PubMed Health⌕ Search

Biomedical subjects

U Tekur

Publications and source records attributed to U Tekur.

12 recordsLinked to original sources
PubMed2005

Quality medicines for the poor: experience of the Delhi programme on rational use of drugs.

Prior to 1994, most Delhi hospitals and dispensaries experienced constant shortages of essential medicines. There was erratic prescribing of expensive branded products, frequent complaints about poor drug quality and low patient satisfaction. Delhi took the lead in developing a comprehensive Drug Policy in 1994 and was the only Indian state to have such a comprehensive policy. The policy's main objective is to improve the availability and accessibility of quality essential drugs for all those in need. The Delhi Society for the Promotion of Rational Use of Drugs (DSPRUD), a non-governmental organization, worked in close collaboration with the Delhi Government and with universities to implement various components of the policy. The first Essential Drugs List (EDL) was developed, a centralized pooled procurement system was set up and activities promoting rational use of drugs were initiated. In 1997, the Delhi Programme was designated the INDIA-WHO Essential Drugs Programme by the World Health Organization. The EDL was developed by a committee consisting of a multidisciplinary group of experts using balanced criteria of efficacy, safety, suitability and cost. The first list contained 250 drugs for hospitals and 100 drugs for dispensaries; the list is revised every 2 years. The pooled procurement system, including the rigorous selection of suppliers with a minimum annual threshold turnover and the introduction of Good Manufacturing Practice inspections, resulted in the supply of good quality drugs and in holding down the procurement costs of many drugs. Bulk purchasing of carefully selected essential drugs was estimated to save nearly 30% of the annual drugs bill for the Government of Delhi, savings which were mobilized for procuring more drugs, which in turn improved availability of drugs (more than 80%) at health facilities. Further, training programmes for prescribers led to a positive change in prescribing behaviour, with more than 80% of prescriptions being from the EDL and patients receiving 70-95% of the drugs prescribed. These changes were achieved by changing managerial systems with minimal additional expenditure. The 'Delhi Model' has clearly demonstrated that such a programme can be introduced and implemented and can lead to a better use and availability of medicines.

Drugs, Essential↗
PubMed2000

Drug utilisation pattern in sexually transmitted diseases and its economic considerations--a prospective study.

OBJECTIVES: WHO regularly revises guidelines for the treatment of these. There are very few studies reported on the drug utilization pattern of STD's in India. METHODS: In the present study, 325 patients attending the STD clinic of Lok Nayak Hospital were analysed over a period of six months. RESULTS: The demographic pattern of the patients was similar to those of studies reported earlier. Syphilis was the commonest of the STD's encountered; followed by viral STD's (c. acuminata and herpes progenitalis); gonorrhoea; chancroid and genital candidiasis. Out of a total of 409 drugs prescribed, the average number of drugs per prescription was 1.25. Sixty seven percent of the drugs were available in essential drug list of the hospital and 60% were prescribed in generic name. Ninety seven percent of the prescriptions were in accordance with WHO treatment guidelines. The cost of the drug treatment was comparable for c.acuminata, syphilis and chancroid while it was less for herpes progenitalis (HPG) due to acyclovir not being prescribed. However, it was more for gonorrhoea and candidiasis because of additional drugs. CONCLUSIONS: The present study shows a trend towards rational prescribing. It would be interesting to compare the results with a non teaching hospital.

Adult↗
PubMed1999

Pharmacokinetics of pyrazinamide in children suffering from pulmonary tuberculosis.

SETTING: The Paediatric and Clinical Pharmacology unit of Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India. OBJECTIVE: The pharmacokinetics of the anti-tuberculosis drug pyrazinamide was evaluated in 10 children aged 6 to 12 years suffering from pulmonary tuberculosis. METHODS: Serial blood samples were collected at 0, 1, 2, 4, 6, 12 and 24 hours after administration of pyrazinamide in a dose of 35 mg/kg. Serum pyrazinamide levels were analysed by spectrophotometry. RESULTS: The serum concentrations of pyrazinamide were above the minimum inhibitory concentration of 20 microg/ml of pyrazinamide for Mycobacterium tuberculosis up to 6 hours after drug administration in all the patients, and up to 12 hours in six patients. The mean peak serum concentration of pyrazinamide was 41.2+/-11.8 microg/ml, and this was attained in (Tmax) 2.9+/-1.7 hours. The elimination half life was 10.9+/-4.5 hours, the volume of distribution 16.1+/-10.9 litres and clearance 20.2+/-16.3 ml/minute. The corresponding mean residence time was 19.9+/-14.6 hours. CONCLUSION: The serum pyrazinamide concentrations achieved with a dose of 35 mg/kg were above the minimum inhibitory concentration of pyrazinamide for M. tuberculosis for over 6 hours after drug administration. It appears that the absorption and the clearance of pyrazinamide is slower, the elimination half life longer and the volume of distribution higher in children compared with the reported values in the adult population.

Antitubercular Agents↗
PubMed1996

Drug utilisation patterns in the Third World.

Drugs are not available to the majority of the population in developing countries. Aggravating factors include weak healthcare structure, inadequate financial resources, nonavailability of pharmaceuticals, lack of drug legislation and policy, ineffective drug utilisation and the prevalence of self-medication. Although most of the population lives in rural areas, available funds are mostly utilised for urban areas. The use of drugs by injection is common in developing countries. In addition, many patients self-medicate because most drugs are available without a prescription from a doctor. There is therefore a great need for prescriber education in rational drug use, and for public education in the use of commonly used drugs. National health and drug policies should be formulated which incorporate the essential drug concept, and drug legislation needs to be revamped and implemented effectively. These measures may be helpful in providing better healthcare to the majority of the population in developing countries.

Delivery of Health Care↗
PubMed1996

Pharmacokinetics of isoniazid in pulmonary tuberculosis--a comparative study at two dose levels.

OBJECTIVES: To compare the pharmacokinetic parameters and the clinical efficacy of isoniazid, administered in 10 mg/kg or 5 mg/kg to children suffering from pulmonary tuberculosis. DESIGN: A randomized, open, controlled clinical trial. SETTING: Teaching hospital in New Delhi. SUBJECTS: Twenty children suffering from pulmonary tuberculosis in the age group 6-12 years. INTERVENTIONS: A three drug antitubercular regimen comprising of rifampicin (10 mg/kg), pyrazinamide (30 mg/kg) and isoniazid in a dose of either 10 mg/kg (Group I) or 5 mg/kg (Group II) was administered for fourteen days. On day fifteen serial blood samples were collected at 0,1,2,3,6 and 24 h of isoniazid administration and analyzed spectrofluorometrically. MAIN OUTCOME MEASURES: Serum isoniazid concentrations and clinical response in both the groups. RESULTS: In both the groups, serum concentration of isoniazid were above the therapeutic range (0.5-2 micrograms/ml) at 6 h following drug administration. The minimum serum concentration of isoniazid was within or above minimum inhibitory concentration of the drug at 24 h in both the groups. The time to achieve maximum serum concentration, elimination half life, elimination rate constant, mean residence time, volume of distribution at steady state and plasma drug clearance were also comparable. At the end of 6 months follow up, all children showed comparable clinical and radiological improvement. CONCLUSION: Isoniazid in a dose of 5 mg/kg administered with other antitubercular drugs appears adequate for treatment of pulmonary tuberculosis in children.

Antibiotics, Antitubercular↗
PubMed1993

Pharmacodynamic bioequivalence: evaluation of different brands of terfenadine hydrochloride.

Terfenadine is a selective histamine H1 receptor antagonist which binds preferentially to peripheral receptors in vivo and is devoid of central nervous system depressant activity and thus has an improved adverse effect profile (1). Hence, terfenadine may be considered to be a first line agent in the treatment of allergic rhinitis and chronic urticaria. In man terfenadine is rapidly absorbed following a single oral dose and a peak terfenadine plasma concentration is reached within 1-2 hr after the drug administration (2). The present study was carried out to compare the bioequivalence of two terfenadine hydrochloride preparations marketed by Kopran Chem. Co. and Marrel Dow U.K. (Triludan) by evaluating their ability to inhibit the skin reaction to intradermally injected histamine (3).

Adult↗
PubMed1992

Drug utilization at primary health care level in southern India.

Primary health centres provide health care to the majority of the population in developing countries. A drug utilization study was conducted for 1 y at two primary health centres in Pondicherry, India. Information on complaints, diagnosis and drugs prescribed was collected. From the 2953 prescriptions studied, it was found that on an average each patient received 2.71 drugs. Vitamins, antibiotics, analgesics and antihistamines were the most commonly used, accounting for more than 80% of the drugs prescribed. The antimicrobials which constituted one fourth of the drug consumption, comprised sulphonamides, tetracycline and cotrimoxazole. About half of the patients received injections, particularly of the vitamin B Complex and antibiotics. The results will be used to plan intervention strategies for the promotion of rational drug use.

Adult↗
PubMed1990

Changing pattern of antimicrobial utilization in an Indian teaching hospital.

A study was conducted at Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India, on the pattern of antimicrobial utilization in hospitalized patients. A retrospective study was conducted during a one-month period between January 18 to February 17, 1987. The data were analyzed according to modified Kunin's criteria. The results were compared with a similar study conducted a decade ago. The study revealed a marked increase in the use of antimicrobial agents (from 19.9% to 56.1%). A more appropriate use of antimicrobial agents was observed (from 66.8% to 79.5%). A significant increase in their appropriate use for therapeutic purpose (50% to 88.2%), but not for prophylaxis (79.05% to 71.18%) was seen. The study revealed a marked increase in the use of antimicrobial agents during the last decade resulting in the emergence of nosocomial infections of resistant strains of organisms.

Anti-Infective Agents↗
PubMedDate not supplied

Effect of drugs influencing synthesis of prostaglandins on haloperidol-induced catalepsy in rats.

Rats pretreated with prostaglandin synthesis stimulators, phenoxymethyl penicillin (2, 4 and 8 mg/kg, ip) and levamisole (2.5, 5 and 10 mg/kg, ip) showed a dose related potentiation of catalepsy after subthreshold doses of haloperidol (0.1 mg/kg, ip). Pretreatment with prostaglandin synthesis inhibitors paracetamol and indomethacin exhibited significant inhibition of catalepsy at lower doses (2.5, 6, 10 and 15 mg/kg, ip). However, this antagonism was paradoxically less at higher dose levels (20 and 30 mg/kg, ip). The data suggest neuromodulatory contribution of prostaglandins in neuroleptic-induced catalepsy.

Acetaminophen↗