International Journal of Basic & Clinical Pharmacology
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Genotoxic and cytotoxic effects of thiomersal and paracetamol combination
Get PDFBackground: Thiomersal is used as a preservative of some vaccines or as a trace from the pathogen inactivation process in vaccine production. Prophylactic use of paracetamol upon vaccination is still common, even though paracetamol decreases immune response on some vaccines. Considering the cytotoxic and genotoxic potential of thiomersal and paracetamol and possible interaction in vivo, in vitro study was performed.
Methods: The genotoxic and cytotoxic effects of thiomersal and paracetamol combination were examined on human lymphocyte cultures by using two methods: analysis of chromosomal aberrations and cytokinesis-block micronucleus cytome assay. Blood samples of three healthy donors were analyzed with the following concentrations of tested substances: thiomersal 1 µg/ml and 0.5 µg/ml, paracetamol 20 µg/ml, thiomersal 0.5 µg/ml with paracetamol 20 µg/ml and thiomersal 1.0 µg/ml with paracetamol 20 µg/ml.
Results: The analysis of structural chromosomal aberrations was significantly increased in all treated cultures. In cells treated with the combination of thiomersal 1 µg/ml and 20 µg/ml of paracetamol, the number of aberrations was significantly decreased. Cytokinesis-block micronucleus cytome assay analyses showed significantly increased micronucleus frequency in lymphocytes cultivated with thiomersal 1 µg/ml compared to lymphocytes cultures exposed to thiomersal 0.5 µg/ml.
Conclusions: Induction of structural chromosome aberrations and micronucleus is shown as a sign of genotoxicity for the examined concentrations of thiomersal and paracetamol. The suppressing effect of paracetamol on thiomersal genotoxicity in lymphocytes culture treated with thiomersal was shown to be indicative of further examination of paracetamol use in the prevention of genotoxicity
A basic insight into COVID-19 vaccines: an overview
Get PDFAtypical serious respiratory illnesses were reported in December 2019 from Wuhan, a city of China, which later spread to other places rapidly and became a global pandemic. Soon it was discovered to be caused by a novel corona virus, named as the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) and the disease caused by it as corona virus disease-19 (COVID-19). Since COVID-19 is a new viral disease, world is still struggling to find out a permanent remedy to overcome this serious health problem. Developing safe and effective vaccine against SARS-CoV-2 has become the only way forward to tackle it. Various vaccines have been developed and are approved for mass vaccination on emergency basis. Both classical and next generation vaccine platforms are being used to develop COVID-19 vaccine. It seems interesting to have a look on the various types of vaccines and get an insight into them so that we can get familiarize with the COVID-19 vaccination
Metronidazole induced neurotoxicity: a case report
Get PDFMetronidazole is a well-known antimicrobial agent, used for the treatment of anaerobic bacterial and protozoal infections. It is generally well tolerated with common side effects like nausea, dizziness, headache and metallic taste in the mouth. But prolonged use of metronidazole can cause neurotoxicity like ataxic gait, dysarthria, seizures and encephalopathy. Here, we are reporting a case of a 60 years old male patient who was a chronic alcoholic with liver abscess and he developed acute ataxia and dysarthria after four weeks use of metronidazole. The causality of metronidazole in this case was “probable” with score 7 as per Naranjo scale. The patient was managed by discontinuing the metronidazole and there was considerable improvement in his gait and speech after that. The case was recorded properly in adverse drug reaction reporting form and was sent to nearby adverse drug reaction (ADR) monitoring centre
Fatal case of acute necrotic pancreatitis secondary to chronic abuse of acetaminophen: a case report
Get PDFAcetaminophen is a widely used analgesic and antipyretic. It is also known to cause hepatotoxicity and is rarely associated with acute pancreatitis due to overdose. We report the case of a 55-year-old man with no known comorbidities, who presented with severe abdominal pain and vomiting. His medication history revealed chronic abuse of a fixed-dose combination containing 37.5 mg of tramadol hydrochloride and 325 mg acetaminophen 3-6 tablets per day for over 20 years for general body pain without a specific diagnosis. He was diagnosed with acetaminophen-induced acute necrotic pancreatitis after ruling out gallstones and other factors such as alcohol consumption, and family history. Although he got discharged against medical advice, follow-up revealed that he had succumbed to his illness within 15 days. This was a fatal case of acetaminophen-induced pancreatitis due to chronic abuse for over 20 years at a dose of less than 2 g/day. This case highlights the need for periodic monitoring of patients taking acetaminophen at doses within the recommended daily dose
A cross-sectional questionnaire-based study of medication adherence in children suffering from epilepsy attending pediatric out-patient department at a tertiary care teaching hospital
Get PDFBackground: Epilepsy is a common chronic disease presenting during childhood that requires long-term treatment. Rates of adherence to antiepileptic drugs are variable in children ranging from 25% to 75%. Non-adherent patients are more likely to experience frequent and recurrent seizures which drastically impact the health of the patient. This study was therefore conducted in order to assess the medication adherence of children suffering from epilepsy to the prescribed anti-epileptic drug therapy.
Methods: Children diagnosed with epilepsy aged 6-18 years were enrolled in the present cross-sectional questionnaire-based study after prior written informed consent and written informed assent. Children with co-morbidities were excluded from the study (as diagnosed by the Paediatrician). The case record form was filled after interviewing the patients. A questionnaire based on the Morisky medication adherence scale-8 (MMAS) was used to evaluate the quality of life of children.
Results: Total 243 patients got enrolled in the study. GTCS was found to be the most common type of epilepsy. Valproate was the most commonly used agent. Out of the 243 patients in total, 201 patients (83%) showed high adherence, 24 patients (10%) showed medium adherence and 18 patients (7%) showed poor adherence to the treatment prescribed. Patients on monotherapy showed higher adherence rates than patients on polytherapy. Medication adherence was highest with Valproate among monotherapy and valproate + carbamazepine among poly-therapy.
Conclusions: We conclude that monotherapy with anti-epileptic agents and patient satisfaction is positive predictors of medication adherence leading to a lesser impact of the disease on the child and improved health
Extracts of Neptunia prostrata Linn. ameliorates progression of diabetes mellitus and hyperlipidemia in animal models
Get PDFBackground: The herb Neptunia prostrata Linn. belonging to the family Mimosaceae has been used in folkloric medicine in the North-eastern states of India of Assam, Tripura and Meghalaya by indigenous herbal healers since time immemorial but there is a scarcity of any background study documenting its use as an antimicrobial herb. For the same, plants were collected and authenticated.
Methods: Following identification of these herbs methanolic, ethanolic, pet ether and chloroform extracts were prepared using soxhlation. Acute toxicity study as per OECD guidelines 420 was assessed in wistar albino rats and in swiss albino mice (n=5) of both sexes at doses of 2000 mg/kg body weight and did not reveal any morbidity or mortality in the animals within the stipulated period. Phytochemical screening was performed on all four extracts of Neptunia prostrata.
Results: Phytochemical constituents depicted presence of glycoside, flavonoids in only ethanolic, methanolic and chloroform extracts. Alkaloids were present in the chloroform extract. The antidiabetic and antihyperlipidemic activity was performed by HFD-STZ models in rats. The herbs showed antioxidant activity comparable to standard antioxidants in-vitro such as Ascorbic acid (Vitamin C) with comparable IC50 values.
Conclusions: Results of the antidiabetic shows immense potential in animal models and therapeutics and the antibacterial screening suggests conspicuous and potent putative role in the therapeutics of a vast plethora bacterial infections that need to be corroborated for the expansion of future prospective in vivo studies with larger sample size
Improving an online higher education pharmacology course based on students’ perception
Get PDFBackground: The COVID-19 pandemic outbreak transformed education thoroughly. Our in-classroom Pharmacology course had to be adapted precipitously into a completely online modality. Hence, we aimed to evaluate its efficacy for learning and improve it based on our students’ perception.
Methods: Semi-open questionnaires were designed and applied at the end of the 2020 and 2021 courses to assess students’ satisfaction on the following fields: eLearning platform, lectures, synchronous discussion section, asynchronous collaborative work, and assessments. Data from the first online course was analyzed and evidence-based improvements were performed for the 2021 course. Quantitative comparison of cohorts was carried out. Furthermore, students’ perception from the last in-person course (2019) was analyzed.
Results: The 2019-course questionnaire demonstrated a good acceptance towards an incipient use of the virtual campus. Comparison of the complete online cohorts revealed a significant increase in positive answers in six items: complementarity of lectures with discussion sections (85% vs. 100%), teaching strategy (30% vs. 84%), adequacy of faculty’s role (47% vs. 79%), pre- and post-class activities (30% vs. 55%), wording of exercises (30% vs. 55%) and assessments (50% vs. 97%). Moreover, a modification of the students’ requests expressed in the comment section was observed.
Conclusions: Custom-designed semi-open questionnaires used to evaluate students’ perception and receiving feedback on the Pharmacology course provided high quality information to promote student-oriented changes that allowed for an improvement in the teaching-learning process
A prospective, randomised, open label study to compare efficacy and safety of hydroxychloroquine and teneligliptin in patients of type 2 diabetes mellitus refractory to concomitant metformin and glimepiride
Get PDFBackground: Diabetes mellitus is chronic, metabolic disease characterized by hyperglycemia, which over time causes both microvascular and macrovascular complications. If HbA1c target is not achieved with dual therapy then 3rd drug is added. Aims of present study were to compare efficacy and safety of Hydroxychloroquine (HCQ) and Teneligliptin in patients of T2DM who are refractory to concomitant Metformin and Glimepiride.
Methods: It was interventional, randomized, prospective, parallel and open-label study. Patients were randomly divided into 2 groups either HCQ 400mg OD or Teneligliptin 20mg OD were added to their current treatment using Metformin 1gm BD and Glimepiride 4 mg OD as 3rd drug. Follow up was done every 15 days for 12 weeks and underwent assessment of glycaemic parameters (FBS, PPG, HbA1c), LFT, RFT, CBC, ADRs and VAS in addition to anthropometric parameters.
Results: After 12 weeks of treatment, HCQ group showed statistically (p<0.05) better improvement in BMI than Teneligliptin group. Both groups showed comparable improvement (p>0.05) from baseline in FBS, HbA1c, PPG and VAS score. In HCQ group there was significant number (p<0.05) of patients who achieved target glycaemic control (HbA1c ≤7.5%) i.e., 56.6%, compared to 37% with Teneligliptin group. Both groups had comparable (p>0.05) safety profile with no serious adverse effects and no significant change (p>0.05) in hepatic, renal and complete blood profiles.
Conclusions: On the basis of effects of HCQ on the glycaemic parameters and BMI, HCQ may be preferred over Teneligliptin in patients of T2DM who are refractory to concomitant Metformin and Glimepiride
A randomised comparative study of induction of labour with sublingual misoprostol 50 μg and oral misoprostol 50 μg in term patients
Get PDFBackground: Current study was conducted to compare the efficacy of tab Misoprostol 50 microgram by oral and sublingual routes for induction of labour.
Methods: A randomised comparative study of induction of labour in 200 cases of pregnant women at term and were divided into two groups of 100 each for 50 µg Misoprostol for oral and sublingual route repeated 4 hourly either by sublingual or oral route until an adequate contraction pattern set in (establishment of 3 uterine contractions in a period of 10 minutes) or once the cervical dilatation reaches 4 cm, maximum up to 6 doses. The patients were monitored for maternal vital signs, progress of labour and foetal heart rate.
Results: In this study, 86% women delivered vaginally with sublingual misoprostol while 76% were delivered vaginally with oral administration. In the present study, no significant maternal side effects were noted in either group. 4% cases of neonates in sublingual group and 6% cases of neonates in oral group required NICU admission. No still birth or neonatal deaths were seen.
Conclusions: Our study shows that sublingual Misoprostol has better efficacy, shorter induction to delivery interval, requirement of fewer doses of misoprostol when compared to oral route
Essential drug list for cardiovascular diseases in a tertiary health care centre
Get PDFBackground: Essential medicines are those that satisfy the priority health care needs of a population. The latest version of NLEM is the 23rd list, published in September 2022, and contains 384 essential drugs, of which 29 are cardiovascular drugs. The drugs in the list may be huge or small according to the local needs. The objectives of our study are to prepare the essential drug list for cardiovascular disease in a tertiary care hospital and to confirm the essential drug list provided and its availability in the pharmacy.
Methods: We interviewed around 28 consultants from various departments who prescribe these cardiac drugs. The names, doses and dosage forms were noted. The list was verified with the NLEM 2022 and counterchecked in the hospital pharmacy.
Results: Most consultants adhered to NLEM, but an additional 42 drugs were prescribed, amounting to 71 drugs. There are four drugs Warfarin, Rivaroxaban, Furosemide and Torsemide which may be considered for the hospital pharmacy list.
Conclusions: Too many drugs other than those present in the NLEM list are prescribed, which can be reduced by adequately training the consultants to adhere to the prescribed list.