Chronopharmacology and drug prescribing pattern of physicians in a tertiary care hospital of North India

Background: Chronopharmacology is the science dealing with the optimization of drug effects and the minimization of adverse effects by timing medication in relation to the biological rhythm. This concept came into picture to make us understand about periodic and predictable changes in both desired effects and tolerance of medication Chronotherapeutics approach gives more accurate determination of the time when patients are at highest risk and in greatest need of therapy. This Chronopharmacological principle is used in the therapy of various diseases like cardiovascular diseases, allergy and many more. The objective of the study was to analyse whether chronopharmacological approach was being applied in clinical practice by comparing chronopharmacology of 4 drugs to their prescribing pattern by the physicians.Methods: This was observational study where 700 prescriptions written by physicians were audited. To study all the drugs would have been tedious so four commonly used drugs were chosen that is, Proton pump inhibitors, statins, Beta blockers and subcutaneous Insulin.Results: Results showed that chronopharmacological approach has been applied in the clinical field though physician didn’t have clear concept about chronopharmacology and it is relation to the prescribing. Despite this, maximum physician prescribing pattern was comparable to the chronopharmacological data except in case of Proton pump inhibitors.Conclusions: It is concluded that Chronotherapeutics approach gives more accurate determination of the time when patients are at highest risk and in greatest need of therapy. Nevertheless, this variation is only seldom considered by clinicians. If drugs are prescribed by following chronopharmacological approach it can prove beneficial to the patients as more of effectiveness of the drug and lesser side effects

Innovations in existing routes and novel drug delivery systems for local anaesthetics

New drug delivery systems (NDDS) are developed for improvement in efficacy of the drugs, provide maximum benefit to the patient and to minimize the adverse drug reactions. For local anaesthetics (LAs), the development of new effective delivery systems modulate the release rate, extend their anaesthetic effect , and helps to enhance their localisation as desired. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous) are under innovation these days. Different methods such as include iontophoresis, electroporation, sonophoresis, and magnetophoresis are being used to enhance local anaesthetic permeation. Adjuvants are added to potentiate drug effects. The use of different delivery systems should  help to keep the LA at  the  target  site  for  longer  periods  prolonging  the  anesthetic  or  analgesic  effect  with an extended range of agent

A comparison of computer assisted learning and practical animal experiment for undergraduate medical students in pharmacology curriculum - a questionnaire based study conducted in a medical college of North India

Background: The practical sessions in pharmacology training involving animal experiments were perceived to be unnecessary as the learning objectives of these practical sessions primarily focus on observational, analytical and interpretative skills. A number of computer simulation and other models have been recommended for use as alternatives to use of animals for medical education. In this study, we compared Computer Assisted Learning (CAL) with practical animal experiments for medical undergraduates based on questionnaire. The objective of the study was to compare Computer Assisted Learning and practical animal experiments for medical undergraduates in pharmacology curriculum.Methods: This was a questionnaire based observational study involving 300 medical undergraduates and eighteen faculty members. It included two systems i.e. CAL and conventional animal experiments. A separate questionnaire was prepared for the faculty members.Results: Results showed that CAL has nearly replaced the practical laboratory experiments as far as the medical undergraduate training is concerned. All the students and teachers believed that CAL is better and more understandable than animal experiments done practically.Conclusions: It is concluded that CAL is a better source of experimentation at the undergraduate level and provides dependable outcomes

Evaluation of usefulness of seminar as a learning tool at medical undergraduate level

Background: Teaching methods has a major role to play in making a subject innovative, interesting and participatory for the students. In India still teaching is controlled by teacher centered classroom method. Apart from this one of the method adopted is organizing seminars for the students. Knowledge acquisition through seminars forms an essential part of medical training programme. The idea behind the seminar system is to familiarize students more extensively with the methodology of their chosen subject.Methods: A questionnaire was prepared containing ten questions and 1000 MBBS students of second, pre-final, final professional and 200 faculty members, were asked to fill up the questionnaire. It included ten questions.Results: Results showed that seminar methods of teaching-learning, is effective way of learning, which is relevant to self-development and is also interactive. It improves communication skills.Conclusions: Many of the students feel that this technique of seminar programme is helpful for them in the long run. Thus teaching by way of seminar could be an effective learning method as it involves the three major domains of teaching i.e., cognitive, affective and psychomotor skills and is thus well -accepted among the medical students

Angiotensin receptor/neprilysin inhibitor: a novel therapy in the treatment of heart failure

Recently US Food and Drug Administration (FDA) approved valsartan/sacubitril is the first angiotensin receptor/neprilysin inhibitor (ARNI) that offers a new standard of treatment to physicians for the patients of heart failure with reduced ejection fraction. Sacubitril is a prodrug which gets activated to sacubitrilat and this inhibits the enzyme neprilysin which is a membrane bound endopeptidase and which in turn is responsible for the degradation of various natriuretic peptides. The action of Valsartan which selectively blocks the angiotensin II type-1 receptor is needed in addition to sacubitril because inhibition of neprilysin is accompanied by the activation of renin-angiotensin system. The combination appears to be a suitable alternative for patients of heart failure with persistent symptoms or with recent exacerbation or hospitalization while on standard optimized treatment. The availability of this novel sacubitril/valsartan combination is an important development in the heart failure management

A comparison of computer assisted learning and practical animal experiment for undergraduate medical students in pharmacology curriculum - a questionnaire based study conducted in a medical college of North India

Background: The practical sessions in pharmacology training involving animal experiments were perceived to be unnecessary as the learning objectives of these practical sessions primarily focus on observational, analytical and interpretative skills. A number of computer simulation and other models have been recommended for use as alternatives to use of animals for medical education. In this study, we compared Computer Assisted Learning (CAL) with practical animal experiments for medical undergraduates based on questionnaire. The objective of the study was to compare Computer Assisted Learning and practical animal experiments for medical undergraduates in pharmacology curriculum.Methods: This was a questionnaire based observational study involving 300 medical undergraduates and eighteen faculty members. It included two systems i.e. CAL and conventional animal experiments. A separate questionnaire was prepared for the faculty members.Results: Results showed that CAL has nearly replaced the practical laboratory experiments as far as the medical undergraduate training is concerned. All the students and teachers believed that CAL is better and more understandable than animal experiments done practically.Conclusions: It is concluded that CAL is a better source of experimentation at the undergraduate level and provides dependable outcomes

Innovations in existing routes and novel drug delivery systems for local anaesthetics

New drug delivery systems (NDDS) are developed for improvement in efficacy of the drugs, provide maximum benefit to the patient and to minimize the adverse drug reactions. For local anaesthetics (LAs), the development of new effective delivery systems modulate the release rate, extend their anaesthetic effect , and helps to enhance their localisation as desired. The various routes of local anaesthetic delivery (epidural, peripheral, wound catheters, intra-nasal, intra-vesical, intra-articular, intra-osseous) are under innovation these days. Different methods such as include iontophoresis, electroporation, sonophoresis, and magnetophoresis are being used to enhance local anaesthetic permeation. Adjuvants are added to potentiate drug effects. The use of different delivery systems should  help to keep the LA at  the  target  site  for  longer  periods  prolonging  the  anesthetic  or  analgesic  effect  with an extended range of agent

Chronopharmacology and drug prescribing pattern of physicians in a tertiary care hospital of North India

Background: Chronopharmacology is the science dealing with the optimization of drug effects and the minimization of adverse effects by timing medication in relation to the biological rhythm. This concept came into picture to make us understand about periodic and predictable changes in both desired effects and tolerance of medication Chronotherapeutics approach gives more accurate determination of the time when patients are at highest risk and in greatest need of therapy. This Chronopharmacological principle is used in the therapy of various diseases like cardiovascular diseases, allergy and many more. The objective of the study was to analyse whether chronopharmacological approach was being applied in clinical practice by comparing chronopharmacology of 4 drugs to their prescribing pattern by the physicians.Methods: This was observational study where 700 prescriptions written by physicians were audited. To study all the drugs would have been tedious so four commonly used drugs were chosen that is, Proton pump inhibitors, statins, Beta blockers and subcutaneous Insulin.Results: Results showed that chronopharmacological approach has been applied in the clinical field though physician didn’t have clear concept about chronopharmacology and it is relation to the prescribing. Despite this, maximum physician prescribing pattern was comparable to the chronopharmacological data except in case of Proton pump inhibitors.Conclusions: It is concluded that Chronotherapeutics approach gives more accurate determination of the time when patients are at highest risk and in greatest need of therapy. Nevertheless, this variation is only seldom considered by clinicians. If drugs are prescribed by following chronopharmacological approach it can prove beneficial to the patients as more of effectiveness of the drug and lesser side effects