ABSTRACT
Background: Schizophrenia is a commonest and one of the well known psychiatric disorders. Life expectancy of a patient with schizophrenia may be 20 to 30 years shorter than the general population. Long term antipsychotic therapy is usually required for the management of schizophrenia. It is not currently possible to predict which antipsychotic may be optimal for a given patient because there are still many debates about effectiveness and efficacy of atypical drugs over first generation antipsychotics. So, our aim is to assess the effectiveness of various antipsychotics by using various psychometric scales, which will be helpful to bring out better treatment options for schizophrenia patients.Methods: This was an observational questionnaire based study, conducted on patients of inpatient and outpatient Department of Psychiatry and Department of Pharmacology at VIMSAR, Burla, for a period of 24 months (September 2015 to August 2017). Patients of schizophrenia aged 18 years or above were subjected to clinical global impression – severity scale (CGI-S) and clinical global impression – improvement scale (CGI-I) questionnaire after taking informed consent. Then scores were calculated using non parametric test with Graph pad Prism version 6.0.Results: Out of the 90 cases, majority (60) of patients belonged to the middle (25 to 45 yrs) age group followed by 20 younger (<25 yrs) age group and rest 10 were elderly (>45 yrs) patients. Both scales showed significant improvement with atypical antipsychotics as compared to first generation antipsychotics.Conclusions: Based on these findings, we can conclude that atypical antipsychotics are more effective than first generation antipsychotics. But further studies are needed to assist clinicians in making optimum treatment decisions.
ABSTRACT
Background: Adverse drug reactions (ADRs) are the major cause of drug related morbidity and mortality. Pharmacovigilance is the science that plays an important role in the reduction of ADRs. Voluntary reporting of ADRs by healthcare professionals is an important tool in the success of pharmacovigilance program, but the same are scantly reported due to lack of awareness and knowledge among the physicians. So, the present study was conducted to evaluate the knowledge, attitude and practice (KAP) regarding ADR reporting among healthcare professionals at a tertiary care hospital.Methods: A questionnaire-based study containing 25 questions (knowledge- 18, attitude -2 and practice- 5) was conducted in 70 prescribers and time allotted to complete it was 1 week. Statistical analysis was done by using Graph Pad Prism version 6.01.Results: Out of 70 prescribers, only 50 (71.43%) responded. ADR reporting was considered very important by almost all of them, but actual practice was lacking as only 36% of consultants had reported any ADR. The higher grading was given to causes most important for reporting were patient safety, to identify safe drug and new ADRs. The main reasons for under-reporting were unavailability of reporting forms when needed, uncertain association and lack of knowledge about reporting procedure.Conclusions: The prescribers are aware of the importance of ADR reporting, but lack of awareness and knowledge are most common cause of under-reporting. So, there is need of pharmacovigilance awareness program to improve voluntary reporting of ADRs.
ABSTRACT
Background: To evaluate the bronchoprotective effect of aqueous extract of Zingiber officinale (AZO) in guinea pigs and compare the same with that of standard drugs.Methods: Guinea pigs of either sex weighing between 350 to 450 Grams were randomly divided into 13 groups, each group containing 6 animals. Bronchospasm was induced by placing guinea pigs in histamine exposition chamber and exposing them to either 0.25% of histamine acid phosphate or 10% acetyl choline through a nebuliser under 40mm Hg pressure. The time for development of asphyxia was noted. After two and half hours, the animals were administered orally with vehicle / drugs as per the following: Gr I- Normal saline 1ml/100 Grams, Gr II- Salbutamol 1.6mg/kg, Gr III- Chlorpheniramine maleate 0.8mg/kg, Gr IV to Gr VI- AZO 200, 400, and 800mg/kg, Gr VII- AZO 200mg/kg and Salbutamol 0.8mg/kg. For acetylcholine-induced Bronchospasm Gr III animals received atropine 2mg/kg and Gr VII was not taken, rest others remaining the same. After 1 hour of treatment, the animals were again exposed to histamine or acetyl choline aerosol. The exposition time for each animal was again noted and mean increase or decrease in exposition time were noted. The data were subjected to stastical analysis by using paired ‘t’ test. Percentage of protection was also calculated.Results: AZO at all the doses studied (except 200mg/kg), showed highly significant increase in exposition time against histamine-induced bronchospasm. Combination of AZO (200mg/kg) with salbutamol (0.8mg/kg) also produced augmented effect. But against Acetylcholine induced bronchospasm, AZO did not produce any significant protective effect at any of the doses.Conclusions: AZO produced significant dose dependant bronchoprotection against histamine induced bronchospasm which might be due to antihistaminic action.
ABSTRACT
Co-ground mixtures of poorly water soluble drug Paliperidone (PAL) with different hydrophilic carriers [Polyvinyl-pyrrolidine (Plasdone K-25 and Plasdone S-630), Hydroxypropyl methyl cellulose (HPMC), Hydroxypropylcellulose (HPC) and Sodium alginate were prepared to improve the dissolution rate of PAL. Co-grinding with PVP, especially with PVP- S630 (Vinyl pyrrolidone/ vinyl acetate co-polymer), was more effective in reduction of particle size than milling of drug alone. DSC studies indicated that crystalline nature of drug was reduced after co-grinding with PVP grades as compared to their corresponding physical mixtures. The hydrophilic carriers other than PVP did not reduce the crystalline nature of the drug significantly. X-ray diffraction (XRD) was carried out for selected batches to confirm DSC results. Significant enhancement in dissolution rate as well as extent was observed with co-ground mixtures of drug and PVP. Among all the prepared batches in this study, co-ground mixture of PAL and Plasdone S-630 in 1:1 ratio showed best results in terms of extent of dissolution as well as dissolution rate in water. This effect was not only due to particle size reduction, but also loss of crystalline nature of the drug during co-grinding. PVP was found to be a better carrier among the different hydrophilic carriers used in the study for improving the dissolution characteris-tics of PAL. The extent of the mean plasma exposures of PAL was 7-fold higher in animals treated with co-ground mixture of PAL, Plasdone S630 (1:1) compared to animals treated with Pure PAL.
ABSTRACT
Co-ground mixtures of poorly water soluble drug Paliperidone (PAL) with different hydrophilic carriers [Polyvinyl-pyrrolidine (Plasdone K-25 and Plasdone S-630), Hydroxypropyl methyl cellulose (HPMC), Hydroxypropylcellulose (HPC) and Sodium alginate were prepared to improve the dissolution rate of PAL. Co-grinding with PVP, especially with PVP- S630 (Vinyl pyrrolidone/ vinyl acetate co-polymer), was more effective in reduction of particle size than milling of drug alone. DSC studies indicated that crystalline nature of drug was reduced after co-grinding with PVP grades as compared to their corresponding physical mixtures. The hydrophilic carriers other than PVP did not reduce the crystalline nature of the drug significantly. X-ray diffraction (XRD) was carried out for selected batches to confirm DSC results. Significant enhancement in dissolution rate as well as extent was observed with co-ground mixtures of drug and PVP. Among all the prepared batches in this study, co-ground mixture of PAL and Plasdone S-630 in 1:1 ratio showed best results in terms of extent of dissolution as well as dissolution rate in water. This effect was not only due to particle size reduction, but also loss of crystalline nature of the drug during co-grinding. PVP was found to be a better carrier among the different hydrophilic carriers used in the study for improving the dissolution characteris-tics of PAL. The extent of the mean plasma exposures of PAL was 7-fold higher in animals treated with co-ground mixture of PAL, Plasdone S630 (1:1) compared to animals treated with Pure PAL.