Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from preclinical studies to multicentric clinical trials and postmarketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved, which puts pressure on the manufacturers to maximize the profit from approved drugs. It is in this key area that the practice of drug promotion plays its role. The World Health Organization defines drug promotion as "all informational and persuasive activities by manufacturers and distributors, the effect of which is to influence the prescription, supply, purchase or use of medicinal drugs". With its humble intent of creating awareness among healthcare professionals and updating their knowledge on recent advances in treatment options, drug promotion has been an important tool, but gradually it has evolved to embrace aggressive marketing strategies and sometimes unethical business and scientific practices where the need for profit-making eclipses commitment to patient care and scientific exploration. In this review, we discuss the evolution of drug promotion practices, the various types, its merits and demerits, the influence of drug promotion on physician prescribing behaviour, the role of regulatory bodies, unethical promotional practices and finally summarize with future directions.

The elucidation of a drug target is one of the earliest and most important steps in the drug discovery process. Ion channels encompassing both the ligand gated and voltage gated types are the second most common drug targets after G-Protein Coupled Receptors (GPCR). Ion channels are basically pore forming membrane proteins specialized for conductance of ions as per the concentration gradient. They are further broadly classified based on the energy (ATP) dependence into active ion channels/pumps and passive ion channels. Gating is the regulatory mechanism of these ion channels by which binding of a specific molecule or alteration in membrane potential induces conformational change in the channel architecture to result in ion flow or its inhibition. Thus, the study of ligand and voltage gated ion channels becomes an important tool for drug discovery especially during the initial stage of target identification. This review aims to describe the ligand and voltage gated ion channels along with discussion on its subfamilies, channel architecture and key pharmacological modulators.

Non-vitamin K antagonist oral anticoagulants have provided an optimization of management of patients in the prevention of stroke in nonvalvular atrial fibrillation. The lack of an effective reversal agent has remained a challenge to these agents’ widespread utilization. Idarucizumab, a specific reversal agent for dabigatran, is approved in many countries including India. However, there is limited data for its use for Indian patients. We are reporting one of the cases of its use in India where it successfully reversed dabigatran prior to mechanical thrombectomy in acute ischemic stroke.

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Dear editor, The anti-tuberculosis drug concentrations in tuberculosis patients with and without diabetes mellitus were studied by AK Hemanth Kumar et al., and the results were published recently [1]. With diabetes mellitus being an established factor increasing the risk of treatment failure, relapse, and death in tuberculosis patients [2], it is necessary to investigate the possible mechanisms behind the association.The authors' effort to address the issue by investigating the variability in plasma drug concentrations in diabetic and nondiabetic tuberculosis patients though appreciable has a number of shortcomings. Sixteen percent of the patients in the TB + DM group were labelled diabetic based on a single random blood glucose estimation on the study day, without proper elicitation of history for symptoms of hyperglycemia; this is in violation of the diagnostic criteria for diabetes mellitus [3]. In estimating the plasma drug concentrations, a multiple timepoint sample collection aimed at demonstrating the AUC would have been more informative and robust rather than a single time point sample collection [4]. Isoniazid metabolism and subsequently the plasma drug concentrations are known to be influenced by the acetylator status of the individual, but this key association has been neglected in the study [5].In the sample size estimation, selection of a higher true difference in the plasma drug concentrations could have led to a reduction in the sample size without affecting the results. The coefficient value for association between gender and pyrazinamide concentrations (−2.363) has not been specified for the gender type. The correlation coefficient at r = −0.09 for isoniazid and r = −0.092 for pyrazinamide demonstrate a very weak correlation despite the statistical significance. Moreover, the plasma drug concentrations for both isoniazid and pyrazinamide show only a relative variability, and the drug concentrations are within the normal therapeutic range for the respective drugs. This makes for a very weak or rather non-existent clinical implication for the results.In spite of failing to add new information on the mechanisms behind the association of diabetes mellitus and poorer outcome in tuberculosis patients, the study brings to light the possibility of exploring the pharmacokinetics of isoniazid and pyrazinamide in the setting of elevated blood glucose levels.