stored at 37.4°C. At regular intervals, aliquots were removed, filtered, and the amount of drug released was measured. The cumulative drug release was calculated using a standard formula.
Results: P04 and P07 had the fastest and the slowest onsets of action, respectively. P01 (Omez DSR) and P08 exhibited the longest and the shortest durations of action, respectively. The P05, P06, and P08 formulations had greater particulate matter than the other formulations. Under in vitro conditions, the bioavailability of Omez DSR was nearly two-fold higher than P07 and five-fold higher than P08.
Conclusions: Although P04 exhibited the fastest onset of action, Omez DSR had the longest duration of action, superior bioavailability, and ensured the rapid and continuous release of domperidone. Omez DSR demonstrated superior properties compared with other brands
Prescription pattern of antibiotics in various clinical departments of a tertiary care health institution: a retrospective observational study
Get PDFBackground: Antimicrobial resistance has been considered as one of the greatest challenges to the general public health today. The Antibiotic Stewardship Program has emphasized on prevention of drug resistant bacterial infection, targeted therapy against susceptible or resistant microorganism and to curtail unnecessary and irrational use of antibiotics. Present study aimed to evaluate the pattern of antibiotic prescription amongst the hospitalized patients of IGMC Shimla in Himachal Pradesh.
Methods: It was a retrospective observational study. Data was collected from hospital records of admitted patients in medicine and Surgical wards. Patient data like demographic profile, average hospital stay and number of antibiotics prescribed were extracted from their hospital records. Also, the data about oral/parenteral, generic/branded empirical/definitive and therapeutic/prophylaxis prescription in each patient were collected.
Results: In medicine ward, the number of generic prescriptions 78 (71.5%) were more as compared to branded 31 (28.5%) and majority were given the parenteral 61 (55.9%) than the oral 48 (44.1%) dosage form. In surgery ward, the branded prescriptions 61 (91%) out-numbered the generic prescription 6 (9%). The route of administration was mostly oral; 56 (83.5%), while only few had parenteral prescription; 11 (16.5%) in this ward.
Conclusions: It was found that majority of patients in medicine ward received generic named antibiotics for definitive management, while in surgical ward branded named antibiotics were prescribed for surgical prophylaxis. The cephalosporin was the most commonly prescribed antibiotic group. Majority of antibiotics belonged to “watch” category as far as WHO’s AWaRe classification is concerned
Acute ischemic stroke: management approach
Get PDFA stroke, or brain attack, happens when blood flow to the brain is stopped. It is an emergency situation. The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. Stroke is the second most common cause of death worldwide and the most important cause of physical weakness, with a growing occurrence in developing countries. Ischemic stroke is the most common type of stroke which occurs due to arterial block and managed by fast reperfusion with endovascular thrombectomy and intravenous thrombolysis. The first step in stroke management is initial identification of patients with stroke and triage to centers accomplished of transporting the suitable treatment, as fast as conceivable. Mobile stroke units, tele stroke and artificial intelligence are technologies playing an important role in recognizing and treating stroke. Stroke system-of-care models remain to streamline the distribution of definitive revascularization in the age of mechanical thrombectomy. Overall, in the present review, we emphasized the pathophysiology, diagnosis and management of acute ischemic stroke (AIS)
An observational study on dapagliflozin as an add-on therapy in type-2 diabetes mellitus patients in a tertiary care teaching hospital
Get PDFBackground: Diabetes mellitus is one of the prevalent morbid conditions all over the world and no exception for India. Day by day, increase in its prevalence is attributed to lifestyle derangements. To treat this condition many drugs and treatment modalities are developed. Dapagliflozin is an oral antidiabetic drug which acts by sodium-glucose cotransport-2 (SGLT-2) inhibition. Its effectiveness seen in type-2 diabetes mellitus makes it an option for Add-On therapy.
Methods: This study is a retrospective observational study conducted at tertiary care hospital, GGH, Kurnool. The study proposal has been reviewed and approved by institutional ethics committee. All adult diabetic patients who were prescribed Dapagliflozin during the period of January 2021 to February 2022, total 45 were included in the study. FBG, HbA1c collected through hospital records from General Medicine and Endocrinology. Patients who stopped drug before 3 months period were excluded.
Results: Administration of dapagliflozin as an add-on therapy was found 26.63% decrease in base line mean FBG 184 mg/dl to 135 mg/dl after 3mnoths which is significant (p=0.001). Mean HbA1c significantly reduced by 0.96 percentage point after 3 months (p=0.001). Dapagliflozin effectively reduced the FBG and HbA1c when used in combination with other OHAs or insulin within 3 months.
Conclusions: Dapagliflozin as an add-on therapy significantly reduced the HbA1c level and fasting blood glucose of Type-2DM patients, in a 3-month treatment period. Due to the frequency of Genitourinary tract infections, caution is indicated while treating the patients
Pharmacoecomonic study of oral antidiabetic drugs available in Indian pharmaceutical market
Get PDFBackground: Diabetes mellitus is a metabolic disorder requiring lifelong medication which further adds to comorbidity. Cost of the drug pays an important role in adherence and compliance to the treatment. There is a wide variation in prices of oral hypoglycemic drugs available in Indian pharmaceutical market. Aims and objectives of the study was planned to evaluate cost of oral antidiabetic drugs of various brands currently available in Indian market either as single drug or in combination.
Methods: Cost of antidiabetic medications manufactured by various pharmaceutical companies in the same strength and dosage form was obtained from the price list provided by various pharmaceutical companies in current index of medical specialties December 2022-March2023. The cost ratio and percentage price variation for each formulation was calculated and analyzed.
Results: Among single antidiabetic drugs, Tab. Metformin 500 mg shows highest percentage price variation (809%) and highest cost ratio (9.09). Among fixed dose combinations, Tab. Glibenclamide 5 mg + Tab. Metformin 500 mg shows highest percentage price variation 300.8% and highest cost ratio 4.
Conclusions: Our study shows that there is high price variation for oral anti diabetics. It is important to bring awareness about wide variation in prices so that drug cost can be reduced and made affordable to common man which plays major role in compliance of patient
A prospective observational study of prescription pattern of antihypertensive drugs in general medicine outpatient department of associated hospital RUHS CMS, Jaipur
Get PDFBackground: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The aim of study is the prescribing pattern and the consumption of antihypertensive drugs in isolated hypertensive patients and in hypertensive patients with different co-existing morbidities.
Methods: The present study is a Prospective observational study. The study was conducted at Medicine Department of associated hospital of RUHS College of Medical Sciences, Jaipur.
Results: A total of 965 patients having hypertension were analyzed, in that 556 patients were male and 409 patients were female. In hypertension patients, angiotensin receptor blockers ARB, diuretics and β- blockers (29.90%) were mostly used classes in three drug therapy. Whereas telmisartan, hydrochlorothiazide and metoprolol (35.05%) were mostly prescribed. Drugs. In hypertension patients, angiotensin receptor blockers ARB, diuretics, β- blockers and calcium channel blockers (56.67%) and calcium channel blockers, angiotensin converting enzyme inhibitors, β-blockers and diuretics (43.33%) were used classes in four drug therapy. Whereas Telmisartan, Hydrochlorothiazide, Nebivolol and Amlodipine (62.5%) were mostly prescribed drugs. Hypertensive Patients with Comorbidity were found in higher prevalence with 276 hypertensive patients (28.60%) along with Diabetes Mellitus most commonly found and 389 hypertensive patients (40.31%) were found to be with No Comorbidity.
Conclusions: Present results reveal that antihypertensive medication adherence to JNC-8 recommendations is suboptimal. Therefore, physicians should follow JNC-8 guidelines to improve the patients care because suboptimal adherence leads to adverse clinical outcomes. The present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with co-morbid conditions
Case report on splenic abscess with pleural effusion caused by enteric fever
Get PDFSplenic abscess is an infrequent complication of enteric fever caused by Salmonella typhi. The incidence rate ranges from 0.14-2%. Clinical manifestations are often nonspecific and may be presented as fever with left upper quadrant abdominal pain and a palpable tender mass. Diagnosis is often difficult and splenic abscess management is based on surgical interventions and antibiotic therapy. In this case report we would like to highlight splenic abscess with left reactive pleural effusion as a rare complication of Salmonella typhi infection