Pattern of Logical Drug Prescription Among Iranian General Dental Practitioners

Objective: To determine the prescribing patterns of the general dental practitioners in Kerman province in Iran. Material and Methods: In this cross sectional study 1200 prescriptions, which were prescribed by general dentists in Kerman province during one-year period, were evaluated. Each prescription was assessed for the number of drugs per prescription, drug (category, name, route of administration, frequency) and duration of treatment. Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. The Chi-square test, analysis of variance (ANOVA) and t-test were used. The statistical tests were performed at the significance level of 0.05. Results: The mean number of drugs per prescription was 2.59. Antibiotics, Analgesics, corticosteroids and antiseptics were the most common drug category prescribed drugs by general dentists. Oral route was the commonest route of drug prescription (84.1%). Amoxicillin capsule (60.5%) was the commonest drug prescribed by general practitioners followed by ibuprofen derivatives (55.4%). Spelling errors was found in 62.7% of prescriptions. The mean score of prescriptions for logical prescription pattern was 7.36 ± 1.32 out of 9. Conclusion: Dental prescribing patterns should be considered as a potential area for improvement in the treatment process and patient safety. It is suggested to emphasis more on principles of prescription at university and retraining courses for dentists.

Prescription Pattern Study in Type 2 Diabetes Mellitus in Diabetic our Patients in Private Clinics in Kerman, Iran.

Aims: Diabetes mellitus (DM) is a chronic disease associated with significant morbidity and mortality. The present study was carried out to assess prescribing practice for oral antidiabetic drugs in type 2 diabetes mellitus patients seen in diabetic outpatients in private clinics in Kerman, Iran. Study Design: Retrospective analysis of prescription pattern for type 2 diabetic outpatients. Place and Duration of Study: Diabetic clinics in Kerman city, Iran, (from 1st September 2012 to 31st August 2013. Methodology: Prescription pattern of 1118 diabetic outpatients were analyzed for age, percentage of male and female patients, antidiabetic drug category, name of prescribed drug, most frequently prescribed antidiabetic drug and percentage of one/two drug combination. Results: Out of the 1118 prescriptions of antidiabetic drugs studied, 424 (37.9%) were for women and 694(62.1%) were for men with mean age of 56.2±11 years. Oral antidiabetic drugs were prescribed for 777(69.5%) and 30.5% of patients received insulin. Biguanides were the most frequently prescribed drugs (61.7%) followed by sulfonylurea (59.9%), alpha-glucosidase inhibitors (4.5%), repaglinide (NovoNorm®) (2.7%) and thiazolidinediones (1.7%). Metformin 690 (61.7%) and glibenclamide 670 (59.9%) were the most frequently prescribed antidiabetic drugs. About 46.9% of patients received monotherapy and a total of 594 (53.1%) patients were on combination therapy of 2 or more antidiabetic drugs. The Combination of glibenclamide plus metformin (41.5%) was the most commonly prescribed antidiabetic drug combination in diabetic outpatients. Most common prescribed drugs associated with DM were found to be antihypertensive/antianginal (65%) and lipid lowering drugs (33.3%). Conclusions: Oral hypoglycemic agents were the main form of antidiabetic therapy in type 2 DM patients. Metformin was the most frequently prescribed biguanides and combination of metformin with glibenclamide has been most widely used. This suggests the need for development of evidence-based guidelines for oral antidiabetic prescription by health professionals.

Antinociceptive Effect of Gabapentin In Visceral Pain is not Mediated by GABAA or Opioid Receptors.

Aims: There is evidence supporting the antinociceptive effect of gabapentin in visceral pain, however, the underlying mechanism(s) is not determined yet. So this study was performed to evaluate probable involvement of opioid and GABAergic receptors in the gabapentin effects on acetic acid-induced visceral pain in mice. Place and Duration of Study: Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran, between June 2012 and March 2013. Methodology: The acetic acid test was induced by intraperitoneal injection (i.p.) of acetic acid 0.6% (10ml/kg of body weight) in male mice. Writhing reflex was measured as the number of abdominal contractions in 45min. Animals received saline (as control) or gabapentin (1, 5, 10, 25, 50, 100 or 200mg/kg/ i.p.) 40min before acetic acid. The least effective dose of gabapentin (50mg/kg i.p.) was selected for further assessments and mice were pretreated either picrotoxin (0.75, 1 and 1.5mg/kg/i.p.) as chloridechannel blocker, bicuculline (0.5, 0.75, 1.5 and 2mg/kg) as GABAA receptor antagonist or naloxone (2mg/kg/i.p.) as opioid receptor antagonist, 10min before gabapentin (50mg/kg i.p.) treatment. Separate groups received naloxone or picrotoxin (1.5mg/kg) or bicuculline (2mg/kg) alone 10min before saline in acetic acid induced visceral contractions test. Results: Gabapentin reduced acetic acid-induced writhing in dose-dependent manner. Visceral contractions following naloxone, picrotoxin and bicuculline administration prior to gabapentin was not significantly different from that of gabapentin alone. Only toxic doses of picrotoxin and bicuculline (1.5 and 2mg/kg, respectively) abolished the inhibitory effect of gabapentin. Conclusion: The effect of gabapentin on visceral nociception is not mediated through opioid and/or GABAA receptors.

Effect of methanolic extract of hyoscymus niger L. on the seizure induced by picritoxin in mice

Effects of Hyoscyamus niger L on central nervous system have been known for many years. The effects of methanolic extract of H. niger L. on seizures induced by picrotoxin was studied in mice in this investigation. In this study 7 groups of animals pretreated with methanolic extract of the plant [12.5, 25, 50, 100, 200, 300, 400 mg/kg/i.p.], 20 minutes prior to the picrotoxin [12 mg/kg/ i.p.] - induced seizures. Control mice received phenobarbital [40mg/kg/ i.p.] as positive control, or saline [10 ml/kg] as negative control. The latency of seizure [sec], duration of seizure [sec] and mortality rate were determined in test and control groups. The results of this study showed that latency of seizure was increased in groups that were pretreated with doses of 100, 200, 300 and 400 mg/kg of extract. In addition, methanolic extract of H. niger L. delayed the death time in mice as compared to control that was significant with doses of 200, 300 and 400 mg/kg. The most effective dose of extract was 300 mg/kg in this investigation [P < 0.01]. In conclusion, the results showed that methanolic extract of H. niger L. posses the anticonvulsant activity against picrotoxin-induced seizures in mice. The exact mechanism[s] by which the plant exerts its anticonvulsant activity is not determined yet