the Indian Journal of Pharmacy最新文献

{"title":"Efficacy and safety of different doses of apremilast in mild to-moderate psoriasis: A randomized controlled study.","authors":"Abhishek Anil, Aswini Saravanan, Anil Budania, Isha Yadav, Pradeep Dwivedi, Shoban Babu Varthya, Sneha Ambwani, Surjit Singh","doi":"10.4103/ijp.ijp_896_25","DOIUrl":"10.4103/ijp.ijp_896_25","url":null,"abstract":"<p><strong>Objectives: </strong>Apremilast, proven to be effective against psoriasis, has many side effects at the standard dose of 30 mg, impacting adherence. Hence, we aimed to compare the lower doses (10 mg and 20 mg) to the 30 mg apremilast dose. Primary objectives were to compare psoriasis area and severity index (PASI) 75 response and adverse events (AEs) in apremilast 30 mg versus 20 mg, and 30 mg versus 10 mg from baseline to 16th week.</p><p><strong>Methods: </strong>In this randomized, active-controlled trial, 124 patients with mild to moderate psoriasis were randomized (1:1:1 ratio) to apremilast 10 mg, 20 mg, or 30 mg twice daily for 16 weeks. Efficacy parameters were evaluated at 16th week, and safety was monitored every 2 weeks.</p><p><strong>Results: </strong>At week 16, PASI 75 response was comparable between apremilast 30 mg (31.7%) and 20 mg (28.6%) (P = 0.756), but significantly higher than 10 mg (9.8%) (P = 0.014). Apremilast 30 mg and 20 mg demonstrated comparable static physician global assessment 0/1 responses (39% vs. 31%, P = 0.441), whereas 30 mg significantly outperformed 10 mg (12.2%, P = 0.005). Common AEs observed in all groups were nausea and headache. Apremilast 30 mg exhibited significantly more AEs than 20 mg (P = 0.023) and 10 mg (P = 0.001).</p><p><strong>Conclusion: </strong>Apremilast 20 mg demonstrated comparable efficacy with significantly fewer side effects than the 30 mg dose in mild-to-moderate psoriasis, while apremilast 10 mg showed no significant improvement in efficacy compared to the 30 mg dose.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 4","pages":"342-349"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of tranexamic acid nebulization to control bleeding of hemoptysis: The tranexamic acid nebulization randomized controlled clinical trial.","authors":"Nitin Gawari, Sujata Shingare, Reshmi Bhattacharya, Abhijeet V Tilak","doi":"10.4103/ijp.ijp_1228_25","DOIUrl":"10.4103/ijp.ijp_1228_25","url":null,"abstract":"","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 4","pages":"484-485"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare rosuvastatin-clarithromycin interaction presenting with acute liver injury and delayed rhabdomyolysis.","authors":"Nithin Tumkur Prasad","doi":"10.4103/ijp.ijp_96_26","DOIUrl":"10.4103/ijp.ijp_96_26","url":null,"abstract":"<p><strong>Abstract: </strong>Rosuvastatin, a hydrophilic statin, is generally considered to have a low risk of clinically significant interactions with macrolide antibiotics, and concurrent use with clarithromycin is not contraindicated according to NHS Specialist Pharmacy Service guidance. However, rare cases of severe toxicity have been reported, particularly in the elderly or critically ill patients. A 69-year-old male, with a past medical history of ischemic heart disease developed marked transaminase elevation followed by severe rhabdomyolysis after receiving high-dose rosuvastatin concurrently with clarithromycin for a lower respiratory tract infection. Withdrawal of both agents, along with supportive treatment with intravenous N-acetylcysteine and ursodeoxycholic acid led to a rapid biochemical improvement. The patient subsequently died due to refractory shock related to his critical illness, and death was not directly attributed to the suspected drug-drug interaction. This case highlights a rare but clinically important interaction between rosuvastatin and macrolides that may be under-recognized, particularly in the elderly or critically ill patients.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 4","pages":"481-483"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of pharmacogenomics-guided dosing in improving treatment outcomes.","authors":"L V Karthikeyan, A Subamathi, P Pragathi, S Vaishnavi, V Sanjana, R Sangamithra","doi":"10.4103/ijp.ijp_1292_25","DOIUrl":"10.4103/ijp.ijp_1292_25","url":null,"abstract":"<p><strong>Abstract: </strong>The pharmacogenomics (PGx) discipline has played the pivotal role in the precision medicine by enabling the tailoring drug therapies to the genomic characteristics on an individual patient. This study reviewed PGx-guided dosing in the treatment of major diseases, such as cardiovascular, psychiatric, transplant, and oncologic. Data from randomized controlled trials, meta-analyses, and system reviews provided important insights. Several case reports indicated that genotype-guided drug prescription, indeed, helped to better select therapies for patients. For cardiovascular care specifically, warfarin and clopidogrel dosing, which were guided by PGx, was shown to work. Psychiatric cases supported better rates of remission and a lower number of side effects. The field of oncology demonstrates a marked reduction in the incidence of toxic reactions in chemotherapy regimens, whereas the field of transplant medicine had improved the management of immunosuppressants and the survival of grafts. Economic analyses further supported PGx testing, showing reduced hospitalizations and fewer treatment failures, thereby lowering healthcare costs. Although the clinical benefits of PGX-guided therapy were evident, several challenges limited its widespread adoption. These include inadequate clinical clinician training in consistent testing standards and gaps in infrastructure. Overcoming these barriers depended on advancements in decision support systems, machine learning applications, and the integration of multiomic data. Growing evidence from recent research has highlighted this shift, demonstrating how the PGx approach continues to evolve. Ultimately, PGF-guided dosing emerged not simply as a new technique but a promising pathway to improving patient outcomes, reducing healthcare costs, and shaping the future direction of personalized medicine.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 4","pages":"332-341"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of prescribing pattern with special reference to antibiotics, using digital platform among inpatients in a tertiary care hospital.","authors":"Saumya Kankanala, Krishna Prakash Joshi, Mohammad Nezamuddin Khan, Rohit Dixit, Rohini Gunasekaran, Tarun Gupta, Yogendra Kumar Gupta","doi":"10.4103/ijp.ijp_836_25","DOIUrl":"10.4103/ijp.ijp_836_25","url":null,"abstract":"<p><strong>Objectives: </strong>Prescribing patterns vary across primary, secondary, and tertiary care due to factors such as referrals and prior treatments. Tertiary care often involves higher-end drugs and more injectables for complex cases. This study assessed inpatient prescribing trends - antibiotic use, polypharmacy, and adherence to the National List of Essential Medicines - across hospital departments using the indigenous, validated digital analytics platform VaidyaRx.</p><p><strong>Methodology: </strong>An observational study was conducted over 4 months (June-September 2024) at SVS Medical College and Hospital, Mahabubnagar, Telangana, analyzing 2104 inpatient prescriptions from six clinical departments. The study evaluated drug utilization, antibiotic prescribing trends, and adherence to the NLEM guidelines. Data were analyzed using the descriptive statistics in Microsoft Excel and VaidyaRx.</p><p><strong>Results: </strong>The majority of patients (60.8%) were in the 19-65 age group, with orthopedics exhibiting the longest hospital stay (11.3 ± 9.9 days). The average number of drugs per prescription was 8.6, with 17.0% prescribed as generics. Antibiotics were present in 66% of prescriptions, with Ceftriaxone (15.7%) being the most commonly prescribed. The WHO Access, Watch, and Reserve classification revealed 38.3% were from Watch, 32.4% Access, and 1.9% Reserve antibiotics. Adherence to NLEM 2021 was 59.3%, with pediatrics (70.5%) showing the highest compliance. 26.1% prescription had fixed-dose combinations, predominantly in orthopedics and pediatrics.</p><p><strong>Conclusion: </strong>This study highlights the importance of rational prescribing, minimizing inappropriate antibiotic use, and optimizing adherence to essential medicine list and supporting enhanced antimicrobial stewardship programs and digital analytics platforms, VaidyaRx to enable real-time prescription monitoring. Strengthening evidence-based prescribing practices is required to improve patient safety and better healthcare outcomes.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 4","pages":"362-368"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torsemide and warfarin: A cautionary case of altered international normalized ratio and bleeding risk.","authors":"V H Mohammed, S R Ranjana, Arya S Kumar","doi":"10.4103/ijp.ijp_1300_25","DOIUrl":"10.4103/ijp.ijp_1300_25","url":null,"abstract":"<p><strong>Abstract: </strong>Warfarin is a widely used oral anticoagulant with a narrow therapeutic index and multiple drug-drug interactions that may significantly alter its anticoagulant effect. Torsemide, a loop diuretic commonly prescribed for heart failure and fluid overload, shares metabolic pathways with warfarin, raising the possibility of clinically significant interactions. However, the evidence regarding this interaction remains limited and inconsistent. A 66-year-old male with a history of type 2 diabetes mellitus, hypertension, chronic kidney disease, and prior aortic valve replacement on chronic warfarin therapy presented with extensive soft tissue necrosis of the left leg following minor trauma. During hospitalization, warfarin (3 mg once daily) and Torsemide (20 mg once daily) were initiated concurrently. Subsequently, the patient developed a progressive elevation in international normalized ratio (INR), necessitating repeated fresh frozen plasma transfusions due to increased bleeding risk. Despite supportive management, INR remained elevated. Torsemide was discontinued and replaced with furosemide, after which a gradual stabilization of INR levels was observed. The patient later required left above-knee amputation due to worsening necrosis but recovered following multidisciplinary management. Assessment using the Naranjo Adverse Drug Reaction Probability Scale suggested a possible interaction between warfarin and Torsemide. This case highlights a potential interaction between warfarin and Torsemide resulting in elevated INR and increased bleeding risk. Clinicians should exercise caution and ensure close INR monitoring when initiating Torsemide in patients receiving warfarin therapy.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 3","pages":"283-286"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Bellapu, Dhanush, et al., sodium glucose co-transporter 2 inhibitors safety depending on their adverse drug reactions and glucose monitoring parameters in type 2 diabetes mellitus.","authors":"Priti Dhande, Sanjay Jaiswal, Jayshree S Dawane, Chandra Dhar Shukla","doi":"10.4103/ijp.ijp_986_25","DOIUrl":"10.4103/ijp.ijp_986_25","url":null,"abstract":"","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 3","pages":"287-288"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of adding ketamine to etomidate infusion on serum cortisol levels for anesthetic induction compared to etomidate infusion alone in elective surgical patients: A randomized controlled trial.","authors":"M V S Satya Prakash, L Jency, Sakthirajan Panneerselvam, Prashant Shankarrao Adole","doi":"10.4103/ijp.ijp_1319_25","DOIUrl":"10.4103/ijp.ijp_1319_25","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether the addition of ketamine to an etomidate infusion could attenuate the reduction in serum cortisol levels compared to etomidate alone in patients undergoing elective surgical procedures.</p><p><strong>Subjects and methods: </strong>Eighty patients aged 18-60 years undergoing elective surgery were randomized into two groups. Group E (n = 40) received etomidate infusion 50 mcg/kg/min till the patient was induced. Group KE (n = 40) received a combined infusion of etomidate (1 mg/dL) + ketamine (5 mg/mL) at a rate of 50 mcg/kg/min of etomidate. The primary aim was to estimate serum cortisol levels at baseline, 4 h, 12 h, and 24 h postinduction.</p><p><strong>Results: </strong>The mean post-induction cortisol levels were significantly lower (p-value < 0.001) in Group E (8 ± 2.54 mcg/dL at 4 hours, 7.06 ± 2.57 mcg/dL at 12 hours, and 8.23 ± 3.1 mcg/dL at 24 hours) compared to Group KE (10.14 ± 1.96 mcg/dL at 4 hours, 10.07 ± 2.48 mcg/dL at 12 hours, and 11.27 ± 2.14 mcg/dL at 24 hours) with a comparable baseline cortisol concentrations (12.95 ± 2.64 mcg/dL) in Group E and (11.74 ± 2.11 mcg/dL) in Group KE. The serum cortisol levels decreased by approximately 39% in Group E and by around 17% in Group KE at 4 h postinduction.</p><p><strong>Conclusion: </strong>The addition of ketamine to an etomidate induction regimen decreases etomidate-induced adrenal suppression while preserving anesthetic efficacy and maintaining hemodynamic stability.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 3","pages":"259-265"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide in obesity and type 2 diabetes: A review of clinical trial evidence from 1 to 5 semaglutide treatment effect in people with obesity program.","authors":"Aastha Khanna, Vipin Kumar, Sahil Gola","doi":"10.4103/ijp.ijp_686_25","DOIUrl":"10.4103/ijp.ijp_686_25","url":null,"abstract":"<p><strong>Abstract: </strong>Obesity and type 2 diabetes mellitus (T2DM) are widespread health concerns that often coexist, contributing to increased cardiometabolic risks and premature death. Despite advancements in both lifestyle interventions and medical treatments, achieving lasting weight reduction and stable glycemic control remains a major clinical challenge. This review examines findings from the semaglutide treatment effect in people with obesity 1 (STEP) 1-5 trials, which assessed the effectiveness, safety, and long-term outcomes of once-weekly semaglutide 2.4 mg for weight management in adults. These trials included individuals with and without T2DM, enabling comparison across different populations and interventions. In nondiabetic participants (STEP 1, 3, and 4), semaglutide led to average weight reductions between 10% and 17%, while in patients with T2DM (STEP 2), the reduction was around 10%. The inclusion of intensive behavioral therapy in STEP 3 further enhanced weight loss outcomes. Results from STEP 4 highlighted notable weight regain following treatment withdrawal, reflecting the relapsing nature of obesity. STEP 5 confirmed semaglutide's ability to maintain significant weight loss (~15%) and improve metabolic health over a 2-year period. The most common side effects were gastrointestinal in nature but were generally manageable and nonsevere. Collectively, these trials support semaglutide 2.4 mg as an effective and sustainable option for managing obesity and overweight, including in people with T2DM. The data also emphasize the importance of combining pharmacological therapy with lifestyle modifications and recognize obesity as a long-term condition that necessitates continuous treatment.</p>","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 3","pages":"166-175"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Null result: Inconvenient, underreported, and indispensable!","authors":"Rituparna Maiti, Archana Mishra, Debasish Hota","doi":"10.4103/ijp.ijp_464_26","DOIUrl":"10.4103/ijp.ijp_464_26","url":null,"abstract":"","PeriodicalId":49189,"journal":{"name":"the Indian Journal of Pharmacy","volume":"58 3","pages":"163-165"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}