Drug utilisation pattern in sexually transmitted diseases and its economic considerations--a prospective study.

OBJECTIVES: WHO regularly revises guidelines for the treatment of these. There are very few studies reported on the drug utilization pattern of STD's in India. METHODS: In the present study, 325 patients attending the STD clinic of Lok Nayak Hospital were analysed over a period of six months. RESULTS: The demographic pattern of the patients was similar to those of studies reported earlier. Syphilis was the commonest of the STD's encountered; followed by viral STD's (c. acuminata and herpes progenitalis); gonorrhoea; chancroid and genital candidiasis. Out of a total of 409 drugs prescribed, the average number of drugs per prescription was 1.25. Sixty seven percent of the drugs were available in essential drug list of the hospital and 60% were prescribed in generic name. Ninety seven percent of the prescriptions were in accordance with WHO treatment guidelines. The cost of the drug treatment was comparable for c.acuminata, syphilis and chancroid while it was less for herpes progenitalis (HPG) due to acyclovir not being prescribed. However, it was more for gonorrhoea and candidiasis because of additional drugs. CONCLUSIONS: The present study shows a trend towards rational prescribing. It would be interesting to compare the results with a non teaching hospital.

Pharmacokinetics of isoniazid in pulmonary tuberculosis--a comparative study at two dose levels.

OBJECTIVES: To compare the pharmacokinetic parameters and the clinical efficacy of isoniazid, administered in 10 mg/kg or 5 mg/kg to children suffering from pulmonary tuberculosis. DESIGN: A randomized, open, controlled clinical trial. SETTING: Teaching hospital in New Delhi. SUBJECTS: Twenty children suffering from pulmonary tuberculosis in the age group 6-12 years. INTERVENTIONS: A three drug antitubercular regimen comprising of rifampicin (10 mg/kg), pyrazinamide (30 mg/kg) and isoniazid in a dose of either 10 mg/kg (Group I) or 5 mg/kg (Group II) was administered for fourteen days. On day fifteen serial blood samples were collected at 0,1,2,3,6 and 24 h of isoniazid administration and analyzed spectrofluorometrically. MAIN OUTCOME MEASURES: Serum isoniazid concentrations and clinical response in both the groups. RESULTS: In both the groups, serum concentration of isoniazid were above the therapeutic range (0.5-2 micrograms/ml) at 6 h following drug administration. The minimum serum concentration of isoniazid was within or above minimum inhibitory concentration of the drug at 24 h in both the groups. The time to achieve maximum serum concentration, elimination half life, elimination rate constant, mean residence time, volume of distribution at steady state and plasma drug clearance were also comparable. At the end of 6 months follow up, all children showed comparable clinical and radiological improvement. CONCLUSION: Isoniazid in a dose of 5 mg/kg administered with other antitubercular drugs appears adequate for treatment of pulmonary tuberculosis in children.

Pharmacodynamic bioequivalence: evaluation of different brands of terfenadine hydrochloride.

Terfenadine is a selective histamine H1 receptor antagonist which binds preferentially to peripheral receptors in vivo and is devoid of central nervous system depressant activity and thus has an improved adverse effect profile (1). Hence, terfenadine may be considered to be a first line agent in the treatment of allergic rhinitis and chronic urticaria. In man terfenadine is rapidly absorbed following a single oral dose and a peak terfenadine plasma concentration is reached within 1-2 hr after the drug administration (2). The present study was carried out to compare the bioequivalence of two terfenadine hydrochloride preparations marketed by Kopran Chem. Co. and Marrel Dow U.K. (Triludan) by evaluating their ability to inhibit the skin reaction to intradermally injected histamine (3).

Effect of drugs influencing synthesis of prostaglandins on haloperidol-induced catalepsy in rats.

Rats pretreated with prostaglandin synthesis stimulators, phenoxymethyl penicillin (2, 4 and 8 mg/kg, ip) and levamisole (2.5, 5 and 10 mg/kg, ip) showed a dose related potentiation of catalepsy after subthreshold doses of haloperidol (0.1 mg/kg, ip). Pretreatment with prostaglandin synthesis inhibitors paracetamol and indomethacin exhibited significant inhibition of catalepsy at lower doses (2.5, 6, 10 and 15 mg/kg, ip). However, this antagonism was paradoxically less at higher dose levels (20 and 30 mg/kg, ip). The data suggest neuromodulatory contribution of prostaglandins in neuroleptic-induced catalepsy.