Background: Irrational drug prescribing is a common practice globally; it results in increased morbidity, mortality & economic burden on society. Drug utilisation studies are an important tool to promote rational prescribing. Aims & Objective: To study on drug prescribing pattern in hypertensive patients. Materials and Methods: A drug utilisation study was conducted in hypertensive patients by the department of pharmacology in medicine OPD at SGRRIM & HS, Dehradun for 6 months. 645 prescriptions were evaluated for prescribing pattern by using WHO drug use indicators. Results: 645 prescriptions were analysed. A total of 1828 drugs were prescribed. 697 (38.13%) antihypertensives, 243 (13.30%) antidiabetics, 174 (9.52%) non-steroidal anti-inflammatory drugs (NSAIDs), 154 (8.44%) statins, 114 (6.24%) thyroid hormone, 54 (2.95%) anti-anxiety/antidepressants and 392(21.44%) miscellaneous drugs were prescribed. 697 antihypertensive drugs were prescribed. 234 (33.57%) angiotensin receptor blockers (ARBs), 117 (16.79%) angiotensin converting enzyme (ACE) inhibitors, 95 (13.63%) Beta blockers, 83 (11.91%) Calcium channel blockers 168 (24.10%) Fixed dose combinations (FDCs) of antihypertensives were included. 2.83 drugs were prescribed per prescription. 225 (32.28%) antihypertensives were prescribed from essential medicine list. Conclusion: Most commonly prescribed drugs were ARBs and ACE inhibitors. Rational prescribing requires consideration to dose and duration and interaction with other medications.

Background: Irrational drug prescribing is associated with increased morbidity, mortality and economic burden on the society. Study of prescribing pattern is a component of medical audit that does monitoring and evaluation of the prescribing practice of the prescribers and recommends necessary modifications to achieve rational medical care. Aims & Objectives: This study was designed to analyze the current prescription patterns of drugs used in the treatment of type 2 diabetes mellitus patients. Materials and Methods: Present study has been conducted in diabetes mellitus patients by the department of pharmacology in medicine outpatient department at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun for 6 months. 312 prescriptions were randomly evaluated for prescribing pattern using WHO drug indicators. Results: A total of 312 prescriptions were analyzed. Mean age was 54.96 ± 0.57 years. Male: Female ratio was 1.04:1. Socioeconomic status (SES): Upper 24 (7.69%), Upper Middle 75 (24.04%), Lower Middle 93 (29.81%), Upper Lower 69 (22.11%) and Lower 51 (16.35%). Family history of diabetes mellitus seen in 129 (41.35%) patients and average duration was 7.92±0.37 years. A total of 1242 drugs were prescribed. 666 (53.62%) antidiabetics, 216 (17.39%) antihypertensives, 159 (12.8%) multivitamins, 90 (7.25%) antiplatelets, 42 (3.38%) statins and 360 (5.56%) in miscellaneous category were prescribed. Amongst antidiabetics, the most frequently prescribed drugs were metformin 273 (40.99%), glimepiride 228 (34.23%) followed by pioglitazone 45 (6.76%), acarbose 33 (4.95%), gliclazide 30 (4.5%), sitagliptin 30 (4.5%), glibenclamide 15 (2.25%) and insulin 12 (1.8%). 99.03% oral drugs were prescribed. Numbers of Fixed dose combinations of antidiabetic drugs were 246 (36.93%). 3.98 drugs per prescription were prescribed. 288 (43.24%) antidiabetics were prescribed from National List of Essential Medicines (NLEM), 2011. 100% drugs were prescribed by brand names. Conclusion: The most commonly prescribed drugs were Metformin and Glimepiride. Rational prescribing can be improved by sensitizing our physicians and providing them with the feedback of the study.

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Tolrestat is a well tolerated nonhydantoin aldose reductase inhibitor that has been reported to improve nerve conduction in diabetic animals and humans. Its effects on nerve biochemistry and structure have not been studied in patients with diabetic neuropathy. Patients with advanced diabetic neuropathy treated with long-term open-label tolrestat were randomly assigned to continuation on drug treatment or to placebo-controlled drug withdrawal for 12 months. At the end of this period, sural nerve biopsies were obtained for measurement of glucose, sorbitol, and fructose content, and for detailed morphometric analysis. Tolrestat ameliorated the glucose-mediated increase in sorbitol and fructose in sural nerve tissue. No statistically significant differences in nerve morphometry emerged between the two groups; however, both treatment groups exhibited increased nerve-fiber regeneration and normalization of axo-glial dysfunction and segmental demyelination following long-term tolrestat treatment. These findings are similar to those previously reported in a placebo-controlled sequential nerve biopsy study with the aldose reductase inhibitor sorbinil. Thus tolrestat is a biochemically effective aldose reductase inhibitor in human diabetic nerve with potential therapeutic efficacy for diabetic neuropathy.