ABSTRACT
Background: The first COVID-19 case was reported in a Chinese province named Wuhan in December 2019, which later spread to 215 countries worldwide infecting 47.9 crores of people and caused 61.1 lakhs of deaths, until March 2022. In India alone, 4.3 crores were infected and 5.17 lakhs deaths were reported until the above said period. Aims and Objectives: In this study, we analyze the drug utilization pattern of mainline and supportive drugs used in the treatment of COVID-19 patients admitted in a tertiary care center. The role of repurposed drugs in the prescription pattern of COVID-19 patients would also be analyzed. Materials and Methods: The study included all the COVID-19 patients admitted in this institution between April 2021 and June 2021. These included patients were laboratory-confirmed positive cases and must have received medical treatment for a minimum of 3 days in the hospital. Pregnant women and children admitted with COVID-19 infection were not included in this study. All the data for this study were retrospectively extracted from the medical records department of the institution. A total of 420 patients have been admitted in COVID-19 ward between April 2021 and June 2021, out of which 300 case records which fulfilled the above said criteria were selected for further scrutiny. Results: Among 300 patients, there were 192 males (64%) admitted with COVID-19 infection compared to 108 females (36%). Predominant age group of distribution of COVID-19 cases was between 50 and 60 years (42%). One hundred and eighty-eight COVID-19 cases had one or more comorbid conditions along with COVID-19 infection. There were 12 deaths among the selected 300 cases during their hospital stay. The most common combination used in the treatment of COVID-19 was an antibacterial, antiviral, antithrombotic, and an anti-inflammatory drug. About 76% (n = 228) of the admitted COVID-19 patients received this combination along with other supportive or symptomatic treatment during the stay in hospital. About 88% (n = 284) of cases had an antiparasitic drug ivermectin in a daily dose of 12 mg for a period of 5 days. Ivermectin is one among the repurposed drugs used in the treatment of COVID-19 infection. Proton-pump inhibitors such as omeprazole 20 mg twice daily in oral route or pantoprazole 40 mg in parenteral route were the supportive drugs used in most prescriptions. Conclusion: Except the high empirical usage of antibiotics, the remaining frontline drugs for COVID-19 such as antiviral, corticosteroids, and antithrombotics were utilized in an appropriate manner. A high positive clinical outcome observed in this study can be attributed to the expertise gained by the physicians over the period of time in handling the COVID-19 infection.
ABSTRACT
Background: Not all second-generation antihistamines were devoid of the central nervous system (CNS) effects such as cognitive and psychomotor impairment. Although these drugs penetrate blood–brain barrier (BBB) to lesser extent, many of them have been found to produce dose-related impairment of CNS functions with interdrug differences present among them. Aim and Objective: This study is aimed to analyze and compare the effects of different antihistamines (first and second generation) on the CNS using Swiss albino mice. Materials and Methods: Twenty-four Swiss albino mice of either sex weighing around 25 - 30 g were randomly divided into six groups with six in each group. Antihistamines such as chlorpheniramine maleate (CPM), ebastine, and fexofenadine were administered to respective groups through oral route. Their effects on CNS were evaluated using rotarod and actophotometer. The data were analyzed using statistical methods. Results: CPM produced significant reduction (P < 0.05) in motor coordination and spontaneous locomotor activity. Ebastine does not have any effect on motor coordination but significant reduction (P < 0.05) in spontaneous locomotor activity. Fexofenadine does not have any effect on motor coordination and spontaneous locomotor activity. Conclusion: We conclude that CPM has significant CNS depressant actions, ebastine has minimal CNS depressant actions, and fexofenadine does not have CNS depressant actions.