Study on the antiemetic property of methanolic stem extract of Swertia chirata using chick emesis model

Background: Swertia chirata has been an important herb known for centuries for its various medicinal uses and bitter taste. The stem of the plant is used as a traditional medicine in an array of diseases including the treatment of vomiting. Therefore, the study was undertaken to explore the possible antiemetic property of methanolic extract of its stems by using chick emesis model.Methods: 25 male chicks of four days old weighing 25 to 35 grams were fed with copper sulfate anhydride at 50mg/kg body weight to induce emesis. The chicks were grouped into 5 with each group bearing 5 chicks (n=5). Group I (control) received 10ml/kg normal saline; group II (standard) received 150mg/kg chlorpromazine; group III (experimental-1), group IV (experimental-2) and group V (experimental-3) received 50, 100 and 150mg/kg respectively of the extract. All doses are given intraperitoneally. Assessment of antiemetic activity was done by calculating the percentage of inhibition of the number of retches in the chicks.Results: All the three doses of the extract showed antiemetic activity. The dose of 50 mg/kg showed activity comparable to chlorpromazine, while dose of 100 mg/kg and 150mg/kg showed greater activity than chlorpromazine. Highest antiemetic activity (79.26% inhibition) was shown by a dose of 150mg/kg and lowest (42.22% inhibition) by 50mg/kg.Conclusions: Methanolic extract from the stems of Swertia chirata has excellent anti-emetic property which can be further investigated for development of potential antiemetic medicines.

FAST-DISINTEGRATING TABLET FORMULATION OF GINGER (ZINGIBER OFFICINALE ROSC.) EXTRACT USING COPROCESSED EXCIPIENT OF PRE-GELATINIZED CASSAVA STARCH-ACACIA GUM

Objective: Fast-disintegrating tablets (FDTs) are tablets that disintegrate and/or dissolve rapidly in the mouth, thereby helping patients who havedifficulty in swallowing tablets. Ginger extract contains gingerol and is generally known for its antiemetic property. This study aimed to obtain anduse coprocessed excipients of pre-gelatinized cassava starch (PCS) with acacia gum (AG) in FDT formulations of ginger extract.Materials and Methods: In this research, five types of PCS-AG coprocessed excipients (Co-PCS-AG) were prepared by mixed PCS and AG with thefollowing ratios mass of PCS and AG were 5:5, 6:4, 7:3, 8:2, and 9:1. The prepared Co-PCS-AG excipients were characterized in terms of morphology,particle size distribution, moisture content, pH, flow-ability properties, and swelling index. Based on the results, three types of Co-PCS-AG excipients,which were 7:3, 8:2, and 9:1, were selected for use in FDT formulation of ginger extract. The FDTs were then examined for tablet hardness, tabletfriability, wetting time, and disintegration time.Results: The results indicated that Co-PCS-AG 9:1 was ideal excipient to be used in FDT formulation, as it revealed good flow properties and swellingindex compare to the other ratios. The Co-PCS-AG excipients were formulated into tablets and evaluated. Analysis of the ginger extract FDTs revealedthat the FDT prepared using Co-PCS-AG 9:1 excipient had the best performance with tablet hardness, friability, wetting time, and disintegration timeof 0.7 kp, 2.12%, 93 seconds, and 134 seconds, respectively.Conclusions: Co-PCS-AG 9:1 excipient is a potential excipient with ideal binder, disintegrant, and filler properties for use in FDT formulation.

Clinicoetiological pattern and pharmacotherapy practices in patients with new onset vertigo: findings from a prospective multicenter registry in India

<p class="abstract"><strong>Background:</strong> The objective was <span lang="EN-IN">to evaluate the clinicoetiological pattern and pharmacotherapy practices of new onset vertigo in India. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This multicentre, prospective, registry was conducted in adult patients across 37 centres. Enrolled patients were followed at week 1, month 1 and 3 to assess clinicoetiological characteristics, prescribed pharmacotherapy, safety and effectiveness of treatment. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 1520 patients enrolled, 1428 (93.95%) completed the study. The mean (SD) age was 50.2 (±15.37) years and 53.2% were women. Of 202 patients reporting co-morbidities, 55.4% had cardiovascular disease and 38.6% had diabetes mellitus. Peripheral causes were predominant in majority (74.3%); benign paroxysmal positional vertigo (BPPV) being the most frequent (67.58%). Migraine affected 68.9% (80/116) patients, .as the central cause. Betahistine (74.6%) and prochlorperazine (21.75%) were the top two drugs of choice irrespective of origin, preferred by all treating specialists. Both the drugs significantly prevented recurrence by week 1 (prochlorperazine: 76.6%; betahistine: 64.2%) (p&lt;0.001) and over 3 months. A lower daily dose of betahistine (15.6±5.26 mg) was preferred. Almost half complained of nausea and vomiting; prochlorperazine significantly reduced recurrence of both within a week (p&lt;0.001). The treatments were well-tolerated with no reported adverse drug reactions. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The study demonstrates vestibular vertigo, BPPV to be the dominant type in Indian patients with new onset vertigo. Betahistine and prochlorperazine top the physicians’ preference list, with equal benefits in preventing recurrence. Prochlorperazine has an additional antinausea and antiemetic property, thereby may improve patient satisfaction. Prescription of a lower dose of betahistine calls for the need to sensitize physicians.</span></p>