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Showing posts from July, 2013

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 Pioglitaz...

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.