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- Shikha Palta
- Anita K. Gupta
- Harcharan Singh
- Ritika Singla
- Sonia Arora
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- Hina Lal
- Harinder Singh
- Kawarjit Singh Sandhu
- Faiziul Haq
- Sanjeev Kumar
- Anjleen Kaur
- Tushar Vashisht
- Gursatinder Singh
- Neetu Sharma
- Rajneet Kaur
- R. P. S. Sibia
- Avneet Kaur
- Avnish Kumar
- Ena Bhajni
- Ashish Kumar
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Sehgal, Vijay K.
- Comparative Study to Evaluate Efficacy & Cost Effectiveness of Olmesartan Versus Telmisartan, in Patients of Stage I Hypertension
Abstract Views :252 |
PDF Views:115
Authors
Affiliations
1 Department of Pharmacology, Government Medical College, Patiala, Punjab, IN
2 Department of Cardiology, Government Medical College, Patiala, Punjab, IN
1 Department of Pharmacology, Government Medical College, Patiala, Punjab, IN
2 Department of Cardiology, Government Medical College, Patiala, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 4, No 1 (2015), Pagination: 568-576Abstract
Background: Hypertension is one of the most common diseases in the world. It is an important and independent risk factor for atherosclerosis, heart failure, renal disease, and peripheral arterial disease. It is directly responsible for 57% of all stroke deaths and 42% of coronary heart disease deaths in India.
Objectives: To evaluate and compare efficacy and cost effectiveness in hypertensive patients receiving Olmesartan and Telmisartan in Stage I hypertension.
Material and methods: The present study was an open, prospective, randomized, parallel group comparative study conducted in 60 patients of stage I hypertension over a period of 16 weeks. Patients were randomly allocated to two, age and sex, matched groups of 30 patients each. Group I patients were started on Olmesartan at a dose of 20 mg&Group II patients were put on Telmisartan at a dose of 40 mg. The BP lowering efficacy and cost effective analysis of Olmesartan versus Telmisartan was calculated&compared. The data was entered in Microsoft excel and compiled. Statistical analysis was done using various tests.
Results: Maximum patients in both the groups were in age group of 51-60 years. In group I there were 13 males and 17 females. In group II there were 14 males and 16 females. Both Olmesartan and Telmisartan are effective in lowering systolic&diastolic BP in supine&sitting positions&mean BP is also lowerer, more in Olmesartan group. By cost effective analysis Telmisartan was found more cost effective. Incremental cost effective ratio was found to be 218.35.
Conclusion: Both Olmesartan and Telmisartan belong to the same antihypertensive drug class, effectively reduce systolic and diastolic blood pressure at various visits. Taking into account Total cost Telmisartan was more cost effective than Olmesartan. ICER was found to be 218.35.
Keywords
Olmesartan, Telmisartan, Cost Effectiveness, Hypertension, Angiotensin Receptor Blockers.Full Text
- A Study of Anti-Hypertensive Drug Prescription Patterns in Hypertensive Post-Menopausal Women
Abstract Views :297 |
PDF Views:113
Authors
Affiliations
1 Department of Pharmacology, Government Medical College, Patiala, Punjab, IN
2 Department of Medicine (Cardiology), Government Medical College, Patiala, Punjab, IN
1 Department of Pharmacology, Government Medical College, Patiala, Punjab, IN
2 Department of Medicine (Cardiology), Government Medical College, Patiala, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 7, No 1 (2018), Pagination: 1594-1603Abstract
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW).
Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW.
Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators.
Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%.
Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
Keywords
Hypertension, Post-Menopausal Women, Prescription Pattern, Polypharmacy, Anti-Hypertensive Drugs.Full Text
References
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- Panja M, Mondal S, Bhattacharya P, Mondal D. Beta Blocker in Combination with Other Antihypertensives. Supplement of JAPI 2009;57:35-7.
- Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilization at the Panjab University Health Centre in India. Singapore Med J 2004;45(3):117-20.
- Che Q, Schreiber MJ Jr, Rafey MA. Beta-blockers for hypertension: are they going out of style? Cleve Clin J Med 2009;76(9):533-42.
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- Cidda M, Mateti UV, Batchu MK, Martha S. Study of prescribing patterns of antihypertensives in South Indian population. Int J Basic Clin Pharmacol 2014;3(2):303-7.
- Sivakumar A, Venkateswaramurthy N, Sambathkumar R. Study of drug prescription pattern of anti-hypertensives in a tertiary care hospital. Der Pharmacia Lettre 2014;6(4):86-8.
- Beg MA, Dutta S, Varma A, Kant R, Bawa S, Anjoom M, et al. A study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Med Sci Public Health 2014;3(8):922-6.
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- Drug Delivery Through Blood Brain Barrier:Taming the Bottleneck in CNS Therapeutics
Abstract Views :219 |
PDF Views:134
Authors
Affiliations
1 Department of Pharmacology, Government Medical College, Patiala, Punjab - 147001, IN
1 Department of Pharmacology, Government Medical College, Patiala, Punjab - 147001, IN
Source
International Journal of Medical and Dental Sciences, Vol 7, No 2 (2018), Pagination: 1653-1656Abstract
Although many agents have therapeutic potentials for Central Nervous System (CNS) diseases, few of these agents have been clinically used because of the brain barriers. Physiological barriers like the blood-brain barrier and blood-cerebrospinal fluid barrier as well as various efflux transporter proteins make the entry of drugs into the central nervous system very difficult. Different strategies for efficient CNS delivery have been studied. This review presents the current approaches to facilitate penetration across these barriers for enhanced drug delivery to the CNS.Keywords
Blood Brain Barrier, CNS Drug Delivery.Full Text
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- Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension
Abstract Views :270 |
PDF Views:153
Authors
Affiliations
1 Department of Pharmacology, Government Medical College, Patiala, Punjab - 147001, IN
2 Department of Medicine, Government Medical College, Patiala, Punjab - 147001, IN
1 Department of Pharmacology, Government Medical College, Patiala, Punjab - 147001, IN
2 Department of Medicine, Government Medical College, Patiala, Punjab - 147001, IN
Source
International Journal of Medical and Dental Sciences, Vol 8, No 2 (2019), Pagination: 1728-1738Abstract
Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.
Keywords
DBP - Diastolic Blood Pressure, HR - Heart Rate, HRQOL - Health Related Quality of Life, HTN - Hypertension, SBP - Systolic Blood Pressure.Full Text
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- A Study of Efficacy and Tolerability of Rosehip Extract (Gopo) vs. Ibuprofen (a nsaid) in Treatment of Osteoarthritis in Weight Bearing Joints
Abstract Views :298 |
PDF Views:113
Authors
Affiliations
1 Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
2 Department of Orthopaedics, GMC, Patiala – 147001, Punjab, IN
1 Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
2 Department of Orthopaedics, GMC, Patiala – 147001, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 8, No 2 (2019), Pagination: 1754-1758Abstract
Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.Keywords
Ibuprofen, Osteoarthritis, Rose hip, Womac Scale, GOPO.Full Text
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- A Study of Prescribing Pattern in Patients of Hypertension
Abstract Views :304 |
PDF Views:137
Authors
Affiliations
1 Department of Pharmacology, GMC Patiala, 147001, Punjab, IN
2 Department of Medicine, GMC Patiala, 147001, Punjab, IN
1 Department of Pharmacology, GMC Patiala, 147001, Punjab, IN
2 Department of Medicine, GMC Patiala, 147001, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 8, No 2 (2019), Pagination: 1759-1765Abstract
Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.Keywords
Anti-Hypertensive Drugs, Fixed Drug Combination, Hypertension, Prescription Pattern, Drug Utilization.Full Text
References
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- A Pharmacoeconomic Analysis to Determine the Relative Cost-effectiveness of Timolol 0.5%, Brinzolamide 1% and Brimonidine 0.2% Eye Drops in Treatment of Primary Open Angle Glaucoma/Ocular Hypertension
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Authors
Affiliations
1 Department of Pharmacology, BFUHS, GMC Patiala – 147001, Punjab, IN
2 Department of Ophthalmology, BFUHS, GMC Patiala – 147001, Punjab, IN
1 Department of Pharmacology, BFUHS, GMC Patiala – 147001, Punjab, IN
2 Department of Ophthalmology, BFUHS, GMC Patiala – 147001, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 8, No 2 (2019), Pagination: 1766-1774Abstract
Aim: A pharmacoeconomic analysis to determine the relative cost-effectiveness of timolol 0.5%, brinzolamide 1% and brimonidine 0.2% eye drops in treatment of Primary Open Angle Glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Comparative, open, randomized, parallel group prospective study. Materials and Methods: 60 patients of POAG or ocular hypertension were included in this study. Time period of study was 6 weeks. 60 eyes of 60 patients were included in the study. Patients were divided randomly into 3 groups of 20 each. Patients in group A, B and C received timolol, brinzolamide and brimonidine respectively. One drop of each medication was instilled twice a day at 9 am and 9 pm daily for 6 weeks. IOP was measured on day 0 at 9 am (before administration of drugs) and then at 11 am, to get baseline IOP. IOP was again measured on subsequent visits at 9 am and 11 am. Treatment outcome was number of mm Hg fall in IOP induced by the study drug. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost‑effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Paired ‘t’ test was used to analyze the parameters within the group. Independent samples t‑test was used to compare the efficacy of drugs with each other. Results: The % reduction of brimonidine, timolol and brinzolamide at end of 6 weeks was 21.43 ± 3.06%, 24.87 ± 2.46% and 18.78 ± 1.73% respectively. Timolol was superior in efficacy to other two drugs. The difference was statistically significant between the efficacy of timolol and brinzolamide (p < 0.001) as well as timolol and brimonidine (p = 0.003). There was no statistical significant difference in the efficacy of brimonidine when compared to brinzolamide (p=0.26). Timolol (5.87 ± 0.83 Rs/mm lowering after 6 weeks) was found to be most cost-effective followed by brimonidine (46.83 ± 7.37) and then brinzolamide (60.49 ± 6.77) in lowering IOP. Conclusion: All three drugs under the present study are useful in the treatment of POAG/OHT, but timolol is a better choice than other two drugs because of greater reduction in IOP and greater cost-effectiveness.Keywords
Cost-Effectiveness, Glaucoma, Pharmacoeconomics, POAG.Full Text
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- Comparative Analysis of Efficacy and Safety of Gabapentin Vs Amitriptyline in Patients of Peripheral Neuropathic Pain in Case of Diabetes Mellitus
Abstract Views :251 |
PDF Views:106
Authors
Affiliations
1 Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, IN
2 Department of Medicine, Rajindra Hospital, Patiala – 147001, Punjab, IN
3 Government Medical College, Patiala – 147001, Punjab, IN
4 Department of Physiology, Government Medical College, Patiala – 147001, Punjab, IN
1 Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, IN
2 Department of Medicine, Rajindra Hospital, Patiala – 147001, Punjab, IN
3 Government Medical College, Patiala – 147001, Punjab, IN
4 Department of Physiology, Government Medical College, Patiala – 147001, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 8, No 2 (2019), Pagination: 1775-1782Abstract
Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.Keywords
Amitriptyline, Diabetic Peripheral Neuropathic Pain, Efficacy, Gabapentin, Nerve Conduction, Safety.Full Text
References
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- The Comparative Study of Azilsartan with Telmisartan in Terms of Efficacy, Safety and Cost - Effectiveness in Hypertension
Abstract Views :238 |
PDF Views:125
Authors
Affiliations
1 Junior Resident, Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
2 Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
3 Department of Medicine, GMC, Patiala – 147001, Punjab, IN
1 Junior Resident, Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
2 Department of Pharmacology, GMC, Patiala – 147001, Punjab, IN
3 Department of Medicine, GMC, Patiala – 147001, Punjab, IN
Source
International Journal of Medical and Dental Sciences, Vol 9, No 1 (2020), Pagination: 1811-1817Abstract
Introduction: Hypertension (HT) represents the most common cardiovascular risk factor amongst the cluster group of Cardiovascular Diseases (CVD). Clinically, HT might be defined as that level of Blood Pressure (BP) at which the institution of therapy reduces the BP-related morbidity and mortality. Azilsartan (AZL) is a relatively new Angiotensin Receptor Blocker (ARB) available for the treatment of any stage of HT. Aim: To compare the efficacy, safety and cost-effectiveness of AZL 40-80 mg once daily versus telmisartan 40-80 mg once daily in patients of stage-I HT. Methods: A prospective, open, randomized parallel group comparative study of AZL versus telmisartan was done in patients of stage-I HT. The study included 80 patients, 40 in each group (group I and group II) coming to the department of Medicine, Rajindra Hospital attached to Government Medical College, Patiala. The study was conducted over 8 weeks. Group I, patients received Azilsartan 40-80 mg per day in divided doses and group II, patients received telmisartan 40-80 mg per day in divided doses according to severity of hypertension. The therapeutic efficacy of drugs was evaluated by monitoring BP. Adverse drug reactions were monitored in patients. The daily cost for each medication was noted and total cost of drugs taken over 8 weeks was calculated. Effectiveness of the drugs was calculated in terms of mm Hg fall in mean BP. All the observations thus made were statistically analyzed using appropriate tests. Results: Patients receiving AZL 40mg and telmisartan 40mg showed a significant fall (p<0.05) in systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at 4 weeks and 8 weeks, when compared to baseline. The difference in SBP and DBP between Group I (AZL) and II (Telmisartan) was statistically significant at 4 weeks (p<0.05) and was highly significant at 8 weeks (p<0.001). Adverse effects such as nasopharyngitis, upper respiratory tract infection, gastroenteritis, headache, dizziness, and fatigue were reported with both drugs. Conclusions: Reduction of BP with AZL was more as compared to telmisartan at 4 weeks and 8 weeks. Safety and tolerability was similar in both groups.
Keywords
Angiotensin Receptor Blocker (ARB), Azilsartan, Hypertension, Telmisartan.Full Text
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