ABSTRACT
Purpose : To assess the temporal prescription patterns of overactive bladder (OAB) pharmacotherapy based on the prescription trend analysis amongst Indian clinicians. Methods : IQVIA (Quintiles and IMS Health) secondary sales audit (SSA) and prescription audit for antimuscarinics and beta-3 adrenoceptor agonist (mirabegron) from 2014 to 2022, were analyzed. Prescribers overlap analysis for solifenacin and mirabegron among Indian urologists was also analyzed. Results : Urologists’ prescription rates of OAB drugs were 65% in 2016 and 52% in 2022. The rate of OAB medication prescription by non-urologists was highest among surgeons (17%), followed by consultant physicians (9%) and gynecologists (8%) in 2022. In addition, among OAB medication prescription rates for antimuscarinics were 100% in 2016 and 56% in 2022 whereas for mirabegron, it was 0% in 2016 and 44% in 2022. The proportion of prescribers of OAB medication among urologists was 38% in 2016 and 33% in 2022. Exclusive prescribers of solifenacin were 748 in 2018 and 715 in 2022 at the urologist, whereas for mirabegron, it was 961 in 2018 and 1475 in 2022. Conclusions : Urologists remained a top prescribing specialty for OAB drugs, although prescription share increased among surgeons and consultant physicians. OAB medicines prescriptions by urologists are shifting from solifenacin to mirabegron. The results of this study could further help clinicians, to design the optimum treatment approach in OAB patients according to their need, which can help to lower antimuscarinic side effects, improves treatment adherence, and improves patient’s QoL.
ABSTRACT
Background: Presently available antiepileptic drugs are effective in controlling seizures in more than half of patients of all epilepsy but use is often limited by adverse effects. H1 receptor antagonists, have a controversial status in patients of epilepsy. Both pro and antiepileptic effect has been documented in various animal studies. Hence, this study was designed to see the effect of promethazine, an H1 antihistaminic drug and its interactions with antiepileptic drugs lorazepam and sodium valproate in rats.Methods: The effect of promethazine (10 mg/kg) and its interactions with antiepileptic drugs lorazepam and sodium valproate was assessed by using maximal electroshock seizures (MES) and chemoshock pentylenetetrazol (PTZ) method.Results: Promethazine along with lorazepam and sodium valproate in subtherapeutic doses exerted significant protection against MES induced seizures whereas no such protection was observed with PTZ method rather the seizure threshold was reduced.Conclusions: Subtherapeutic doses of promethazine alone and in combination with lorazepam and sodium valproate showed protection against seizures in MES method. However, proconvulsant effect was seen with PTZ method. This shows dual behavior of promethazine on MES and PTZ induced seizures.
ABSTRACT
Background: Current antiepileptic drugs (AEDs) are effective in controlling seizures in about 70% patients but use is often limited by adverse effects. Promethazine, H1 receptor antagonist, has a controversial status in patients of epilepsy. Both pro and antiepileptic effect has been documented in various animal studies. Hence, this study was designed to see the effect of promethazine, an H1 antihistaminic drug and its interactions with antiepileptic drugs in rats.Methods: The effect of promethazine (10mg/kg) and its interactions with antiepileptic drugs diazepam and phenytoin was assessed by using maximal electroshock seizures (MES) and chemoshock (PTZ) method.Results: Promethazine along with diazepam in subtherapeutic doses exerted significant protection against MES induced seizures whereas no such protection was observed with PTZ method rather the seizure threshold was reduced.Conclusions: Subtherapeutic doses of Promethazine alone and in combination with diazepam showed protection against seizures in MES method. However, proconvulsant effect was seen with PTZ method suggesting histamine plays a protective role in development of seizures. This shows dual behavior of promethazine on MES and PTZ induced seizures.