International Journal of Basic & Clinical Pharmacology

Journal Information
ISSN / EISSN: 23192003 / 22790780
Published by: Medip Academy
Total articles ≅ 3,356

Latest articles in this journal

Raunak J. Soman, Sarath Chandra Gorantla, Malisetty Venkat Swamy
International Journal of Basic & Clinical Pharmacology;

Background: Probiotic potential (efficacy and safety) of Bacillus coagulansSNZ 1969has been studied in patients with constipation-predominant irritable bowel syndrome (IBS-C) and-diarrhea predominant IBS (IBS-D). Methods: This randomized, double-blind, two-arm, placebo-controlled parallel study randomized 92 patients (1:1) to receive either 500 million CFU of Bacillus coagulans SNZ 1969 (treatment group) or placebo (placebo group) twice daily for 60 days under two subtypes of IBS, IBS-D (n=46) and IBS-C (n=46). Primary outcomes were changes in IBS symptom severity noted using the gastrointestinal symptom rating scale-IBS version (GSRS-IBS) on days 30, 60, and 75, and the number of treatment responders defined by subject’s global assessment (SGA) of relief ≤3 and ≤2 at days 30 and 60, respectively. We also assessed patient’s quality of life. Results: The GSRS-IBS scores reduced from day 30 through 75 in both IBS groups treated with Bacillus coagulans SNZ1969 compared to placebo (p<0.05). Higher GSRS-IBS score was noted in patients with IBS-C in the treatment group (22.45±2.7) than the placebo group (3.55±3.02; p<0.0001), and this trend was similar in IBS-D patients (p<0.0001). Most patients (90%) with IBS-C and all with IBS-D responded to Bacillus coagulans SNZ 1969 compared to no responders with placebo (p<0.0001). The SF-8 scores significantly reduced in patients receiving Bacillus coagulans SNZ 1969 than placebo for both IBS subtypes. One adverse event unrelated to the study treatments was reported in IBS-D group. Conclusions: Bacillus coagulans SNZ 1969 is safe, effective in alleviating IBS-associated clinical symptoms, and improves quality of life.
Hirva S. Santoki, Dhaiwat M. Shukla, Shikha V. Sood, Supriya D. Malhotra
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 487-489;

Adult-onset still’s disease (AOSD) is a rare multisystemic inflammatory disorder of unknown etiology characterised by high spiking fever, evanescent skin rash, arthralgias, arthritis, neutrophilic leucocytosis. Initial treatment strategy includes use of hands-on drugs like non-steroidal anti-inflammatory drugs, low dose corticosteroids, conventional DMARDs. But as the disease progresses to severe form, targeted and biologic DMARDs could be the option for management. Interleukin-6 being one among the many cytokines involved in the pathogenesis of AOSD, has made itself a target for the treatment of refractory cases. Tocilizumab, a recombinant humanized anti IL-6 monoclonal antibody, is one such biologic drug available in the market that has proven its therapeutic efficacy in several clinical trials. We are presenting a case of 37-year-old female patient, known case of AOSD for 4 years. Patient was initially maintained on low dose corticosteroid and conventional DMARD like hydroxychloroquine and methotrexate. Flare ups of the disease warranted the use of tocilizumab and tofacitinib in this patient. After clinical as well as pathological improvement with tocilizumab 2 years before, signs of immunosuppression were observed when tocilizumab was reintroduced for the treatment. Patient suffered from acute pyelonephritis, septicemia, shock, oropharyngeal candidiasis and bronchitis which could be owned to immunosuppressive action of tocilizumab. One can reduce the chances of infection and other adverse effects by careful periodic monitoring of various laboratory parameters like total W.B.C., total platelet count and liver enzymes. Cautious selection of the patient is needed for the treatment with newer biologic agents.
Ankit Bhardwaj, Shoma Mukherjee
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 438-445;

Background: Polypharmacy, contribute to an increased risk of adverse drug reaction morbidity, and mortality, and increases the length of hospital stay, hospital revisits and readmissions. We aimed to evaluate the prevalence and trends of polypharmacy and potentially inappropriate medications in elderly patients with version 2. STOPP/START criteria, and assess the severity of adverse drug events in patients with PIMs. Methods: This is a retrospective, record-based study of over-the-counter, and potentially inappropriate medications in the prescriptions of patients (>60 years). PIMs have been identified and further investigated to determine any adverse effects. If harm occurred, the severity of an adverse effect was rated using a modified Hartwig and Siegel scale. The causality of the events was assessed by using Naranjo's scale. Results: Out of 583 patients polypharmacy and excessive polypharmacy were found in 36.0%, and 42.8% of pre-admission medications. The most common over-the-counter (OTC) drugs were hydrocortisone (39.86%), ranitidine (21.62%), bisacodyl (14.86%), and diphenhydramine (12.84%). A statistically significant positive correlation was seen between age and the number of drugs prescribed (r2=0.16), while a non-significant positive correlation was found between sex, length of stay (LOS), and the number of drugs prescribed (r2 =0.0002, r2 =0.001). Common PIMs related incidence reported include Insulin (regular) 31.25% (N=20), Trihexyphenidyl (THP) 18.75%, zolpidem 12.5%, acetylsalicylic acid 9.3%, pantoprazole 52 7.81%, furosemide 7.8%, hydrocortisone 6.25%, and glimepiride 6.25%. Total of 130 ADRs 50% were mild, 28.4% were moderate, and 21.5% were severe. Out of 130 incidents, 64.6% were preventable, 22.3% were probably preventable, and 13.0% were not preventable. A total of 50.0% recovered completely from the ADRs, 33.0% had been recovering, 12.3% recovered with a squeal, 2.3% could not recover and 2.3% had been fatal. Conclusions: The study shows high uses of OTC and PIMs and PGx in elderly patients; which encourage intent need to develop awareness and action plans.
Akash Agnihotri, M. Kanimozhi, Subhash Samanta, Manjunath Bidarolli, Shailendra Handu
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 532-537;

Migraine is the second leading cause of disability in terms of ‘years lived with disability’ and it affects globally about 12% of the general population. Currently available preventive therapies are not specific to migraine. After the discovery of calcitonin gene-related peptide’s (CGRP’s) role in migraine pathophysiology, CGRP receptor antagonist drugs were developed specifically for migraine. Atogepant is the only oral, selective, potent, second-generation CGRP receptor antagonist approved in September 2021 by Food and Drug Administration (FDA) for prophylaxis of episodic migraines and chronic migraines. It acts by blocking the α-CGRP receptor present on the vascular smooth muscle cell membrane of cranial arteries. It has the added advantage of oral administration, less hepatotoxicity, minimal drug–drug interactions (DDIs) with better efficacy, safety, and tolerability profile compared to the other CGRP receptor antagonists. This present review summarizes the physicochemical properties, pharmacokinetics-pharmacodynamics (PK-PD) parameters, uses, and drug-food interactions with the help of available current evidence.
Ankit Bhardwaj, Atma Ram Sharma
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 490-493;

Neurological manifestations are emerging as relatively frequent complications of coronavirus disease 2019 (COVID-19), including stroke and encephalopathy. Here we reporting a case of a young male presented with acute aphasia at the emergency department. The patient has a positive history of upper respiratory tract symptoms, subjective fever, and myalgias, a week before for which he was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse transcription polymerase chain reaction (PCR) on a nasopharyngeal swab. An electroencephalogram (EEG) demonstrated interictal epileptiform abnormalities over the left posterior frontal lobe. Magnetic resonance imaging (MRI) axial T2- weighted image shows focal area of altered intensity appearing hyperintense involving the left frontotemporal lobes pre-dominantly the pre-central gyrus. A subtle restriction on diffusion-weighted imaging (DWI), with a minimal drop on apparent diffusion coefficient images. In contrast, it shows gyriform enhancement with suspicious adjacent meningeal thickening and enhancement. Cerebrospinal fluid was negative for antibody. Intravenous immunoglobulin (IVIG) 400 mg/kg was given for 5 days. The patient responded well to the therapy without any major clinical side effects and revealed complete resolution after 2 months.
Krishna Modi, Vipul Prajapati, Dhaiwat Shukla, Supriya D. Malhotra
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 477-479;

Adalimumab is a disease-modifying antirheumatic drug and monoclonal antibody that works by antagonising tumour necrosis factor-alpha prescribed in many rheumatological conditions like Rheumatic arthritis, Ankylosing spondylitis and Behcet’s disease. Serious side effects with this drug include heart and liver failure, nervous and blood disorders, allergic and immune system reactions and opportunistic infections. A 27-year-old female patient, known case of Behcet’s disease presented to the hospital with complaints of fever, cough and breathlessness following administration of Adalimumab, six doses over three months. Chest X-ray and BAL-CBNAAT was suggestive of Tuberculosis. AKT was started and Adalimumab was suspended until patient recover.
Mohit Shukla, Rakesh Chandra Chaurasia, Dwividendra Kumar Nim, Kamlesh Kumar Sonkar
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 395-400;

Background: The present study was undertaken to assess the efficacy of pregabalin and gabapentin in treatment of neuropathic pain at a government tertiary care hospital of Uttar Pradesh, India. Due to indiscriminate use of drugs for treatment of neuropathic pain, selection of an effective drug is need of hour. Methods: Out of 130 patients, 62 patients were given pregabalin and 68 were given gabapentin. Douleur Neuropathique 4 questionnaire (DN4) which was used to diagnose patients of neuropathic pain. Efficacy of drug was based on their capability to decrease neuropathic pain at regular intervals. Results: On comparing the efficacy of drugs by their ability to decrease neuropathic pain, there was a significant difference when comparing pregabalin and gabapentin, pregabalin being statistically significant than gabapentin. Conclusions: On the basis present study efficacy of pregabalin 300 mg once daily brought better improvement of symptoms and sign than that of gabapentin 600 mg administered once daily dose. So pregabalin is a better drug than gabapentin.
Kuruvilla P. Chacko, Romy Susan Thomas, Ashely Varghese, Hanna Maria Baiju, Philip Jacob, Abel Abraham Thomas
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 425-430;

Background: Pregnancy is a physiological state where drug therapy is of particular concern. The pertinent use of drugs during pregnancy is beneficial as it affects not only the health of the pregnant woman but also the developing fetus. The study was carried out to access the knowledge and awareness regarding the drug use among pregnant women. Methods: Cross sectional descriptive study was conducted among 150 pregnant women for six-month duration. All the information was acquired through direct interview with the subjects and from treatment chart of subjects which were then recorded in a data collection form. Results: Majority of the subjects were under the age group of 18-28 years (50%). Most of the subjects predominantly has tertiary level of education (69%). Furthermore, 57% of the subjects were at the third trimester of their pregnancy. Knowledge regarding use of their own medications were significantly high (95%), which suggest that the subjects were well aware of their medications. Besides, 82% of the subjects had knowledge about the medications that were not to be consumed during pregnancy. In addition, 89% of the pregnant women did not take any over the counter medications and about 92% of the subjects did not treat themselves with any ayurvedic or homeopathic medications. Conclusions: Significant number of subjects were aware about their medication use. They ensured themselves and their developing fetus a better health.
Aalesh Shah, Nehal R. Parikh, Devang Rana, Supriya Malhotra, Tejas Patel
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 410-418;

Background: India has the highest burden of acute coronary syndrome (ACS) in the world. This research is to evaluate prescriptions pattern and extent of adherence to American College of Cardiology (ACC)\American Heart Association (AHA) guidelines in the management of ACS with patient outcome. Methods: Case record form containing patient’s demographic, clinical profile, diagnosis, prescription drugs (with dose, duration and frequency) were noted. Pharmacotherapy was compared to ACC/AHA guidelines, to evaluate adherence, guideline adherence index (GAI-5) was used for 5 major drug groups for ACS. GAI was calculated as: number of patients using the prescribed medications/number of eligible patients multiplied by 100. Results: A total of 172 patients diagnosed with ACS. 64 (37.20%) Patients with the highest preponderance to ACS belonged to 51-60 years age group with a 4.73:1 male to female ratio. ST-elevation myocardial infarction (STEMI) (44.77%) was the most common diagnosis and an average of 14.66±4.34 drugs were prescribed. Majority of the patients opted for percutaneous coronary intervention (PCI) with or without having received fibrinolytic therapy at onset. Adherence to the ACC/AHA guidelines being 93.75% and 118 prescriptions being 100% adherent to the guidelines. A positive correlation between adherence and number of drugs was statistically significant. Conclusions: The success of evidence-based medicine (EBM) was well noted with a 0% in hospital mortality rate i.e. all of the 172 patients were discharged with therapeutic success. Despite the concept of EBM and its proven effectiveness, there is a paucity of availability of such guidelines in India, so this study, a first of its kind can serve as a starting point of generating national as well as local guidelines.
Amitrajit Pal, Rohini Gambre
International Journal of Basic & Clinical Pharmacology, Volume 11, pp 446-452;

Background: The rapidly expanding field of psychopharmacotherapy is challenging the traditional concepts of psychiatric treatment and research and is constantly seeking new and improved drugs to treat psychiatric disorders. Methods: The present study was undertaken to analyse the pattern of drug utilization of antipsychotic medications in outdoor patients of psychiatry department of a tertiary care hospital. 600 prescriptions of 600 patients suffering from different psychiatric illnesses were taken for analyses in which antipsychotic agents were prescribed either as a main drug or as a concomitant agent after proper taking written informed consent. Results: A total of 1681 drugs were prescribed in our study population The average number of drugs prescribed per prescription in the study population was 2.61±1.32. Schizophrenia, bipolar disorder, depression were among the most common illnesses for which antipsychotics were prescribed. Atypical antipsychotics were most commonly prescribed in the study population out of which olanzapine was prescribed in most of the patients. Considering the cost analysis of the present study, the average cost per prescription was 475.02 INR. Average cost of antipsychotics per prescription was 208.1 INR. Conclusions: The present study provides valuable insight into the overall pattern of antipsychotic drugs prescribed in patients suffering from different psychiatric illnesses and mental health disorders and the principles of rational prescribing were followed in accordance with the various drug use indicators mentioned by WHO.
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