Everybody wants to get success in their life but on the cost of their health. Due to that the chances of irrationality of drugs increase in which self-medication is one of the major cause. The basic principle for the rational use of drug is better supply of drugs, better prescribing and lower costs for health care. When the basic principle of rational use of drugs is not fulfill it leads to irrationality which further leads to adverse effects and toxicity. There are number of factors which contributes to irrationality either they are inter-related to each other or they directly have affects and it may cause some effects on health and economic consequences. There is a cycle for rational use of medicine which help the clinician to prescribe the appropriate drug for appropriate disease condition, if each step is followed appropriately the irrationality improves. The concept of "rational use of medicine" can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom needs to collaborate effectively to address this challenge and the policy makers should be need to update with current trends.

14 patients with refractory hypertension did not respond either to captopril, an angiotensin II converting enzyme inhibitor, combined with a diuretic, a beta-blocker and hydralazine or minoxidil, a potent vasodilator, but they did respond to the combination of captopril, minoxidil, furosemide and a beta-blocker. There were no disturbing side effects from this combination. There may be a synergistic effect between captopril and minoxidil in the treatment of refractory hypertension. The combination is an interesting and novel method of treating patients with refractory hypertension.

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Fixed drug eruption (FDE) is one of the most common cutaneous adverse drug reactions in Indian patients. Chlorthalidone (CTD), a thiazide-type diuretic that inhibits distal convoluted tubule sodium and chloride resorption, is a commonly used oral antihypertensive. We are presenting a case of chlorthalidone induced FDE where a 75 year old hypertensive male admitted in hospital with complains of rashes associated with burning sensation on trunk, back and left arm after the administration of tablet chlorthalidone. FDE is believed to be a lymphocyte CD8-mediated reaction, wherein the offending drug may induce local reactivation of memory T cell lymphocytes localized in epidermal and dermal tissues and targeted initially by the viral infection. The initial treatment of FDE is discontinuation of the causative agent.