PLANT-MEDIATED ZNO NANOPARTICLES USING FICUS RACEMOSA LEAF EXTRACT AND THEIR CHARACTERIZATION, ANTIBACTERIAL ACTIVITY

Objective: The motto of this research work was to synthesize the zinc oxide nanoparticles (ZnONPs) should be environmental friendly. Hence, it receives more attention toward the green route method.Methods: At last, the Ficus racemosa ZnONPs (FR-ZnONPs) were successfully synthesized using a simple protocol and eco favorable technique. This paper highlights the biosynthesis of ZnONPs using leaf extract of F. racemosa. Results: FR-ZnONPs formation was confirmed by the different spectral analysis such as UV-visible spectroscopy, Fourier transform-infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM), and electronic dispersive X-ray spectroscopy. UV-visible studies revealed that the intrinsic band gap absorptions were at 372 nm and photoluminescence study showed that the blue emission at 492, 481, 473, and 450 nm and the green emission at 540 nm, respectively. FR-ZnONPs are wurtzite hexagonal structure with an average grain size of 15 nm was found from XRD analysis.Conclusion: FR-ZnONPs exhibited good antimicrobial efficacy on Escherichia coli and Staphylococcus aureus with various concentrations (100 μg/mL, 75 μg/mL, and 50 μg/mL) by disc diffusion method. The results showed the good antibacterial activity of FR-ZnONPs on G+ve and G-ve bacteria

Impact of pharmacist-directed counseling and message reminder services on medication adherence and clinical outcomes in type 2 diabetes mellitus

Introduction: Medication nonadherence is the most common issue observed in the management of diabetes because of complex and lifelong therapy. The study aimed to assess the effect of pharmacist-directed counseling and daily text message reminder on medication adherence and clinical profile of patients with type II diabetes. Materials and Methods: This prospective, open-labeled, randomized control trial was carried out in outpatient medical department of a secondary care referral hospital. A total of 330 patients who met study criteria were enrolled and randomized into an intervention group (n = 165), received counseling and daily messages about medication intake and control group (n = 165), and usual care by physician. Medication adherence and clinical outcomes such as glycosylated hemoglobin (HbA1C), systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol, triglyceride (TG) levels, and body mass index (BMI) were recorded at baseline and follow-up visits. Two-sample Wilcoxon rank sum test was used to compare the mean difference of medication adherence and paired t-test was used to compare clinical outcomes. Results and Discussion: The mean age of intervention and control groups were 57.1±8.55 and 58.5±8.53 years, respectively. The mean difference of medication adherence from baseline to second follow-up visit was significantly more in intervention group (12.2±7.1%) compared to that in control group (0.75±10.2%) with a P < 0.001. From baseline to second follow-up visit, HbA1C (7.79±0.67 to 6.91±0.83%), SBP (136.75±20.09 to 126.23±18.22mm Hg), and LDL cholesterol (104.14±26.23 to 98.29±20.87mg/dL) levels were significantly reduced in intervention group compared to that in control group with a P < 0.01. No significant improvement was observed in TG (169±33.71 to 168 65±33.90mg/dL) and BMI (27.9±4.21 to 27.1±3.12Kg/m2) levels from baseline to second follow-up visit. Conclusion: Pharmacist-directed patient counseling combined with message reminder showed a greater effect on the improvement of medication adherence and control of glycemia, blood pressure, and lipid profile in diabetes

DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p&lt;0.001), polypharmacy (p&lt;0.001), and hospital stay (p&lt;0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit

FABRICATION AND ASSESSMENT OF LERCANIDIPINE HYDROCHLORIDE SOLID DISPERSIONS FOR SOLUBILITY PREFERMENT USING POLYMER COMBINATION

Objective: An attempt has made in fabricating solid dispersions (SDs) by taking lercanidipine hydrochloride (LCD) as a model drug. Methods: The SDs were made using a poly mix of poly vinyl pyrrolidone (PVP) K-30, Poloxamer-188, and hydroxy propyl methyl cellulose (HPMC) K4M. Different proportions of LCD: polymer mix in 1:1, 1:3, 1:5, and 1:7 ratios were fabricated as SDs by solvent evaporation and melting method, further compressed into tablets. The LCD SDs were assessed for physicochemical, and LCD release possessions. Results: The results were observed to be attractive with the increase in solubility LCD SD (F-3 and F-7) with 1:5 ratios of LCD. Conclusion: The study concludes that the poly mix of PVP K-30, Poloxamer-188, and HPMC K4M and was found to be a better combination for elevating the solubility and release of LCD from the SDs

Impact of one-dose package dispensing with patient counseling on medication adherence in geriatrics suffering from chronic disorders

Introduction: Medication nonadherence in elderly patients could result in a waste of medical expenses in a long-time span as well as deterioration of the patient's medical condition. Aim: The aim of this study is to evaluate the impact of one-dose package dispensing with patient counseling on medication adherence among elderly patients suffering from chronic disorders. Settings and Design: This is prospective, open-labeled, randomized trial carried out at dispensing pharmacy of the secondary care referral hospital, located in resource-limited settings of Anantapur District, Andhra Pradesh, India. Subjects and Methods: A total of 330 (aged ≥60 years) patients were randomly assigned to one of three study groups: Group A (n = 110), no change in dosing and packing; Group B (n = 110), one-dose package dispensing; Group C (n = 110), One-dose package dispensing with patient counseling. Medication adherence levels were measured using a pill count and visual analog scale (VAS) method at baseline and follow-up (after 1 month). Statistical Analysis: Descriptive statistics were used to represent the sociodemographic, clinical, and medication adherence profile of study participants. One-way ANOVA test is used to assess significant differences between three groups with a P 60 years who are on multiple medications can benefit from one-dose package dispensing and appropriate counseling. This will improve medication adherence hence better outcomes

Development and Validation of a Stability-Indicating Assay of Etofenamate by RP-HPLC and Characterization of Degradation Products

A validated stability-indicating RP-HPLC method for etofenamate (ETF) was developed by separating its degradation products on a C18 (250 mm × 4.6 mm 5 μm) Qualisil BDS column using a phosphate buffer (pH-adjusted to 6.0 with orthophosphoric acid) and methanol in the ratio of 20:80 % v/v as the mobile phase at a flow rate of 1.0 mL/min. The column effluents were monitored by a photodiode array detector set at 286 nm. The method was validated in terms of specificity, linearity, accuracy, precision, detection limit, quantification limit, and robustness. Forced degradation of etofenamate was carried out under acidic, basic, thermal, photo, and peroxide conditions and the major degradation products of acidic and basic degradation were isolated and characterized by 1H-NMR, 13C-NMR, and mass spectral studies. The mass balance of the method varied between 92–99%

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