A study of adverse drug reactions among elderly patients in a tertiary care hospital

Background: Adverse drug reactions are major setback in the advancement of current therapeutic modalities and safe treatment becomes a challenge in elderly patients. Multifarious health issues in elderly patients require assorted groups of drugs leading to prominent ADRs (Adeverse drug reactions). This study was designed to analyse the most affront drug group causing ADRs among elderly patients and the most frequent signs and symptoms of ADR in tertiary care hospital.Methods: All elderly inpatients aged 60 years and above were included in the study. Clinical pharmacist monitored and reported ADRs which were analysed by pharmacologist and physicians. The drugs causing ADRs were identified and different signs and symptoms of ADR were evaluated.Results: A total of 810 (7.26%) ADRs were reported from 11157 inpatients. Out of 810 ADRs reported 320 (39.5%) ADRs were among elderly patients. ADR analyses showed a sight male predominance among elderly patients. Antibacterial agents were the most offended drug group contributing for 18.76% of ADR’s. Gastointestinal tract was the most frequently affected system with maximum number of ADRs 102 (31.88%).Conclusions: ADRs are major threat to hospitalized elderly patients. The risk of ADRs can be reduced by dosing the drug according to the age of the patient and by close monitoring of patients

Stimulation of cannabinoid receptor agonist 2-arachidonylglycerol by chronic ethanol and its modulation by specific neuromodulators in cerebellar granule neurons

AbstractIn an earlier study, we reported that chronic ethanol (EtOH) stimulates the formation of anandamide in human SK-N-SH cells. In the present study, we investigated the effect of chronic EtOH on the formation of yet another cannabinoid receptor (CB1) agonist, 2-arachidonylglycerol (2-AG), in cerebellar granule neurons (CGNs). The formation of 2-[3H]AG without any stimulation was more pronounced in the older cultures than in younger cultures. Exposure of CGNs to EtOH led to a significant increase in the level of 2-[3H]AG (P<0.05). Incubation with the anandamidehydrolase inhibitor phenylmethylsulfonyl fluoride and EtOH did result in an additive increase in 2-[3H]AG, but did not with E-6-(bromomethylene)tetrahydro-3-(1-naphthelenyl)-2H-pyran-2-one. The formation of 2-[3H]AG was enhanced by ionomycin in both the control and EtOH-exposed CGNs, and the ionomycin-stimulated 2-[3H]AG synthesis was inhibited by the intracellular chelating agent 1,2-bis(2-aminophenoxy)ethane-N,N,N′,N′-tetraacetic acid. Further, glutamate increased the formation of 2-[3H]AG only in control CGNs. MK-801 inhibited the EtOH-induced 2-[3H]AG synthesis, suggesting the participation of intracellular Ca2+ in EtOH-induced 2-[3H]AG synthesis. The dopamine receptor (D2) agonist did not modify the 2-AG synthesis in either the control or EtOH-exposed CGNs. However, the D2 receptor antagonist inhibited the EtOH-induced formation of 2-[3H]AG. The EtOH-induced 2-[3H]AG formation was inhibited by SR141716A and pertussis toxin, suggesting the CB1 receptor- and Gi/o-protein-mediated regulation of 2-AG. The observed increase in 2-AG level in CGNs is possibly a mechanism for neuronal adaptation to the continuous presence of EtOH. These findings indicate that some of the pharmacological actions of EtOH may involve alterations in the endocannabinoid signaling system

A retrospective study of Adverse Drug Reactions in a tertiary care centre

Background: Adverse drug reactions (ADRs) are a major concern in present day clinical practice. They are inevitable consequences of drug therapy; as no pharmacotherapeutic agent is completely free from noxious and unintended effects. They are major contributors for morbidity, mortality and hospitalization of the patients increasing the economic burden on the society and uncertainty in clinical outcomes.Methods: This was a retrospective observational study, extending over 6 months (September 2016 to February 2017). A total of 290 cases were studied, excluding the geriatric age group. The data was collected using CDSCO ADR reporting form. A comparison of ADR between males and females was made; based on the organ system affected and the category of drug using “proportion test”.Results: The study showed the ADR incidence was equal in both sexes (≈50%). It was observed that majority ADRs were from gastro intestinal system (39%) followed by CNS (20%) and skin and soft tissue (14%). Constipation was found to be the most common of the reported ADRs (18%) followed by vomiting (9%) and diarrhoea (8%).Conclusions: ADRs are a major cause of morbidity worldwide. Several studies; including the present one, has shown GIT to be the most common system affected. Frequency of ADRs can be reduced by careful follow up and a robust hospital based pharmacovigilance setup

Adverse drug reactions in hospitalized paediatric patients in a tertiary care center in Kerala, India

Background: Drug safety information about children is scarcely available. This study aims to describe the ADRs in hospitalized paediatric patients under 12 years of age in paediatrics wards of DM WIMS Hospital, Wayanad, Kerala, a tertiary care center in southern part of India.Methods: A retrospective study based on data collected as per the ongoing pharmacovigilance program of India (PvPI) was conducted for twelve months period in order to study the ADRs in hospitalized paediatric patients under 12 years of age with at least one medication prescribed. The study was conducted in paediatrics wards of DM WIMS Hospital, Wayanad. WHO-UMC scale and Naranjo´s Algorithm was used to evaluate causality, the modified Hartwig and Siegel assessment scale was used to establish severity and the Schumock and Thornton criteria was used to determine preventability.Results: Forty-two children (42) who experienced 55 ADRs were included in the study. The frequency was higher in children under 1 year of age (47.62%). Emergence of ADRs was higher in male patients (59.52%), in those used three or more medicines together (71.43%) and in those with systemic antibiotics (58.18%).Conclusions: Being the first study from Kerala in paediatric patients, it is an important contribution to drug safety profile in children from this region of India. ADRs frequency and other descriptive characteristics are provided for the enrolled children under 12 years of age. ADRs are an additional burden of morbidity and risk, particularly in those who used several medicines, including antibiotics

Solanum tuberosum L: Botanical, Phytochemical, Pharmacological and Nutritional Significance

Solanum tuberosum commonly known as potato belongs to solanaceae family. The whole part of potato plant including leaves; tuber, peel and juice are used in traditional medicine. A number of pharmacological activities of potato have been reported viz. Antioxidant, anticancer, antiallergy, antibacterial, anti-inflammatory, antiobesity, anti-ulcer activity. Potato contains Phenolic acids, anthocyanin, flavonoids, vitamin B6, vitamin B3, pantothenic acid, potassium, manganese, phosphorous; copper and fibres. The medicinal properties, traditional uses, nutritional value, phytochemical constituents, taxonomy, geographic origin and distribution have been mentioned in this present review to provide collective data for multipurpose benefits.

Research Journal of Pharmaceutical, Biological and Chemical Sciences Silent Myocardial Infarction in Type 2 Diabetes Mellitus: Prevention Is Prudent Than Diagnosis and Management

ABSTRACT About 21% of diabetic patients develop Silent Myocardial Infarction (SMI). A long term survival rate after SMI is poor over the next 6-7 years. In view of lack of symptoms like chest pain, it is not easy to diagnose SMI. Presence of Q wave in Electro cardio graphy (ECG) alone may suggest a SMI and in many cases Q wave disappears after sometime. ECG is considered as poor investigation technique for diagnosis of SMI. SMI is diagnosed objectively using very expensive investigations such as thallium perfusion imaging. Hence, to prevent the disastrous consequences of SMI it is prudent to assume that all type 2 diabetic patients above the age of 50 years as suffers of Coronary artery disease (CAD) and they should be started with established cardioprotective pharmacological regimen comprising antiplatelet agents, lipid lowering agents and ACE inhibitors. In addition it has been shown that patients with diabetic retinopathy are more prone for CAD and coronary artery bypass graft (CABG) offers them better survival rate. Further, oral hypoglycemic drugs such as acarbose and glimepiride which have been shown to have favorable effect on CAD, should be liberally used. In addition, advice to patients on the importance of fiber rich, low glycemic, vegetable protein diet and exercise should be part and parcel of management of diabetes

Diet and nutrition strategies for cancer prevention: A comprehensive review

Maintaining a healthy diet is crucial for preventing cancer, as it provides the essential nutrients needed for proper physiological functioning. It is predicted that simple lifestyle and dietary changes can lessen the risk of developing 30-40% of all malignancies. Obesity, the consumption of nutrient-deficient foods such as sugary and refined flour products, which can lead to impaired glucose metabolism and, eventually, diabetes, a lack of dietary fiber, an excess of red meat, and an imbalance in the consumption of omega-3 and omega-6 fats are all risk factors for cancer. To reduce your risk of cancer, include flax seeds, a variety of fruits and vegetables, and dietary fiber in your diet. Additionally, there is proof that nutritional supplements may help lower the risk of breast cancer recurrence. To prevent various types of cancer, it is important to include vegetables, fruits, whole grains, and specific fatty acids in your diet, alongside engaging in regular physical exercise. Furthermore, it is crucial to use advances in genetics and molecular biology to extend nutritional research from observational studies to demonstrating causative linkages. Cancer prevention strategies that involve dietary changes targeted at specific groups should be based on a thorough understanding of these fundamental principles. Such dietary methods can be effective as well as in cancer prevention but also cancer rehabilitation. This review investigates the relationship between cancer and diet, examines straightforward approaches to incorporating cancer-preventive foods into one’s diet, investigates the impact of dietary variables and lifestyle choices on the risk of cancer, and investigates clinical studies focused on nutrition and cancer prevention

Role of Vitamin A and Vitamin D in management of polycystic ovary syndrome

Polycystic ovarian syndrome (PCOS), a very common cause of infertility in reproductive age groups, has increased exponentially in the past few years registering 9% of cases annually worldwide. It is one of the most common syndromes which manifests hormone secretion and its activity. Insulin resistance, obesity, Vitamin and mineral deficiency, etc., are commonly associated with PCOS. Vitamin A is a lipid-soluble vitamin that is useful in antioxidant activity and steroid synthesis is known to prevent the occurrence of PCOS. Vitamin D, a steroid hormone originating from cholesterol is commonly known as “the sunshine vitamin,” is also one of the observed vitamin deficiencies in PCOS women. Supplementation of Vitamins in the diet is essential in the management of PCOS women. This review attempts to brief the role of Vitamin A and Vitamin D as an important agent to overcome the challenges of PCOS by reviewing the investigations of various authors about the potential role of supplementation of Vitamin A and Vitamin D in various model organisms and Randomised Clinical Trials (RCT’s)

Myocardial infarction protective effect of xyloglucan on Drosophila melanogaster: A review

Myocardial infarction, more often known as cardiac arrest, occurs when the supply of blood to the heart’s coronary artery decreases or ceases, causing damage to the heart muscle. Xyloglucan is a plant polysaccharide. Xyloglucan has been proven in several studies utilizing model organisms to reduce the risk of coronary heart disease by avoiding post-occlusion phases inhibiting apoptosis and enhancing energy metabolism. Many studies utilize Drosophila melanogaster because its SRY-related HMG-box 5 (SOX5) gene encodes a SOX family transcription factor; the human SOX5 ortholog, Sox102F, is well conserved in Drosophila melanogaster. Suppressing Sox102F in flies resulted in significant heart dysfunction, structural defects, and a disturbance in notch signal transduction. This demonstrates that SOX5 serves an important functional part in the heart and that variations in SOX5 concentrations may contribute to the possibility of myocardial infarction. Xyloglucan activity is significant in myocardial infarction and may be lowered in the myocardium after H/R damage by stimulating Notch signaling, which may benefit myocardial survival, angiogenesis, and cardiac function. This review discusses the roles of the human SOX5 and Drosophila SOX102F genes, the notch signaling system, and how xyloglucan in tamarind seeds may defend against heart damage by preventing apoptosis along with improving energy metabolism

SPECIAL ISSUE ARTICLE ROLE OF THE ENDOCANNABINOID SYSTEM IN THE DEVELOPMENT OF TOLERANCE TO ALCOHOL

Abstract — The present review evaluates the evidence that the endocannabinoid system plays in the development of tolerance to alcohol. The identification of a G-protein-coupled receptor, namely, the cannabinoid receptor (CB 1 receptor), which was activated by ∆ 9-tetrahydrocannabinol ( ∆ 9-THC), the major psychoactive component of marijuana, led to the discovery of endogenous cannabinoid agonists. Until now, four fatty acid derivatives identified to be arachidonylethanolamide (AEA), 2-arachidonylglycerol (2-AG), 2-arachidonylglycerol ether (noladin ether) and virodhamine have been isolated from both nervous and peripheral tissues. Both AEA and 2-AG have been shown to mimic the pharmacological and behavioural effects of ∆ 9-THC. The role of the endocannabinoid system in the development of tolerance to alcohol was not known until recently. Recent studies from our laboratory have implicated for the first time a role for the endocannabinoid system in development of tolerance to alcohol. Chronic alcohol treatment has been shown to down-regulate CB 1 receptors and its signal transduction. The observed downregulation of CB 1 receptor function results from the persistent stimulation of the receptors by AEA and 2-AG, the synthesis of which has been shown to be increased by chronic alcohol treatment. The enhanced formation of endocannabinoids may subsequently influence the release of neurotransmitters. It was found that the DBA/2 mice, known to avoid alcohol intake, have significantly reduced CB 1 receptor function in the brain, consistent with other studies in which the CB 1 receptor antagonist SR 141716A has been shown to block voluntary alcohol intake in rodents. Similarly, activation of the CB 1 receptor system promoted alcohol craving, suggesting a role for the C