There is an increase in population of elderly above the age of 65. As age advances, more diseases develop resulting in use of more medications. Physiological changes, alterations in homeostatic regulation and diseases modify pharmacokinetics and drug response in older patients. The risk for drug interactions and drug-related problems increases along with multiple medications. Periodic evaluation of the patients’ drug regimen is essential to minimize polytherapy. Clinicians must be alert to the use of herbal and dietary supplements as they are prone to drug-drug interactions. This article focuses on the possible pharmacokinetic, pharmacodynamic, and herbal drug interactions occurring in the elderly.

Objective: Hypertension is a chronic disorder requiring lifelong treatment. This study is done to find out the percentage variation of cost among different brands of angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) used in hypertension.: The cost of a particular drug being Materials and methods manufactured by different companies, in the same strength and dosage forms, was referred from ''Indian Drug Today (January -March 2017)". The difference between the maximum and minimum prices of same drug was analyzed and percentage variation in the prices and cost ratio were calculated.: In Single drug therapy, among ACE Results inhibitors, Enalapril (5 mg) shows maximum price variation of 4748% and among ARBs, Valsartan (80 mg), has the price variation of 494.2%. In combination therapies, Irbesartan + Hydrochlorothiazide (150 mg +12.5 mg) combination showed the maximum variation of 289.85 %.: This study shows a wide variation in the prices of ACE Conclusion inhibitors and ARBs. Prescribers should be aware of these variations and select cost effective drug to decrease the economic burden on population.

Objectives:To identify the quality of life (QOL) in epileptics, the risk factors and many unseen reasons for their wretched QOL, and to suggest the steps and methods to overcome the barriers in leading a quality life. Materials and Methods: In this study questionnaire was designed for doctors instead of patients for evaluating the QOL in epileptics. A structured questionnaire was used to collect information on various factors simultaneously like demographic profile, seizure characteristics, knowledge regarding cause of epilepsy, attitude towards medical treatment, etc., Results: Overall the total score of physical well-being (71), mental/emotional state (75), handle stress (76), medication effect (70), life enjoyment (70), and overall QOL (70) are worse in epileptics. Conclusion: Almost all different factors like seizure severity, frequency, depression, anxiety, underlying causes, socioeconomic status, type of therapy, etc., had strong interlinked influence on QOL especially stigma and attitude of society towards epileptics. Hence, to improve the QOL in epileptics it is essential to give equal importance to all factors simultaneously instead of giving separately.

The elderly, above the age of 65, are heterogeneous population with increased morbidity. They are more exposed to medication due to multiple health problems. The natural physiological changes and alterations in homeostatic regulation alter drug response and increase the risk of adverse drug reactions in them. Multi-prescription, polytherapy also increases the incidence of adverse reactions. It is difficult to diagnose adverse reactions in the elderly as they often present with nonspecific symptoms and to differentiate whether they are due to medications or not. Most of the hospital admissions due to adverse reactions are predictable and 50% among them are preventable Type A reactions as most of the errors occur during prescribing or monitoring of drugs. Prescribers should review the medication list regularly and be cautious in prescribing new medicines. Physicians’ awareness of the physiology and pharmacology of aging can reduce adverse reactions that help in promoting better health care for older adults.

Objective: Systemic lupus erythematosus (SLE) is a chronic, inflammatory disorder, experiencing an excess of cardiovascular morbidity and mortality. Arterial stiffness (AS) and Endothelial dysfunction are key events in the initiation, progression, and rupture of atheromatous plaque. L-arginine corrects derangements in the vascular endothelial nitric oxide dependent signaling pathway. Thus, the aim of our study was to evaluate the effect of L-Arginine on AS and endothelial function in patients with SLE. Materials and Methods: Twenty-Five (22F, 3M) SLE patients, demographic data, associated risk factors, disease activity, and treatment regimen were collected. Pulse Wave Velocity (PWV) and Refl ection index (RI) was determined non-invasively by PeriScope and Autodicrowin, respectively. PWV refl ects large artery stiffness, whereas RI represents small artery tone. Patients were randomized to receive either placebo or L-arginine (3 g t.i.d) for 2 weeks. Paired Student 't' Test and percentage change was used for statistical comparison. Results: L-arginine treatment improved Carotid femoral PWV (P0.002) and excellent improvement in change in RI (P0.0001). There was signifi cant change in hemodynamic parameters. In placebo group, neither there was statistical change in carotid femoral PWV nor change in RI. Conclusion: L-arginine supplementation has been shown to restore vascular function and to improve the clinical symptoms in SLE patients with vascular dysfunction.