Indian Journal of Pharmacy and Pharmacology

Page No. 155-161

Authors: Prabhu M.R, Sahajanandha H, Dwajani S

Bone is a dynamic organ made up of mostly collagen that provides the structure to the skeleton and calcium phosphate that gives strength and hardens the skeleton structure. Bone is constantly renewed by remodeling, a lifelong process consisting of bone resorption (osteoclasts) and formation (osteoblasts) to repair skeletal damage and maintain calcium homeostasis. Several hormones like calcitonin, parathyroid hormone, vitamin D, estrogen, testosterone etc. regulate resorption and formation. Several factors like age, low diet calcium, smoking, certain medications, - glucorticoids, aromatase inhibitors, proton pump inhibitors, immunosuppressant, selective serotonin inhibitors and antiepileptic drugs can influence bone health which are used for long term treatment. Imaging techniques like dual X-ray absorptiometry (DEXA), Quantitative computerized tomography (QCT) are available for exact measurement of bone mineral density which helps identifying the fracture risk. Newly, bone biomarkers are known to increase their demand and play an important role in detection of bone loss at early stage. Recent evidence suggests that these markers may be useful in monitoring the response to anti-resorptive therapy. The potential for these markers used along with imaging techniques helps to diagnose bone loss, possibly prior to overt clinical signs. Hence, the aim of the article was to review the diagnosis of bone loss using specific bone biomarkers which can strongly correlate to these classes of drugs causing bone loss at early stage with possible duration of the treatment.

Page No. 165-168

Authors: Nagesh Raju G., Manjunath S.M., Dharmaraj B

Introduction: Most of the common health ailments are treated by general population themselves without medical supervision, which is termed as self-medication. There are potential risks of self-medications like adverse drug reaction, disease aggravation, drug dependence, drug resistance etc. The undergraduate medical and dental students have easy access to information from various sources to self-diagnose and self-medicate. So, we conducted the study to assess the practice of self-medication among 2nd year medical and dental students studying at Basaveshwara Medical College & S.J.M. Dental College, Chitradurga. Materials: This was an observational, cross-sectional study based on a semi-structured, pre-validated questionnaire. Descriptive statistics was used for analysing the data. The result was analysed using the software Microsoft Excel sheet. Results: The study included 172 students (medical & dental), out of which 57.5% were females and 42.4% were males. 82.5% of participants had practised self-medication at some point in their life. 85% felt that there was no need to consult physician for simple ailments. The source of information for self-medication was pharmacist (61.6%), followed by google & internet (46.5%), senior (32.5%). Most common conditions for which self-medication was practiced included cold (93%), cough (85%), diarrhea (80%). Drugs commonly used for self-medication included Paracetamol (94%), Antacids (59%), Antibiotics (41%). Conclusions: Our study revealed that there is a high prevalence of self-medication among medical and dental students. We as the healthcare professionals need to raise the awareness regarding the ill effects of self-medication among undergraduates and also stress on various measures to curb its growing trend.

Page No. 173-177

Authors: V.M. Motghare, C.S. Bajait, A. Turnakar, S.D. Sontakke, S. Chavan Page No. 173-177

Introduction: Skin diseases are chronic in nature and they require lifetime treatment. Prescription pattern reflects health professional attitude towards the disease and role of drugs in its treatment. The study of prescription pattern is important to make medical care rational and cost effective. Objective: To evaluate drug prescribing pattern and adverse drug reaction profile in Dermatology department of tertiary care hospital. Results: 410 prescriptions were analyzed which include 1696 drugs. Majority of drugs prescribed were antihistaminic (20.99%), antibacterial (16.05%), antifungal (9.08%), and corticosteroids (7.78%). Eighteen patients were reported with ADR. Most of ADRs are reported with Antimicrobials (50%) & common ADR was Maculopapular rash (50%), On severity assessment by modified Hartwig and Siegel’s scale, out of 18 ADRs, 8 (44.44%) were mild, 8 (44.44%) were moderate and 2 (11.11) were severe in nature. Conclusion: The present study showed antihistaminic were commonly prescribed class & antibiotics were responsible from majority of ADR. Maculopapular rash was most common ADR.

Page No. 182-185

Authors: Hemamalini MB, Rekha MB, Basavaraj Bhandare, Adarsh E

Introduction: Acute respiratory infection (ARI) is the largest cause of morbidity across the world in children under five years of age. Antibiotics are the most commonly prescribed medications for Lower respiratory tract infection [LRTI]. Rational use of antibiotic is very necessary to avoid resistance. Objective: To evaluate the pattern of antibiotic use among children under 5yrs of age. Methods: A hospital based, non-interventional, prospective, observational study was carried out between April 2014 to September 2014 in the department of Pediatrics in collaboration with pharmacology department, Rajarajeswari Medical College and Hospital, a tertiary care hospital, Bangalore. The demographic data, diagnosis, type of drug, dosage duration of treatment and hospital stay was collected from inpatients admitted to pediatric ward over a period of 6 months. The descriptive analysis was done and was presented as mean and percentage. Results: A total of 250 in patient case records of children with LRTI were analyzed. In this study less than 1 year children constituted highest percentage (59.2%).56.8%were males and 43.2% were females. A total of 1045 drugs were prescribed in 250 prescriptions (4.18 drugs/ prescription). Brochiolitis (41.6%) was the most common diagnosis followed by Bronchopneumonia(33.6%). 32.77% of patients receive one antibiotic, 39.49% received 2 antibiotics and 27.73% of patients received 3 antibiotics. Most commonly prescribed antibiotic was Amoxcillin+clavulanic acid(58%), followed by Amikacin(57%) and Ceftriaxone(53%). Conclusion: It is evident from the present study that antibiotics were most commonly prescribed for LRTI. Bronchiolitis is most often associated with a viral etiology and use of unnecessary antibiotics for viral LRTI will lead to increased threat of antibiotic resistance.

Page No. 192-196

Authors: Ashutosh Tiwari, Pooja Reddy, Chhaya Goyal

Introduction: Fungal infections are common and treatment imposes economic burden on the patients. The compliance of the patient may be significantly dependent on the cost of the prescribed medicines, especially in developing countries like India. Therefore, this study was conducted to analyze cost variation of drugs used for fungal infections. Aim and Objectives: To evaluate the cost of different brands of anti-fungal drugs available in India, and to analyze the variations in cost of same dosage of different brands of the same active drug. Material and Methods: Cost of a particular drug that is manufactured by different companies, in the same strength, number and dosage forms was obtained from Current Index of Medical Specialties, July-October 2016 and Drug Today, July-September 2016 and were analysed. Cost range, cost ratio and percentage cost variation were calculated. Correlation between percentage cost variation and number of companies manufacturing the drug was analysed by linear regression and Spearman correlation analysis. p < 0.05 was considered statistically significant. Result: The costs of a total of 8 antifungal drugs available in 18 different formulations were analysed and a substantial variation in cost was found. Fourteen drugs had percentage cost variation more than 100%, fluconazole 150 mg (10214%) had maximum percentage cost variation while griseofulvin 500 mg (42%) had minimum percentage cost variation. There was a linear relationship between no. of manufacturing companies and percentage cost variation and Spearman correlation analysis showed a statistically significant positive correlation between these two variables. Conclusion: The present study shows wide variation in the cost of the different brands of the same antifungal drugs manufactured by different companies. This adds to the economic burden for the patients. Ideally, generic drugs should be prescribed to decrease the healthcare cost and to enhance the compliance. Hence, the stakeholders should aim at decreasing the cost variation among different brands while maintaining the therapeutic efficacy.

Page No. 206-209

Authors: P. Chakraborty, NN Bala, S. Das

Acacia nilotica Linn. Subsp. indica (Family- Mimosaceae) bark has many activities like anti-plasmodial, molluscidal, antifungal, anti-microbial activity. The plant has no CNS depressant action found yet, but having such good number of beneficial action to human being has drawn our interest to study the same. The aim of the present study is to investigate the CNS depressant activity of ethanolic extracts A.nilotica bark on mice. The CNS depressant activity was determined by muscle relaxant property, reduction in spontaneous motility. The investigations had brought out that ethanolic extract of Acacia nilotica bark has significant CNS depressant property.

Page No. 214-220

Authors: Manju Agrawal, Toshanlal Todar, Rajesh Hishikar, Usha Joshi, Preeti Singh

Objective: The aim of the study was to evaluate the medical student’s knowledge and attitude towards generic drugs and categorize if a drug is generic or branded from the drug label. Method: A prospective cross sectional survey was undertaken among 90 final year medical students.17 item questionnaire was developed, validated and administered to assess their knowledge and attitude on generic vs. branded drugs. Results: In our survey 71% students knew that generic drugs are bioequivalent to branded drugs but only 17.77% knew that generic are manufactured after expiry of patent. 73.33% students were aware that Medical Council of India has made generic prescription mandatory. 88% students were sensitive to the difference in generic vs. branded pricing. However 47% students felt that incentives will increase generic prescription. 50% of the students did not categorize the given sample of drugs either as branded or generic. 100% stressed the need of sensitization programmes at undergraduate level to update them on drug prescription patterns. Conclusion: Good percentage of students had knowledge about generic medicines. They showed positive attitude towards generic prescription in their future practice and were ready to consume generic drugs themselves when required. Inspite of this fact patients and practitioners still favour branded drugs.

Page No. 225-226

Authors: Chhaya Goyal, Mohammad Rafi, Ghazala Khan

Anaphylaxis is a rare condition during ante natal care since most of the drugs except nutraceuticals are avoided in pregnancy unless essentially required to prevent developing foetus from any teratogenic effects. An anaphylactic reaction follows idiosyncrasy that may occur with any drug or food to which an individual is previously known or unknown to be allergic. Antibiotics and NSAIDs are the most common class of drugs known to cause allergic reactions. Maternal anaphylaxis has the potential to cause foetal defects (morbidity) and in rare cases foetal death (mortality), latter possibly due to hypoxia. The authors here report a similar case of maternal anaphylaxis to ciprofloxacin infusion during third trimester in which maternal outcome was positive but 8 months foetus died within an hour of reaction. Iron sucrose infusion was also administered to the mother prior to ciprofloxacin in a community clinic.