ABSTRACT
Cancer persists to be a major cause of hospitalization and death every year. With the passage of time, new formulations of anticancer drugs are being introduced to the market and are drawing the concern of healthcare professionals in terms of the superiority, toxicology, and cost-effectiveness of the new formulations in comparison to the conventional formulation of the same drugs. Doxorubicin, a highly potent chemotherapeutic agent, it comes with three formulations (pegylated liposomal, nonpegylated liposomal and non-liposomal conventional formulations). English-language literature of the three formulations of Doxorubicin has been reviewed to inform the healthcare professionals regarding the differences between these formulations. Liposomal Doxorubicin promotes better toxicology profile than non-liposomal conventional Doxorubicin with an increased cost. Due to very limited studies, the cost-effectiveness of liposomal Doxorubicin is not well defined. Apart from that, this review highlights the inter patient variability in regard to the clearance and volume of distribution following the administration of liposomal Doxorubicin. In conclusion, further studies regarding the superiority of liposomal formulation of Doxorubicin , efficacy and dose standardization of liposomal Doxorubicin should be sought in the near future in a more better way.
ABSTRACT
Background: Depression is the most important neuropsychiatric complication in chronic kidney disease because it reduces quality of life and increases mortality. The beginning of dialysis treatment causes subtle changes in the life of CKD patients, mainly in the physical and social spheres. It affects the self-care of these patients which lead to poor adherence to dialysis. Hence, the present study was conducted to screen for depression.Methods: This was an observational study among 100 patients undergoing haemodialysis at HIMS, HASSAN. After taking informed consent, subjects were requested to complete Beck, depression Inventory, a 21-question multiple-choice self-report inventory for measuring the severity of depression. Descriptive statistics was applied to infer the findings.Results: The study population showed depression of mild (31%), borderline (10%), moderate (17%), severe (7%) and extreme (3%) grade and the remaining subjects did not show depressive symptoms (32%).Conclusions: Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status of the patients, low literacy rate, gender and those started on dialysis recently.
ABSTRACT
Background: There is much debate regarding the importance of promoting the use of cheaper generic alternatives over brand-name drugs. While generic drugs have been noted to be comparable to brand-name drugs in their ability to treat conditions, significant debate surrounding their bioavailability or the concentration of the drug that reaches its site of action has arisen. Many experts continue to believe that generic and brand-name drugs are bioequivalent and equally viable options for effective drug treatment, as assumed in this review.Methods: Prices of commonly used branded and generic medicines in same concentration, dosage form and combination were compared with the help of Indian Drug Review, brochures of pharmaceuticals and pharmacies and Jan Aushadhi price list 2017. Mean of all the prices available of branded and generic medicine were calculated and the percentage difference in the mean costs of generic and branded medicines were calculated.Results: The mean cost of 47 branded medicines out of the selected 50 medicines was higher than their generic versions. Mean cost of 3 generic medicines was higher than branded ones. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%.Conclusions: This study has shown a very noteworthy difference of prices between branded and generic drugs. Efforts should be taken to promote the generic medication. Misconception about low efficacy with generic drugs should be erased.
ABSTRACT
Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.
ABSTRACT
Background: Prescription audit is a tool as well as a technique by its application,all professionals will improve the quality of prescribing drugs. Standards of medical treatment can be assessed by prescription audit. It is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Prescription audit is a quality improvement process that seeks to improve patient care. In this background the present study was conducted. The objectives of the study were to know the frequently prescribed drugs in OPD, number of the drugs used per prescription and to find out the rationality.Methods: Study was conducted at Sri Chamarajendra Hospital, HIMS, Hassan in OPD of General Medicine.1000 prescriptions were collected and noted down the frequently used medication, number of drugs prescribed and their type of formulations for the particular diagnosis.Results: From the study it is noted that 1910 drugs out of 1000 prescriptions were prescribed which is approximately 1.91 drugs per prescription about 55% of the prescriptions contained single drug. Very few received 4-5 drugs (7%). Almost all the drugs in prescriptions were in Generic names. Around 95% of prescriptions doses were mentioned in mg, ml etc. The most commonly prescribed drugs in order are Antibiotics, antidiabetics antihypertensives, bronchodilators, steroids antiemetics and ORS were prescribed.Conclusions: Polypharmacy was not found in our prescriptions which indicates our prescriptions improved the patient conditions. This type of study will ensure to know the 慞� drug development and select the essential medicine list for various levels of health care.