Indian Journal of Pharmacy and Pharmacology

37-41

Authors: Ashok Kumar*,Vasant R.Chavan,Mohammaed Arshad,Raghunanadan M,Mohammed Fayazuddin

Introduction: Osteoarthritis (OA) is a major cause of chronic pain and lower extremity disability among the elderly due to its predilection for lower extremity joints such as the knee and hip. The treatment of pain and inflammation is an important area of therapeutics. Over the past two decades, non steroidal anti-inflammatory drugs (NSAIDs) have played a central role in these indications. NSAIDs constitute the largest single group of drugs used worldwide, constituting more than 20% of all drug prescriptions. In India over 400 formulations of NSAIDs are marketed, resulting in wide spread exposure of patients to this class of drugs and its adverse effects, For all these reasons, studies that evaluate the pattern, extent and frequency of NSAID prescriptions are valuable. Periodic evaluation of drug utilization studies provides the information for suitable modifications in the prescription of drugs in order to increase the therapeutic benefit and decrease the adverse effect associated with drug. Materials and Methods: A prospective, observational study was conducted on newly diagnosed as well as old treated patients with osteoarthritis from orthopaedic outpatient department in a tertiary care teaching hospital. A total of 428 were enrolled after screened for the inclusion and exclusion criteria. Data was recorded in a specially designed proforma which include information regarding the demographic profile of the patients and about the pattern of drugs prescribed. Results: Four hundred and twenty-eight patients with the diagnosis of Osteoarthritis visited the orthopedic outpatient department during the period of six months in which the data was collected. Prescriptions of all 428 patients were analyzed. Osteoarthritis was found to be more common in males (56.07%) compared to that of females (43.92%). Results also revealed that, OA was more prevalent in middle age group of 51-65 years (45.32%),with knee joint (66.58%) being most commonly effected, majority of patient were treated with Combination therapy (80.80%) over Monotherapy (19.19%). Most of patients were treated as first line with NSAIDS (79.75%) and Paracetamol (20.10%), was under prescribed. Aceclofenac (32.85%) was the most common NSAID used followed by Diclofenac sodium (25.49%). Gastroprotective agents were used in 12.28% along with Non-selective NSAIDS to prevent gastrointestinal adverse effects, out of which Ranitidine (53.47%) was most preferred, followed by Pantoprazole (16.66%), Various other drugs were also used as adjunct therapies that includes, Calcium and Vitamin D3, symptomatic slow acting drugs for OA (SYSADOA) which included diacerin and glucosamine sulfate as combination in (10.15%) of patients. Conclusions: Our study showed Osteoarthritis most common among males affecting knee joint in middle age group, Paracetamol and SYSADOA being under prescribed and NSAIDS are the most frequently used drugs in OA. National drug policy is needed to rationalize the drug use and bring awareness among the prescribing doctors.

45-51

Authors: Rhythm ,Nirav Asarawala,Barna Ganguly*

Context: Long term use of anti-hormonal therapy in breast cancers is effective for extending long term survival rates but simultaneously can lead to various side effects affecting quality of life. Aims: Aim of this study was to assess the utilization of hormonal treatment in patients suffering from breast cancer with specific objective of reviewing their quality of life with relation to side effects. Settings and Design: This was an OPD based cross sectional study, conducted in Shree Krishna Hospital, Karamsad. Methods and Materials: Prior permission from institutional ethics committee was taken. Utilization part of the study was a record based study, from the case files available in record section of cancer OPD. For quality of life part of the study, written informed consent was taken from the participants and were interviewed according to quality of life questionnaires. Statistical Analysis Used: Data were analyzed as per descriptive statistics and results were presented in form of percentage and range. Mean scores for various quality of life subscales were calculated using EORTC scoring manual. Results: Out of total 38 patients of breast cancer, 26(68.42%) patients were on treatment with letrozole, 12(31.57%) were on tamoxifen. We found better role functioning and cognitive functioning subscales in breast cancer patients of tamoxifen group as reflected in the highest mean score of 93.74 in functional scale. Mean sexual functioning scores in both letrozole and tamoxifen groups were on lower side. Percentage of patients experiencing systemic therapy side effect (dry mouth, hot flushes, hair loss, headache, dysgeusia) were found to be more in tamoxifen group. Conclusions: Overall, the parameters of quality of life in breast cancer patients on hormonal therapy, were found to be in better side, except for sexual functioning scores which were on lower side.

56-59

Authors: Roshi*,Vishal R. Tandon,Annil Mahajan

Menopause is an important physiological process in a female's life. It is not free from different variety of symptoms affecting day to day life. With increasing life expectancy, female spends many years with menopausal symptoms. Having knowledge about these symptoms provides us a guide about treatment for various symptoms to be introduced into postmenopausal health guidelines. Materials and Methods: The present study was undertaken in Medicine OPD of Govt. Medical College Jammu. Total 60 patients were divided into two groups and were given tab gabapentin and nortryptiline. The readings were taken at 0 week, 4 weeks and 8 weeks after noting the demographic profile. Results: Most of the females in both the groups were from rural areas, housewives and with natural menopause. Both the study drug were effective in decreasing the postmenopausal symptoms were none was better than the other. Conclusion: both nortryptiline and gabapentin have potential to be used as drugs in postmenopausal symptoms besides other treatment options.

65-72

Authors: Pradeep Javedar,Shrinivas R Raikar*,Prashant Dass

Introduction: Mental disorders form an important public health priority. Less work has been carried out in India on the economic burden of mental illness. Policy makers are increasingly dependent on clinical data to formulate and implement guidelines on Psychotropic drug use. This study aims to further the database of knowledge regarding Psychotropic drugs and their utilisation in mental health disorders in this region. Materials and Methods: After institutional ethics committee approval, a prospective drug utilisation study of 100 out patient prescriptions was undertaken. Preparation of the protocol and conduct of the study was as per the WHO – DUS and the STROBE guidelines. Results: 100 prescriptions were analysed containing 207 drugs, 174 of these were psychotropic drugs. Utilisation from National Medicines List and WHO Essential Medicines List was 54.54% and 45.45% respectively. Average psychotropic drugs per prescription were 1.74±0.066 (SD). 30% prescriptions contained fixed dose combinations. Only 0.48% drugs were prescribed by generic name. Drug utilisation pattern: Commonly prescribed drugs were Haloperidol, Valproate, Dosulepin, and Clonazepam. The PDD/DDD ratio of three drugs – Risperidone, Lorazepam and Amisulpride – was equal to one. The average cost borne by the patient was 385.2 rupees per month. Conclusion: Overall the principles of rational prescribing were followed. Hospital schedule needs to add more SSRIs. Practice of using typical anti–psychotics as first line was as per recommendations. More drugs need to be prescribed by generic name to reduce the economic burden. Use of drugs from essential medicine lists needs to be increased in order to have more rational prescribing.