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   Table of Contents - Current issue
Coverpage
January-March 2018
Volume 8 | Issue 1
Page Nos. 1-52

Online since Wednesday, July 11, 2018

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REVIEW ARTICLE  

Drug information center in India: Overview, challenges, and future prospects p. 1
Amol N Patil, Biswa Mohan Padhy, S Krishna Prasanthi, Rachna Rohilla
DOI:10.4103/jphi.JPHI_103_17  
Medicine is a forever-evolving science and commands continuous research. Pharmacologists and pharmacists contribute various amounts of medicine-related information to physicians, while clinicians face challenges in evidence-based medicine practice due to several reasons such as overloaded number of drug approvals, as well as the enormous quantity of scientific research data in medical journals published every day, making it more complicated for doctors to stay updated with the current advancements. This in addition, results in the call for more sophisticated crisis-targeting skills in order to respond to the more complex clinical difficulties that brazen out practitioners today. The drug information center (DIC) service run by Department of Pharmacology is the bridge between doctors by providing accurate, unbiased, up-to-date drug information for better patient care. Novel initiatives, such as antibiotic stewardship programs, therapeutic drug monitoring, pharmacovigilance, and materiovigilance are being considered by Department of Pharmacology. On a similar note, DIC activities have a huge potential to fit in as an integral part of pharmacology curriculum. Undergraduate, postgraduate, and superspeciality pharmacology curricula are deficient in formal teaching of evidence-based medicine. Western countries have been running variety of courses on drug information like residencies , fellowships for the training of pharmacy, pharmacology postgraduate students for last four decades. This is the need of the hour for a country like India to inculcate such practices for promoting rational use of drugs. This review will highlight how pharmacology and pharmacy curricula can be upgraded so as to contribute for improvement of rational therapeutics in the era where alternative medicines are also considered by patients in disease management.
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ORIGINAL RESEARCH ARTICLES Top

Design and investigation of metformin hydrochloride–Indion-254 complex for dispersible tablets p. 7
Arlene Stuart Villarroel, Madan Mohan Gupta, Lexley M Pinto Pereira, Andanappa K Gadad
DOI:10.4103/jphi.JPHI_3_18  
Objective: Metformin is a first-line agent for the treatment of Type 2 diabetes. The taste of metformin hydrochloride drug powder is bitter and its formulation are orally used. The objective of this study was to make a complex of metformin hydrochloride with Indion-254 resin for the purpose of preparation of dispersible tablet. Materials and Methods: This study formulated metformin hydrochloride–Indion-254 complexes with different proportion of resin with fixed amount of drug as well as mixed at varying speed which improved the flowability. Results: The resulted complex was investigated by the help of Fourier Transform- Infrared Spectroscopy, differential scanning calorimetry, and X-ray diffraction which were used to confirm complexation and to differentiate its features from the individual ingredients and the physical mixtures of ingredients. Conclusion: The formulated metformin hydrochloride–Indion-254 complex showed better drug loading as well as good release in mixed phosphate buffer in 200 ml.
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In vitro characterization of statistically optimized quetiapine-loaded self-nanoemulsified systems with quality by design p. 14
Jyothshna Devi Katamreddy, Prasanna Raju Yalavarthi, D Subba Rao, S P Surya Teja, Sowjanya Battu
DOI:10.4103/jphi.JPHI_9_18  
Objective: To optimize and characterize quetiapine (QP)-loaded self-nanoemulsified drug delivery systems (SNEDDS) by 3-factorial 3-level Box–Behnken design (BBD) to improve the dissolution. Methods: Amounts of olive oil (X1), tween 80 (X2), and PEG 400 (X3) as independent factors, whereas % limpidity (Y1), self-emulsification time (SET) (Y2), and drug released at 15 min (T15) (Y3) as responses were employed in BBD. Three-dimensional response surface plots were run to understand the main interaction and quadratic effects of independent variables. Preliminary screening was carried out by equilibrium solubility and emulsification efficiency studies. Nanoemulsification region was recognized by pseudoternary plot. Results: Mean droplet size of optimized nanodispersion was 89.68 nm, electrokinetic potential was −27.2 mV and polydispersity index <1 and represented 94% of limpidity, 69 s of SET, and 93.4% of T15. Software-generated model graphs (predicted versus actual and residual versus predicted) for all three responses were produced without outliers and thus indicated the adequacy of selected statistical model. Conclusion: This study explained the effectiveness of BBD in insights of formulation variables and quality of QP-loaded nanoemulsified systems so as to enhance dissolution. As a result, BBD was a well-suitable experimental design in predicting the responses of QP-loaded liquid SNEDDS.
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Microcapsule-based chronomodulated drug delivery systems of montelukast sodium in the treatment of nocturnal asthma p. 24
Vuppalapati Lavakumar, Cherukuri Sowmya, Narayanan Venkateshan, Velayutham Ravichandiran, Kagithakara Vajravelu Leela, Narayanaswamy Harikrishanan, Jayaraman Anbu
DOI:10.4103/jphi.JPHI_101_17  
Background: Asthma is a chronic disease characterized by repeated attacks of breathlessness and wheezing, which occurs principally during night. This is due to circadian changes in ventilation and airway responsiveness. Hence, the chronomodulated therapy is more considering in the treatment of nocturnal asthma. Objective: The objective of the study was to prepare microcapsule-based chronomodulated drug delivery system of montelukast sodium (MLS) for the treatment of nocturnal asthma. Materials and Methods: Five batches of MLS microcapsules were prepared using pH-dependent polymer combination of Eudragit® S-100 with L-100. The optimized batch microcapsules were enclosed in a capsule to obtain chronomodulated pulsincap systems (CMPSs). In this system, natural gums were used as hydrogel plugs to achieve the required time lag. Microcapsules and CMPSs have been evaluated for their characteristic properties. Results: The developed microcapsules are spherical in shape with smooth surfaces. In vitro release studies predicted that M4 and M5 batches could control the drug release for a period of 12 h. The optimized batch microcapsules (M4) were used in the preparation of CMPSs. The natural hydrogel plugs, i.e. xanthan gum, gum kondagogu, and guargum used in CMPSs showed approximate lag phase of 5, 6, and 5.5 h and drug releases up to 16, 24, and 24 h, respectively. Conclusion: CMPSs containing Eudragit® microcapsules of MLS with programmable lag phase and prolonged drug release were successfully developed using natural gums as hydrogel plugs, which congregates the demands of chronomodulated therapy in asthma.
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Hyperglycemia-induced intramitochondrial glycogen granules: A potential mechanism of glucose cytotoxicity in brain of mice p. 33
Mohd Alaraj, Bahaa Deen Al-Trad, Samir Qiblawi, Audah Al Hazmi, Fahaad S. H. Alenazi, Ashfaque Hossain, Tolgahan Acar, Mohammad Almermesh, Mohammed Qumani Ahmed
DOI:10.4103/jphi.JPHI_95_17  
Aim: The main objectives of this work were to prove that subcutaneous injection of high doses of glucose can lead to occurrence of glycogen granules inside ultrastructurally changed mitochondria of mouse cerebral cortex and to check whether blocking of mitochondrial permeability transition pore (MPTP) by cyclosporine A would diminish occurrence of these granules inside some mitochondria. By this, we aimed to explore if hyperglycemia-induced intramitochondrial glycogen granules (HIMG) may represent a molecular pathway through which hyperglycemia may lead to dysfunction of brain mitochondria. Materials and Methods: Electron microscopic studies and histopathological investigations have been carried out. We then incubated samples of brain cortex of mouse injected with high doses of glucose in alpha-amylase solvent or disolvent alone before being subjected to microscopic examination. Results: Electron microscopy experiments established that the observed granules are built of glycogen. It has been also demonstrated that blocking of MPTP by cyclosporine A diminished occurrence of glycogen inside some mitochondria in cerebral cortex, thus inhibiting hyperglycemia-induced apoptotic signaling that results from increased vulnerability of mouse brain mitochondria. Concurrently, cyclosporine A partially suppressed the histopathological changes of brain cortex of these animals. Conclusions: Taken together, this study indicates that cytotoxicity of hyperglycemia might occur through HIMG and we postulate this as a key molecular pathway through which hyperglycemia may lead to dysfunction of brain mitochondria. This is the first report showing HIMG as a cytotoxic molecular mechanism in mouse model.
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Efficacy and safety of olmesartan and hydrochlorothiazide versus telmisartan and hydrochlorothiazide in newly diagnosed patients with mild-to-moderate hypertension p. 38
Revathi Ramesh, N Sarala, PN Venkatarathnamma
DOI:10.4103/jphi.JPHI_4_18  
Background: Hypertension is one of the most prevalent noncommunicable diseases. The Joint National Commission VIII guidelines recommend angiotensin receptor blockers (ARBs) as the first-line drug and addition of hydrochlorothiazide (HCTZ) increases their efficacy. Olmesartan medoxomil is recently introduced, whereas telmisartan is a relatively older ARB. This study was conducted to assess the efficacy and safety of olmesartan and HCTZ versus telmisartan and HCTZ in the treatment of mild-to-moderate hypertension. Materials and Methods: A total of 120 patients with mild-to-moderate hypertension were recruited and randomized to receive either olmesartan 20 mg+HCTZ 12.5 mg (Group O) or telmisartan 40 mg+HCTZ 12.5 mg (Group T) orally once daily for 8 weeks. Blood pressure (BP) and heart rate were recorded at baseline and at 4th and 8th weeks, but blood sugar and lipid profile were estimated at baseline and 8th week. Results: Forty-six Group O and 44 Group T patients completed the study. Majority of patients were in the fifth decade of life (72.3%), 56% were males, and 35% had type II diabetes mellitus and received oral antidiabetics. The mean BP was 148.6 ± 5.9/89.2 ± 5.9 and 147.9 ± 5.2/88.1 ± 4.2 mmHg at baseline and decreased significantly at week 8 (131.0 ± 5.4/80.3 ± 2.9 and 136.8 ± 5.5/83.6 ± 3.9 mmHg) in Group O and Group T respectively. Patients in Group O had significant reduction in systolic BP (SBP) (P = 0.0001) and diastolic BP (P = 0.04) than that in Group T. More than 10 mmHg decrease in SBP was observed in 86.9% versus 65.9% of patients in Group O and Group T, respectively, which was statistically significant (P = 0.01). Diabetic patients in both groups had a significant decrease in blood sugar by week 8, but intergroup comparison was insignificant. Change in heart rate and lipid profile was negligible. Common adverse effects were dizziness, abdominal pain, and pedal edema in both groups. Conclusion: Olmesartan + HCTZ was more effective than telmisartan + HCTZ in lowering BP.
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The pharmacists' knowledge, attitude, and practice toward the application of radio-frequency identification in Iranian pharmacies p. 44
Peivand Bastani, Alireza Yusefi, Parisa Dehghanian, Maryam Radin Manesh, Nasrin Shaarbafchi Zadeh, Fatemeh Khademian
DOI:10.4103/jphi.JPHI_86_17  
Background: Health care is a vitally sensitive area, in which the smallest medication error may lead to patient's loss that cannot be compensated. In this area, information technology is a useful tool for practical improvement of health-care units such as hospital and community pharmacies. The aim of this study was to investigate the pharmacists' knowledge, attitude, and practice in applying radio-frequency identification (RFID). Methods: This is a cross-sectional research carried out in 2016. Research population and sample included 196 pharmacists in Shiraz city, the largest metropolitan in the South of Iran. The data were collected using the researcher-made questionnaire, and its validity and reliability were confirmed. Data were analyzed using descriptive indices and Pearson's correlation in SPSS 23. Results: The results showed that the means of practice, knowledge, and attitude of the participants were 1.64 ± 0.5, 1.82 ± 0.61, and 3.62 ± 0.62 (out of 5), respectively, showing weak practice and knowledge but good attitude toward RFID technology. In addition, the majority of the pharmacists' attitude toward applying RFID technology was evaluated as positive. There was a significant relationship between the items of pharmacists' knowledge and attitude toward RFID technology (P = 0.03, r = 0.36). Conclusion: Considering the fact that the concept of technology was newly developed in health area, we concluded that the studied pharmacists were not familiar with RFID technology and its advantages and they doubted its application. Therefore, it is suggested that required instructions should be taken into consideration by health authorities for introducing and applying the technology.
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LETTER TO EDITOR Top

Comparative efficacy of tea tree oil nanoemulgel and clove oil nanoemulgel against Candida albicans p. 50
Jasjeet Kaur Narang, Ramandeep Singh Narang, Balwinder Singh, Sukhdeep S Kahlon, Jiji George, Anmol Dogra
DOI:10.4103/jphi.JPHI_14_18  
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