Pharmacoeconomics of allergic rhinitis drugs treatment in tertiary care hospital

Background: Allergic rhinitis also called hay fever; it is a very common in India. Harmless exposing substances cause an allergic reaction. Allergic rhinitis is of the two types, one is the seasonal occurred with the change of seasons, second is the perennial means any time during the year.Methods: This was a cross-sectional study to determine the cost analysis allergic rhinitis drugs used in treatment of ENT OPD in a tertiary care teaching hospital, Kamothe, Navi Mumbai. The patients were interviewed; prescriptions were analyzed number of medicines prescribed.Results: Incidence of polypharmacy two drugs per prescriptions were prescribed 140 and three drugs per prescriptions 60. In the total number of 200 prescriptions, the cost of 43 prescriptions were in between 251-300 Indian rupees and 18 prescriptions were 301-350 Indian rupees. Patient knowledge about the drug use in this study, out of 200 pts 37% of allergic rhinitis patients knew the correct dosage of the prescribed drugs while 63% were not aware.Conclusions: Majority of the participants drugs were prescribed two to three drugs, per prescription cost was high because all the drugs prescribed by brand name and no drugs were prescribed by generic name. Improvement in knowledge about generic medicines is important factor to prefer generic medicine. Reduction in cost of drug will improve compliance

Pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis

There are no available pharmacokinetic data to guide piperacillin dosing in critically ill Australian Indigenous patients despite numerous reported physiological differences. This study aimed to describe the population pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis. A population pharmacokinetic study of Indigenous patients with severe sepsis was conducted in a remote hospital intensive care unit. Plasma samples were collected over two dosing intervals and assayed by validated chromatography. Population pharmacokinetic modeling was conducted using Pmetrics. Nine patients were recruited, and a two-compartment model adequately described the data. The piperacillin clearance (CL), volume of distribution of the central compartment (V-c), and distribution rate constants from the central to the peripheral compartment and from the peripheral to the central compartment were 5.6 +/- 3.2 liters/h, 14.5 +/- 6.6 liters, 1.5 +/- 0.4 h(-1), and 1.8 +/- 0.9 h(-1), respectively, where CL and Vc were found to be described by creatinine clearance (CLCR) and total body weight, respectively. In this patient population, piperacillin demonstrated high interindividual pharmacokinetic variability. CLCR was found to be the most important determinant of piperacillin pharmacokinetics

Optimising meropenem dosing in critically ill Australian Indigenous patients with severe sepsis

Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography. Concentration-time data were analysed with data from a previous PK study in critically ill Caucasian patients using Pmetrics. The population PK model was subsequently used for Monte Carlo dosing simulations to describe optimal doses for these patients. Six Indigenous and five Caucasian subjects were included. A two-compartment model described the data adequately, with meropenem clearance and volume of distribution of the central compartment described by creatinine clearance (CLCr) and patient weight, respectively. Patient ethnicity was not supported as a covariate in the final model. Significant differences were observed for meropenem clearance between the Indigenous and Caucasian groups [ median 11.0 (range 3.0-14.1) L/h vs. 17.4 (4.3-30.3) L/h, respectively; P < 0.01]. Standard dosing regimens (1 g intravenous every 8 h as a 30-min infusion) consistently achieved target exposures at the minimum inhibitory concentration breakpoint in the absence of augmented renal clearance. No significant interethnic differences in meropenem pharmacokinetics between the Indigenous and Caucasian groups were detected and CLCr was found to be the strongest determinant of appropriate dosing regimens. Crown Copyright (C) 2016 Published by Elsevier B.V. All rights reserved

Evaluation of pharmacokinetic and pharmacodynamic interaction between repaglinide and atazanavir in healthy, diabetic and hepatic impaired rats: possible inhibition of CYP3A, OATP, and P-glycoprotein transporters

The metabolic syndrome in HIV infected patients is particularly associated with the use protease inhibitors. Atazanavir is an inhibitor of the cytochrome P 450 (CYP) system, in particular CYP3A4 and CYP2C9 which can affect the metabolism of several drugs. To treat metabolic syndrome in HIV patients repaglinide is used and it is a short acting insulin secretagogues undergoing metabolism with CYP 3A4 and CYP 2C8 enzyme system. The purpose of this study was to assess the possible pharmacokinetic and pharmacodynamic drug interaction of repaglinide and atazanavir in healthy, diabetic and impaired hepatic function rats. Human oral therapeutic doses of atazanavir and repaglinide were extrapolated to rats based on the body surface area. The pharmacokinetic parameters and blood glucose concentrations of repaglinide were determined after oral administration of repaglinide alone (0.5 mg/kg) and in the presence of atazanavir (36 mg/kg) in normal, diabetic and hepatic impaired rats. The pharmacokinetics (PK) and blood glucose concentrations of repaglinide were significantly altered in the presence of atazanavir. The peak plasma concentration (Cmax), area under the plasma concentration time profile (AUC) and elimination half-life of repaglinide were significantly (P<0.0001) increased. The repaglinide clearance (CL) was significantly (P<0.0001) decreased in the presence of atazanavir treatment. In the presence of atazanavir, repaglinide hypoglycaemic activity was increased significantly (P<0.0001) when compared with the repaglinide control group. The present study demonstrated the significant difference in the PK/PD changes due to the enhanced bioavailability and decreased total body clearance of repaglinide may be due to the inhibition of the CYP P450 metabolic system, OATP and P-gp transporters by atazanavir

Community prevalence of methicillin and vancomycin resistant Staphylococcus aureus in and around Bangalore, southern India

INTRODUCTION: Staphylococcus aureus is a known colonizer in humans and has been implicated in community acquired soft tissue infections. However emergence of methicillin resistant S. aureus (MRSA) has aroused great concern worldwide. This study aimed to determine the prevalence of MRSA in the community of Bangalore, southern India. METHODS: Swabs were collected from anterior nares, forearm, dorsum and palm of the hands of 1,000 healthy individuals residing in and around Bangalore, belonging to different socioeconomic strata and age groups. RESULTS: Analysis verified that 22.5% and 16.6% of the individuals presented Staphylococcus aureus and MRSA, respectively, at any of the three sites. Vancomycin resistance was observed in 1.4% of the S. aureus isolates, which was confirmed by detection of the vanA gene. It was interesting to note that 58.8% of the children in the age group 1-5 years-old presented MRSA, the highest percentage compared to other age groups of < 1 (44.4%) year-old, 5-20 (21.7%) years-old, &gt; 40 (11%) years-old and 20-40 (9.9%) years-old. Among the population of various socioeconomic strata, maximum MRSA colonization was observed among doctors (22.2%), followed by upper economic class (18.8%), lower economic class (17.7%), apparently healthy hospital in-patients (16.5%), nurses (16%) and middle economic class (12.5%). Most of the MRSA isolates were capsular polysaccharide antigen type 8 (57.1%). CONCLUSIONS: There is a need for continuous surveillance and monitoring of the presence of MRSA in the community and a clearer understanding of the dynamics of the spread of MRSA will assist in controlling its dissemination

Mollusk-Inspired 3D Printing of Polycarbonate via Fused Deposition Modelling

Mollusk-Inspired 3D Printing of Polycarbonate via Fused Deposition Modellin

Contrasting Effects of Laser Shock Peening on Austenite and Martensite Phase Distribution and Hardness of Nitinol

Laser shock peening of cold rolled Nitinol was carried out at high power density (7 and 9 GW/cm2) and high overlap ratio (90%). Tensile surface residual stresses were generated in the peened material. An enhancement in surface microhardness from 351 for unpeened material to 375 and 394 VHN for the 7 and 9 GW/cm2 samples, respectively, was also observed. However, at a depth of 50 μm, the hardness of the peened material was lower than that of the as-received material. These contrasting observations were attributed to the change in the austenitic phase fraction brought about by laser interactions