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Background: This comparative efficacy quantification research between metformin monotherapy and metformin combination therapy, and the subsequent systematic review, along with a consecutive meta-analysis of the different as well as wide-ranged study literature on oral hypoglycemic application rationality of metformin pharmacotherapeutics were performed, for a better comprehension of multicenter maintenance of rational pharmacotherapeutic aspects in the regular antidiabetic mono- and combination therapies prescribed to the new Type II diabetic patients. Aim and Objective: This clinical research study was conducted with the objective for a comparative quantitative evidence-based chronopharmacological efficacy research between metformin monotherapy and metformin combination therapy, and a systematic review, along with an accompanying meta-analysis, on the application rationalities of metformin pharmacotherapeutics. Materials and Methods: In this comparative quantitative evidence-based chronopharmacological efficacy research study, 100 patients suffering from newly detected early moderate grade Type II diabetes mellitus, were allotted into Group A consisting of 50 patients and Group B consisting of 50 patients. The Group A patients were prescribed the anti-diabetic treatment of orally administered metformin 500 mg, to be taken once daily for a span of 30 days, as metformin 1st line (only) monotherapy. The Group B patients were prescribed an oral hypoglycemic drug other than metformin, as 1st line anti-diabetic treatment, for the 1st 30 days, and then these Group B patients were gradually transferred to oral metformin combination therapy with another oral hypoglycemic drug, as metformin 2nd line (only) combination therapy, for the next 30 days. The derived study findings of comparative percentage efficacy quantification were statistically analyzed, on the basis of comparison between both the deduced results, for obtaining the comparative quantitative evidence-based chronopharmacological efficacy between metformin monotherapy and metformin combination therapy. Systematic review as well as meta-analysis is clinical research methods, comprising of a detailed, systematic and interpretative method of collecting, assessing and synthesizing the various medical evidences, to elaborate the research solution to a well-defined research question, in the form of a well-structured qualitative research review as well as quantitative analytical interpretations. Results: In this study, it was derived that the evidence-based chronopharmacological comparative percentage efficacy quantification of anti-diabetic metformin treatment showed 53% of percentage efficacy, when metformin was administered as 1st line (only) monotherapy, and 47% of percentage efficacy, when metformin was administered as 2nd line (only) combination therapy, with other oral hypoglycaemic drugs, prescribed in diabetes mellitus type II treatment regimens. The systematic review as well as meta-analysis in this study deduced 2482 refined, and also relevant, medical research database records, from total 3211 medical research database records, with a comprehensive qualitative and quantitative research database analyses. Conclusions: In this study, it was concluded that there was a slightly greater pharmacological efficacy of metformin 1st line (only) monotherapy than metformin 2nd line (only) combination therapy. The systematic review as well as meta-analysis derived a refined and conclusive medical research analysis, which was qualitatively synthesised, along with quantitative interpretations, on the various application rationalities of metformin pharmacotherapeutics.
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Background: Rational prescribing of the medicines is an essential skill required by all the doctors. Interns are not prepared or confident in rational prescription either because of inadequate training or knowledge is not retained by the time they come to internship or due to fast change in the concepts or protocols in pharmacology. The objectives of the study were to introduce and assess a short sensitization and training for interns regarding clinical pharmacology and therapeutics (CPT).Methods: It was a quasi-experimental type of interventional study done on 30 pediatrics interns. A short sensitization and training was given regarding CPT using flipped classroom model. Pre-test and post-test was conducted to know the effectiveness of the sensitization/training. Students’ opinion was also taken regarding the training and incorporation of similar training in other departments.Results: The mean percentage scores of the objective type questions in the pretest was 40.6±3.25 which increased significantly (p<0.05) to 74±2.95 in post-test. The mean percentage scores of the problem solving type questions in the pretest was 30.78±5.25 which increased significantly (p<0.05) to 65.21±4.65 in post-test.Conclusions: The sensitization and training was effective and there was overall satisfaction of conduct of such training among pediatrics interns. Further detailed research has to be conducted in different departments and faculties’ opinion regarding incorporation of CPT training and feasibility has to be considered before we recommend such training during internship.
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La enfermedad de Chagas afecta aproximadamente a 10 millones de personas en Sudamérica y 1,5 millones en la Argentina. La transmisión congénita es la más importante en áreas urbanas. Existen dos drogas aprobadas para el tratamiento: nifurtimox (Laboratorios Bayer) y benznidazol (BNZ) (Laboratorios Roche, LAFEPE y Elea) que fueron desarrolladas hace más de 40 años y cuya farmacología y metabolismo en humanos han sido poco estudiados. La información disponible es virtualmente inexistente en niños y mujeres embarazadas. Se busca aportar estudios sistemáticos hacia una farmacoterapéutica racional en niños ya que empíricamente ha demostrado gran efectividad. Se desarrollaron métodos bioanalíticos aplicables a matrices biológicas como plasma, orina y leche materna para las drogas madres y la identificación de metabolitos en muestras de pacientes bajo terapéutica. La farmacocinética poblacional pediátrica descripta aquí para BNZ es concluyente respecto de sus diferencias con la farmacocinética en adultos. Se identificaron tres compuestos presentados como metabolitos del BNZ. La transferencia de dicho fármaco a la leche materna no supone riesgo para el lactante. Estos resultados brindan información para mejorar los protocolos de tratamiento existentes buscando una farmacoterapéutica adaptada a la edad y un uso más seguro de los fármacos en niños y eventualmente en adultos.
Chagas disease affects approximately 10 million people in South America and 1.5 million in Argentina. Congenital transmission is most important in urban areas. There are two drugs approved for treatment: nifurtimox (Bayer) and benznidazole (BNZ) (Roche, LAFEPE, Elea),developed more than 40 years ago. Their pharmacology and metabolism in humans have been seldom studied. The information available on children and pregnant women is virtually non-existent. The aim of this study is to provide systematic studies towards a rational pharmacotherapeutic sin children, which has been empirically proven to be highly effective. Bioanalytical methods were developed for plasma, urine and breast milk for parent drugs and for the identification of their metabolites in samples of patients under treatment. The pediatric population pharmacokinetics described here for BNZ is conclusive about their differences from adult pharmacokinetics. Three compounds presented as BNZ metabolites were identified. The transfer of this drug to the breast milk does not present a risk to the infant. These evidences offer information to improve the existing treatment protocols, seeking a pharmacotherapy adapted to the age and a safer use of the drugs in children and eventually in adults.
A doença de Chagas afeta aproximadamente 10 milhões de pessoas na América do Sul e 1,5 milhão na Argentina. A transmissão congênita é a mais importante em áreas urbanas. Existem dois medicamentos aprovados para o tratamento: nifurtimox (Laboratórios Bayer) e benznidazol (BNZ) (Laboratórios Roche, LAFEPE e Elea), desenvolvidas há mais de 40 anos, e sua farmacologia e seu metabolismo em humanos têm sido pouco estudados. A informação disponível é praticamente inexistente em crianças e mulheres grávidas. O objetivo é fornecer estudos sistemáticos para uma farmacoterapêutica racional em crianças visto que foram comprovadas empiricamente como sendo altamente eficazes. Métodos bioanalíticos aplicáveis a matrizes biológicas como plasma, urina e leite materno para fármacos-mãe e para a identificação de metabólitos em amostras de pacientes em tratamento terapêutico foram desenvolvidos. A farmacocinética da população pediátrica aqui descrita para BNZ é conclusiva em relação às suas diferenças com a farmacocinética de adultos. Três compostos apresentados como metabólitos do BNZ foram identificados. A transferência do referido medicamento para o leite materno não representa risco para o lactente. Essas evidências oferecem informações para melhorar os protocolos de tratamento existentes, buscando uma farmacoterapia adaptada à idade e um uso mais seguro dos medicamentos em crianças e eventualmente em adultos.
Subject(s)
Humans , Male , Female , Toxicology , Chagas Disease/diagnosis , Chagas Disease/drug therapy , Lactation/drug effects , Chagas Disease/etiology , Chagas Disease/ethnology , Pharmacologic Actions , Metabolic Side Effects of Drugs and SubstancesABSTRACT
Background: Knowledge of pharmacology forms the basis of rational pharmacotherapy practice. Teaching the medical students about systematic application of pharmacology in patients’ care forms an essential component. It facilitates the medical students to develop a methodical approach in solving patients’ clinical problems.Methods: A questionnaire-based study was conducted, at Government Medical College Rajnandgaon involving second year MBBS students. Total 100 students participated in the study.Results: Hundred percent of the students responded that pharmacology was presently taught to them, seventy nine percent of them agreed with the fact that pharmacology was preferred to pass the MBBS, eighty eight percent of them responded that in pharmacokinetics was the least preferred topic, ninety seven of them were not aware of the essential drug list. Their suggestions regarding the change in teaching methodology was recorded.Conclusions: This study concludes that efforts are needed to develop a curriculum that encompasses important aspects of clinical pharmacology and therapeutics along with incorporation of the useful suggestions by the undergraduate students.
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In order to cultivate clinical pharmacy undergraduates to have better quality, Chongqing Medical University collaborated with The University of Chicago and University of Cincinnati in the reform of the course of pharmacotherapeutics. We build pharmacotherapeutics series curriculum with the center of disease, construct department of clinical pharmacy for transnational departments, build course leader and teaching team of pharmacotherapeutics series curriculum , compile teaching program and its material of pharmacotherapeutics series curriculum, build pharmacotherapeutics series curriculum and teaching model in line with the current direction of China's education system of clinical pharmacy training, reform teaching methods, and strengthen clinical pharmacy practice and community clinical pharmacy education.
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All clinicians should be fully aware of the recent trends in their speciality to enable them to provide effective and successful treatment to their patients. One vital aspect of the treatment is that the clinician should constantly update his knowledge on the drugs being administered during the course of treatment and their interactions. The purpose of this article is to review the current pharmacological agents being used in Prosthodontics along with their interactions and indications. The paper mainly focuses on Therapeutic drugs and drugs that aid in prosthodontics treatment. Therapeutic drugs include local anesthetics, antiseptics, steroids, analgesics, antimicrobials, antifungals, antianxity drugs, centrally acting muscle relaxants. Drugs that aid in prosthodontics treatment include astringents, vasoconstrictors, hemostatic agents, sialogogues, anti-sialogogues, denture cleansers, gum paints, denture cleansers, denture adhesives, ORAL protective agents and demulcents. An odontologist should have sound knowledge of the benefits and drawbacks of all these agents. This will enable the clinician to provide a safe and predictable treatment to the patients.
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Fungal keratitis is the first common infectious corneal disease and has become the main cause of blindness in China.Along with the intensive explore for the pathogenic mechanisms,the significant progress has been achieved in the pharmacotherapeutics.For lowering its blindnessrate,it is imperative to the study on increasing therapeutic option and enhancing therapeutic efficacy.This review summarizes the current advance in clinical use in ophthalmology of novel antifungal agents,including new azoles such as voriconazole and posaconazole,and echinocandins such as caspofungin and micafungin.This article also reviews the progress of administration routes for the management of recalcitrant fungal keratitis,including subconjunctival,interstromal,intracameral and intravitreal injection.