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Papers by SitaRam Khadka

Journal of Nepal Health Research Council, 2021

Background: The global spread of COVID-19 and the lack of definite treatment have caused an alarm... more Background: The global spread of COVID-19 and the lack of definite treatment have caused an alarming crisis in the world. We aimed to evaluate the outcome and potential harmful cardiac effects of hydroxychloroquine and azithromycin compared to hydroxychloroquine alone for COVID-19 treatment.Methods: PubMed, Medline, Google Scholar, Cochrane Library, clinicaltrials.gov, and World Health Organization clinical trial registry were searched using appropriate keywords and identified six studies using PRISMA guidelines. The quantitative synthesis was performed using fixed or random effects for the pooling of studies based on heterogeneities.Results: The risk of mortality (RR=1.16; CI: 0.92-1.46) and adverse cardiac events (OR=1.06; CI: 0.82-1.37) demonstrated a small increment though of no significance. There were no increased odds of mechanical ventilation (OR=0.84; CI: 0.33-2.15) and significant QTc prolongation (OR=0.84, CI: 0.59-1.21). Neither the critical QTc threshold (OR=1.92, CI: 0...

Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific... more Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific treatment of this disease has not yet been approved. In this review, we aimed at assessing the role of hydroxychloroquine with/without macrolide in terms of efficacy and adverse effects against the standard of care. Methods: Pubmed, Medline, Google Scholar, Cochrane Library, and Clinicaltrials.gov were searched for the quantitative and qualitative synthesis of 13 studies using PRISMA guidelines for a proper review. Assessment of heterogeneity was done using the I-squared (I2) test and fixed/random effect analysis was done to determine the odds/risk ratio among the selected studies.Results: Meta-analysis of our study demonstrated no significant differences in improvement for the virological cure (RR 0.95, 0.67-1.34), whereas a significant relationship was there in radiological progression (pneumonia resolution) (RR 1.40, 1.03-1.91) between the two arms. There are 1.52 times the odds of i...

NHLBI Bias of observational and case series

Synthesis and sensitivity assessment

Europasian Journal of Medical Sciences, 2020

The continuously escalating burden of COVID-19 pandemic is challenging the health care systems ar... more The continuously escalating burden of COVID-19 pandemic is challenging the health care systems around the world. The healthcare professionals of different specialties throughout the globe are working day and night for its proper mitigation. Pharmacists are healthcare professionals who are working on the frontline for the management of COVID-19 in different settings. In this review, we highlight the potential roles pharmacists can play for effective management of COVID-19. The collaborative effort of all professionals, including healthcare and other stakeholders is necessary for the appropriate management of such pandemic. Pharmacists, having expertise in clinical as well as administrative aspects, can play a pivotal role in extended health services (EHS) from prevention to eradication of COVID-19. Firm determination, inter- and intra- professional collaboration, and legislative support are mandatory for the rational practice of professionalism in such disasters.

Journal of Karnali Academy of Health Sciences, 2020

Since the first outbreak, COVID-19 has manifested itself as a serious public health threat with s... more Since the first outbreak, COVID-19 has manifested itself as a serious public health threat with severe social and economic implications. Gender is an essential component that requires special attention and action in such crisis. This review is aimed at finding the gender-related issues amid COVID-19 pandemic that need to be considered and help stimulate related stakeholders to devise effective policies and actions. Health, socio-economical and education, all domains of gender are viciously affected by this pandemic. Though men and women have the same prevalence, men with COVID-19 are more at risk of worse outcomes and death. Even though the direct impact of disease is observed significantly high in men, the secondary socio-economic impact is catastrophic in women and girls considering their status in society as they are systemically oppressed and vulnerable group of population. The pandemic will have a prolong effect on socioeconomic dynamics. Hardly achieved milestones on gender eq...

Europasian Journal of Medical Sciences, 2021

Background: The rampant use of antimicrobials in poultry farms is creating a global public health... more Background: The rampant use of antimicrobials in poultry farms is creating a global public health threat as antimicrobial resistance (AMR) in humans may arise from such practice. This study was conducted with the objective of quantification and hence assessment of the level of antimicrobial use in Pakistani poultry farms so that appropriate utilization of such agents can be assured. Methods: Six randomly selected poultry farms of Pakistan with ten production cycles with 20,000- 30,000 birds in every production cycle were selected for the study from 2018 to 2019. The average dosage utilized on-farm was described by the defined daily dose (DDD) and used daily dose (UDD). Results: It was found that enrofloxacin, amoxicillin, doxycycline, tylocin, and lincomycin were the antimicrobials commonly used by all poultry farms. However, only Enrofloxacin (UDD/DDD = 0.95) was being used within the rational therapeutic range. All the antimicrobials were used irrationally without proper indicatio...

COVID-19 is creating a chaotic scenario all over the world. Due to the unavailability of approved... more COVID-19 is creating a chaotic scenario all over the world. Due to the unavailability of approved therapy, the number of affected cases is escalating day by day. Different components of the healthcare system have been consistently working in different settings for its containment. Pharmacists are one of the healthcare experts, who are working on the front-line. In this review, we aimed to evaluate the activities of pharmacists as a healthcare professional in disasters such as; COVID-19 management. The focus on services offered by pharmacists has shifted from traditional dispensing and compounding to patient-specific over a period contributing to the quality use of medicine and primary care. Pharmacists are thus, considered essentially one of the main pillars of the healthcare team for the provision of extended health services (EHS), for instance, the effective management of COVID-19. They are working from community to clinical setting. Practicing tele-pharmacy health services, they ...

Europasian Journal of Medical Sciences, 2021

Click on "Download Full Text pdf" to read

Background: Chronic kidney disease (CKD) has challenged the healthcare system for years. Use of α... more Background: Chronic kidney disease (CKD) has challenged the healthcare system for years. Use of αketoanalogue (KA) supplemented with a low protein diet (LPD) may improve renal function. In this study, we aim to find out the effectiveness of KA supplemented with LPD for the therapy of CKD. Methods: A quantitative cross-sectional study was conducted at Shree Birendra Hospital with 25 control and 25 treatment groups. The control group was treated with LPD (0.8 g/kg/day), while the treatment group was treated with KA (3 tablets/day for 4 weeks followed by 6 tablets/day for the next 16 weeks) along with LPD. The baseline parameters were measured on day 0, then subsequently at week 4, week 12, and lastly at the end of week 16. Results were then compared with the control group for analysis. Results: The serum level of creatinine showed a progressive decline in the treatment group (2.03±0.39 to 1.68±0.51) in comparison to the control group (2.03±0.36 to 2.54±0.69). However, there was a prog...

Context Drug repurposing is a relevant approach during the COVID-19 pandemic, because development... more Context Drug repurposing is a relevant approach during the COVID-19 pandemic, because development of new drugs is time-consuming and costly, and the safety of new drugs is paramount. Drug repurposing focuses on researching new indications for existing drugs and can reduce the challenges faced in drug development. Objective The current review intended to examine the current status of drugs being repurposed for COVID-19 treatment. Design The research team performed a literature review, searching relevant literature databases to find abstracts of relevant articles in journals published from 2010 until May 16, 2020. The sources of data included Google Scholar, PubMed, and ScienceDirect. The search terms used included repositioning of drugs, repurposing of drugs and COVID-19 therapy, and SARS-CoV-2 therapy. Setting The research team conducted this study at the Department of Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan; Mangalbare Hospita...

Europasian Journal of Medical Sciences, 2020

Coronavirus disease (COVID-19) is a respiratory infectious ailment caused by severe acute respira... more Coronavirus disease (COVID-19) is a respiratory infectious ailment caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first outbreak of this disease occurred in China and declared a pandemic in a very short period of time. SARS-CoV-2 gets transmitted mainly through the respiratory tract by droplets or respiratory secretions and by direct contact with the infected person as well as indirect contact through touching the contaminated surface accompanied by poor hygiene practice. Until the vaccine, a therapeutic agent or any other treatment modality gets approved; contact tracing and management, social distancing, personal hygiene, respiratory etiquette, and environmental decontamination are the prime factors to be considered for transmission containment and hence for appropriate safety measures for COVID-19 which is possible with the support of social work from the community level.

SN Comprehensive Clinical Medicine, 2020

Virology Journal, 2020

Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA... more Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19. Methods Databases like Pubmed, Pubmed Central, Scopus, Embase, Google Scholar, preprint sites, and clinicaltirals.gov were searched. The studies with the standard of care (SOC) and FVP as a treatment drug were considered as the treatment group and the SOC with other antivirals and supportive care as the control group. Quantitative synthesis was done using RevMan 5.4. Clinical improvement, negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), adverse effects, and oxygen requirements were studied. Results We identified a total of 1798 studies after searching the electronic databases. Nine in the qualitative stud...

Aim COVID-19 outbreak spread all over the world and created a public health catastrophe. Here, we... more Aim COVID-19 outbreak spread all over the world and created a public health catastrophe. Here, we have aimed to conduct a systematic review and meta-analysis on remdesivir use for COVID-19. Methods We searched Pubmed, Pubmed Central, Scopus, Embase, clinicaltrials.gov, and preprint sites and identified ten studies for qualitative and four studies for quantitative analysis using PRISMA guidelines. The quantitative synthesis was performed using fixed and random effect models in RevMan 5.4. Heterogeneity was assessed using the I-squared (I2) test. Results Comparing remdesivir group with placebo or standard of care (SOC) group, remdesivir reduces 14 days mortality (OR 0.61, CI 0.41-0.91), need of mechanical ventilation (OR 0.73, CI 0.54-0.97), and overall severe adverse effects (OR 0.69, 95% CI 0.54 to 0.88). There is better clinical improvement on day 28 (OR 1.59, CI 1.06-2.39); day 14 clinical recovery (OR 1.48, CI 1.19-1.84); day 14 discharge rate (OR 1.41, CI 1.15-1.73) among remdesivir groups. Earlier clinical improvement (MD-2.51, CI-4.16 to-0.85); and clinical recovery (MD-4.69, CI-5.11 to-4.28) seen among remdesivir group. While no difference on 28 days mortality rate; discharge rate; overall adverse effect. Longer course (10 days) of remdesivir showed higher discharge rate at day 14 (OR 2.11, CI 1.50-2.97), but there are significantly higher rates of serious adverse effects, and drug discontinuation than the shorter course. Conclusion Remdesivir showed a better 14 days mortality profile, clinical recovery, and discharge rate. Overall clinical improvement and clinical recovery were earlier among remdesivir group.

Drugs & Therapy Perspectives, 2020

Background: Playing venue conditions is a prominent contributor to the performance of players in ... more Background: Playing venue conditions is a prominent contributor to the performance of players in a competition. Hence, the present study was designed to evaluate the effect of playing venue on the hormonal responses, psychological state, and perception of effort in inter-university basketball players. Methods: A total of 96 male basketball players from eight different public and private sector universities were monitored during eight competitive matches played against each other on a home and away ground. Testosterone and cortisol levels were measured before and after each match. The psychological state test was conducted before each match and the perception of effort score was taken after the match. Results: Elevated testosterone levels, before playing a match, as evidenced at home ground, however, a 4% decline was recorded in testosterone level at away venue, even before playing the match. Both testosterone and cortisol levels depicted the same trend on home as well as away ground...

Europasian Journal of Medical Sciences, 2020

Anti-inflammatory drugs are among the mostly used drugs in geriatrics. Geriatrics usually encount... more Anti-inflammatory drugs are among the mostly used drugs in geriatrics. Geriatrics usually encounter problems of pain and inflammation and are more vulnerable to the toxicity of drugs as compared to young patients. In this review, we aimed to find out the toxic profile of drugs and the pharmacotherapy considerations for geriatric care. The diseases geriatrics mostly suffered from are osteoarthritis (OA), ankylosing spondylitis, carcinoma, and other degenerative disorders that require anti-inflammatory medicines. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are mostly used agents for the treatment of inflammation in geriatrics. Due to the over the counter (OTC) availability, NSAIDs are mostly used and being self-medicated as well. As the pharmacokinetics of drugs get altered due to alteration in body physiology in geriatrics, the pharmacodynamics also gets affected, and hence toxicity ensues even with normal dose. Depending upon the nature of the drugs; gastroint...

Journal of Nepal Health Research Council, 2021

Background: The global spread of COVID-19 and the lack of definite treatment have caused an alarm... more Background: The global spread of COVID-19 and the lack of definite treatment have caused an alarming crisis in the world. We aimed to evaluate the outcome and potential harmful cardiac effects of hydroxychloroquine and azithromycin compared to hydroxychloroquine alone for COVID-19 treatment.Methods: PubMed, Medline, Google Scholar, Cochrane Library, clinicaltrials.gov, and World Health Organization clinical trial registry were searched using appropriate keywords and identified six studies using PRISMA guidelines. The quantitative synthesis was performed using fixed or random effects for the pooling of studies based on heterogeneities.Results: The risk of mortality (RR=1.16; CI: 0.92-1.46) and adverse cardiac events (OR=1.06; CI: 0.82-1.37) demonstrated a small increment though of no significance. There were no increased odds of mechanical ventilation (OR=0.84; CI: 0.33-2.15) and significant QTc prolongation (OR=0.84, CI: 0.59-1.21). Neither the critical QTc threshold (OR=1.92, CI: 0...

Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific... more Background: Coronavirus disease (COVID-19) pandemic has been a global health threat. The specific treatment of this disease has not yet been approved. In this review, we aimed at assessing the role of hydroxychloroquine with/without macrolide in terms of efficacy and adverse effects against the standard of care. Methods: Pubmed, Medline, Google Scholar, Cochrane Library, and Clinicaltrials.gov were searched for the quantitative and qualitative synthesis of 13 studies using PRISMA guidelines for a proper review. Assessment of heterogeneity was done using the I-squared (I2) test and fixed/random effect analysis was done to determine the odds/risk ratio among the selected studies.Results: Meta-analysis of our study demonstrated no significant differences in improvement for the virological cure (RR 0.95, 0.67-1.34), whereas a significant relationship was there in radiological progression (pneumonia resolution) (RR 1.40, 1.03-1.91) between the two arms. There are 1.52 times the odds of i...

NHLBI Bias of observational and case series

Synthesis and sensitivity assessment

Europasian Journal of Medical Sciences, 2020

The continuously escalating burden of COVID-19 pandemic is challenging the health care systems ar... more The continuously escalating burden of COVID-19 pandemic is challenging the health care systems around the world. The healthcare professionals of different specialties throughout the globe are working day and night for its proper mitigation. Pharmacists are healthcare professionals who are working on the frontline for the management of COVID-19 in different settings. In this review, we highlight the potential roles pharmacists can play for effective management of COVID-19. The collaborative effort of all professionals, including healthcare and other stakeholders is necessary for the appropriate management of such pandemic. Pharmacists, having expertise in clinical as well as administrative aspects, can play a pivotal role in extended health services (EHS) from prevention to eradication of COVID-19. Firm determination, inter- and intra- professional collaboration, and legislative support are mandatory for the rational practice of professionalism in such disasters.

Journal of Karnali Academy of Health Sciences, 2020

Since the first outbreak, COVID-19 has manifested itself as a serious public health threat with s... more Since the first outbreak, COVID-19 has manifested itself as a serious public health threat with severe social and economic implications. Gender is an essential component that requires special attention and action in such crisis. This review is aimed at finding the gender-related issues amid COVID-19 pandemic that need to be considered and help stimulate related stakeholders to devise effective policies and actions. Health, socio-economical and education, all domains of gender are viciously affected by this pandemic. Though men and women have the same prevalence, men with COVID-19 are more at risk of worse outcomes and death. Even though the direct impact of disease is observed significantly high in men, the secondary socio-economic impact is catastrophic in women and girls considering their status in society as they are systemically oppressed and vulnerable group of population. The pandemic will have a prolong effect on socioeconomic dynamics. Hardly achieved milestones on gender eq...

Europasian Journal of Medical Sciences, 2021

Background: The rampant use of antimicrobials in poultry farms is creating a global public health... more Background: The rampant use of antimicrobials in poultry farms is creating a global public health threat as antimicrobial resistance (AMR) in humans may arise from such practice. This study was conducted with the objective of quantification and hence assessment of the level of antimicrobial use in Pakistani poultry farms so that appropriate utilization of such agents can be assured. Methods: Six randomly selected poultry farms of Pakistan with ten production cycles with 20,000- 30,000 birds in every production cycle were selected for the study from 2018 to 2019. The average dosage utilized on-farm was described by the defined daily dose (DDD) and used daily dose (UDD). Results: It was found that enrofloxacin, amoxicillin, doxycycline, tylocin, and lincomycin were the antimicrobials commonly used by all poultry farms. However, only Enrofloxacin (UDD/DDD = 0.95) was being used within the rational therapeutic range. All the antimicrobials were used irrationally without proper indicatio...

COVID-19 is creating a chaotic scenario all over the world. Due to the unavailability of approved... more COVID-19 is creating a chaotic scenario all over the world. Due to the unavailability of approved therapy, the number of affected cases is escalating day by day. Different components of the healthcare system have been consistently working in different settings for its containment. Pharmacists are one of the healthcare experts, who are working on the front-line. In this review, we aimed to evaluate the activities of pharmacists as a healthcare professional in disasters such as; COVID-19 management. The focus on services offered by pharmacists has shifted from traditional dispensing and compounding to patient-specific over a period contributing to the quality use of medicine and primary care. Pharmacists are thus, considered essentially one of the main pillars of the healthcare team for the provision of extended health services (EHS), for instance, the effective management of COVID-19. They are working from community to clinical setting. Practicing tele-pharmacy health services, they ...

Europasian Journal of Medical Sciences, 2021

Click on "Download Full Text pdf" to read

Background: Chronic kidney disease (CKD) has challenged the healthcare system for years. Use of α... more Background: Chronic kidney disease (CKD) has challenged the healthcare system for years. Use of αketoanalogue (KA) supplemented with a low protein diet (LPD) may improve renal function. In this study, we aim to find out the effectiveness of KA supplemented with LPD for the therapy of CKD. Methods: A quantitative cross-sectional study was conducted at Shree Birendra Hospital with 25 control and 25 treatment groups. The control group was treated with LPD (0.8 g/kg/day), while the treatment group was treated with KA (3 tablets/day for 4 weeks followed by 6 tablets/day for the next 16 weeks) along with LPD. The baseline parameters were measured on day 0, then subsequently at week 4, week 12, and lastly at the end of week 16. Results were then compared with the control group for analysis. Results: The serum level of creatinine showed a progressive decline in the treatment group (2.03±0.39 to 1.68±0.51) in comparison to the control group (2.03±0.36 to 2.54±0.69). However, there was a prog...

Context Drug repurposing is a relevant approach during the COVID-19 pandemic, because development... more Context Drug repurposing is a relevant approach during the COVID-19 pandemic, because development of new drugs is time-consuming and costly, and the safety of new drugs is paramount. Drug repurposing focuses on researching new indications for existing drugs and can reduce the challenges faced in drug development. Objective The current review intended to examine the current status of drugs being repurposed for COVID-19 treatment. Design The research team performed a literature review, searching relevant literature databases to find abstracts of relevant articles in journals published from 2010 until May 16, 2020. The sources of data included Google Scholar, PubMed, and ScienceDirect. The search terms used included repositioning of drugs, repurposing of drugs and COVID-19 therapy, and SARS-CoV-2 therapy. Setting The research team conducted this study at the Department of Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan; Mangalbare Hospita...

Europasian Journal of Medical Sciences, 2020

Coronavirus disease (COVID-19) is a respiratory infectious ailment caused by severe acute respira... more Coronavirus disease (COVID-19) is a respiratory infectious ailment caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first outbreak of this disease occurred in China and declared a pandemic in a very short period of time. SARS-CoV-2 gets transmitted mainly through the respiratory tract by droplets or respiratory secretions and by direct contact with the infected person as well as indirect contact through touching the contaminated surface accompanied by poor hygiene practice. Until the vaccine, a therapeutic agent or any other treatment modality gets approved; contact tracing and management, social distancing, personal hygiene, respiratory etiquette, and environmental decontamination are the prime factors to be considered for transmission containment and hence for appropriate safety measures for COVID-19 which is possible with the support of social work from the community level.

SN Comprehensive Clinical Medicine, 2020

Virology Journal, 2020

Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA... more Background The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19. Methods Databases like Pubmed, Pubmed Central, Scopus, Embase, Google Scholar, preprint sites, and clinicaltirals.gov were searched. The studies with the standard of care (SOC) and FVP as a treatment drug were considered as the treatment group and the SOC with other antivirals and supportive care as the control group. Quantitative synthesis was done using RevMan 5.4. Clinical improvement, negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), adverse effects, and oxygen requirements were studied. Results We identified a total of 1798 studies after searching the electronic databases. Nine in the qualitative stud...

Aim COVID-19 outbreak spread all over the world and created a public health catastrophe. Here, we... more Aim COVID-19 outbreak spread all over the world and created a public health catastrophe. Here, we have aimed to conduct a systematic review and meta-analysis on remdesivir use for COVID-19. Methods We searched Pubmed, Pubmed Central, Scopus, Embase, clinicaltrials.gov, and preprint sites and identified ten studies for qualitative and four studies for quantitative analysis using PRISMA guidelines. The quantitative synthesis was performed using fixed and random effect models in RevMan 5.4. Heterogeneity was assessed using the I-squared (I2) test. Results Comparing remdesivir group with placebo or standard of care (SOC) group, remdesivir reduces 14 days mortality (OR 0.61, CI 0.41-0.91), need of mechanical ventilation (OR 0.73, CI 0.54-0.97), and overall severe adverse effects (OR 0.69, 95% CI 0.54 to 0.88). There is better clinical improvement on day 28 (OR 1.59, CI 1.06-2.39); day 14 clinical recovery (OR 1.48, CI 1.19-1.84); day 14 discharge rate (OR 1.41, CI 1.15-1.73) among remdesivir groups. Earlier clinical improvement (MD-2.51, CI-4.16 to-0.85); and clinical recovery (MD-4.69, CI-5.11 to-4.28) seen among remdesivir group. While no difference on 28 days mortality rate; discharge rate; overall adverse effect. Longer course (10 days) of remdesivir showed higher discharge rate at day 14 (OR 2.11, CI 1.50-2.97), but there are significantly higher rates of serious adverse effects, and drug discontinuation than the shorter course. Conclusion Remdesivir showed a better 14 days mortality profile, clinical recovery, and discharge rate. Overall clinical improvement and clinical recovery were earlier among remdesivir group.

Drugs & Therapy Perspectives, 2020

Background: Playing venue conditions is a prominent contributor to the performance of players in ... more Background: Playing venue conditions is a prominent contributor to the performance of players in a competition. Hence, the present study was designed to evaluate the effect of playing venue on the hormonal responses, psychological state, and perception of effort in inter-university basketball players. Methods: A total of 96 male basketball players from eight different public and private sector universities were monitored during eight competitive matches played against each other on a home and away ground. Testosterone and cortisol levels were measured before and after each match. The psychological state test was conducted before each match and the perception of effort score was taken after the match. Results: Elevated testosterone levels, before playing a match, as evidenced at home ground, however, a 4% decline was recorded in testosterone level at away venue, even before playing the match. Both testosterone and cortisol levels depicted the same trend on home as well as away ground...

Europasian Journal of Medical Sciences, 2020

Anti-inflammatory drugs are among the mostly used drugs in geriatrics. Geriatrics usually encount... more Anti-inflammatory drugs are among the mostly used drugs in geriatrics. Geriatrics usually encounter problems of pain and inflammation and are more vulnerable to the toxicity of drugs as compared to young patients. In this review, we aimed to find out the toxic profile of drugs and the pharmacotherapy considerations for geriatric care. The diseases geriatrics mostly suffered from are osteoarthritis (OA), ankylosing spondylitis, carcinoma, and other degenerative disorders that require anti-inflammatory medicines. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are mostly used agents for the treatment of inflammation in geriatrics. Due to the over the counter (OTC) availability, NSAIDs are mostly used and being self-medicated as well. As the pharmacokinetics of drugs get altered due to alteration in body physiology in geriatrics, the pharmacodynamics also gets affected, and hence toxicity ensues even with normal dose. Depending upon the nature of the drugs; gastroint...