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Objectives: Drug-drug interactions (DDIs) are an important issue in clinical practice as management of co-morbidities necessitates polypharmacy and some of these interactions can transmute into or accentuate adverse drug reactions (ADRs). The objective was to estimate the proportion of ADRs due to DDIs and to describe the pattern of drug-drug interactions that resulted in ADRs. Materials and Methods: Cross-sectional study was done in the Department of Pharmacology of a Government Medical College in Kerala for a period of 1 year after getting clearance from the Institutional Ethics Committee. ADR reports submitted to the ADR Monitoring Centre from June 2015 to May 2017 formed the study material and details were entered in a structured proforma. Each suspected drug and concomitant drugs were entered in MICROMEDEX®, MEDSCAPE, and LEXICOMP drug interaction softwares to identify all potential DDIs (pDDIs). The interactions which matched with ADR description were considered to be the probable cause of that ADR. SPSS software version 16 was used for data analysis. Descriptive data were expressed as frequencies and percentages. Results: Of the 345 ADR patients reported during the study period, 249 had concomitant drugs (mean 2.84±1.85 drugs/patient) from whom we identified 295 pDDIs (mean 1.18 ± 1.59 pDDIs/patient). Of the 295 pDDI, 30 matched the description of ADR, thus the proportion of ADRs due to DDIs was 12.05% (30 out of the 249 ADRs). Aspirin with Clopidogrel (n=5) and Heparin with Clopidogrel (n=5) topped the list of interactions contributing to ADR. Amongst the 30 suspected drug interactions causing ADR, 23 (76.67%) were pharmacodynamic, 21(70%) were of major severity and in 27(90%) the time of onset were not specified. Conclusions: Drug-drug interactions attributed to 12.05% of the ADRs in which data on concomitant drugs were available. Pharmacodynamic interactions (76.7%) contributed to sADRs more than pharmacokinetic interactions.

Background: Sphaeranthus indicus Linn is a widely used medicinal plant in Indian traditional system of medicine against human pathogens. Alarming bacterial resistance is urging scientist to search for newer anti-microbial substances from the medicinal plants. The objective of the study was to evaluate the antibacterial activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn (Asteraceae).Methods: The antibacterial activity of ethanolic extract of whole plant of Sphaeranthus indicus Linn was done against Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus in Mueller Hinton Agar (MHA) and compared with ciprofloxacin as standard by disc diffusion method.Results: The study revealed that there was no zone of inhibition in doses of 100 mcg, 200 mcg and 300 mcg of ethanolic whole plant extract of Sphaeranthus indicus in MHA plates compared with ciprofloxacin 30 mcg.Conclusions: Ethanolic extract of Sphaeranthus indicus does not have antibacterial activity. Further studies are needed in different extracts and parts of the plant. Simultaneous studies can be done in different places to evaluate environmental factors and regional variations.

Background: Sphaeranthus indicus as an entire plant or the specific parts like roots, leaves, flowers are used for treating helminthiasis, jaundice, diabetes, dyspepsia, fever, cough, hernia, gastritis, hemorrhoids, migraine, leprosy and skin diseases. The objective of this study was to evaluate the antifungal activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn. Methods: The antifungal activity of ethanolic extract of the whole plant Sphaeranthus indicus Linn was evaluated by incorporating the extract in Sabourauds dextrose agar. This property was studied in vitro using the ethanolic extract on Candida albicans, Microsporum gypseum, Trichophyton mentagrophytes and Epidermophyton floccosum by using Clotrimazole as standard drug.Results: This study revealed that the ethanolic extract of Sphaeranthus indicus is having good antifungal activity against Dermatophytes and Candida species. Conclusions: This study demonstrates the promising antifungal action of ethanolic extract of whole plant of Sphaeranthus indicus Linn. This feature can be exploited in the development of a newer antifungal agent from plant.