Survelliance of Anti-Allergic Drugs from Indore Locality of Madhya Pradesh

SURVELLIANCE OF ANTI-ALLERGIC DRUGS FROM INDORE LOCALITY OF MADHYA PRADESH DWIVEDI S.1*, PATIDAR H.C. 1, DWIVEDI A. 1, SHRIVASTAVA S. 2 & DUBEY R. 3 1, VINAYAKA MISSION’S COLLEGE OF PHARMACY, SALEM (T.N.)-INDIA 2, SWAMIVIVEKANAND COLLEGE OF PHARMACY, INDORE (M.P.)-INDIA 3, CHORDIA INSTITUTE OF PHARMACY, INDORE (M.P.)-INDIA

ABSTRACT Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions occur to environmental substances known as allergens; these reactions are acquired, predictable and rapid.The present paper through the light on the marketing survey of Antiallergic drugs and a comparison of drugs, having less drug-drug interaction and adverse drug reaction which benefits the patient’s compliance towards the use allergy. Market research of Antiallergic drugs was carried from Jan 2008 to May 2008; data’s were collected from five doctor’s cabin and ten chemist of Indore city. Data’s revealed that market sale of Cetrizet having highest sale of 130 strips per day followed by Avil 50 strips per day and Avomine 48 strips per day.

For Correspondence *Sumeet Dwivedi Vinayaka Mission’s College of Pharmacy Vinayaka Mission’s (Deemed) University Salem, T.N-India Mob. No. 09893478497, 09003504487 E.Mail: [email protected] INTRODUCTION Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions occur to environmental substances known as allergens; these reactions are acquired, predictable and rapid. Strictly, allergy is one of four forms of hypersensitivity and is called type I (or immediate) hypersensitivity. It is characterized by excessive activation of certain white blood cells called mast cells and basophils by a type of antibody, known as IgE, resulting in an extreme inflammatory response. Common allergic reactions include eczema, hives, hay fever, asthma, food allergies, and reactions to the venom of stinging insects such as wasps and bees. Mild allergies like hay fever, are highly prevalent in the human population and cause symptoms such as allergic conjunctivitis, itchiness and runny nose. Similarly, conditions such as asthma are common, in which allergy plays a major role. In some people, severe allergies to environmental or dietary allergens, or to medication, occur that may result in life-threatening anaphylactic reactions and potentially death. A variety of tests now exist to diagnose allergic conditions; these include testing the skin for responses to known allergens or analyzing the blood for the presence and levels of allergen-specific IgE. Treatments for allergies include allergen avoidance, use of antihistamines, steroids or other oral medications, immunotherapy to desensitize the response to allergen, and targeted therapy.

STUDY AREA The present market research of anti-allergics drugs was carried out in 10 different chemists (Jain Medical Store, Veena Nagar; Agrawal Medical Store; Pardesipura, Drug Home, Bajrang Nagar; Charu Medical Store, Meghdoot Nagar; Sneh Medical Store, Subhash Nagar; Mamta Medical Store, Subhas Nagar; Bharat Medical Store, Bajrang Nagar; Rohan Medical Store, Daba Bajar; Vikas Medical Store, Palasia and Ravi Medical Store, Daba Bazar) and doctors (Dr, B.B.Gupta, Vapat Chouraha; Dr. D. K. Chauresia, Pardesipura and Dr. Meenakshi Agrawal, South Tukoganj) located in different areas of Indore, study sites were selected considering the number of patient in the hospital, prescription and sale of anti-allergies drugs at the chemists and the doctors as per plan suggested. METHODOLOGY Different study sites (10 Chemists and 3 doctors cabin), scattered over different areas of Indore locality (Jain Medical Store, Veena Nagar; Agrawal Medical Store; Pardesipura, Drug Home, Bajrang Nagar; Charu Medical Store, Meghdoot Nagar; Sneh Medical Store, Subhash Nagar; Mamta Medical Store, Subhas Nagar; Bharat Medical Store, Bajrang Nagar; Rohan Medical Store, Daba Bajar; Vikas Medical Store, Palasia and Ravi Medical Store, Daba Bazar and Dr, B.B.Gupta, Dr. D. K. Chauresia, Dr. Meenakshi Agrawal) were selected on the basis of number of patient, prescription, sale of drugs and presence of allergens. The knowledge about the use of drugs was obtained both by doctors and chemists. During the course of present market research, all the study sites were visited after carefully planned trip in the months of Jan-2008 to May-2008. Data regarding the use of the drugs were collected as per plan suggested. SURVEY DATA Survey I The data cited below is the outcome of survey of the generic drugs in different chemist located in different locality of Indore district of Madhya Pradesh, which were selected randomly. Also, the help of Doctors have been taken to search the more accurate generic drugs. Survey II On the basis of Survey I these drugs (Promethazine, Pheniramine, Chlorpheniramine, Cetirizine, Levo- Cetirizine and Fexofenadine) were found to have the highest sale and then these six drugs were surveyed according to their brand name as given in CIMS, MIMS, Drug Today and ADR. The data cited below is the outcome of the survey of the brand drugs in different chemist located in different locality of Indore district of Madhya Pradesh, which were selected randomly. Also, the help of Doctors have been taken to search the more accurate brand drugs, which will prescribe, by the doctors to treat different kinds of the allergies in the Indore locality of Madhya Pradesh. RESULT AND CONCLUSIONS Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions occur to environmental substances known as allergens; these reactions are acquired, predictable and rapid. A number of allergens are there which cause the disease and to treat allergy there are numbers of drugs available in the market. During the course of present investigation the help of chemist and doctors have been important source of collection of the data. In the present market research, carried out in chemists- S1: Jain Medical Store, Veena Nagar; S2: Agrawal Medical Store; Pardesipura, S3: Drug Home, Bajrang Nagar; S4: Charu Medical Store, Meghdoot Nagar; S5: Sneh Medical Store, Subhas Nagar; S6: Mamta Medical Store, Subhas Nagar; S7: Bharat Medical Store, Bajrang Nagar; S8: Rohan Medical Store, Daba Bajar; S9: Vikas Medical Store, Palasia and S10: Ravi Medical Store. Daba Bazar, and doctors Dr, B.B.Gupta, Vapat Chouraha; D2: Dr. D. K. Chauresia, Pardesipura and D3: Dr. Meenakshi Agrawal, it has been revealed that there are several drugs, which are used in Allergy viz., which were either prescribed by the doctors or they were normally sold on the counter. Thus the above finding indicates that a drugs; Promethazine, Pheniramine, Chlorpheniramine, Cetrizine, Levocetrizine and Fexofenadine (given in Table: 1) are more efficacious with minimum drug-drug interaction, adverse drug reaction and toxic effect. So, it is expected that in future, it may lead over other drugs used in allergy and proven to be an intensive choice for the human health benefits. The data collected during market survey give the following information about the feasibility of new products, forecasting of marketing demands, study of competitor activities, study of physician behaviors on prescription drugs and consumers on OTC drugs, capacity of patient to afford drug and need for drug in that category, cultural changes of society and its impact on drug consumption. SurveyI (Table: 1), which was carried out in five chemist and three doctor cabin reveals that out of various categories of the drugs used to treat the disease as gathered from review literature, the categories such as Promethazine, Pheniramine, Chlorpheniramine, Cetrizine, Levocetrizine and Fexofenadine are highly sale drugs in the markets of Indore, localities and the same result was confirmed by the Bar Graph 1 mentioned below: Graph showing Sale of Generic Drugs

Avg. Sale/Day 30 Series1 20

0 A B C D E F Generic Drugs

Abbr. A: Promethazine, B: Pheniramine, C: Chlorpheniramine, D: Cetrizine, E: Levocetrizine F: Fexofenadine

Survey II (Table: 2) which was carried out in 10 chemist reveals that out of various categories of the drugs used to treat the disease as gathered from review literature and CIMS, MIMS, Drug Today and ADR the brand drugs such as Promethazine (Avomine), Pheniramine (Avil), Chlorpheniramine (Sinarest), Cetrizine (Cetrizet), Levocetrizine (1 Al) and Fexofenadine (Allegra) are highly sale drugs in the markets of Indore localities and the same result was confirmed by the Bar Graph 2 mentioned below: Graph Showing Sale of Brand Drugs

140 120 100 80 Avg. Sale/Day 60 Series1 40 20 0 A B C D E F Brand Drugs

Abbr. A: Avomine, B: Avil, C: Sinarest, D: Cetrizet, E: 1 Al, F: Allegra

The studies show the following facts about survelliance of anti-allergics drugs in Indore locality: Cetrizet having highest sale of 130 strips per day followed by Avil 50 strips per and Avomine 48 strips per day (Table: 2). Data revealed that market share of Cetirizine (Cetrizet) is growing very fastly due to its high efficacy, minimum drug-drug interaction, adverse drug reaction and toxic effect. Safety profile and having unique structure properties, which make it more efficacious with minimum drug-drug interaction, adverse drug reactions & toxic effects. So, it is expecting that in future, it may lead over the other drugs and proved to be an intensive choice for the human health benefits. Also, Avil, and Avomine are the drug of the choice due to their less cost and minimum side effect. Hence, the present markets survey of the anti-allergics drugs present the salient features of the most commonly used drugs in the treatment of various allergic conditions and thus, the above finding confirms the sale of the drugs in the Indore locality of the Madhya Pradesh, which will be beneficial for the further market research. ACKNOWLEDGMENT The author is thankful to the chemist of the study area for their valuable support during the course of present market survey. Also, special thanks to the doctor’s for their valuable guidance. REFERENCES 1. Kay AB (2000). "Overview of 'allergy and allergic diseases: with a view to the future'". Br. Med. Bull. 56 (4): 843–64. 2. Ishizaka K, Ishizaka T, Hornbrook MM (1966). "Physico-chemical properties of human reaginic antibody. IV. Presence of a unique immunoglobulin as a carrier of reaginic activity". J. Immunol. 97 (1): 75–85. 3. Galli SJ (2000). "Allergy". Curr. Biol. 10 (3): R93–5. 4. De Swert LF (1999). "Risk factors for allergy". Eur. J. Pediatr. 158 (2): 89–94. 5. Croner S (1992). "Prediction and detection of allergy development: influence of genetic and environmental factors". J. Pediatr. 121 (5 Pt 2): S58–63. 6. Cooper PJ (2004). "Intestinal worms and human allergy". Parasite Immunol. 26 (11- 12): 455–67. 7. Yazdanbakhsh M, Kremsner PG, van Ree R (2002). "Allergy, parasites, and the hygiene hypothesis". Science 296 (5567): 490–4. 8. Ten RM, Klein JS, Frigas E (1995). "Allergy skin testing". Mayo Clin. Proc. 70 (8): 783–4. 9. Li JT, Andrist D, Bamlet WR, Wolter TD (2000). "Accuracy of patient prediction of allergy skin test results". Ann. Allergy Asthma Immunol. 85 (5): 382–4. 10. Benjamin DM, Reducing medication errors and increasing patient safety: Case studies in Clinical Pharmacology; J. Clin Pharmacology July 2003; 43(7): 768-83. 11. Ed. Wiltink H. Medication control in hospitals: A practical approach to the problem of drug-drug interaction. Pharm.Word Sci. 1998, 20(4): 175. 12. Lucian Leape I. et al. Pharmacist participation on physician rounds and reverse drug events in the intensive care unit. J. Am. Medical Assoc. 1999; 3:267. 13. .Khan, Parvez; Dwivedi, Sumeet; Pandey, Deepak and Shrivastava, Satyaendra. Marketed protein and polypeptide: An Overview. Pharmainfo.net, Aug-16-2007. 14. Shrivastava, S.; Dwivedi, S.; Kapoor, S.; Dubey, D,; and Sonaniya, R. Surveillance of some recent proton pump inhibitors. Farmavita.Net., 2007.

Table: 1 Survey of Drug by their Generic Name

CATIGORY SURVEY DATA (SALE/DAY) S.NO OF DRUG DRUGS S1 S2 S3 S4 S5 AVG. D1 D2 D3 1. Highly Diphenhydramine 30 25 20 30 30 25 ++ ++ ++ Sedative Promethazine 40 45 20 35 15 31 +++ +++ ++ Hydroxyzine 5 20 10 15 20 15 + ++ + 2. Moderately Pheniramine 20 25 10 15 30 20 +++ +++ +++ Sedative ++ + +

Cypro heptdine 10 5 15 20 25 15 3. Mild Chlorpheniramine 25 35 35 30 25 30 +++ ++ +++ Sedative Dimethindine 10 15 20 5 25 15 ++ + +

+ ++ +

Clemastine 5 10 15 20 7 12 4. Second Cetirizine 75 50 60 40 45 54 +++ +++ +++ generation Levo-cetirizine 50 25 30 20 35 35 +++ ++ ++

++ + ++

Fexofenadine 30 35 20 25 15 25

Abbr. S1: Jain Medical Store, Veena Nagar; S2: Agrawal Medical Store; Pardesipura, S3: Drug Home, Bajrang Nagar; S4: Charu Medical Store, Meghdoot Nagar; S5: Sneh Medical Store, Subhas Nagar; D1: Dr, B.B.Gupta, Vapat Chouraha; D2: Dr. D. K. Chauresia, Pardesipura and D3: Dr. Meenakshi Agrawal, South Tukoganj; ++ +=Maximum; ++=Moderate and +=Mininum.