Browsing by Author "R, Almeida"
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Publication Safety monitoring of drugs - Where do we stand?(Kathmandu University, 2006) S, Palaian; P, Mishra; PR, Shankar; AK, Dubey; D, Bista; R, AlmeidaDrug related complications, a major cause of hospitalizations, lead to huge economic burden and significant human suffering. New chemical entities enter the market without sufficient safety data on patient population making rare (Adverse Drug Reactions) ADRs undetected in the clinical trials. ADR monitoring helps in detecting the occurrence of rare and unknown ADRs and helps in prevention of further occurrence. Several methods are adopted for effective monitoring of ADRs. An effective ADR monitoring program requires adequate infrastructure and trained manpower. In developed countries, the ADR monitoring system is well established. In Nepal, the concept of ADR monitoring is in the infant stage. A simple approach for ADR monitoring may be helpful in starting an ADR monitoring program in hospital setups in Nepal. Though it is difficult to prevent ADRs, a systematic approach will definitely helps in minimizing the further occurrence of similar ADRs. Key words: Adverse Drug Reactions, Causality assessment, Pharmacoeconomics, Pharmacovigilance, Safety monitoringPublication Therapeutic dimensions of ACE inhibitors- A review of literature and clinical trials(Kathmandu University, 2005) M, Prabhu; S, Palaian; A, Malhotra; P, Ravishankar; D, Bista; R, Almeida; P, MishraIn the 1970s, pharmacological therapy interrupting the renin-angiotensin system was considered beneficial for patients with high-renin hypertension. This gave rise to the development of ACE inhibitors. Surprisingly, the ACE inhibitors proved to be effective not only in patients with high renin hypertension, but also in many patients with normal levels of plasma renin activity. At present ACE inhibitors have a significant position in a wide range of chronic illnesses such as atherosclerosis, hypertension, myocardial infarction, diabetic complications, stroke etc. They are combined safely with drugs like angiotensin receptor blockers, calcium channel blockers and thiazides with varying degree of benefits. Though they are safe drugs, patients need monitoring for renal insufficiency, hypotension, hyperkalemia etc. The safety of these drugs in paediatrics patients is not established. It is better to avoid these drugs during pregnancy. Keywords: ACE inhibitors, Atherosclerosis, Diabetic complications, Hypertension, Myocardial infarction