J. Kaur, S. Rani, A. Gulia, G. Bhutani, Sanjeev Kumar, Arvind Narwat
Objective: This study was conducted with the aim to evaluate the efficacy and safety of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis (OA) of the knee. Materials and Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 130 patients of age >40 years with primary OA of knee attending orthopedics OPD were randomly allocated into two groups of 65 each, i.e., Group D and Group B. In Group D, patients received tablet diclofenac 75 mg and in Group B, patients received tablet Vitamin B complex along with diclofenac once daily for 4 weeks, respectively. Clinical assessment was done at baseline and at the end of 4 weeks and 8 weeks by the visual analog scale (VAS), WOMAC index, and Lequesne index. Results: During the intergroup comparison, it was found that Vitamin B complex as an add-on therapy to diclofenac produced statistically significant reduction in mean VAS pain score (P < 0.05). However, the difference in mean WOMAC index and Lequesne index was not statistically different at 4 and 8 weeks between the two groups (P > 0.05). Mild side effects were seen at 4 weeks, but no side effects persisted up to 8 weeks in both the groups. Conclusion: The present study suggested that Vitamin B complex as an add-on therapy was found to cause a significant reduction in pain score. It could be a promising drug in patients with OA to improve the analgesic effect, when combined can reduce the dose of diclofenac, thereby minimizing the side effects.
{"title":"Role of Vitamin B Complex as an Add-on Therapy to Diclofenac in Patients with Primary Osteoarthritis of the Knee","authors":"J. Kaur, S. Rani, A. Gulia, G. Bhutani, Sanjeev Kumar, Arvind Narwat","doi":"10.4103/jpp.jpp_32_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_32_21","url":null,"abstract":"Objective: This study was conducted with the aim to evaluate the efficacy and safety of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis (OA) of the knee. Materials and Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 130 patients of age >40 years with primary OA of knee attending orthopedics OPD were randomly allocated into two groups of 65 each, i.e., Group D and Group B. In Group D, patients received tablet diclofenac 75 mg and in Group B, patients received tablet Vitamin B complex along with diclofenac once daily for 4 weeks, respectively. Clinical assessment was done at baseline and at the end of 4 weeks and 8 weeks by the visual analog scale (VAS), WOMAC index, and Lequesne index. Results: During the intergroup comparison, it was found that Vitamin B complex as an add-on therapy to diclofenac produced statistically significant reduction in mean VAS pain score (P < 0.05). However, the difference in mean WOMAC index and Lequesne index was not statistically different at 4 and 8 weeks between the two groups (P > 0.05). Mild side effects were seen at 4 weeks, but no side effects persisted up to 8 weeks in both the groups. Conclusion: The present study suggested that Vitamin B complex as an add-on therapy was found to cause a significant reduction in pain score. It could be a promising drug in patients with OA to improve the analgesic effect, when combined can reduce the dose of diclofenac, thereby minimizing the side effects.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"68 - 72"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42995459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Arivazhahan, G. Raj, Deepthi Puttur, S. Atal, M. George, L. Bairy
Medical postgraduation in India is available across various disciplines, one among them being pharmacology. As with the other MD courses, MD Pharmacology is a 3-year-long course that involves strenuous theoretical, practical, and clinical training. However, the curriculum does not clearly enlighten MD residents on the career vistas available for them once they pass out. The awareness level of majority of MD pharmacology postgraduates or freshers on these career options is meagre due to lack of professional guidance or literature, and hence, majority of them tend to travel along the path that is most commonly traversed by their seniors and peers. This comprehensive review details a few of the different vistas that an MD pharmacologist can pursue, highlighting the scope, roles, responsibilities, and monetary compensation of each, in an honest attempt to educate and enlighten the MD pharmacology fraternity.
{"title":"Career Vistas for Indian Medical Pharmacologists: A Comprehensive Review","authors":"A. Arivazhahan, G. Raj, Deepthi Puttur, S. Atal, M. George, L. Bairy","doi":"10.4103/jpp.jpp_37_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_37_21","url":null,"abstract":"Medical postgraduation in India is available across various disciplines, one among them being pharmacology. As with the other MD courses, MD Pharmacology is a 3-year-long course that involves strenuous theoretical, practical, and clinical training. However, the curriculum does not clearly enlighten MD residents on the career vistas available for them once they pass out. The awareness level of majority of MD pharmacology postgraduates or freshers on these career options is meagre due to lack of professional guidance or literature, and hence, majority of them tend to travel along the path that is most commonly traversed by their seniors and peers. This comprehensive review details a few of the different vistas that an MD pharmacologist can pursue, highlighting the scope, roles, responsibilities, and monetary compensation of each, in an honest attempt to educate and enlighten the MD pharmacology fraternity.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"29 - 36"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47749741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gowshika Krishnakumar, Dhaarani Jayaraman, D. Jeevarathnam, P. Kommu, J. Scott
Hypoglycemia in a child with acute lymphoblastic leukemia (ALL) often makes the clinician think of sepsis or metabolic disturbances due to relative adrenal insufficiency with steroid withdrawal. We report a rare scenario of drug-induced hypoglycemia in a child on treatment for ALL. Recurrent symptomatic episodes of hypoglycemia in a 4-year-girl on treatment for high-risk ALL were analyzed and it was surprising to note that the episodes were noted on early hours on Monday and Sunday nights. Detailed evaluation for the etiology and the workup was not contributory. With the background of drug history for ALL maintenance and occurrence of episodes on Mondays, possibility of drug-induced hypoglycemia secondary to cotrimoxazole was considered. Dose alteration for trimethoprim-sulfamethoxazole was considered stopping the drug is not feasible. Malnutrition was attributed as the coexisting risk factor in our child.
{"title":"Monday Blues - Rare Cause of Hypoglycemia in a Child with Leukemia","authors":"Gowshika Krishnakumar, Dhaarani Jayaraman, D. Jeevarathnam, P. Kommu, J. Scott","doi":"10.4103/jpp.jpp_57_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_57_21","url":null,"abstract":"Hypoglycemia in a child with acute lymphoblastic leukemia (ALL) often makes the clinician think of sepsis or metabolic disturbances due to relative adrenal insufficiency with steroid withdrawal. We report a rare scenario of drug-induced hypoglycemia in a child on treatment for ALL. Recurrent symptomatic episodes of hypoglycemia in a 4-year-girl on treatment for high-risk ALL were analyzed and it was surprising to note that the episodes were noted on early hours on Monday and Sunday nights. Detailed evaluation for the etiology and the workup was not contributory. With the background of drug history for ALL maintenance and occurrence of episodes on Mondays, possibility of drug-induced hypoglycemia secondary to cotrimoxazole was considered. Dose alteration for trimethoprim-sulfamethoxazole was considered stopping the drug is not feasible. Malnutrition was attributed as the coexisting risk factor in our child.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"100 - 101"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48263407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Fardan, A. Shiva, Aswathy M. Shaji, K. Yadav
An estimated ratio (i.e., 1 in 10) babies are born too early every year. Roughly 1 million children die each year due to impediments raised pertaining to preterm birth. One such extreme preterm male baby was presented in the neonatal care unit with respiratory distress and grunting. Baby was confirmed to have ventricular septal defect along with patent ductus arteriosus and craniosynostosis which was treated with medications and surgical managements. He was also engaged with various prophylactic and empirical antibiotic therapies to cover the microbial growth. The most disturbing stage here was the appearance of liver mass sizing 5.8 cm × 1.3 cm accompanied with area of necrosis, diagnosed with hepatoblastoma which was evident with the aid of ultrasound. Hence, chemotherapy was commenced which was in accordance with Societe Internationale d Oncologie Pediatrique Epithelial Liver Tumor Study Group-3. Although the existing comorbidities haunted the baby for a long time, he finally made it successfully to get into track by fighting all the hurdles bravely, which was a sheer miracle. Along with the clinicians/surgeons, we Clinical Pharmacists worked hand in hand to ensure the baby to be receiving optimized drug regimen keeping in mind the risk-benefit ratio.
据估计，每年有1 / 10的婴儿过早出生。每年大约有100万儿童死于与早产有关的障碍。一个这样的极端早产男婴被呈现在新生儿护理单位呼吸窘迫和咕噜声。婴儿被证实有室间隔缺损、动脉导管未闭和颅缝闭闭，并经药物治疗和手术治疗。他还从事各种预防性和经验性抗生素治疗，以覆盖微生物的生长。最令人不安的阶段是肝脏出现5.8 cm × 1.3 cm大小的肿块并伴有坏死区域，超声检查明显诊断为肝母细胞瘤。因此，根据法国国际肿瘤学会儿童上皮性肝肿瘤研究组第3组，开始化疗。虽然现有的合并症困扰了宝宝很长一段时间，但他最终还是勇敢地克服了所有的障碍，成功地走上了正轨，这是一个纯粹的奇迹。与临床医生/外科医生一起，我们临床药师携手合作，确保婴儿接受优化的药物方案，并牢记风险-收益比。
{"title":"A Survival Case of Premature Infant with Hepatoblastoma (Fetal Pattern) along with Other Serious Comorbidities and Surgical Interventions","authors":"Mohammed Fardan, A. Shiva, Aswathy M. Shaji, K. Yadav","doi":"10.4103/jpp.JPP_146_20","DOIUrl":"https://doi.org/10.4103/jpp.JPP_146_20","url":null,"abstract":"An estimated ratio (i.e., 1 in 10) babies are born too early every year. Roughly 1 million children die each year due to impediments raised pertaining to preterm birth. One such extreme preterm male baby was presented in the neonatal care unit with respiratory distress and grunting. Baby was confirmed to have ventricular septal defect along with patent ductus arteriosus and craniosynostosis which was treated with medications and surgical managements. He was also engaged with various prophylactic and empirical antibiotic therapies to cover the microbial growth. The most disturbing stage here was the appearance of liver mass sizing 5.8 cm × 1.3 cm accompanied with area of necrosis, diagnosed with hepatoblastoma which was evident with the aid of ultrasound. Hence, chemotherapy was commenced which was in accordance with Societe Internationale d Oncologie Pediatrique Epithelial Liver Tumor Study Group-3. Although the existing comorbidities haunted the baby for a long time, he finally made it successfully to get into track by fighting all the hurdles bravely, which was a sheer miracle. Along with the clinicians/surgeons, we Clinical Pharmacists worked hand in hand to ensure the baby to be receiving optimized drug regimen keeping in mind the risk-benefit ratio.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"102 - 105"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41723607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Mahatme, M. Bargade, Sachin K. Hiware, M. Motlag
Objectives: To compare the effects of atorvastatin and rosuvastatin in type II diabetes mellitus (T2DM) patients with dyslipidemia. Materials and Methods: Eighty patients with history of T2DM of more than 3 months duration, glycated hemoglobin <7%, dyslipidemia, and normal electrocardiogram were included in the randomized double-blind trial. The patients received either tablet atorvastatin 20 mg or rosuvastatin 10 mg once a day along with metformin and glimepiride twice daily orally. Patients were evaluated by the change in estimated average glucose (eAG), lipid profile, and incidence of adverse drug reactions (ADRs). Results: Rise in fasting blood sugar (FBS), postprandial blood sugar, and eAG were significant in the atorvastatin group as compared to the rosuvastatin group where there was a significant increase only in FBS levels. Changes in lipid parameters and incidence of ADR were similar in both the groups. Conclusion: Rosuvastatin can be preferred to atorvastatin in T2DM with dyslipidemia due to less variation in the blood sugar parameters, effective control over lipid profile, pleiotropic effects, and less microsomal interactions.
{"title":"Effect of Atorvastatin and Rosuvastatin on the Glycemic Control in Patients with Type II Diabetes Mellitus: A Comparative, Randomized, Double-Blind Study","authors":"M. Mahatme, M. Bargade, Sachin K. Hiware, M. Motlag","doi":"10.4103/jpp.jpp_8_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_8_21","url":null,"abstract":"Objectives: To compare the effects of atorvastatin and rosuvastatin in type II diabetes mellitus (T2DM) patients with dyslipidemia. Materials and Methods: Eighty patients with history of T2DM of more than 3 months duration, glycated hemoglobin <7%, dyslipidemia, and normal electrocardiogram were included in the randomized double-blind trial. The patients received either tablet atorvastatin 20 mg or rosuvastatin 10 mg once a day along with metformin and glimepiride twice daily orally. Patients were evaluated by the change in estimated average glucose (eAG), lipid profile, and incidence of adverse drug reactions (ADRs). Results: Rise in fasting blood sugar (FBS), postprandial blood sugar, and eAG were significant in the atorvastatin group as compared to the rosuvastatin group where there was a significant increase only in FBS levels. Changes in lipid parameters and incidence of ADR were similar in both the groups. Conclusion: Rosuvastatin can be preferred to atorvastatin in T2DM with dyslipidemia due to less variation in the blood sugar parameters, effective control over lipid profile, pleiotropic effects, and less microsomal interactions.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"54 - 60"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42821204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.
{"title":"Fostemsavir, a Drug with Novel Mechanism for the Treatment of HIV-1 Infection","authors":"R. Priyadharsini, C. Divyashanthi, D. Elango","doi":"10.4103/jpp.jpp_19_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_19_21","url":null,"abstract":"HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"42 - 46"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45274350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niraj Niraj, N. Shafiq, C. Mothsara, G. Garg, Amit Gupta, S. Malhotra
Drug utilization studies offer an excellent platform to ascertain the role of drugs because the periodic monitoring of prescribing pattern helps in advancement of rational use of drugs. The aim of drug utilization research is to encourage the rational use of drugs by analyzing the drug use pattern, generating early signs of irrational drug use, and suggesting intervention to improved drug usage. In recent times, drug utilization research is an essential part of pharmacoepidemiology because it describes the extent, nature, and determinants of drug exposure.[1] The WHO defined drug utilization research as “the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences.”[2] A wide spectrum of diseases come under the term corneal disorders including blepharitis, meibomitis, dryness in eyes, and corneal ulcers, and hence, various therapeutic agents including antibacterial, antifungals, antivirals, steroids, and antiallergic are used in the management of corneal disorders.[3] Wide variability in the prescribing trends of drugs, variable adverse event profiles among different brands of the same drug, and the ever-increasing prices of drugs are some prime examples of the need for such drug utilization studies. The plethora of literature is available for the utilization patterns of systemically used drugs, while the literature for topical drugs is patchy at best. Since the topical drugs are of prime usage in eye-related diseases, the studies of such importance will help identify the rationale of topical drugs and, hence, helps in promoting better drug usage when minimizing the occurrence of untoward adverse effects.[4] Therefore, the present study evaluated the prescribing pattern practices in the cornea clinic of a tertiary care hospital.
{"title":"Evaluation of Recent Prescription Pattern in Cornea Clinic of a Tertiary Care Hospital: A Developing Country's Perspective","authors":"Niraj Niraj, N. Shafiq, C. Mothsara, G. Garg, Amit Gupta, S. Malhotra","doi":"10.4103/jpp.JPP_34_21","DOIUrl":"https://doi.org/10.4103/jpp.JPP_34_21","url":null,"abstract":"Drug utilization studies offer an excellent platform to ascertain the role of drugs because the periodic monitoring of prescribing pattern helps in advancement of rational use of drugs. The aim of drug utilization research is to encourage the rational use of drugs by analyzing the drug use pattern, generating early signs of irrational drug use, and suggesting intervention to improved drug usage. In recent times, drug utilization research is an essential part of pharmacoepidemiology because it describes the extent, nature, and determinants of drug exposure.[1] The WHO defined drug utilization research as “the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences.”[2] A wide spectrum of diseases come under the term corneal disorders including blepharitis, meibomitis, dryness in eyes, and corneal ulcers, and hence, various therapeutic agents including antibacterial, antifungals, antivirals, steroids, and antiallergic are used in the management of corneal disorders.[3] Wide variability in the prescribing trends of drugs, variable adverse event profiles among different brands of the same drug, and the ever-increasing prices of drugs are some prime examples of the need for such drug utilization studies. The plethora of literature is available for the utilization patterns of systemically used drugs, while the literature for topical drugs is patchy at best. Since the topical drugs are of prime usage in eye-related diseases, the studies of such importance will help identify the rationale of topical drugs and, hence, helps in promoting better drug usage when minimizing the occurrence of untoward adverse effects.[4] Therefore, the present study evaluated the prescribing pattern practices in the cornea clinic of a tertiary care hospital.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"97 - 99"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44336264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Katoch, A. Bhardwaj, Kapil Suchal, Sangeeta Sharma
Objectives: To determine the optimum range of phenytoin (PHT) and valproate (VAP) levels and find out the critical drug levels below which chances of breakthrough seizures increase in North Indian population. Methodology: A cross-sectional, case-controlled, record-based study was conducted in a quaternary care hospital from September 2018–2019. The case group comprised epilepsy patients on monotherapy with PHT/VAP presenting with breakthrough seizures after at least 6 months of seizure control. Noncompliant, overdose, toxicity, no or partial response, any other psychiatric or neurological disorder, adverse effects, and patients taking two or more antiepileptic drugs were excluded. Results: Data of 100 patients in each group were analyzed. Significantly lower mean levels in cases were observed in PHT (5.74 ± 3.68 mg/L vs. 13.75 ± 4.27 mg/L control) and VAP (24.13 ± 27.39 mg/L vs. 76.37 ± 17.71 mg/L control). A negative correlation of drug levels was observed with age and weight in both the groups. The level/dose ratio in controls (0.05 ± 0.03; 0.09 ± 0.06) was significantly (P < 0.0001) higher than cases (0.02 ± 0.01; 0.02 ± 0.03) in PHT and VAP, respectively. Conclusions: This study identifies the critical levels and level/dose ratio at which the risk of breakthrough seizures increases. A wide level/dose ratio was found in controls, more so in the VAP group. A prospective study with larger group size along with genetic studies should be done to evaluate further.
{"title":"Correlation between Breakthrough Seizures and Serum Level of Phenytoin and Valproate in Indian Patients","authors":"N. Katoch, A. Bhardwaj, Kapil Suchal, Sangeeta Sharma","doi":"10.4103/jpp.jpp_3_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_3_21","url":null,"abstract":"Objectives: To determine the optimum range of phenytoin (PHT) and valproate (VAP) levels and find out the critical drug levels below which chances of breakthrough seizures increase in North Indian population. Methodology: A cross-sectional, case-controlled, record-based study was conducted in a quaternary care hospital from September 2018–2019. The case group comprised epilepsy patients on monotherapy with PHT/VAP presenting with breakthrough seizures after at least 6 months of seizure control. Noncompliant, overdose, toxicity, no or partial response, any other psychiatric or neurological disorder, adverse effects, and patients taking two or more antiepileptic drugs were excluded. Results: Data of 100 patients in each group were analyzed. Significantly lower mean levels in cases were observed in PHT (5.74 ± 3.68 mg/L vs. 13.75 ± 4.27 mg/L control) and VAP (24.13 ± 27.39 mg/L vs. 76.37 ± 17.71 mg/L control). A negative correlation of drug levels was observed with age and weight in both the groups. The level/dose ratio in controls (0.05 ± 0.03; 0.09 ± 0.06) was significantly (P < 0.0001) higher than cases (0.02 ± 0.01; 0.02 ± 0.03) in PHT and VAP, respectively. Conclusions: This study identifies the critical levels and level/dose ratio at which the risk of breakthrough seizures increases. A wide level/dose ratio was found in controls, more so in the VAP group. A prospective study with larger group size along with genetic studies should be done to evaluate further.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"73 - 78"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46545128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To estimate the prevalence of Chronic renal failure (CRF) in the Indian subcontinent and to identify risk factors and treatment regimens for CRF. Methods: A prospective observational study was carried out for 7 months. A total of 200 patients with a level of creatinine >1.5 mg/dl were enrolled. CRF prevalence was measured using the hospital's inpatient department registry and medical records. The risk factors and prescribing were evaluated from the patient file report. Results: The prevalence rate of CRF was 13.7%. Male patients (59%) dominate the entire group of patients. Most patients (n = 52) were found between the age group of 71–80 years with a mean age of 62.67 ± 16.33 years. Drugs such as diuretics, and hypoglycemics were indicated to treat comorbidities. The average number of drugs per prescription were 7.43 ± 2.75 with high use of antimicrobial agents (88%). Out of 156 drugs prescribed, 76 were from essential as per essential Drug List 2017. Hypertension (P = 0.0072) and diabetes (P = 0.0084) were major concerns as risk factors followed by the drugs used for dyslipidemia, and recurrent infections. Conclusion: The prevalence rate was found to be 13.7% with significant association with risk factors such as hypertension, diabetes, and nonsteroidal anti-inflammatory drugs, dyslipidemia, chronic infections, smoking, and renal calculus for CRF. The pattern of prescribing was suitable and with few irrationalities.
{"title":"Prevalence, Risk Factors, and Prescribing Trends in Chronic Renal Failure in the Indian Population","authors":"J. Suthar, Rutvi Patel, S. Desai","doi":"10.4103/jpp.JPP_149_20","DOIUrl":"https://doi.org/10.4103/jpp.JPP_149_20","url":null,"abstract":"Objective: To estimate the prevalence of Chronic renal failure (CRF) in the Indian subcontinent and to identify risk factors and treatment regimens for CRF. Methods: A prospective observational study was carried out for 7 months. A total of 200 patients with a level of creatinine >1.5 mg/dl were enrolled. CRF prevalence was measured using the hospital's inpatient department registry and medical records. The risk factors and prescribing were evaluated from the patient file report. Results: The prevalence rate of CRF was 13.7%. Male patients (59%) dominate the entire group of patients. Most patients (n = 52) were found between the age group of 71–80 years with a mean age of 62.67 ± 16.33 years. Drugs such as diuretics, and hypoglycemics were indicated to treat comorbidities. The average number of drugs per prescription were 7.43 ± 2.75 with high use of antimicrobial agents (88%). Out of 156 drugs prescribed, 76 were from essential as per essential Drug List 2017. Hypertension (P = 0.0072) and diabetes (P = 0.0084) were major concerns as risk factors followed by the drugs used for dyslipidemia, and recurrent infections. Conclusion: The prevalence rate was found to be 13.7% with significant association with risk factors such as hypertension, diabetes, and nonsteroidal anti-inflammatory drugs, dyslipidemia, chronic infections, smoking, and renal calculus for CRF. The pattern of prescribing was suitable and with few irrationalities.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"86 - 90"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44603761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jison Jose, B. Baby, Shabeer Ahammed, Sharad Chand, U. Nandakumar, B. Vinay, K. Subramanyam, J. Joel
Congestive heart failure (CHF) is considered a condition that impairs the ventricle’s ability to fill or eject blood due to a structural or functional disorder of the heart, having a prevalence rate of 0.3%–2%.[1,2] Left-sided heart failure is most commonly caused by ischemic heart disease and hypertension (HTN), whereas right-sided heart failure is generally caused by the later stage of left-sided heart failure. These cardiac conditions may lead to mental complications, including stress and depression.[3] In India, there is less data regarding the exact prevalence and incidence of CHF.[4] Availability of these data may lead to the planning of safe and effective therapy. Drug utilization studies help in identifying the trends of the therapy for the disease.[5,6] A prescription pattern study provides an insight into the treatment compliance with hospital formulary and other guidelines.[7] Deviation and irrationality in the standard therapy will help in amending the prescribing guidelines in the hospital.[8] The clinical pharmacist plays an essential role in assessing the risk factors and drug prescription patterns.[9] Hence, this study is carried out to identify the risk factors associated with CHF and pharmacotherapy in patients diagnosed with CHF.
{"title":"Risk Factors and Prescription Pattern among Patients with Congestive Heart Failure","authors":"Jison Jose, B. Baby, Shabeer Ahammed, Sharad Chand, U. Nandakumar, B. Vinay, K. Subramanyam, J. Joel","doi":"10.4103/jpp.jpp_25_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_25_21","url":null,"abstract":"Congestive heart failure (CHF) is considered a condition that impairs the ventricle’s ability to fill or eject blood due to a structural or functional disorder of the heart, having a prevalence rate of 0.3%–2%.[1,2] Left-sided heart failure is most commonly caused by ischemic heart disease and hypertension (HTN), whereas right-sided heart failure is generally caused by the later stage of left-sided heart failure. These cardiac conditions may lead to mental complications, including stress and depression.[3] In India, there is less data regarding the exact prevalence and incidence of CHF.[4] Availability of these data may lead to the planning of safe and effective therapy. Drug utilization studies help in identifying the trends of the therapy for the disease.[5,6] A prescription pattern study provides an insight into the treatment compliance with hospital formulary and other guidelines.[7] Deviation and irrationality in the standard therapy will help in amending the prescribing guidelines in the hospital.[8] The clinical pharmacist plays an essential role in assessing the risk factors and drug prescription patterns.[9] Hence, this study is carried out to identify the risk factors associated with CHF and pharmacotherapy in patients diagnosed with CHF.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":"12 1","pages":"94 - 96"},"PeriodicalIF":0.2,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43866716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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