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India bans pioglitazone : The impact

Widely prescribed anti-diabetes drug pioglitazone and its combinations were banned on June 26 by Governemnt of India. Along with this, painkiller analgin and anti-depressant deanxit(Flupenthixol+ Melitracen) were also banned under Section 26A of the Drugs and Cosmetics Act(1940) by ministry of health and family welfare, India. Pioglitazone's safety : Always a concern   Pioglitazone is an anti-diabetic drug, which has unique action on improving insulin resistance by acting on PPAR receptors. Studies have reported pioglitazone causes congestive heart failure due to fluid retention and also bladder cancer. It also causes   muscle aches, headache, nausea, vomiting, loss of appetite, pain in the abdomen etc. Three years ago another drug from this family, rosiglitazone was banned in India following a decision taken in European Union.   Following the reports of adverse effects, France has discontinued Pioglitazone, but USA and UK allowed restricted use of Pioglitazone with a

Cytochrome enzymes nomenclature

Cytochrome : CYP Followed by family in numbers like 3 Subfamily indicated by capital letters like A Isoenzymes again by numbers like 4

The heart innervation : Parasympathetic vs sympathetic

Heart has property of automaticity : The ability to generate impulses without external stimulation. Parasympathetic vs sympathetic So which part of the Autonomic nervous system has a predominant action on heart. Normal heart rate : 60-80 Heart rate when both parasympathetic and sympathetic supply is severed : 100 The parasympathetic tone predominates in order to keep the heart rate reduced at normal rate.

Hy's Rule for hepatotoxicity

Named after Hyman Zimmerman,  Hy's rule states that drug induced hepatotoxicity with Elevation of serum ALT : >3 times the upper limit of normal Elevation of serum bilirubin : > 2 times the upper limit of normal The above two findings are associated with mortality rate of at least 10%.

Red man syndrome

Presentation  Cutaneous wheals and urticaria Local phenomenon  Progression to anaphylaxis : rare  Mechanism  De granulation of mast cells : direct action  Drugs implicated  Vancomycin  Ciprofloxacin  Amphotericin B  Rifampicin Teicoplanin Cremophor : excipient in paclitaxel & cyclosporine  Management  For vancomycin  Slowing infusion rate or stopping Prophylactic use of antihistamines  Repeated administration : tolerance can develop. 

Neurotransmitters and Neuromodulators : Diifference

Neurotransmitters  Chemical transmitters involved in transmission of impulse from one nerve to another. In other words, it is involved in the conduction of impulse. Eg : GABA, Glycine Neuromodulators  Chemicals which by itself does not have any effect or a minimal effect but modulates the activity of other neurotransmitters or receptors. The neuromodulators can either amplify or dampen the effect of neurotransmitters. Many neurotransmitters also behave as neuromodulators at specific sites. Eg : Substance P (both neurotransmitter and neuromodulator)

Nice story to remember about antimalarial drugs...

The anti malarial drugs is one such thing where recalling the names itself is like repeating a tongue twister. But here is a story which helps to retain the important points about the mechanism, adverse effects, uses of these drugs. Antimalarials: The Harem Once upon a time in a parallel Universe, there was a swampy kingdom ruled by King Medico. So, the story goes that once the kingdom was attacked by an epidemic of Malaria (Attack of the Plasmodia). The King (who is you in this story) decided to send his Queens out to destroy Malaria (much like in Chess: the Queen goes out to destroy, the King sits at home and watches ESPN!) He had 10 queens (including one eunuch), a mafia couple, a cyclist-warrior, a new warrior, and a CIA agent. Chloe-Queen (Chloroquine). Right, so…Chloe the Queen was a pretty effective warrior; she fought fast and long. The parasites had occupied the Temples of the Red Corpuscles and were trying to degrade the sacred substance Heme, but she complexed with Heme an