STUDY OF FIXED DOSE COMBINATIONS IN A TERTIARY CARE HOSPITAL

ABSTRACTObjective: To study and analyze the pattern of fixed dose combinations (FDCs) in medicine outpatient clinic.Methods: The study is prospective cross-sectional study was conducted for 2 months in medicine outpatient clinic in tertiary care hospital. Aftertaking approval from Institutional Ethics Committee, the data were collected on every working day of the hospital. Prescriptions from the patientscoming to medicine outpatient clinic outpatient department were taken and required information is filled in data record form.Results: A total of 83 prescriptions were included in the study. Out of 287 drugs, 111, i.e., 39.92% were fixed dose formulations. As per drug categoryanalysis, nutritional supplements were used (47.74%). While 27.02% and 9.03% of FDCs were given for cardiovascular complains and respiratorycomplains, respectively. FDCs used for other conditions were 16.21%. About 29.72% of total FDCs are included in approved list of FDCs by DrugsController General of India (DCGI), November 2014.Conclusion: 39.92% drugs are FDCs out of total prescribed drugs. Nutritional supplements are prescribed in higher concentrations. Out of total FDCsonly 29.72% were included in DCGI approved list of FDCs and only four FDCs are found in the WHO list of essential drugs.Keywords: Fixed dose combinations, Prescriptions, Approved, Drugs Controller General of India

Effect of telmisartan on acute model of inflammation in male Wistar rats: an experimental study

Background: The objective of the study was to investigate the influence of telmisartan on acute model of inflammation in adult male Wistar rats.Methods: After obtaining ethical clearance from Institutional Animal Ethics Committee, animals were allotted to the three groups i.e. control, aspirin and telmisartan (n=6 animals in each group). The effect of telmisartan, administered orally, on inflammation was studied using acute (Carrageenan induced rat paw edema) model. Experiment was conducted according to the Committee for the purpose of Control and Supervision of Experiments on Animals (CPCSEA) guidelines. Analysis was done using one way ANOVA followed by post hoc tests of Dunnet’s and Bonferroni’s. P < 0.05 was considered as statistically significant.Results: Telmisartan, used orally in the present study, showed significant anti-inflammatory activity in acute model of inflammation.Conclusions: In view of role of inflammation in the pathogenesis of atherosclerosis and their complications, treatment by telmisartan can reduce complications by virtue of its anti-inflammatory activity, in addition to its antihypertensive effect. Also this study may help to open new avenues for therapeutic indications of telmisartan

Effect of telmisartan on sub-acute model of inflammation in male Wistar rats - an experimental study

Background: Cardiovascular diseases remain the major cause of death and premature disability in developed societies.Current predictions estimate that by the year 2020 cardiovascular diseases, notably atherosclerosis and hypertension will become leading global causes of total disease burden. The objective of the study was to investigate the influence of telmisartan on sub-acute model of inflammation in adult male Wistar rats.Methods: After obtaining ethical clearance from Institutional Animal Ethics Committee, animals were allotted to the three groups i.e. control, aspirin and telmisartan (n=6 animals in each group). The effect of telmisartan on inflammation was studied using sub-acute (Cotton pellet granuloma and histopathologic examination of grass piths) models. Experiment was conducted according to the Committee for the purpose of Control and Supervision of Experiments on Animals (CPCSEA) guidelines. Analysis was done using one way ANOVA followed by post hoc tests of Dunnett’s and Bonferroni’s. P<0.05 was considered as statistically significant.Results: In the present study telmisartan showed significant anti-inflammatory activity in sub-acute models of inflammation.Conclusions: In view of role of inflammation in the pathogenesis of atherosclerosis and their complications, treatment by telmisartan can reduce complications by virtue of its anti-inflammatory activity, in addition to its antihypertensive effect. Also this study may help to open new avenues for therapeutic indications of telmisartan.

Effects of angiotensin converting enzyme inhibitor: ramipril on different biochemical parameters in essential hypertensive patients

Background: Hypertension is a major risk factor for macrovascular diseases. The beneficial effects of lowering blood pressure on the vascular morbidity and mortality are well documented and demonstrated. The beneficial effects of antihypertensive agents on cardiovascular system can be counter-balanced by the induction of metabolic disorders. The modifications in various metabolic parameters (like lipids, serum electrolytes, uric acid, blood glucose levels, etc) are responsible for different adverse drug reactions of antihypertensive drugs. It might also have potential to produce secondary morbidities after long term use. The present study was designed to evaluate the effect of the commonly used first line antihypertensive drugs on these different biochemical parameters. Recent comparative studies suggest that, for the prevention of cardiovascular events, angiotensin converting enzyme inhibitor (ACEI) may be superior to alternative antihypertensive agents, independently of their antihypertensive effect and also claimed to have neutral or favourable effects on carbohydrate metabolism, lipid profile, uric acid. The metabolic abnormalities can be improved by ACEI. Therefore, this study was conducted to evaluate the effects of ramipril on different biochemical parameters in essential hypertensive patients. Objective was to study effects of six months monodrug therapy with ramipril on different biochemical parameters in essential hypertensive patients.Methods: 30 newly diagnosed patients of either gender with essential hypertension were included in the study. Patients having co-morbidities like diabetes mellitus, hyperlipidemia, gout, pregnant females were excluded from the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting ramipril drug therapy. Same biochemical tests were repeated after six months ramipril monodrug treatment.Results: After comparing the means there is significant decrease in triglyceride levels, highly significant decrease in LDL, uric acid, sodium and fasting sugar level and highly significant increase in HDL levels.Conclusions: Ramipril has beneficial effects on RAS (Renin angiotensin system) and kinin system or both may contribute to the improvement in different biochemical parameters by ramipril

Effect of Mirtazapine Pre-treatment on Haloperidol, Ergometrine and Fluoxetine Induced Behaviours in Albino Rats

Background: Central 5-HT2A and 5-HT2C serotonergic receptors are mainly involved in the control of nigrostriatal and mesolimbic dopaminergic neuronal activity has been well proved and established. 5-HT has facilitatory effect on stimulated dopamine release by stimulating central 5-HT2A receptors and inhibitory effect by stimulating 5-HT2C receptors. Aim and Objectives: To evaluate 5-HT2A and 5-HT2C receptor blocking activity of Mirtazapine (MIR) and the effect of mirtazapine pre-treatment on Ergometrine (ERG) induced behaviours, Fluoxetine (FLU) induced penile erections and Haloperidol (HAL) induced catalepsy in rats. Material and Methods: Each group was subdivided into different subgroups consisting 6 animals in each. Control group received Dimethyl Sulfoxide (DMSO) and other groups received different doses of mirtazapine one hour before ERG/FLU/HAL. Values obtained from control group were compared with all remaining groups pre-treatment with different doses of MIR. Results: MIR (MIR) at 2.5, 5, 10 and 20 mg/kg intraperitoneally (i.p) did not produce any per se effects. Pre-treatment with 5, 10 and 20 mg/kg i.p. MIR significantly antagonised ERG induced behaviours. 5 mg/kg i.p. MIR significantly antagonised whereas 10 and 20 mg/kg i.p. MIR abolished FLU (10 mg/kg) induced penile erections in rats. MIR 5 and 20 mg/kg i.p. significantly antagonised HAL (1mg/kg) induced catalepsy at 1 hr testing time interval while 10 and 20 mg/kg MIR significantly antagonised HAL (1 mg/kg) induced catalepsy at 2 hr testing time interval. Conclusion: Our results indicate that MIR at 5, 10 and 20 mg/kg possesses 5-HT2A and 5-HT2C receptors blocking activity. At 5, 10 and 20 mg/kg MIR, by blocking central 5-HT2C receptors predominantly, causes release of dopamine from nigrostriatal dopaminergic neurons and therefore antagonizes HAL induced catalepsy