INDIAN PHARMACIST ASSOCIATION

GERD is an ongoing condition in which the contents of the stomach come back into the esophagus (the tube that carries food from your mouth to your stomach). Doctors call this “acid reflux.”  There are several reasons why people have GERD. One possible reason has to do with the muscle at the bottom of the esophagus. Normally, this muscle closes to keep food and stomach acid from coming back up the esophagus. In some people with GERD this muscle does not always work right.

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Polycystic ovary syndrome (PCOS) is an inherited disease that affects women of childbearing age.
The disorder causes multiple abnormal cysts in enlarged ovaries, so that they do not produce the normal number of eggs and do not ovulate (release eggs) normally.
The disease is present at birth but does not cause symptoms until women enter puberty. PCOS occurs in up to 10% of women and is a leading cause of female infertility. Women with PCOS have irregular and infrequent menstrual periods and may develop amenorrhea (complete absence of menstrual periods).
Women with PCOS are likely to have high blood pressure, obesity (especially central obesity, around the midsection of the abdomen), facial acne, hirsutism (excessive facial and body hair growth), and thinning scalp hair. They also have insulin resistance, which may lead to development of type 2 diabetes. The February 7, 2007, issue of JAMA includes an article about polycystic ovary syndrome

Diagnosis and Testing
• History of irregular or absent menstrual periods.
• Ultrasound examination of the ovaries (looking for the presence of multiple cysts)
• Blood pressure checks (since the risk of high blood pressure is high in women with PCOS)
• Screening for diabetes because women who have PCOS are likely to develop glucose intolerance (elevated glucose levels on an oral glucose tolerance test) and type 2 diabetes.

Treatment
Treatment of PCOS focuses on the symptoms that occur in each individual. Risk reduction for diabetes and heart disease is important. A number of treatments are available:
• Weight loss and exercise can help to manage diabetes and high blood pressure and reduce risk of development of cardiovascular disease and stroke. Weight loss and exercise are also crucial to prevent type 2 diabetes. Medications may be prescribed to control blood pressure.
• Stopping smoking reduces risk of cardiac disease
• Treating type 2 diabetes may involve oral medications and insulin if diet and exercise do not control elevated blood sugar levels.
• Oral contraceptives (birth control pills) regulate menstrual periods and suppress androgen ( the hormone that causes excess body and facial hair growth in women).
• Metformin, an oral medication often used in treating type 2 diabetes, improves insulin resistance even if diabetes is not yet present, decreases androgen, and improves ovulation.
• Spironolactone is a diuretic that decreases androgen and treats acne and hirsutism.
• Mechanical methods (plucking, shaving, depilatory product) help to manage excessive hair growth. Laser treatments and prescription creams may also be prescribed for women and hirsutism.

Source: JAMA

“India’s health care sector is estimated to be worth US $ 275.6 billion by 2020 .The expansion of the health care market will need efficient management professionals apart from the medical and technical professionals. We have taken the initiative through AVAGMAH Online School to train and prepare the individuals with the relevant knowledge and skill for the uprising sector.” Karthik KS, CEO and Founder of 24X7 Learning.

Source: IndiaInfoline

Dear friends,

A new drug Iloperidone (Generic Name)  has been approved for marketing in India.

Details of drug is as under.

Iloperidone

Iloperidone is an atypical antipsychotic agent indicated for the treatment of
schizophrenia in adults.

DOSAGE AND ADMINISTRATION

The recommended target dosage  is 12 to 24 mg/day administered twice daily. This target dosage range is achieved by daily dosage adjustments, alerting patients to symptoms of orthostatic hypotension, starting at a dose of 1 mg twice daily, then moving to 2 mg, 4 mg, 6 mg, 8 mg, 10 mg, and 12 mg twice daily on days 2, 3, 4, 5, 6, and 7 respectively, to reach the 12mg/day to 24 mg/day dose range.

Iloperidone can be administered without regard to meals.

DOSAGE FORMS AND STRENGTHS

1 mg, 2 mg, 4 mg, 6 mg, 8 mg, 10 mg and 12 mg tablets.

CONTRAINDICATIONS
Known hypersensitivity to Iloperidone or to any components in the formulation.

WARNINGS AND PRECAUTIONS

• Elderly patients with dementia-related psychosis who are treated with atypical antipsychotic drugs are at an increased risk of death and cerebrovascular-related adverse events, including stroke.
• Neuroleptic Malignant Syndrome: Manage with immediate discontinuation of drug and close monitoring.
• Tardive dyskinesia: Discontinue if clinically appropriate.
• Hyperglycemia and diabetes mellitus: Monitor glucose regularly in patients at risk for diabetes.
• Seizures: Use cautiously in patients with a history of seizures or with conditions that lower seizure threshold.
• Orthostatic hypotension: Dizziness, tachycardia, and syncope can occur
  with standing.
• Leukopenia, Neutropenia, and Agranulocytosis have been reported with
  antipsychotics. Patients with a pre-existing low white blood cell count
  (WBC) or a history of leukopenia/neutropenia should have their
  complete blood count (CBC) monitored frequently during the first few
  months of therapy and should discontinue Iloperidone at the first sign of a decline in WBC in the absence of other causative factors.
• Suicide: Close supervision of high risk patients.
• Priapism: Cases have been reported in association with Iloperidone treatment.
• Potential for cognitive and motor impairment: Use caution when operating machinery.

ADVERSE REACTIONS

Commonly observed adverse reactions (incidence ?5% and two-fold greater
than placebo) were: dizziness, dry mouth, fatigue, nasal congestion, orthostatic hypotension, somnolence, tachycardia, and weight increased.

USE IN SPECIFIC POPULATIONS
• Pregnancy: No human or animal data. Use only if clearly needed.
• Nursing Mothers: Should not breast feed.
• Pediatric Use: Safety and effectiveness not established in children and adolescents.
• Hepatic Impairment: Not recommended for patients with hepatic
impairment.
• The dose of Iloperidone should be reduced in patients who are poor
metabolizers of CYP2D6.

PATIENT COUNSELING INFORMATION

Physicians are advised to discuss the following issues with patients for whom they prescribe Iloperidone:

QT Interval Prolongation
Patients should be advised to consult their physician immediately if they feel faint, lose consciousness or have heart palpitations. Patients should be counseled not to take Iloperidone with other drugs that cause QT interval
prolongation. Patients should be told to inform physicians that they are
taking Iloperidone before any new drug is taken.

Neuroleptic Malignant Syndrome
Patients and caregivers should be counseled that a potentially fatal symptom complex sometimes referred to as
NMS has been reported in association with administration of antipsychotic drugs. Signs and symptoms of NMS include hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (irregular
pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia).

Orthostatic Hypotension
Patients should be advised of the risk of orthostatic hypotension, particularly at the time of initiating treatment, re-initiating treatment, or increasing the dose [see Warnings and Precautions.

Interference with Cognitive and Motor Performance
Because Iloperidone may have the potential to impair judgment, thinking, or motor skills, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that
Iloperidone therapy does not affect them adversely.

Pregnancy
Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy with Iloperidone.

Nursing
Patients should be advised not to breast-feed an infant if they are taking Iloperidone.

Concomitant Medication
Patients should be advised to inform their physicians if they are taking, or plan to take, any prescription or over the counter drugs, since there is a potential for interactions.

Alcohol
Patients should be advised to avoid alcohol while taking Iloperidone.

Heat Exposure and Dehydration
Patients should be advised regarding appropriate care in avoiding overheating and dehydration.