Apalutamide: a better option for the treatment of non-metastatic castration resistant prostatic carcinoma

Prostate cancer is cancer of the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other area of the body, particularly the bones and lymph nodes. Factors that increase the risk of prostate cancer include older age, a family history of the disease, and race. About 99% of cases occur in males over the age of 50. Clinical features include hematuria, dysuria (painful urination),nocturia(urination at night). Lower blood levels of vitami D may increase the risk of developing prostate cancer. Infection with the sexually transmitted diseases, chlamydia, gonorrhea, syphilis and prostatitis seem to increase risk of prostate cancer. Diagnosis can be confirmed by digital rectal examination (DRE) with prostate-specific antigen (PSA) blood test, cystoscopy, transrectal ultrasonography and biopsy (The removal of small pieces of the prostate for microscopic examination). Medicines like 5-alpha-reductase inhibitors (finasteride and dutasteride) reduce the overall risk of prostate cancer. Apalutamide, sold under the brand name Erleada, is a nonsteroidal antiandrogen (NSAA) medication which is used in the treatment of prostate cancer. It is specifically indicated for use in conjunction with castration in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC). It is taken by mouth. Apalutamide was first described in 2007 and was approved for the treatment of prostate cancer in February 2018. Apalutamide is used in conjunction with castration, either via bilateral orchiectomy or gonadotropin-releasing hormone analogue (GnRH analogue) therapy, as a method of androgen deprivation therapy in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC)

The comparative effects of Itopride and Levosulpiride orally used in patients suffering from Non-ulcer dyspepsia

Background: Itopride and Levosulpiride both comes under the group of Prokinetic drugs. These drugs are used for the treatment of non-ulcer dyspepsia, heart burn, nausea and vomiting. Both drugs act on dopaminergic D2 receptor as antagonist and increases the concentration of acetylcholine so that gastric peristalsis will be increase and that time pressure at lower oesophageal sphincter will be increase thus gastric motility increases and there will be good gastro-duodenal co-ordination.Method: This study has to conduct on patients with complains of non-ulcer dyspepsia attended Medical outdoor and department of pharmacology of SKMCH Muzaffarpur, Bihar, India. The total 60 patients have to include in the study, which have to randomly divide in two groups. Group A (itopride) comprising of 30 patients and Group B (Levosulpiride) comprising of 30 patients. Patients have to randomly allocate to receive one tablet of itopride hydrochloride, 50 mg three times daily before meal and one tablet Levosulpiride of 75 mg three times daily before meal. Authors have to enroll the patients at the interval of two weeks and continue it upto 3 months.Results: Study did not found any remarkable change in biochemistry profile. Only QT prolongation changes were found in two patients, but no serious cardiac toxicity was observed with patient receiving Levosulpiride. Neither QT prolongation nor serious cardiac toxicity was observed with itopride hydrochloride therapy.Conclusions: In present study, efficacy of Itopride was comparable to Levosulpiride in relieving the symptoms of non-ulcer dyspepsia. Both the drugs were clinically and biochemically well tolerated. QT prolongation changes were found in two patients, but no serious cardiac toxicity was observed with patient receiving Levosulpiride. Itopride does not show cardiac toxicity and any changes in ECG

Efficacy and safety of topical 2% dorzolamide and 0.5% timolol in cases of open angle glaucoma in a tertiary care hospital of East Singhbhum: an observational, prospective and comparative study

Background: Present study was undertaken to evaluate and compare the efficacy and side effects of 2% dorzolamide and 0.5% timolol in patients with open angle glaucoma.Methods: There were 60 randomly selected patients were equally divided into Group I (n=30) and Group II (n=30). Further both groups were divided into IA (n=10), IB (n=20), IIA (n=10) and IIB (n=20). 2% Dorzolamide hydrochloride in Group IA and IIA and 0.5% Timolol maleate in Group IB and IIB was administered for 24 weeks. Patients were evaluated for general and ocular examinations on day of enrolment and then at the end of 1st, 4th, 8th and 24th week. Adverse effects of the drug during study period were also noted. Mean±SD, t value, p value and comparison between groups were analysed by graph pad software.Results: At the end of 24 weeks difference in mean reduction of IOP was not significant with 6.2±1.85mm Hg (Right eye) and 5.55±1.68mm Hg (left eye) and 4.72±2.97mm Hg (Right eye) and 5.37±1.24mm Hg (left eye) in Group IA and Group IIA respectively. At the end of 24 weeks difference in mean reduction of IOP was not significant with 5.06±1.62mm Hg (Right eye) and 4.40±1.96mm Hg (left eye) and 4.30±1.41mm Hg (Right eye) and 4.12±2.08mm Hg (left eye) in Group IB and Group IIB respectively. Fall in both systolic and diastolic blood pressure in both the groups were significant. Both drug regimens were well-tolerated, and no serious drug-related adverse effects were reported.Conclusions: Dorzolamide was more efficacious for reduction of intra ocular pressure, well-tolerated, had low allergic response and had a favourable ocular, cardiovascular and respiratory safety profile than Timolol.

Analysis of the variations in price of anti-glaucoma eye preparations available in Indian pharmaceutical market

Background: The aim of the study was to analyze the percentage cost variations among different brands of the commonly prescribed anti–glaucoma drugs.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition Drug Today April to June 2018 Vol-1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of each eye drop was calculated. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for anti-glaucoma eye preparations marketed in india was found to be eye drop timolol maleate (0.5%) of 5 ml:263.63, eye drop dorzolamide (2%) of 5 ml:9.77, eye drop pilocarpine (2%) of 5 ml:160.40, eye drop Betaxolol (0.5%) of 5 ml:56.54, eye drop Latanoprost (50 mcg/ml) of 2.5ml:135.88, eye drop Brimonidine tartarate (0.15%) of 5 ml:183.9, eye drop Levobunolol (5 mg/ml) of 5 ml:32.38.Conclusions: Glaucoma is the most common ocular disease and eye drops are to be prescribed for prolonged period. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy

Study of price variations of anti-epileptic drugs available in different brands in Indian pharmaceutical market

Background: To analyze the cost ratio and percentage cost variations in different brands of the commonly prescribed anti-epileptic drugs available in Indian pharmaceutical market.Methods: The maximum and minimum price of each brand of the drug given in INR was noted by using CIMS January to April 2018 edition and drug today April to June 2018 Vol-1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of one bottle in case of 100ml syrup and 10 tablets/capsules was calculated in case of oral drugs and the cost of one 1 vial or ampoule was noted in case of injectable drugs. At last the cost ratio and percentage cost variation of various brands was compared.Results: After calculation of cost ratio and percentage cost variation for each brand of anti-epileptic drug tablet clonazepam (2mg) shows highest cost ratio and percentage cost variation as: 10.41 and 941.66, carbamazepine (200mg SR tablet) shows lowest cost ratio and percentage cost variation as: 1.09 and 9.32.Conclusions: Epilepsy is the most common neurological disorder and Epileptic drugs are to be prescribed for prolonged period. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. There is a wide difference in the cost of different brands of anti-epileptic drugs available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy

Cost variation analysis of proton pump inhibitors available in Indian market

Background: In now days proton pump inhibitors are prescribing more and more by Indian physicians not only in peptic ulcer,gastroesophageal reflux disease, gastritis but also along with non steroidal anti-inflammatory drugs to overcome the side effects as gastric irritation and discomfort by non steroidal anti inflammatory drugs.There are many brands of PPI drugs available in Indian market. Costly drugs can lead to economic burden which results in decreased compliance or even non-compliance. Non –compliance leads to incomplete treatment which tends to increase morbidity.Increase in the patient medication cost was found to associated with decreased adherence to prescription medication.Hence this study was done to assess the cost variation of proton pump inhibitors [PPI] drugs.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition Drug Today April to June 2018 Vol-1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of 10 tablets/capsules was calculated in case of oral drug and the cost of one 1 vial or ampoule was noted in case of injectable drug. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for proton pump inhibitors marketed in india was found to be tablet/capsule Esomeprazole [20mg]:141.17, tablet/capsule Esomeprazole [40mg]:196.29, capsule/tablet Omeprazole[20mg]: 569.53, Tablet/capsule Pantoprazole[40mg]: 248.8, tablet /capsule Rabeprazole[20mg]: 815.78, capsule/tablet Lansoprazole[30mg]: 173.33, Inj. Esomeprazole [40mg] 1 vial: 81.81, Inj. Omeprazole[40mg] 1vial: 47.95, Inj. Pantoprazole[40mg] 1vial: 66.66, Inj.Rabeprazole [20mg] 1vial: 176.625.Conclusions: Tablet Rabeprazole[20mg] shows highest cost ratio and percentage cost variation as 9.15 and 815.78. While Inj. Omeprazole[40mg] 1 vial shows lowest cost ratio and percentage cost variation as 1.47 and 47.95

Study of price variation analysis of fluoroquinolones eye drops manufactured by various pharmaceutical companies in India

Background: Fluoroquinolone eye drops is being prescribed by Opthalmologist in many ocular diseases as conjunctivitis, keratitis, bacterial corneal ulcers etc in more and more amount. There are many brands of fluoroquinolones drugs available in Indian market. Costly drugs can lead to economic burden on patients. Modifications in pharmaceutical policy are required, and prices of the drug should be controlled in effective way for all the drugs. Hence this study was done to assess the cost variation of fluoroquinolones opthalmic solutions available in Indian market.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2020 edition and Drug Today April to June 2020 volume 1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of each eye drop was calculated. At last the cost ratio and percentage cost variation of various brands was compared.Results: Percentage variation in cost for fluoroquinolones eye preparations marketed in India was found to be Eye drop Ciprofloxacin (0.3%) of 5 ml:210.39, Eye drop Ciprofloxacin (0.3%) of 10 ml:162, Eye drop Gatifloxacin (0.3%) of 5 ml:156, Eye drop Moxifloxacin (0.5%) of 5 ml:196.95, Eye drop Ofloxacin (0.3%) of 5 ml:245.16, Eye drop Ofloxacin (0.3%) of 10 ml:62.5, Eye drop Norfloxacin (0.3%) of 5 ml:120.68, Eye drop Sparfloxacin (0.3%):8.31, Eye drop Lomefloxacin (0.3%):16.17.Conclusions: There is a wide difference in the cost of different brands of fluoroquinolones eye preparations available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy

The comparative effects of oral famotidine and lansoprazole in prophylaxis of aspirin induced peptic ulcer in albino rat

Background: Peptic ulcer is defined as any break in the continuity of gastric or duodenal epithelial layer. There are mainly three factors which are responsible for peptic ulcer disease which are Helicobacter pylori infections, NSAIDs and stress. Famotidine is H2 receptor blocker and Lansoprazole is proton pump inhibitor which are used prophylactically in aspirin induced peptic ulcer.Methods: The experimental work was carried out on albino rat. Experiment was carried out with two ulcer protecting agents e.g-famotidine, lansoprazole and one ulcer producing agent Aspirin. Each ulcer protecting drug was used separately but simultaneously with aspirin to see their ulcer protecting efficacy. There was three groups of animals each consisting of ten albino rats. Ist group was control group which was given aspirin only.2nd group was given aspirin+famotidine, 3rd group was given aspirin+lansoprazole.Results: The prophylactically ulcer preventing activity was the most with lansoprazole and least with famotidine.Conclusions: Finally, all the two drugs like famotidine, lansoprazole prevented the ulcerogenic effects of Aspirin effectively, although not completely

Students’ attitudes on personal drug selection exercise in writing prescription

Background: This study was developed to know the students’ views regarding personal drug (P-drug) concept in rational prescription of drugs and also giving them training of creating and using personal drug concept.Methods: 40 medical students (5th semester) divided in four groups were involved voluntarily in a three phase, questionnaire based and prospective study. In first and second phase students were taught and asked to derive P-drug using different standard text books and Current Index of Medical Specialties (CIMS) by analyzing efficacy, safety, cost and convenience of drugs used for type II diabetes mellitus. Third phase was designed to know the students’ perception regarding the exercise and difficulties faced in the process of P-drug selection. It contained demographic and 12 questions with answer using Likert scale.Results: Students selected biguanide (metformin) as a P-drug in terms of efficacy, safety, cost and convenience. 95% (36 out of 40) responded in the questionnaire, out of which 92% (33 out of 36) had given answer with mean score ≥4. Overall median score was 4 and Interquartile Range was 4-5. 89% (32) strongly agreed that P-dug selection teaching helped them to understand pharmacology better. Majority (83% or 30) were in favour of introducing P-drug selection exercises in undergraduate pharmacology curriculum.Conclusions: P-drug selection exercise helped students to understand the differences among various drugs used for the treatment of type II diabetes mellitus and given them a strong foundation for developing rational use of the medicine in their future career as a doctor

Study of the comparative effects of fluoxetine and ziprasidone in albino rats by using tail suspension test model

Background: Depression is a group of disorders results from a combination of multiple etiologic factors- genetic, biochemical, psychodynamic and socio-environmental. A depression consists of following clinical features as sadness, apathy, changes in sleep pattern, impaired concentration, feeling of shame or guilt and thoughts of dying or death. Fluoxetine and Ziprasidone both are used for the treatment of Depression in human being. Fluoxetine is Selective serotonin reuptake inhibitors (SSRI) and Ziprasidone is atypical antipsychotic.Methods: Healthy male albino rats weighing between 150-200 grams were taken for the present study. Study animals were divided into three groups randomly with each group consisting of ten animals. Drugs were powdered with help of mortar and pestle and mixed in gum acacia solution. Appropriate volume of the freshly prepared solution was administered orally daily between 9 am to 10 am to all animal as per their individual body weight. Group A administered 1ml of 0.9% normal saline orally and serves as control group. Group B administered 0.4 mg of fluoxetine orally. Group C administered 1.6 mg of ziprasidone orally. Animals were evaluated for antidepressant activity using two models – Tail suspension test and Forced swimming test.Results: The results in the tail suspension test were assessed by duration of immobility in 6 minutes duration. Antidepressant activity is indicated by the reduction in the duration of immobility i.e. lesser the duration indicates more effectiveness of the drug.Conclusions: There is significant difference in antidepressant activity of fluoxetine with antidepressant activity of ziprasidone.