Background: Hypertension (HTN) and Diabetes mellitus (DM) are the leading contributors to the cardiovascular mortality and morbidity. Drug utilisation studies (DUS) are potential tools in the evaluation in health care systems. Objectives was to analyse the drug usage pattern of anti-hypertensives in elderly hypertensive diabetic in-patients in a tertiary hospital. To analyse drug usage pattern of anti-hypertensives in elderly hypertensive, diabetic in-patients with renal impairment in a tertiary hospital.Methods: The study population consisted of 165 hypertensive diabetic in-patients at Shri Dharmasthala Manjunatheshwara (SDM) Hospital. Questionnaire based study was conducted and prescriptions of patient with HTN and DM at and above the age of 60 years irrespective of gender were included.Results: Our study revealed that angiotensin receptor blockers (ARBs) were the most commonly prescribed (42.4%) class of anti-hypertensive drugs. In patients with impaired renal function also ARBs were the most common class prescribed (22.0%). Out of 35 anti-hypertensive fixed drug combinations (FDCs) prescribed the most frequent combination was combination with an ARBs (85.7%). There was a significant increase in the number of anti-hypertensive drugs prescribed in patients with impaired renal function when compared to patients without impaired renal function (p <0.05). The cost index was high, and the percentage cost variation was more than 100% in most of the anti-hypertensive drugs prescribed.Conclusions: This study shows that the most commonly prescribed anti-hypertensive drug class was ARBs in patients with and in patients without impaired renal function.

Cirrhosis of liver is a pathologically defined entity that is associated with a spectrum of characteristic clinical manifesta­tions. Portal hypertension is one of the complication of cirrhosis of liver. We report the case of a 55-year-old man with liver cirrhosis and subsequently portal hypertension and ascites who was admitted to the hospital with headache and indigestion. The patient was treated with furosemide 40 mg OD, lactulose 10 ml HS, Tone, vit K 10 gm IV, Usoliv 300 mg BD and pantoprazole 40 mg OD. The relevant and evidence based clinical practice guidelines and clinical status of furosemide on particular condition were discussed with treating physician. Journal of Chitwan Medical College 2013; 3(1): 65-66 DOI: http://dx.doi.org/10.3126/jcmc.v3i1.8470

Background: There are numerous brands of antimalarial existent in the market. Expensive drugs could result in financial drain that causes reduced compliance or even non-compliance. Non-adherence to therapy could consequently cause partial treatment that leads to higher morbidity and in certain cases mortality too. Thus this evaluation was conducted to measure the cost disparity of malaria therapy.Methods: The maximum and minimum price of each brand of the drug in Indian rupee rate was noted by using the latest edition of current index of medical specialities. The cost ratio and the percentage cost variation for individual drug brands were calculated.Results: The analysis of data reflected a considerable cost variation among antimalarial drugs. Chloroquine DS 500 mg showed the highest cost ratio and cost variation (cost ratio=15.3 and % cost variation=1434). Overall injectable antimalarials showed considerable cost variation as compared to oral antimalarial agents.Conclusions: The maximum variation shown by oral antimalarial was found to be for chloroquine DS 500 tablet. But there was significant price variation among injectable antimalarial. Injectable antimalarials are often the choice of drug when dealing with critically ill malaria patients specially when suffering from complicated malaria. So, such significant price variation creates burden on poor patients economically which leads to non-compliance and hence increased morbidity and mortality due to incomplete treatment.

Background: The objective of the present study was to analyse price differences between parenteral antibiotics available in a tertiary care teaching hospital.Methods: The study was done in the Department of Pharmacology of S. D. M. College of Medical Sciences, Dharwad, Karnataka. Latest volume of current index of medical specialties or Indian Drug Review was used to analyze the prices of parenteral antibiotics.Results: Overall, prices of 17 single drug antibiotics available in 37 strengths marketed and 8 fixed-dose combinations available in 16 strength marketed were analyzed. It was observed that the maximum cost variation among the single ingredient parenteral antibiotic was with cefpirome 1000 mg. The price difference being Rs. 283 and the cost variation being 90.7%. The minimum price variation was seen with Ampicillin 100 mg of Rs. 4.3 and the cost variation being 40.2%. Additionally the highest price difference was also seen teicoplanin 400 mg i.e., Rs. 610 and its cost variation being 68.5%. Among the fixed-dose combination (FDC’s) the maximum price variation was observed in the combination of cefoperazone+sulbactum 1000+1000 of Rs. 340. Whereas the cost variation of the same was 212.5 %. The minimum price variation among the FDC’s was of the combination of ceftriaxone 250 mg + tazobactum 31.25 mg Rs. 3.3 and its cost variation being 7.9 %.Conclusions: Pharmacoeconomics facets must be taken into deliberation by healthcare practitioners while prescribing antibiotics to the patients for infectious disease treatment. This will assist compliance, reduce antibiotic resistance and treatment failure.

Background: Hypertension (HTN) and Diabetes mellitus (DM) are the primary contributors to the renovascular mortality and morbidity. Drug utilisation studies (DUS) are prospective tools in the assessment of health care systems. Objectives: To analyse the prescription pattern of anti-microbials in elderly hypertensive diabetic in-patients with or without renal impairment in a tertiary hospital.The study population comprised of 165 hypertensive diabetic Methods: in-patients at Shri Dharmasthala Manjunatheshwara (SDM) Hospital. Questionnaire based evaluation was carried out and prescriptions of patient with HTN and DM at and above the age of 60 years irrespective of gender were included. Results: Out of 226 anti-diabetic drugs, 193 were single drugs and 33 were FDCs, among the total 123 drugs were used in patients with impaired renal function. There was no significant difference in the number of anti-diabetic drugs used in patients with impaired renal function and in patients with normal renal function, (p >0.05). Out of 193 single drugs, 83.42% (n=161) were insulins and 16.58% (n=32) were of oral anti-diabetic drugs. Among insulins, intermediate acting insulins were used in majority 63.73% (n=123) followed by long acting insulins, 19.69% (n=38). Amongst oral antidiabetics drugs, biguanides, with metformin being the most commonly prescribed drug, 9.84% (n=19). Conclusions: Intermediate acting insulin was the most common class of drug prescribed and combination of glimepiride + metformin was the most common FDC prescribed in patients with or without impaired renal function.