ABSTRACT
Background: Beta blockers are known to cause attenuation of sympathetic stimulation mediated increase in cardiovascular parameters. Very few studies are available in Indian set-up comparing these changes between different beta blockers available in market. The objective of the study was to compare efficacy and safety of propranolol, atenolol and celiprolol on heart rare, blood pressure and airway resistance, both at rest and during exercise.Methods: A prospective interventional study was carried out involving 72 healthy volunteers in the clinical pharmacology laboratory. Participants were divided in three groups of 24 each and given single oral doses of propranolol 40 mg, Atenolol 50 mg and celiprolol 40 mg was given to the participants. Exercise given in the form of step ladder test and hand grip dynamometer and effect on the different parameters like HR, SBP, DBP and PEFR were recorded before and immediately after exercise and compared.Results: All the three drugs were effective in attenuating the exercise induced cardiovascular parameters (p <0.05). Drug A cause change in HR, SBP, DBP and PEFR significantly (p <0.05). Change in SBP was more significant with drug B while significant difference was found in HR, SBP and DBP before and after exercise in drug C in both SL and HGD tests. No significant difference was found between the drug groups (p >0.05). No adverse effects were reported in the study participants.Conclusions: All the three drugs are effective in attenuating cardiovascular changes after sympathetic stimulation like exercise and there was no significant difference among them.
ABSTRACT
Background: Cough and common cold are one of the commonest morbidities in the community. Cough and cold medicines are abound in Indian market despite the fact that majority of them lack scientific evidence of their use in this common condition. Aims & Objective: To analyze the prescribing pattern of ‘cough and cold’ medicines in Central Gujarat. Material and Methods: An observational, cross-sectional, questionnaire- based study was carried out to assess the prescribing pattern of doctors with regard to cough and cold. A total of 100 prescribers with a graduate degree (n=50) or a post-graduate degree (n=50) from Central Gujarat were selected randomly. After interviewing all doctors, data were analyzed to find the percentage of patients prescribed ‘cough & cold medicines’, their types of dosage form, use of FDCs, indications, any adverse events encountered and non-pharmacological measures advocated. Results: Prescribing FDCs for cough and cold was significantly higher (92% vs 72%, P<0.05) in post graduate prescribers attached to private hospitals than in graduate prescribers attached to government/teaching hospitals. Usage of solid dosage forms was significantly higher (p<0.05) in prescribers attached to government or teaching hospitals as compared to prescribers attached to private hospitals (84% vs 60%). About 18% of graduate and 25% of post graduate prescribers gave cough and cold medicines at patients’ behest. Only 15% prescribers prescribed cough and cold medicines for dry cough while antihistamines were advocated by 96% of prescribers. About 50% of the physicians prescribed these medicines for conditions like upper and lower respiratory tract infections. Non pharmacological measures were recommended by 75% prescribers. Conclusion: Efforts are needed to create awareness amongst prescribers about the rational use of cough & cold medicines and also pay attention to ADR caused by them. Reforms in medical education and CME are recommended.