Accidental tramadol ingestion in children admitted in tertiary care centre

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present

Marine pharmacology: an ocean to explore novel drugs

The rise in burden of diseases and treatment failure demands discovery of novel compounds. Exploiting natural sources which include territory of land and water in potential manner paves the way for significant future innovations in drug discovery. Marine environment has striking functionalities in its skeleton that has fascinated scientists to show enormous interest in investigation of new compounds. Marine sponges, algae, tunicates, sea whip etc. from the marine pipeline are the important sources for biological active compounds. Recent technology advancements further added to the domain of drug research in isolation and evaluation of marine derived products. To date, significant number of compounds have been isolated. Wide range of antibacterial, anti-inflammatory, antiparasitic, neuroprotective, antiviral, anticancer, analgesic, antimicrobial, antimalarial compounds have been pursued in control and management of diseases. These represent marine ecosystem as a hopeful resource in discovery of novel compounds with ideal starting point in scaffolding additional screening of natural marine products. This is review of abstracting on history, lead development process in identifying and comprehending basic nature of compounds that is promising initial step towards unique pharmacological design, the triumph of approved and ongoing trails, brief depiction on current status and challenges being faced in marine drug discovery field

Drug utilization study of drugs used in the management of post-partum hemorrhage at a tertiary care hospital

Background: Postpartum haemorrhage remains a major cause of both maternal mortality and morbidity worldwide, uterotonic drugs such as oxytocin, with or without ergometrine, have been used to prevent PPH. The objective to study the drugs used in the management of post-partum haemorrhage at a tertiary care hospital.Methods: An observational and cross-sectional study design was adopted for this study. The case sheets of 100 patients presenting in active stage of labour to the labour room in a tertiary care hospital were analysed.Results: In the prescriptions analysed from the patients in the labour room, drugs used to prevent PPH are oxytocin and misoprostol. Oxytocin is the most commonly prescribed drug to prevent PPH in the study group. It is a life-saving drug to prevent PPH and thereby maternal mortality. In the study group having 103 patients, a total of 81 patients received only 10 IU oxytocin IM and 14 patients received 10 IU oxytocin IM and 600 g misoprostol to prevent PPH.Conclusions: Oxytocin is an essential drug included in the WHO essential drug list and in the national list of essential medicine, so it shouldn’t have been dealt in such a biased manner