Lalit Mohan

Abstract

Objective: Various studies have showed the increased incidence of joint pain with the use of DPP-4 inhibitors. There is also some evidence of increase in inflammatory mediators like substance P, SDF-1 and other cytokines with the inhibition of DPP-4 from some experimental studies. But this association is still unclear and DPP-4 inhibitor continue to be prescribed in inflammatory disorders. So, this study was planned to assess the development of hyperalgesia in albino mice with the use of sitagliptin. Materials and Methods: Sitagliptin dissolved in saline was administered in the doses of 10, 20, 30 mg/kg to Albino mice of either sex weighing 25-30 gm. Hyperalgesia was assessed in the mice with hot plate method and acetic acid induced writhing test. Results: We found that reaction time of the mice receiving higher dose of Sitagliptin in hot plate method was lower than that of mice receiving lower doses or distilled water (P-Value Conclusion: Our findings show that in a cohort of mice receiving Sitagliptin and distilled water at baseline, there was significant association between dose of Sitagliptin and hyperalgesia. However, P-Value was greater than 0.01, but with these finding we can’t rule out this association and need for further prospective studies to assess the relationship between DPP-4 inhibitors and hyperalgesia.   Keywords: Sitagliptin, Hyperalgesia, Hot plate method, Acetic acid induced Writhing test, Albino mice

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Abstract

Objective: There is increasing trend among psychiatrists to use newer psychotropic medications in their practice. Assessing the pattern of prescription and setting standards according to it should become part of clinical practice. Keeping this in mind, present study was planned to highlight the utilization pattern, comparing it with other studies and assess safety outcomes. Materials and Methods: This was an observational and prospective study. One hundred forty-three (n=143) prescriptions were analysed and were followed up for 12 months. Patient on psychotropic drugs were screened for suspected Adverse Drug Reactions (ADRs) and were reported to AMC (Adverse Drug Reaction Monitoring Centre), Department of Pharmacology. Result: Total 514 drugs were prescribed in 143 prescriptions. Total number of antipsychotic drugs prescribed was 375. The average number of antipsychotic drugs per prescription was 2.62. Among Antipsychotics atypical antipsychotics (64.52%) were prescribed more than typical antipsychotics (39.02%). Most commonly reported ADR was weight gain (28.38%) followed by sedation (14.19%), tremor (12.16%) and akathisia (10.81%). 6.08% of ADRs were Gastrointestinal side effects. Weight gain was found exclusively in atypical antipsychotics while tremor and akathisia were found mostly in typical ones. Conclusion: Polypharmacy was avoided in prescriptions. Atypical antipsychotics were prescribed more than typical ones with olanzapine having highest percent drug utilisation. But this trend is increasing burden of obesity and metabolic syndrome in old age populations. The study results strongly suggest the need for healthcare team to focus on assessing and reporting suspected ADRs for enhancing the quality of monitoring and managing ADRs. Keywords: Antipsychotic drugs, Adverse drug reactions (ADRs), Prescribed daily dose (PDD), Defined daily dose (DDD), Prescription.

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