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Objective: Comparative evaluation of efficacy and safety ofBepotastine besilate versus Olopatadine and Ketorolaccombination in patients with vernal keratoconjunctivitis.Materials and Methods: This was a prospective, open label,randomized, comparative clinical study. Hundred patients ofvernal keratoconjunctivitis between 6 to 20 years of age ofeither sex willing to give informed consent were enrolled in thestudy. In Group 1, 50 patients received Bepotastine besilate(0.15%) eye drops twice daily for 8 weeks whereas in Group 2,50 patients received Olopatadine (0.2%) and Ketorolac (0.4%)combination eye drops twice daily for 8 weeks. Symptoms andsigns scoring of VKC were recorded on baseline and at thetime of follow up at 4 and 8 weeks. Safety assessments werealso done in both the drug groups during the study period forany serious adverse effects.Results: After the 2 months of drug therapy, patients in boththe groups showed improvement in the symptoms and signsscoring of VKC. However, there was no statistically significantdifference between the two treatment groups at 4th and 8thweek. Both the drugs were well tolerated without any seriousadverse effect.Conclusion: Both bepotastine besilate versus olopatadine andKetorolac combination ophthalmic solutions were found to beeffective in alleviating the clinical symptoms and signs of VKC.
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Background: This study was to assess the usefulness of nasal smear as a quick, easy and inexpensive diagnostic method for allergic rhinitis and for assessment of the cost effectiveness of antihistaminics.Methods: This study was conducted in rural setting of tertiary care hospital. Nasal smears were taken from 52 patients with a clinical history of nasal allergy having nasal congestion score of at least 3 or more. Nasal smears were stained with Hematoxilin-Eosin and examined by pathologists.Results: A total of 52 patients 13 in each groups of the age group 18 to 65 years (Mean age, 33.73±10.23 years); 48.08% are Female and 51.92% are Male were randomized and received either Cetirizine, Levocetirizine, Loratadine, or Fexofenadine over a period of one week. The association of eosinophil before and after the treatment was obtained using logistic regression analysis for each treatment separately. Eosinophil is marginally associated with Cetirizine before and after treatment.Conclusions: Evaluation of eosinophils in nasal smear is an insensitive but cheaper test for the diagnosis of allergic rhinitis and use as a simple tool for comparison of cost effectiveness among commonly used oral antihistaminics. pharmacoeconomic analysis of present comparative clinical study shows that cetirizine is a better choice in comparison with levocetrizine, loratidine and fexofenadine due to its cost effectiveness.
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Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable condition characterized by persistent airflow obstruction that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Bronchodilators are mainstay of pharmacologic management of COPD and Inhaled corticosteroids (ICS) are the central of treatment of asthma but in management of COPD their role is controversial. Aim &Objectives: The sole aim and objective of this study is to evaluate the current prescription pattern of COPD management using data generated in a tertiary care hospital of UP India.. Methods: : In this prospective study, all patient data relevant to the study were obtained by examination of Case sheets of inpatients visiting the OPD of TB & Chest department. Results: In this prospective study, prescriptions of 74 patients were selected. Out of total patients, 60 (81.08%) were males and 14(18.9%) were females. Out of total 74 patients, 73 (98.64%) are smokers, in which 30 (40.54%) are currently smoking while 43(58.1%) are ex-smokers. Out of total patients 60(81.08%) have comorbidities. Hypertension is most common comorbidity having 36 (48.65%) of patients. Inhalational route was most common route of administration of drugs in the study. Oral route was second most common route; it was used for administration of 42.03% of drugs. Formoterol was maximum prescribed drug used in 60 (81.09%) of patients followed by Budesonide 57 (77.03%), Acebrophylline 48 (64.86%),followed by Levocetrizine 41 (51.41%), Salbutamol and Montelukast were used in equal no. of patients 40(54.06%) , followed by Ipratropium 39 (52.70%), Tiotropium which was used in 29 (39.19%) of patients, followed by Amoxicillin 16 (21.63%) followed by Theophylline and Azithromycin used in 8 (10.81%) patients ,followed by Doxophylline and Terbutaline which were also used in equal number and percent of patients that is 3 (4.05%). Conclusion: The prescribing trend observed in the study appears to be in concordance with the current GOLD guidelines for the management of COPD patients.
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Vertigo is a sense of whirling and rotation and is frequently associated with nausea and vomiting. Vertigo is a cardinal manifestation of vestibular disorders. Pharmacotherapy is required for symptomatic treatment of vertigo and motion sickness irrespective of the aetiology. Drugs like cinnarizine, betahistine and scopolamine are time honoured drugs. Antihistaminics and phenothiazines are also useful agents. Surprisingly, very few newer agents have shown undisputed efficacy against vertigo. This review describes the neurotransmitters involved in the genesis of vertigo and current status and evolution of appropriate pharmacological options for the treatment.
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Los antihistamínicos han sido usados durante los últimos 50 años y se han convertido en los medicamentos de mayor prescripción en el mundo. En este artículo se revisa el desarrollo de nuestro conocimiento referente a la histamina en el transcurso del siglo, como mediador biológico almacenado y liberado mayormente por los basófilos y mastocitos; mediador biológico situado en diferentes tejidos corporales, y otras células, con un papel fisiológico fundamental en el control de la secreción de ácido gástrico y un papel fisiopatológico en una gama de trastornos alérgicos. La síntesis y estudios farmacológicos de agonistas y antagonistas selectivos han establecido la existencia de cuatro tipos de receptores de histamina y antagonistas de ellos, que han encontrado muy importantes aplicaciones terapéuticas. Debido al aumento de la prevalencia de las enfermedades alérgicas según el Libro Blanco de Alergia (WAO), se deben crear normas que promuevan el uso de los antihistamínicos de manera adecuada y racional. De esta manera, la correcta elección debe ser realizada de acuerdo a su eficacia, tolerabilidad, seguridad, grupo etario, situaciones y precauciones particulares en pacientes con algún riesgo incrementado. El crear normas que promuevan una práctica terapéutica óptima o uso racional de dichos medicamentos. Elegirlos de acuerdo a su eficacia, tolerabilidad, seguridad, grupo etario, situaciones y precauciones especiales en pacientes portadores de ciertas enfermedades de riesgo a utilizarlos.(AU)
Antihistamines have been used for the past 50 years and have become the most prescribed drugs in the world. This article reviews the development of our knowledge concerning the histamine in the course of the century, as a biological mediator mostly stored and released by basophils and mast cells biological mediator located in different body tissues, and other cells, having a fundamental physiological role in the control of gastric acid secretion and pathophysiological role in a variety of allergic disorders. The synthesis and pharmacological studies of selective agonists and antagonists has established the existence of four types of histamine receptor antagonists and histamine receptor found important therapeutic applications. Power demonstrations relate most allergic diseases whose symptoms are chronic and persistent emphasis by (WAO) White Paper on Alergia1 a steady increase in allergic diseases with a prevalence of 30-40% of the world population affected at least one allergic condition, considering the most common allergic rhinitis and chronic diseases common in our modern society. Creating standards that promote optimal therapeutic practice or rational use of such drugs. Choose them according to their efficacy, tolerability, safety, age group, situations and special precautions in patients with certain diseases risk to use. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Histamine Antagonists/pharmacology , Pharmacology , Urticaria , Histamine , Dermatitis, AtopicABSTRACT
Antihistaminics are widely used for various indications during microbial infection. Hence, this paper investigates the antimicrobial activities of 10 antihistaminics belonging to both old and new generations using multiresistant Gram-positive and Gram-negative clinical isolates. The bacteriostatic activity of antihistaminics was investigated by determining their MIC both by broth and agar dilution techniques against 29 bacterial strains. Azelastine, cyproheptadine, mequitazine and promethazine were the most active among the tested drugs. Diphenhydramine and cetirizine possessed weaker activity whereas doxylamine, fexofenadine and loratadine were inactive even at the highest tested concentration (1 mg/ml). The MIC of meclozine could not be determined as it precipitated with the used culture media. The MBC values of antihistaminics were almost identical to the corresponding MIC values. The bactericidal activity of antihistaminics was also studied by the viable count technique in sterile saline solution. Evident killing effects were exerted by mequitazine, meclozine, azelastine and cyproheptadine. Moreover, the dynamics of bactericidal activity of azelastine were studied by the viable count technique in nutrient broth. This activity was found to be concentration-dependant. This effect was reduced on increasing the inoculum size while it was increased on raising the pH. The post-antimicrobial effect of 100 fg/ml azelastine was also determined and reached up to 3.36 h.
Subject(s)
Humans , Histamine H1 Antagonists/analysis , Histamine H1 Antagonists/pharmacology , Drug Resistance, Microbial , In Vitro Techniques , Culture Media/analysis , Culture Media/pharmacology , Methods , Methods , Therapeutic UsesABSTRACT
Several antihistaminics possess antibacterial activity against a broad spectrum of bacteria. However, the exact mechanism of such activity was unclear. Hence, the aim of this study is to investigate their mechanism of antibacterial activity especially their effect upon the permeability of the bacterial cytoplasmic membrane. The effects of azelastine, cetirizine, cyproheptadine and diphenhydramine were studied using Gram-positive and Gram-negative multiresistant clinical isolates. Leakage of 260 and 280 nm UV-absorbing materials was detected upon treatment with the tested antihistaminics; indicative of membrane alteration. Using an artificial membrane model, cholesterol-free negatively-charged unilamellar liposomes, confirmed the effect of antihistaminics upon the membrane permeability both by showing an apparent membrane damage as observed microscopically and by detection of leakage of preloaded dye from the liposomes colorimatrically. Moreover, examination of the ultrastructure of cells treated with azelastine and cetirizine under the transmission electron microscope substantiated the detected abnormalities in the cell wall and membrane. Furthermore, the effect of pretreating certain isolates for both short and long periods with selected antihistaminics was followed by the viable count technique. Increased vulnerability towards further exposure to azelastine was observed in cells pretreated with azelastine for 2 days and those pretreated with azelastine or cetrizine for 30 days.