Utilization pattern of antihypertensive drugs among chronic kidney disease patients in a tertiary care hospital

Background: Chronic kidney disease (CKD) exists both as a common cause of hypertension and also a complication of uncontrolled hypertension. This complex interplay of hypertension and CKD further increases the risk of adverse cardiovascular and cerebrovascular outcomes in patients with compromised renal function. Aim and Objectives: The present study tried analyze the characteristics of hypertensive CKD patients and the current antihypertensive treatment pattern in CKD patients in a tertiary care set up in Eastern India. Materials and Methods: A prospective and observational study included adult currently diagnosed CKD patients along with hypertension. Basic demographics along with medical history, blood pressure (BP) measures treatment details, and laboratory information were retrieved for each included patient, noted and analyzed statistically. Results: Around 47% patients were taking two antihypertensives, followed by 19.7% on three and 17.97% on one antihypertensive, respectively, and over 50% patients demonstrating high normal BP, followed by 25% having Grade I hypertension and around 20% having Grade II hypertension. Various classes of antihypertensives prescribed in the present study included calcium channel blockers, beta-blockers, angiotensin receptor blocker, angiotensin-converting enzyme (ACE) inhibitors, centrally acting drugs, alpha-blockers, and diuretics. Beta-blockers were found to be the most prescribed antihypertensives, being prescribed in 92.69% CKD patients. This was followed by calcium channel blockers, centrally acting drugs, alpha-blockers, angiotensin receptor blocker, diuretics, and ACE inhibitor. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in hypertensive CKD patients. Conclusion: Considering the interplay of hypertension and CKD, it is imperative to essentially treat hypertension robustly to ensure better cardio and renoprotection in these CKD patients. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in such patients. A rational multidrug antihypertensive regime can help achieve better patient outcomes in hypertensive CKD patients.

Zolpidem in insomnia 3-year post-marketing surveillance study in the Philippines

A post-marketing surveillance study was conducted in the Philippines in routine practice and involved 1482 patients treated with zolpidem (Stilnox R), an imidazopyridine hypnotic agent. The patient population was 53.24 percent women and 45.28 percent men with a mean age of 47 years old (18.42 percent were over 65 years old). Of the patients, 44.26 percent were treated with a zolpidem dosage of 10 mg/day and 35.96 percent, 5mg/day. The treatment duration range from 2 to 35 days and a mean of 8 days. All adverse events were collected through spontaneous reporting. Thirty-nine patients (2.6 percent) reported 79 adverse events 20 (1.3 percent) of them discontinued treatment. CNS (central nervous system) related adverse events accounted for 70 percent of the total events. The most common events were headache and drowsiness the next day in 0.88 percent and 0.81 percent of the total cases respectivelv. Dizziness, lack of concentration, restlessness, hallucinations, nightmares, incoherence and disorientation were observed in a lower proportion, with one episode of twitching of the lower extremities. No serious adverse event was reported and no new risk factors or at-risk populations were identified. The safety profile of zolpidem is thus consistent with its known pharmacological properties, the results of previous clinical trials, and the cumulative international experience gained with this short-acting hypnotic drug.

Cytotoxic nucleosides and parasitic diseases: a new therapeutic approach

Tubercidin, a cytotoxic nucleoside derivative, has been effective in the treatment of murine schistosomiasis when coadministered with nucleoside transport inhibitors. The latter drugs, which include nucleoside derivatives and several vasodilators, selectively act on mammalian cells and not on parasites, thus providing host protection against the toxic action of tubercidin in the experimental animal.this combination-therapy principle should be applicable to other extracellular parasitic infections and may become clinically useful. The need for further studies dealing with selection of cytotoxic nucleosides and host-protecting nucleoside transport inhibitors with favorable pharmacokinetic properties is emphasized