Self medication: need for increased awareness among general population

In a recently published study Sugumar R et al evaluated self medication prevalence in primary dysmenorrhea in India. The results of the study prompted me to write regarding drug induced issues with self medication in primary dysmenorrhea and other diseases in general. The results of this study give some insights on the self medication pattern in primary dysmenorrhea among urban Indian women. The authors have highlighted the high prevalence (42%) along with inappropriate self-medication practices in a large number of participants. Inappropriate self-medication practices inadvertently pose the patient to both the risk of lack of efficacy in case of sub-therapeutic dose as well as adverse events in case of excess than recommended dose. Mefenamic acid, a nonsteroidal anti-inflammatory drugs (NSAID) or its combination i.e. mefenamic acid + dicyclomine was used by close to one third (35%) of study population consumed mefenamic acid containing product for treatment for primary dysmenorrhea. NSAIDs can cause adverse events; it is important to point out some of the reported findings related respiratory, renal and gastrointestinal safety of mefenamic acid

Self medication: a potentially avoidable cause of antibiotic misuse and resistance

I read the article by Chawla S et al on buying patterns of drugs from pharmacies in Northern India with interest. Overall self medication was reported by close to one third (35.7%) study population. The results prompted me to write about burden of antibiotic self medication and measures to tackle this serious issue.Self medication with antibiotics is concern not only in India; several studies from different parts of world have shown antibiotics being misused and commonly consumed without prescription

Advantages of modified drug delivery system in psychiatry

Non-compliance is a common problem in chronic diseases including psychiatric disorders. Various attempts have been made for improving adherence in psychiatry; one of them being simplifying dosage regimen by designing modified dosage formulation. For example, depot formulation, oral disintegrating tablets or extended release formulations are some of the strategies for improving compliance in psychiatry patients. Modified dosage formulations also have some other advantages too. For example, oral disintegrating tablet of olanzapine cause lesser weight gain compared to standard olanzapine tablet while Zolpidem extended release tablet provides better sleep maintenance in middle of night. This article reviews some of the modified dosage formulations in psychiatric diseases with their advantages

Sleep disturbances in allergic rhinitis: disease and/or the drug?

Allergic rhinitis is a common chronic disease in adults as well as children. Allergic rhinitis has negative impact on sleep and quality of life of the patient. Antihistamines are widely used in the management of allergic rhinitis. First generation antihistamines cause sedation and drowsiness. Second generation antihistamines cause minimal or no sedation. There is difference in propensity to cause sedation amongst second generation antihistamines. As sleep is important for physical as well as mental health, present article reviews impact of allergic rhinitis and antihistamines on sleep

Adverse drug reaction (ADR) reporting in India: a long way to go

New drugs are regularly introduced for treatment, diagnosis or prevention of diseases. Adverse drug reactions (ADR) can be seen in clinical practice with both new as well as marketed medicines. Spontaneous reporting of ADR is commonly practiced method for monitoring of ADR. Healthcare practitioners have an important role in pharmacovigilance and ADR reporting. Many studies have been conducted to understand the knowledge, attitude and practice of ADR reporting among healthcare practitioners in India. The population surveyed in these studied ranged between 90-1200. One large study4 included population of 1200 physicians across India out of which 1000 were contacted for study participation

Efficacy and safety of blonanserin versus other antipsychotics: a review

Although many atypical antipsychotics are available, there is a need of an atypical antipsychotic effective in all symptom domains of schizophrenia and well tolerated especially for side effects like extrapyramidal side effects, weight gain and blood prolactin elevation. Blonanserin is an atypical antipsychotic which blocks dopamine D2 and serotonin 5HT2A receptors. Its efficacy and safety has been studied in patients with schizophrenia and delirium. Blonanserin is found to be effective and well tolerated in both conditions. This article has reviewed efficacy and tolerability of blonanserin in these two psychiatry diseases

DRUG UTILIZATION STUDY IN THE ORTHOPEDICS OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN MAHARASHTRA

Objective: The objective of this study was to analyze the pattern of drug utilization in outpatients of orthopedics department from a tertiary care hospital.Material and Methods: In this retrospective study, prescriptions of randomly selected patients attending orthopedics clinic were screened to analyze a number of medicines per prescription. Number and percentages of prescribed medicines were calculated.Results: In this study, 512 patients (male 260 [50.8%] and females 252 [49.2%]) were included in the study. The total number of prescribed medicines was 1562, accounting for 3.1 medicines per patient. A total number of oral, parenteral, and topical medicines were 1375 (88%), 176 (11.3%), and 11 (0.7%), respectively. Nonsteroidal anti-inflammatory agents (NSAIDs), antacid/anti-ulcerants, and antimicrobial agents were 641 (41%), 371 (23.8%), and 102 (6.5%), respectively. A total of 54 (52.9%), 29 (28.4%), 9 (8.8%), 6 (5.9%), 3 (2.9%), and 1 (1%) patients were prescribed fluoroquinolones, beta-lactam antibiotics, metronidazole, trimethoprim plus sulfamethoxazole, macrolides, and doxycycline, respectively. For 371 (23.8%) patients, anti-ulcerant and antiulcer were prescribed, among which ranitidine was the most common prescription [353 (95.1%)]Conclusion: Number of medicines prescribed per patient in orthopedic clinic was 3.1. NSAIDs and antacid/anti-ulcerants were the most commonly prescribed medicines

Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

Objective: To examine pattern of lepra reaction andmedicines used in the treatment of lepra reactions in a tertiary hospital.Material methods: In this retrospective study, prescriptions of patients treated for the lepra reactions were reviewed to find out prevalence of type 1 and type 2 reactions and medicines used in the treatment of lepra reactions.Results:A total of66 patients (male 59.1%; female 40.9%) with mean age of 36.6 (+13.1) years were included in the study. Multibacillary leprosy was present in 93.7% patients.  A total of 39 (60%) patients had type 2 reaction whereas 26 (40%) had type 1 reaction. Mean number of medicines per patients was 7.5. Prednisolone was used in 62 (93.9%) patients with mean duration of 33.32 (+33.2) days whereas chloroquine was used in 52 (78.8%) patients for 36.6 (+27.9) days. Thalidomide was used in 25 (37.9%) patients. Analgesic and anti-inflammatory and anti-acidity drugs were used in 63 (95.4%) patients each whereas paracetamol was given to 41 (62.1%) patients. Antihistamine, antimicrobial agent and vitamins were given to 27 (40.9%), 27 (40.9%) and 35 (53.0%) patients respectively.Conclusion:Lepra 2 reaction is more common than lepra 1 reaction.  Prednisolone and chloroquine are the two most commonly used medicines in the treatment of lepra reaction. Similarly, thalidomide, older drug has emerged as common treatment for lepra reaction

Use of information technology in healthcare sector for improving outcomes

With revolutionary success of internet and mobile usage in India, use of information technology for healthcare promotion by pharmaceutical industry and other healthcare sectors is increasing. Information technology provides an unlimited opportunity for promoting correct healthcare practices for prevention of certain diseases, providing information for maintaining health and other suitable information to the expected target audience. Information technology provides numerous advantages including extended reach, quick dissemination of facts, providing unlimited amount of information and also eliminates the need of large number of manual resources. There is enormous potential for improving the awareness about healthcare through digital media and information technology. However, with its increasing usage, there are some challenges, responsibilities and precautions which need to be considered while using information technology as a resource for healthcare promotion. This article discusses the use of information technology in healthcare promotion along with the challenges in its usage

Fiction contract: its importance in simulation-based medical education

Simulation-based education has become an integral part of education and training in high-risk professions and disciplines such as aviation, aerospace, military, nuclear power plants, medicine and healthcare. In the last decade, medical simulation has globally emerged as a powerful instructional technique across various specialties and disciplines. Despite its increasing popularity and various advantages, simulation-based medical education (SBME) poses a unique challenge, that is, realism. This is where the concept of fiction contract or suspension of disbelief comes into the picture. In this article we provide an overview of fiction contract in SBME including how can it be effectively addressed during training