No abstract

The use of antipsychotic medications necessitate a hard indulgence between the benefit of alleviating psychotic symptoms and likelihood of concern, sometimes life shortening adverse effects. Psychotic symptoms such as restlessness and excitement, hallucinations, delirium might occur following the atropine administration. Moreover atropine induced psychosis has been reported rarely in literature. A 26year old male patient manifested with visual and auditory disturbances, hallucinations, fatigue and anxiety following the atropine administration during the treatment of organophosphate intoxication. The adverse drug reaction was classified as probable with a score of 6 according to Naranjo's casualty assessment scale and on the Hartwig's sale it is at level 5 (severe). The WHO-UMC casualty assessment system is indicated as probable with atropine. Initially the patient was managed by gastric lavage. Further management was done by tapering the dose of atropine and by supportive therapy along with antipsychotic medications. However the patient was not rechallenged with atropine owing to severity of reaction. Since atropine is one of the highly potent drug used in the treatment of organophosphate intoxication, due care is essential while prescribing doses especially with IV administration and early withdrawal of the offending drug is crucial to avoid further complications.

Until now injectable glucagon was the only available treatment used in the management of severe hypoglycemia wherein glucagon had to be prepared in several steps before administration. This method of delivery of injectable glucagon being cumbersome and unappealing for a wide majority of the patients had led to a search for an alternative route of drug delivery. Intranasal (IN) glucagon now serves an efficient, safe, easy to administer, and a favorable substitute to glucagon injections. This ready-to-use device stands in clear contrast to overcome the limitations associated with the currently available glucagon preparations, which has emerged a key advancement in the management of severe hypoglycemia in adolescents and children with type 1 diabetes. IN glucagon is now being developed and studied in other countries as well to meet the unmet need for an easy and convenient glucagon administration. This review covers the basic information of nasal glucagon, trials on nasal glucagon in children's and adults, and its potential uses, limitations, and future scope in practice.

Until now, injectable glucagon was the only available treatment used in the management of severe hypoglycemia wherein glucagon had to be prepared in several steps before administration. This method of delivery of injectable glucagon being cumbersome and unappealing for wide majority of the patients had led to a search for an alternative route of drug delivery. nasal glucagon (NG) now serves an efficient, safe, easy-to-administer, and a favorable substitute to glucagon injections. This ready to use device stand in clear contrast to overcome the limitations associated with the currently available glucagon preparations has emerged a key advancement in the management of severe hypoglycemia in adolescents and children with type 1 diabetes. NG is now being developed and studied in other countries as well to meet the unmet need for an easy and convenient glucagon administration. This review covers the basic information of nasal glucagon, trials on nasal glucagon in children and adults and its potential uses, limitations, and future scope in practice.

Objectives: The objectives of the study were to estimate the relative impact of triple therapy on lung function, health status, and mortality risk compared with combination inhaled corticosteroid (ICS)/long-acting β-agonist (LABA) therapy in symptomatic chronic obstructive pulmonary disease (COPD) patients with frequent exacerbations in an Indian clinical population. Methodology: The GLIMPSE (Lung Function, Health Status, and Mortality Risk Assessment in COPD using Triple Therapy) was as a prospective, parallel design, single-center observational study comparing 24 weeks of triple therapy (twice-daily combination of budesonide [BUD]-formoterol [FOR] [100/6 μg] and once-daily tiotropium [TIO] [9 μg]) with ICS/LABA (twice daily BUD-FOR [100/6 μg]). The primary outcome was the mean change in forced expiratory volume in the 1st s (FEV1%) predicted and COPD assessment test total score from baseline at week 24. Secondary outcomes were variation in dyspnea grade and BODE total score from baseline. Results: At week 24 in triple therapy (n=70) and ICS/LABA therapy (n=70), mean difference from baseline in FEV1% predicted were 5.40 (95% confidence interval [CI]: 1.29–9.50) and 1.90 (95% CI: –1.87–5.68) respectively, and mean difference in CAT total score from baseline was –5.10 units (95% CI: –3.49–−6.71) and –1.80 units (95% CI: –0.052–−3.548), respectively. In addition, there was a statistically significant reduction in dyspnea grading and BODE score with comparable adverse events in both groups. Conclusion: Overall, the results favored triple therapy over dual therapy in advanced symptomatic COPD patients.