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Faruk et al. / In vivo Passive and Iontophoretic Delivery of Lisinopril.... transdermal patch gave an effective plasma concentration of 15 and 25 ng/ml, respectively, maintained for about 15 h. The iontophoretic patches delivered therapeutically relevant concentrations of lisinopril in rats and delivery comparable to conventional routes such as intravenous injection was achieved. The result confirm that electronic transdermal delivery can be a potential mode for systemic delivery of therapeutic molecules and present study confirmed the viability of lisinopril delivery from designed and fabricated patch by iontophoresis, using a convenient device configuration. REFERNCES 1. Droog EJ, Sjoberg F. Nonspecific vasodilatation during transdermal iontophoresis-The effect of voltage over the skin. Microvasc Res. 2003; 65(3):172-8. 2. De Graaff AM, Li GL, van Aelst AC, Bouwstra JA. Combined chemical and electrical enhancement modulates stratum corneum structure. J Control Rel. 2003; 90(1): 49-58. 3. Banga AK, Bose S, Ghosh TK. Iontophoresis and electroporation: comparisons and contrasts. Int J Pharm. 1999; 179(1):1-19. 4. Nair VB, Panchagnula R. Effect of iontophoresis and fatty acids on permeation of arginine vasopressin through rat skin. Pharmacol Res. 2003; 47(6): 563-569. 5. Kalia YN, Naik A, Garrison J, Guy RH. Iontophoretic drug delivery. Adv Drug Deliv Rev. 2004; 56(5): 619-58. 6. Wang Y, Thakur R, Fan Q, Michniak B. Transdermal iontophoresis: combination strategies to improve transdermal iontophoretic drug delivery. Eur J Pharm Biopharm. 2005; 60(2): 179-191. 7. Pillai O, Nair V, Panchagnula R. Transdermal iontophoresis of insulin: IV. Influence of chemical enhancers. Int J Pharm. 2004; 269(1): 109-120. 8. Gannu R, Yamsani VV, Palem CR, Yamsani SK, Yamsani MR. Iontophoretic delivery of lisinopril: Optimization of process variables by Box-Behnken statistical design. Pharm Dev Technol. 2009; 1: 1-9. 9. Banga AK. in “Electrically Assisted Transdermal and Topical Drug Delivery”, Taylor & Francis, London, UK. 1998. 10. Banga AK, Bose S, Ghosh TK. Iontophoresis and electroporation: comparisons and contrasts. Int J Pharm. 1999; 179: 1-19. 11. Chang SL, Hofmann GA, Zhang L, Deftos LJ, Banga AK. The effect of electroporation on iontophoretic transdermal delivery of calcium regulating hormones. J. Control Rel. 2000; 66: 127-133. 12. Lelawongs P, Liu JC, Siddiqui O, Chien YW. Transdermal iontophoretic delivery of arginine-vasopressin (I): Physicochemical considerations. Int J Pharm. 1989; 56:13-22. 13. Phipps, J. B.; Padmanaphan, R. V.; Lattin, G. A. Iontophoretic delivery of mode1 inorganic and drug ions. J Pharm Sci. 1989; 78: 365-369. 14. Gupta M, Verma PRP, Marwaha RK, Faruk A, Singh G. Formulation and evaluation of meloxicam gel. J Pharm Res. 2008; 7(1): 27-31. 15. Fang JY, Kuo CT, Huang YB, Wu PC, Tsai YH. Transdermal delivery of sodium nonivamide acetate from volatile vehicles: effects of polymers. Int J Pharm. 1999; 176(2): 157-167. 16. Kari B. Control of blood glucose levels in alloxan-diabetic rabbits by iontophoresis of insulin. Diabetes. 1986; 35: 217-221. 17. Neibergall PJ. Ionic Solutions and Electrolytic Equilibrium in “Remington’s Pharmaceutical Sciences”, Chap.17, 16th Edn., Osol, A. (Eds.), 1980. 18. Martin A, Swarbrick J, Cammarata A. in “Physical Pharmacy”, (IIIrd Eds.), pp. 222, Lea & Febiger, Philadelphia, 1983. 19. Pikal MJ. The role of electroosmosic flow in transdermal iontophoresis. Adv Drug Del Rev. 1992; 9: 201-237. 20. Tamimi JJ, Salem II, Mahmood AS, Zaman Q, D Ruwayda. Bioequivalence evaluation of two brands of lisinopril tablets (Lisotec and Zestril) in healthy human volunteers. Biopharmaceutics & drug disposition. 2005; 26(8): 335-339. 21. Santi P, Colombo P, Bettini R, Catellani PL, Minutello A, Volpato NM. Drug reservoir composition and transport of salmon calcitonin in transdermal iontophoresis. Pharm. Res. 1997; 14: 63-66. 22. Chaturvedula A, Joshi DP, Anderson C, Morris R, Sembrowich WL, Banga AK. In vivo iontophoretic delivery and pharmacokinetics of salmon calcitonin. Int J Pharm. 2005; 297: 190-196. 23. Ludden TM, Beal SL, Sheiner LB. Comparison of the Akaike Information Criterion, the Schwarz criterion and the F test as guides to model selection. J Pharmacokinet Biopharm. 1994; 22: 431-445. 24. Singh P, Maibach HI. Transdermal iontophoresis. Pharmacokinetic considerations. Clin Pharmacokinet. 1994; 26: 327-334. 25. Singh P, Roberts MS, Maibach HI. Modelling of plasma levels of drugs following transdermal iontophoresis. J Control Rel. 1995; 33: 293-298. IJPCR October-December, 2009, Vol 1, Issue 3 (131-135) 135
Available online at www.ijpcr.com International Journal of Pharmaceutical and Clinical Research 2009; 1(3): 136-140 Research Article ISSN 0975 1556 Evaluation of Prescription Pattern and Cost-Effectiveness among Patients Associated With Gynaecological Diseases in Government Maternity Hospital, Lucknow (U. P.)-India Rohit K. Verma * , Kiran Chaudhary, Amita Rai, Ayush Garg, Manisha Pandey, Shubhini A Saraf Faculty of Pharmacy, Babu Banarasi Das National Institute of Technology & Management, Lucknow, Uttar Pradesh, India-227105 ABSTRACT Drug is a very important link between producer and consumer. Thus a study on prescribing pattern and pharmacoeconomics helps in accessing the quality of health care services. A retrospective study was undertaken in the OBG Department, Maternity Hospital, Lucknow, India. A clinical survey was conducted on 119 gynaecological patients, out of which 19 patients were excluded according to exclusion criteria. Audited patients were in the age group of 18 to 60 years. Clinical data indicated that 22 % of women suffered from irregular menses, leucorrhoea (18 %), vulvitis (16 %), osteoporosis (15 %), recurrent bleeding (11 %), uterus inflammation (8 %), endocervitis (2 %), feranculitis (2 %) and breast pain (2 %). Clinical survey revealed that 80 % women were prescribed minerals and vitamins, 56 % Analgesics, 47 % Antibiotics, 42 % Antimicrobials, 39 % Iron tonics, 23 % Steroids, 6 % Anti-allergic, 4 % antispasmodic and 6 % Antiinflammatory therapy at the mean age of 38 years. It was observed that the drugs prescribed were correct for the current diagnosis and treatment. There were no any earlier records pertaining to their medical history and treatment regimen already undertaken. Most of the physicians were very much aware about diagnosis and treatment of gynaecological problems. Physicians are required to pay more attention while prescribing drugs involved in long term therapy with serious side effects such as antibiotics, steroidal drugs etc. Patients on long term drug therapy should undergo proper counseling and regular monitoring regarding the use of drugs. Pharmacoeconomical steps taken up by the hospital is highly appreciated. But care should be taken that the outcome of the therapy is not compromised while providing cost benefits to the patients. Keywords: Gynaecological diseases, Prescription pattern, Pharmacoeconomical evaluation, Patient safety. INTRODUCTION Irrational prescription of drugs is of common occurrence in clinical practice. [1] The study of prescribing pattern is an important component of medical audit which helps in monitoring, evaluating and making necessary modifications in the prescribing practices to achieve a rational and cost effective medical care. Auditing of prescriptions forms an important part of drug utilization studies. [2] The misuse of these agents leads to increased incidence of adverse effects, emergence of resistant strains and increase in cost of therapy. [3] In India and other Third World countries, women usually do not consult physicians or gynaecologists, due to inhibition or lack of perception of causes of disease. *Corresponding author: Mr. Rohit K. Verma, Faculty of Pharmacy, Babu Banarasi Das National Institute of Technology & Management, Lucknow, Uttar Pradesh, India-227105 Tel: 91-9997856074; E-mail: royal_mpcp@yahoo.co.in Their only contact with the health care system is through health workers for family welfare programs. [4] The lack of concern of health care planners for the prevention of gynaecological abnormalities can be traced to the lack of adequate information about rural health problems. Most data on morbidity among nonpregnant women are either hospital based [5-6] or selective for a particular disease. [4, 7] Occasional studies among the rural population in India have pointed out that gynaecological morbidity may be present in 92 % of the women. [6] Gynaecological health is an important component of any woman's health status. Gynaecological disorders can have a substantial impact on many aspects of quality of life, including reproductive ability, sexual functioning, mental health, and the ability to work and to perform routine physical activities. [8] More than a third of women in the United States will, at some point in their lives, develop a gynaecological problem that is severe or potentially problematic enough to lead to 136
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