International Journal of Basic & Clinical Pharmacology

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https://imsear.searo.who.int/handle/123456789/149644

Chief Editor: Dr. Bhaven Kataria

Print ISSN: 2319-2003 (Print)

Frequency: 6 issues a year

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijbcp.com/index.php

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Now showing 1 - 20 of 1928

A 12 week prospective clinical evidence of empagliflozin efficacy in uncontrolled type 2 diabetes mellitus treated with metformin and a sulfonylurea
(Medip Academy, 2019-12) Puli, Keerthana; Vanjari, Nikhil Kumar
Background: The main aim of the study is to evaluate the efficacy of empagliflozin 10 mg once daily over 12 weeks as add-on therapy to metformin plus sulfonylurea in patients with type 2 diabetes mellitus with inadequate glycemic control.Methods: It is a prospective, observational, study conducted in patients of Sri Badhrakali Diabetic Center located in Warangal, Telangana, India. The efficacy of empagliflozin 10 mg was assessed by measuring the change in the glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI) at the baseline and 12 weeks, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and after 24 hours of treatment.Results: In the present study, the addition of empagliflozin to metformin and Sulfonylurea therapy for 12 weeks provided 0.87 % reduction in HbA1c. The mean changes of FPG from baseline to 12-week is -26 mg/dl. At 24 hours empagliflozin significantly reduced blood pressure with mean changes of SBP and DBP -4.147 and -1.526 mmHg respectively. The mean changes in BMI from baseline to week 12 is -0.638 kg/m2.Conclusions: Empagliflozin 10 mg provided ancillary reduction in HbA1c outside of metformin and sulfonylurea. Controlled body weight, HbA1c, blood pressure decreases diabetes progression, decreased risk of diabetic complications and reduced risk for cardiovascular disorders.
A 6 months retrospective observational study to assess the rationality and effectiveness of snake bite management in a tertiary care teaching hospital of rural Bengal, India
(Medip Academy, 2018-10) Dan, Satrajit; Mandal, Ananya; Das, Abhijit; Chakrabarty, Sourav; Gangopadhyay, Tanmoy
Background: Snake envenomation is a common life-threatening problem encountered all-over West Bengal particularly in the rural areas. There are a large number of patients attending the Emergency unit and being admitted to the Medicine ward, some in the intensive care unit (ICU) and intensive therapy unit (ITU) of the tertiary health care facilities. The objective of this study was to assess rationality and effectiveness of management of venomous snake bite following standard protocol – Standard treatment guidelines of Government of West Bengal and National snakebite management protocol of Government of India.Methods: This was a retrospective observational study of six months (May - October 2017) duration. Data were collected from the treatment records of patients admitted with history of snake bite in the Medicine ward, ICU and ITU of tertiary care teaching hospital of rural Bengal.Results: Of the 63 venomous bite patients, most (82.5 %) were diagnosed to have features of neurotoxic envenomation. All of them (100%) received anti-snake venom (ASV). There was no incidence of anaphylactic reaction as well as any serious adverse drug reaction following ASV administration. Two patients developed acute renal failure, needed haemodialysis. Overall percentage of mortality was 3.2%.Conclusions: The survival rate in venomous snake bite is found to be high in this institution. The practice of snake bite management is found to be adherent with standard protocol. A multicentric study of longer duration is suggested to draw a firm conclusion.
Accentuation of general anaesthetic activity of ketamine by glutamate NMDA (N-methyl D-aspartate) receptor antagonist
(Medip Academy, 2018-11) Umamageswari, M. S.; Vasanthan; Kumar, Nikitha S.
Background: The aim of the present study was to evaluate the potentiation of general anaesthetic activity of ketamine by NMDA receptor antagonist ‘amantadine’ in wistar albino rats.Methods: The wistar albino rats of either sex were divided into three groups of five animals in each group. Group I received ketamine 80mg/kg, group II received ketamine 40mg/kg along with amantadine 40mg/kg and group III received ketamine 80mg/kg along with amantadine 40mg/kg to evaluate the potentiation of general anaesthetic effect of ketamine. The sleep latency time and the total sleeping time were measured in all the three groups.Results: The sleep latency time of group III is significantly decreased (p <0.035) and as equal to that of group II when compared to group I. The sleeping time of group III is significantly increased (p <0.001) when compared to group I.Conclusions: Amantadine - the NMDA receptor antagonist potentiates the general anaesthetic activity of ketamine.
Accidental chronic lithium toxicity
(Medip Academy, 2018-12) Kanellis, Vangelis George; Varendran, Ramila
Lithium is an effective first-line mood stabiliser for bipolar disorder, treatment-refractory depression and suicide prevention. Studies have demonstrated its ability to produce neuroprotective benefits. Despite this, Lithium can cause neurotoxicity, cardiotoxicity and endocrine derangement resulting in severe (and potentially permanent) side effects. Lithium toxicity can be precipitated by illness, salt restriction diets, dehydration, nephrogenic diabetes insipidus, impaired creatinine clearance, concomitant drugs. This is particularly true in older patients with altered pharmacodynamics and pharmacokinetics. We present a 52-year-old female who presented with prolonged signs of lithium toxicity post-diarrhoea. Lack of monitoring due to her nomadic life-style resulted in the combination of long-lasting neurotoxicity and thyroid dysfunction. Our patient displayed neurotoxicity that was not present on imaging. This highlights the importance of regular monitoring of renal function, lithium serum levels and neuro-endocrine function to reduce complications associated with lithium toxicity.
Accidental injection of lignocaine with adrenaline in subarachnoid space: a case report
(Medip Academy, 2019-09) Arya, Swati; Arya, Ashish; Gupta, Namrata
Drug errors are very common in medical field especially in anaesthesia where it’s the game of drugs. Here, we are presenting a case in which accidentally we injected lignocaine with adrenaline in place of heavy bupivacaine. Patient was of geriatric age group and posted for lower limb surgery under combined spinal epidural anaesthesia after placement of epidural catheter lumber puncture was done and 3ml of lignocaine with adrenaline was injected. After this patient develop complete sensory, motor blockade with hypotension. Level of block was up to T12 level patient was monitored for signs and symptoms of ransient neurologic syndrome (TNS) and anterior spinal artery syndrome for 24 hours. After 24 hours patient develop no complications and posted for surgery under general anaesthesia.so we have to be very careful about the labelling of drugs.
Accidental tramadol ingestion in children admitted in tertiary care centre
(Medip Academy, 2019-12) Sruthi, Vadlakonda; Narendra, Annaladasu
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.
Aceclofenac induced morbilliform eruptions: a case report
(Medip Academy, 2018-04) Priyanki; Sinha, Praveen Kumar; Suman, Shruti; Mishra, Pranay Kumar
Maculopapular or morbilliform eruptions may be the most common of all cutaneous drug reactions. Antimicrobials, NSAIDS, barbiturates, anticonvulsants, oral hypoglycemics etc. have been commonly implicated in these adverse reactions (ADR). Here, authors are presenting a case of a 38-year-old female with morbilliform eruptions due to aceclofenac for the treatment of joint pain. The patient was treated with antihistaminics, steroids, antimicrobials and local application of GV paint. She was discharged after eleven days with good recovery.
Active surveillance of adverse drug reactions in patients with rheumatoid arthritis in a tertiary care teaching hospital
(Medip Academy, 2018-10) R., Nalini; D., Keerthi; B., Meenakshi; J., Ezhil Ramya; Vidhya
Background: Drugs used in the treatment of rheumatoid arthritis show significant toxicity and morbidity. The objective of the study was to evaluate the nature and incidence of adverse drug reaction in patients with rheumatoid arthritis on anti-rheumatic drugs and to assess the causality and severity of the documented adverse drug reactions.Methods: The prospective observational study was done for two months in rheumatology outpatient department. All patients were interviewed for basic details, treatment history and adverse drug reactions and were recorded. Causality assessment and severity assessment of the recorded adverse drug reactions were done.Results: About 283 patients attended the rheumatology out-patient department during the two months period out of which 57 patients had one or more adverse drug reaction. The incidence of adverse drug reaction observed in rheumatology out-patient department to anti rheumatic drug was 20.14%. A total of 145 adverse drug reactions were noted in 57 patients. The most common adverse drug reaction reported was epigastric pain (6.89%) followed by headache and dyslipidemia (6.25%). The most common system associated with adverse drug reaction was gastrointestinal system (29.66%) followed by central nervous system and cardiovascular system (15.86%). Reported adverse drug reactions were assessed for causality and maximum belonged to probable (66.9%). Severity assessment revealed that most of the adverse drug reactions were mild (74.48%) in nature.Conclusions: Active surveillance for adverse drug reactions to anti rheumatic drug in patients with rheumatoid arthritis will allow early detection of adverse drug reactions and timely intervention to provide maximum benefit to the patients.
Acute anti-inflammatory activity of ethanolic extract of leaves of Leucas indica by carrageenan induced paw oedema in wistar albino rats.
(2013-05) Chandrashekar, R; Rao, S N
Background: Inflammation is basically a defense phenomenon but can lead to serious pathological conditions. It is treated by various agents with good to moderate success because of both considerable toxicity and side effects. There are various mediators to cause an inflammatory reaction that can contribute to the associated symptoms and tissue injury. Even though non steroidal anti-inflammatory drugs are the most commonly prescribed drugs in the world, their use as anti-inflammatory agents continues to be principally limited by their undesired side effects. Hence, the traditional medical practitioners and scientists are turning towards Indian System of Medicine (ISM). Methods: Dried powdered leaves of Leucas indica were subjected to solvent extraction by using 90 % ethanol. Based on acute oral toxicity study according to Organization for Economic Cooperation and Development (OECD) guidelines No. 423, three doses of the test drug 75, 150 & 300mg/kg were selected and subjected to preclinical anti-inflammatory screening by carrageenin induced paw oedema in Wistar Albino rats. Results : Oral administration of Ethanolic Extract Of Leaves of Leucas Indica (EELLI) at doses of 150 mg/kg and 300mg/kg showed significant anti-inflammatory activity 52.58% (p<0.01) and 36.87% (p<0.05) respectively compared to control. Conclusion: Even though oral administration of EELLI has shown significant anti-inflammatory activity, further studies are required to evaluate its comprehensive analysis including quantitative / semi quantitative analysis, characterize its chemical structure and assess its pharmacotherapeutic activities with exact mechanism of action as an anti-inflammatory agent.
Acute ischemic stroke: management approach
(Medip Academy, 2023-04) Singh, R. K.; Sachin; Samanta, S.; Yunus, N.; Kumar, M.; Sinha, R. I.
A stroke, or brain attack, happens when blood flow to the brain is stopped. It is an emergency situation. The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. Stroke is the second most common cause of death worldwide and the most important cause of physical weakness, with a growing occurrence in developing countries. Ischemic stroke is the most common type of stroke which occurs due to arterial block and managed by fast reperfusion with endovascular thrombectomy and intravenous thrombolysis. The first step in stroke management is initial identification of patients with stroke and triage to centers accomplished of transporting the suitable treatment, as fast as conceivable. Mobile stroke units, tele stroke and artificial intelligence are technologies playing an important role in recognizing and treating stroke. Stroke system-of-care models remain to streamline the distribution of definitive revascularization in the age of mechanical thrombectomy. Overall, in the present review, we emphasized the pathophysiology, diagnosis and management of acute ischemic stroke (AIS).
Acute muscle dystonia resulting from medication error: a case report.
(2013-11) Solanke, Bhupendra P; Dakhale, Ganesh N; Mahatme, Mohini S; Hiware, Sachin K; Pimpalkhute, Sonali
Acute Muscle Dystonia (AMD) due to medication error is rarely reported in the literature. We are reporting a case of adverse drug reaction due to a single dose of haloperidol. Patient was free from any psychiatric illness and still he developed AMD with use of haloperidol because of medication error. The patient recovered completely from AMD symptoms in one hour after receiving the treatment. This case report intends to improve the awareness among clinicians to be cautious while writing the prescriptions.
Acute pancreatitis-induced by platinum compounds in patients with cancer: a review of the literature.
(2015-03) Nashwan, Abdulqadir J; Yassin, Mohamed A; Nair, Sindhumole L
The purpose of this review of the literature was to describe the relationship between use of platinum-based antineoplastics and development of acute pancreatitis in patients with cancer. A literature search was conducted using PubMed, Science Direct and Google scholar databases for articles published from 1985 to 2014. The headings and/or text words (platinum compounds), (acute pancreatitis-induced by platinum compounds), and (cisplatin, carboplatin, and oxaliplatin) were entered, and the search was limited to articles describing case reports in adults with cancer. A total of 12 cases were reported between 1985 and 2012; including three platinum compounds; cisplatin, carboplatin, and oxaliplatin. In conclusion, it is highly recommended to include baseline assessment for acute pancreatitis risk factors and to consider acute pancreatitis in the differential diagnosis of abdominal pain in patients who have received platinum-based chemotherapy.
Acute psychosis induced by topiramate.
(2014-03) Raj, Rajnish; Kumar, Raj
Topiramate (TPM) is a new potent antiepileptic drug (AED) used as add-on therapy for generalized and partial seizures that are resistant to the other AEDs; or as a mood stabilizer, and for reducing weight gain associated with olanzapine and clozapine in patients with bipolar disorder or schizophrenia. However, there is a higher risk of psychosis with TPM in patients with a past history of psychiatric disorder. This case report highlights emergence of psychosis that was related to TPM which resolved on discontinuation.
Acute ST elevation myocardial infarction after intravenous immunoglobulin infusion in a young patient: a rare but probable adverse effect of immunoglobulin.
(2014-05) Ruhela, Manish; Parashar, Kushmendra; Bishnoi, Rameshwar; Gautam, Dinesh
Intravenous immunoglobulin (IVIG) is used in the treatment of a variety of disorders, including autoimmune conditions. IVIG has been considered a safe medication, with minor and transient adverse effects. With the wider use of IVIG, the reported rate of adverse effects has been increased, some of them are potentially fatal cardiovascular reactions due to induction of hypercoagulable state. We report a 40-year-old female treated with IVIG for Guillain-Barre syndrome, who developed chest pain 1 hr following IVIG infusion. The symptoms were associated with ST elevation in anterior leads on electrocardiogram. This anterior wall myocardial infarction (MI) is compatible with IVIG-induced hypercoagulability and considered as a probable adverse effect of this medication. To the best of our knowledge, this is probably the first case report where a young patient developed acute MI without any cardiac risk factors after IVIG infusion.
Acute thrombocytopenia due to meropenem: a case report
(Medip Academy, 2019-12) Dhande, Priti; Deshmukh, Shreyas
Meropenem is a broad spectrum antibacterial drug from the carbapenem family. It is commonly used as an empirical antimicrobial in severe infections like pneumonia, intra-abdominal infections, septicaemia, meningitis etc. Severe adverse effects with meropenem are rare (<1 %) which include hypersensitivity and hematologic adverse effects. In the literature, few cases have been reported of meropenem induced thrombocytopenia that has shown the immune mechanism by which thrombocytopenia occurs. Drug induced thrombocytopenia (DITP) can be a life threatening condition if not diagnosed and managed properly. As meropenem is being widely used in hospitals nowadays, it is important to be aware of the rare but serious adverse effects it causes.
Adequacy of phosphodiesterase inhibitor in prevention and treatment of LPS induced organ failure in BALB/c mice
(Medip Academy, 2019-03) Khan, Ammara; Afzal, Ayesha; Butt, Hammad A.; Waheed, Akbar
Background: Even though with immense improvement and extensive understanding of pathophysiology of sepsis induced organ failure and affected population, it continues to put hundreds of people worldwide to eternal sleep due to lack of targeted therapy. Newer treatment modalities is the dire need of time. The present study was aimed to ascertain the adequacy of phosphodiesterases inhibitor - pentoxifylline (75mg/kg i.p) in endotoxin/LPS induced hepatotoxicity in BALB/c mice.Methods: The number of animals in each group was six. Endotoxin/lipopolysaccharides induced hepatotoxicity was reproduced in mice by giving lipopolysaccharide of serotype E. coli intraperitoneally. To ascertain the Preventive role, pentoxifylline was administered forehand LPS injection whereas therapeutic potential adjuged via post LPS delivering. The extent of liver damage was evaluated through serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with histopathological examination of liver tissue.Results: Results set forth that serum ALT, AST levels and histological alteration abated considerably (p ?0.05) both in animals subjected to pentoxifylline pre and post-treatment.Conclusions: Pentoxifylline set up promising results in endotoxin induced hepatotoxicity and can be used therapeutic adjuncts to conventional treatment strategies in sepsis induced liver failure.
Adherence to treatment in patients undergoing dialysis
(Medip Academy, 2019-05) B. V., Rakshitha; G. K., Nalini; G. N., Sahana; P., Deepak; Nagaral, Jayashree V.; N., Mohith; C. R., Divyashree
Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.
Adjuvant role of testosterone in treatment of schizophrenia and its interaction with combination of first and second generation anti-psychotics, chlorpromazine and risperidone
(Medip Academy, 2018-07) Vijaywargia, Tarun
Background: There is great controversy about role of male sex steroid, testosterone, in mental disorders like schizophrenia. This study assessed the effectiveness of testosterone in schizophrenic patients and probes how it modulates the action of combination of first and second generation anti-psychotic medications (Chlorpromazine + Risperidone) both of which are very commonly used anti-psychotic agents in clinical psychiatric practice.Methods: It Is randomized, double-blind, Clinical study performed in Indian schizophrenic patients (new cases) in the Department of psychiatry from Feb 2003 to March 2004. Patients twelve (12) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. 12 Patient was treated with combination of oral Chlorpromazine 200mg BD + oral Risperidone 2mg BD, half of the 12 patients also received single dose of testosterone 100mg intramuscularly with above-mentioned treatment. Measure How symptomatology in schizophrenic patients affected is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).Results: Single dose of Testosterone 100mg administered initially by I.M. route potentiated the reduction level in negative symptoms of schizophrenia by 119% in patients receiving oral Chlorpromazine 200mg along with oral Risperidone 4mg/day.Conclusions: In this study, Testosterone potentiated the effects of combination of oral Chlorpromazine 100mg BD + Risperidone 2mg BD, on general psychotic manifestations, positive symptoms and negative symptoms of schizophrenia, assessed on BPRS, SAPS and SANS scoring scales, however the effect is most pronounced in negative symptomology of schizophrenia.
Advances in human papilloma virus vaccines: a review.
(2014-01) Tomar, Akhilesh; Kushwah, Anjali
Cervical cancer is the second most common cancer among women and third leading cause of cancer death. Approximately 500,000 women worldwide develop new cases of cervical cancer annually, with 80% of these new cases occurring in developing countries. Human papilloma virus (HPV) infection is the main factor associated with the development of cervical cancer. The currently available HPV vaccines, gardasil and cervarix, can prevent infection by certain HPV types, but not all. At present, research efforts are being devoted to developing broader spectrum preventative vaccines, as well as therapeutic vaccines. To confer additional therapeutic activities, chimeric vaccines have been developed. Multivalent vaccine technologies employ strategies for addressing a broader spectrum of HPV types or for combining HPV with other pathogens. Edible vaccines are also disclosed. For needleless immunization, jet gun, gene gun and microneedles have been developed. Biodegradable and mucoadhesive polymer-based vaccine formulations have been developed to deliver vaccines through the mucosa and enhance immunogenicity. Various viral vectors of recombinant HPV DNA vaccine are disclosed.
Advances in therapy of breast cancer: overexpression and therapeutic implications of targeting human epidermal growth factor receptors
(Medip Academy, 2019-05) Bhalla, Amit
The human epidermal growth factor receptor 2 (HER2) ERbb2 gene is amplified in approximately 25% of breast cancers. Characteristics of HER2-amplified tumors include increased proliferation rates and a propensity for distant metastasis. The discovery of overexpression of HER2 in a subset of breast cancers was an important milestone in our understanding of the biology of the disease. This paved the way for the discovery of trastuzumab, a humanized monoclonal antibody targeting HER2. Trastuzumab is the foundation of treatment of HER2- positive breast cancers, demonstrating dramatic responses in patients with metastatic disease. Recent advances in our understanding of the interaction between HER2 and other members of the epidermal growth factor receptor family have led to the identification of newer agents, resulting in the expansion of the clinical armamentarium of available agents for the treatment of HER2-positive tumors. The biology of the ERbb receptor family, the use of HER2-targeted agents in breast cancer, and the advances in anti-HER2 agents that are currently in clinical development are reviewed here.

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