Study of drug prescription pattern in ischemic heart disease patients

Background: Drug utilization pattern studies helps to screen, assess and propose appropriate modifications in prescription practices, this would help to make patient care rational and cost effective. Study was intended to analyse the drug prescribing pattern for treatment of Ischemic heart disease using WHO indicators.Methods: This is a cross sectional observational study conducted on ischemic heart disease patients admitted at inpatient department of medicine in a tertiary care teaching hospital. The study consisted of analysis of drug utilization pattern of prescribed drugs.Results: IHD was more commonly seen in males (70.06%) than females (29.94%). IHD was most commonly seen in patients of age group of 61-70 year. Drugs prescribed to patients belong to various therapeutic classes ranging from anti-platelets, anticoagulants, anti-anginal, antithrombin, thrombolytic, hypolipidemics. The most commonly prescribed therapeutic class of drugs was antiplatelet (86.26%) followed by hypolipidemic (82.25%) and ACE inhibitors drugs (46.60%). Average number of drugs per encounter was 7.70. Drugs were prescribed by their generic names were 29.99%. Out of total study group 22.06% patients were prescribed at least one antibiotic. Injections were prescribed only in 1392 (27.86%) out of 4995 drugs. Of total drugs 3270 (65.45%) of drugs were from National List of Essential Medicines-2016 (NLEM -2016) and 2774 (55.53%) drugs prescribed were from WHO-EML-2016.Conclusions: Risk of artery disease increased with increasing age. IHD was more common in males than females. The most commonly prescribed drug classes in Ischemic heart disease were anti-platelet drugs followed by hypolipidemic agents.

Knowledge, attitude and practices of generic names usage in prescription among the medical postgraduate residents of a tertiary care teaching hospital: an observational cross-sectional study

Background: Establishment of Pradhan Mantri Bhartiya Janaushadhi Kendras through Pradhan Mantri Janaushadhi Pariyojana (PMBJP) is a breakthrough step to reduce expenses in healthcare due to costly branded names in prescription. Medical council of India also amended clause 1.5 of the Indian Medical Council Regulations, 2002 mandating the doctors to prescribe medicines by generic names in place of brand names. Moreover, medical practitioner nowadays has raised concern about education/qualification of the chemist who is being made the decision maker.Methods: In this questionnaire based cross-sectional observational study, all students admitted to post graduation course in academic year 2018 were included and those who were not willing to give consent were excluded from study. A knowledge, attitude and practices (KAP) questionnaire containing 12 questions was assessed by using true/false type and Likert scale-based questions. Descriptive statistics used to generate frequencies, percentages and proportions.Results: Majority of the population have answered positively about knowledge questions. Surprisingly 72.41% population don’t know about process of new drug approval. Most of them agreed to pros and cons of generic drug prescribing. 58.14% population always write generic names in their prescription. Shockingly 74.42% population write prescription based on their knowledge from promotional literature by a medical representative.Conclusions: Findings of present study highlights usefulness of the practice of writing generic names in prescriptions. It also raises concern about professional qualification of the chemist who will be decision maker in drug delivery to consumers.

A study of effect of Nigella sativa oil in paracetamol induced hepatotoxicity in albino rats.

Background: Acetaminophen (paracetamol) toxicity is a common cause of drug induced hepatotoxicity in children and adults. Specific treatment of paracetamol induced hepatitis is available in the form of N acetylcysteine only. Nigella sativa (NS) is used for the treatment of various ailments. Many studies have shown that NS plant has hepatoprotective potential. Hence, this study study was carried out to explore the prophylactic and therapeutic effect of NS oil against hepatotoxicity induced by paracetamol. Methods: Hepatotoxicity was induced in rats by paracetamol and it was assessed using biochemical parameters such as serum (Sr.) alanine aminotransferase (ALT), Sr. aspartate aminotransferase (AST), Sr. bilurubin, Sr. alkaline phosphatase, and Sr. total protein. In addition, histopathological score was also assessed. The therapeutic and prophylactic effect of NS oil administration on paracetamol induced hepatotoxicity was investigated by using above mentioned biochemical and histopathological parameters. Results: Paracetamol administration leads to rise in serum liver enzymes ad fall in Sr. total protein levels. NS oil has heptoprotective effect. NS oil significantly reversed changes in serum levels of AST, ALT, alkaline phophatase, bilurubin, and total protein produced by paracetamol. Furthermore, histopathological changes produced by paracetamol were reversed. Conclusion: This study demonstrated that NS oil has hepatoprotective effect. NS oil administration can prevent or reverse the hepatotoxicity induced by paracetamol.

Drug utilization pattern in outpatient department of Government Medical College and C.P.R. Hospital, Kolhapur.

Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in outpatient department of Government Medical College and C.P.R. Hospital, Kolhapur which is one of the important medical college in western Maharashtra. Methods: One thousand prescriptions were screened & analyzed as per the study parameters from OPD of Government Medical College & C.P.R. Hospital, Kolhapur. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Also groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed. Results: Most common group of drugs prescribed by physicians was Analgesics (32.83%), followed by Antimicrobials (22.82%), Multivitamins (16.42%) and Antacids (9.14%). The average number of drugs prescribed per patient was four; the average number of analgesic was one. The incidence of polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc. Conclusions: We conclude that most of the prescriptions which were analyzed at R.C.S.M. Government Medical College and C.P.R. Hospital, Kolhapur, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern.

Hypolipidemic and antioxidant activities of pioglitazone in hyperlipidemic rats.

Background: Diabetes mellitus (DM) is an endocrine disorder characterized by abnormal carbohydrate, lipid and protein metabolism along with specific long-term complications which are associated with hyperlipidemia and oxidative stress. Hence, it is important to find hypoglycemic drug that improves lipid profile and reduces oxidative stress in diabetic patient. This study, therefore, was performed to investigate hypolipidemic and antioxidant potential of Pioglitazone (PIO) in hyperlipidemic rats. Methods: Hyperlipidemia was induced in normal rats by including 0.75 gm% cholesterol and 1.5 gm% bile salt in normal diet and these rats were used for the experiments. PIO hydrochloride was administered as 10 mg/kg and 30 mg/kg dose levels to the hyperlipidemic rats. Hypolipidemic activity was estimated by plasma lipid profile parameters while antioxidant potential was estimated by ascorbic acid, catalase activity, malondialdehyde and superoxide dismutase activity using standard methods. Statistical analysis was done by one way analysis of variance (ANOVA) followed by Dunnett’s test. Results: Treatment with 10 mg/kg and 30 mg/kg dose levels of PIO hydrochloride resulted in a significant decrease in serum TG and VLDL only in 30 mg/kg PIO treated group and significant increase in serum HDL in both groups, but no significant decrease in cholesterol and LDL in both PIO treated groups. PIO increased activities of catalase enzyme and concentration of malondialdehyde significantly in only 30 mg/kg PIO treated group. But there were no significant changes in the superoxide dismutase activity and ascorbic acid concentration in both PIO treated groups. Conclusions: The present study demonstrated that treatment with 10 mg/kg and 30 mg/kg dose levels of PIO hydrochloride improves the plasma lipid profile and also reduces oxidative stress in hyperlipidemic animals.

Lipid lowering and antioxidant potential of Asparagus racemosus in hyperlipidemic rats.

Background: Atherosclerosis is associated with hyperlipidemia which is a major risk factor for coronary artery disease. Therefore, treatment of hyperlipidemia is one of the major approaches to decrease the atherogenic process. Many studies revealed that Asparagus racemosus (AR) possesses hypolipidemic and antioxidant potential, but results were not consistent. Therefore, the present study was undertaken to investigate lipid lowering and antioxidant potential of AR root powder in hyperlipidemic rats. Methods: Hyperlipidemia was induced in normal rats by including 0.75 gm% cholesterol and 1.5 gm% bile salt in normal diet and these rats were used for the experiments. Dried root powder of Asparagus racemosus was administered as feed supplement at 5 gm% and 10 gm% dose levels to the hyperlipidemic rats. Plasma lipid profile, malondialdehyde, ascorbic acid, catalase and superoxide dismutase were estimated using standard methods. Statistical analysis was done by one way analysis of variance (ANOVA). Results: Feed supplementation with 5 gm% and 10 gm% Asparagus racemosus resulted in a significant decrease in plasma cholesterol, LDL and significant increase in HDL. But there were no significant decrease in triglycerides and VLDL. The feed supplementation increased activities of catalase, superoxide dismutase and ascorbic acid content increased significantly in both the experimental groups (5 and 10 gm% supplemented groups). But there was no significant change in the concentration of malondialdehyde in these groups. Conclusions: The present study demonstrated that addition of Asparagus racemosus root powder at 5 gm% and 10 gm% level as feed supplement reduces the plasma lipid levels and also acts as an antioxidant.