Archive for the ‘ Pharmacology ’ Category

Prescribing Practices of Psychiatrists in Treatment of Depression

ABSTRACT

Introduction: Depression is an illness it affects millions of people each year and does not discriminate between age, sex or race. Depression can devastate not only the person experiencing the depression but their loved ones. The risk of death from suicide, accidents, heart disease, respiratory disorders, and stroke is higher among the depressed.
Objective: The objective was to fi nd out the choice of Antidepressant by Psychiatrists.
Materials and Methods: This is a cross-sectional study conducted in Tamil Nadu and Pondicherry in India. Between December, 2005 and April 30, 2006. All practicing psychiatrists and doctors working in private and government organization were as asked to complete a self-administrated questionnaire. These doctors were chosen for the study as they are responsible for treating the majority of psychiatric patients in government hospitals, public outpatient clinics and private clinics in Chennai, Madurai, and Pondicherry. The survey included demographic data on age, gender, and type of practice. It also covered fi rst – line preferences in the treatment of depression and effi cacy of anti-depressants.
Results: The survey refl ected the prescribing pattern for the period studied December 1, 2005 to April, 2006. Of the 26 questionnaires sent to 31 persons, there were 30 respondents, an overall response rate of 97%. According to this study, selective serotonin reuptake inhibitors (SSRI) agents are favored as fi rst-line treatment in a fi rst episode of depression and are prescribed more frequently than tricyclic antidepressants (TCA) agents. Fluoxetine and citalopram were the most frequently prescribed SSRI. The SSRIs were probably the drug class of choice because of minimum the side effects better tolerated than the older drugs, there is better patient compliance with the once a day dosing and the suicide potential is low. This study clearly revealed that fl uoxetine, amitriptyline, and moclobemide are most frequently prescribed antidepressant drugs in the group of SSRIs, TCAs, and monoamine oxidase inhibitors (MAOIs), respectively.
Conclusion: This study shows the newer antidepressant, SSRIs were prescribed in the majority of cases and were considered to be of greater effi cacy than the older antidepressants such as the TCAs and MAOIs. It has been concluded that SSRIs were deemed to be the class of drugs that would most likely be prescribed.

ABSTRACT

Objective: This study was intended to evaluate perception of the young adult obese women toward weight training as a proper and useful modality as compared to walking.
Study Design: The questionnaire-based study was conducted in a weight management clinic in Maharashtra state, India. Obese women between 18 and 40 years of age during their first visit were studied for their perception about weight training.
Results: There was no signifi cant difference between the scores with walking and weight training indicating these as proper and useful modalities of exercise.
Conclusions: Our results clearly indicate that weight training is perceived to be an equally proper and useful modality of exercise as compared with walking among obese women. Further studies using larger sample size are required.

A PROSPECTIVE STUDY OF CUTANEOUS ADVERSE DRUG REACTIONS IN A TERTIARY CARE HOSPITAL

ABSTRACT

INTRODUCTION: Adverse drug reactions are inevitable negative consequences seen with drug therapy and cutaneous adverse drug reactions are the commonest manifestations. These unwanted and unintended drug effects are responsible for responsible for significant morbidity and mortality.
OBJECTIVES: To study the clinical pattern of CADRs and to establish the causal relationship between drugs and r e a c t i o n s , t o i d e n t i f y a n d a s s e s s t h e predisposing/underlying risk factors and to evaluate treatment outcome of CADRs.
SUBJECTS AND METHODS: This was a prospective study  was carried out on 120 consecutive patients with suspected CADRs. The pattern, extent, severity and duration of the reactions were assessed and any other organ/system involvement as a part of the drug reaction was also assessed. Causality, severity and preventability of the reactions were also assessed.
RESULTS: The mean age of the study population was 40.98±20.61 years with little gender difference. The predominant patterns of reactions observed were erythematous eruptions (n=37, 30.8%) and urticaria (n=23, 19.2%). The common causative drugs were
a n t i m i c r o b i a l s ( n = 5 2 , 4 3 . 3 % ) f o l l o w e d b y analgesics/NSAIDs (n=30, 25%) and antiepileptics (n=15, 12.5%). Among the antimicrobials, beta-lactams (n=19, 36.5%) and flouroquinolones (n=9, 17.3%) were the leading causative drugs. Among the analgesic/NSAIDs, diclofenac (n=9, 30%) was the leading causative drug. Among the antiepileptics, carbamazepine (n=6, 40%) and
phenytoin (n=5, 6%) were the common offenders. The time interval between the drug exposure and the appearance of CADRs, was variable with different patterns of reactions. Majority of the reactions were mild to moderate , and serious reactions were infrequent.
Most of the reactions were not preventable as the predisposing risk factors could not be ascertained.
CONCLUSION: Proper awareness cutaneous adverse drug reactions, early detection and timely withdrawal of the offending drugs and appropriate rescue measures may greatly contribute to reduce the incidence, frequency, severity and morbidity and possible mortality associated with drug therapy.

ABSTRACT

The prevalence of hypertension and its complications are on the rise in the urban population, possibly related to their sedentary lifestyle, stressful job and altered eating habits. Most of the hypertensive population are under diagnosed, untreated, and have inadequate awareness about the disease and associated risk factors. In this study, records of 117 hypertensive patients who underwent treadmill test were analyzed to see the effect of three commonly used antihypertensive drugs and the occurrence of associated risk factors . The patients on Angiotensin converting enzyme inhibitors/Angiotensin receptor blockers (ACEI/ARB), Beta Blockers (BB) and Calcium Channel Blockers (CCB) are expected to have a good control over their BP during treadmill test. But in our study, the rise in mean maximum exercise systolic and diastolic blood pressure of ACEI/ARB groupwere found to be statistically significant when compared to Beta blockers and Calcium channel blockers group.There is also occurrence of significant associated risk factors among the three groups. Hence the combination of the above antihypertensive drugs with Beta Blockers may adequately control exercise induced hypertension .The control of associated risk factors like obesity, Diabetes, Dyslipidemia is also very important to prevent cardiovascular morbidity and mortality.

ABSTRACT

The prevalence of hypertension is increasing at an alarming rate worldwide. Hypertension is now considered as ‘metabolic syndrome’. High blood pressure affects many systems of the body and can alter various biochemical parameters in essential hypertensive patients. Objective: The present studywas undertaken to study effects of calcium channel blockers (CCBs) on different biochemical parameters in essential hypertensive patients.
Materials and Methods: 21 females and 18 males with mild to moderate hypertensionwere enrolled in the age group of 25- 80 yrs.
All 39 patients received mono drug therapy with calcium channel blockers, for six months. Levels of total cholesterol(TC), LDL, HDL cholesterol, triglycerides, uric acid, fasting blood sugar and serum electrolytes sodium, potassium and calcium were measured at pretreatment and at the end of six months drug therapy. Statistical significance of difference was calculated by using students paired ‘t’ test.
Results: At the end of six months there was significant decrease in total cholesterol (TC), serum uric acid level and significant increase in HDL cholesterol.
Conclusion: Calcium channel blockers are well tolerated when administered as mono therapy. These findings suggest that calcium channel blockers may be an attractive option for treatment of essential hypertension and for improving cardio vascular (CV) risk profile and also in patients having gout.

ABSTRACT

To Compare Analgesic and Anti-inflammatory activity of Ethanolic Extract of Asparagus racemosus with Aspirin.Analgesic method – 18 Albino mice of either sexweighing about 20-25gmwere randomly divided in to 3 groups of 6 animals each. The control group, Standard and test group were given distilled water, Aspirin (100mg/kg) and Ethanolic extract of Asparagus racemosus (200mg/kg) respectively. Drugs were given orally after overnight fasting. Analgesic activity is evaluated before drug
administration, after 2 hrs and 4 hrs of drug administration by Tail clip method. A wash out period of 15 days is given and the same group was utilized for evaluation of analgesic activity by hot platemethod. Anti-inflammatory activity – 18 Albino rats of either sex  weighing about 175-225 gm were randomly divided in to 3 groups of 6 animals each. The control group, Standard
and test group were given distilled water, Aspirin  (300mg/kg) and Ethanolic extract of Asparagus racemosus (1600mg/kg) respectively. Drugs were given orally after overnight fasting. Anti-inflammatory activity  is evaluated by measuring foot paw volume by using plethysmograph before administration of 1% carrageenan and 3 hrs after drug and 1% carrageenan
administration.The observations from Analgesic activity of the extract showed, the mean reaction time(In Tail clip and Hot platemethod) in the test group after 2nd and 4th hour of drug administ ration was stat i st i ca l l y significant (P<0.01,P<0.001) and it was comparable with Aspirin. Observations from Anti-inflammatory activity of the extract showed, there was 61.11% of inhibition of edema in the test group and itwas comparable with the standard which had 69.45% of inhibition of edema.Ethanolic extract of Asparagus racemosus has analgesic and anti-inflammatory activity which was comparablewith Aspirin.

Effects of acamprosate disulfiram on serum lipid profile in chronic alcoholics

ABSTRACT

To measure the effect of Acamprosate/Disulfiram on serum lipid profile and lactate dehydrogenate. Methods: Participants were identified by screening through Alcohol Use Disorder Identification Test (AUDIT) with 8 or more than 8 score. Total 89 patients of 20-60 years withDSMIV criteriawere enrolled with history of alcohol consumption without de-addiction treatment. They were admitted and detoxified for 3 weeks. Enrolled participants were randomized among three groups consisting placebo, acamprosate and disulfiram. At baseline, serum lipid profile and LDH were measured and same were measured at the end of 4th and 8th week of treatment.Biochemical values were expressed as mean ± SD and intergroup and time changes were expressed using “t test”. One way Analysis of Variance F-Test was used to compare biochemical values among three groups. Results: Serum LDH value was found to be decreased compared to baseline in all treatment groups without intergroup variation. LDL,
Triglyceride and total cholesterol were decreased in groups treated by acamprosate or placebo with statistical significance(P <0.01). It was continued to decrease till 8th week of treatment while they were significantly increased in disulfiram treated group.Triglyceride and total cholesterol were significantly increased in disulfiram group at 8th week of treatment than 4th week, moderately affecting lipid metabolism. Conclusion: D i s u l f i ram i s found detrimental to cardi o vas c u l a r sys tem by
i n d u c i n g atherosclerosis through hyper-lipidemia; physicians should be precautious in prescribing disulfiramin chronic alcoholics.