Qualification: 
M. Pharm.
meenuvijayan@aims.amrita.edu

Meenu Vijayan joined as lecturer in Department of Pharmacy Practice, Amrita School of Pharmacy in February 2011. She completed her B. Pharm from Department of Pharmaceutical Sciences, Cheruvandoor campus, M.G University and M. Pharm from Amrita School of Pharmacy, Kochi. She has more than 21 international and 4 national publications to her credit. Now she is actively involving and monitoring the various clinical activities of Pharm D and M. Pharm students at Amrita hospital. She has also guided various B. Pharm, M. Pham and Pharm D projects. Her main areas of interests are therapeutic Drug Monitoring, Pharmacovigilance and Pharmacoeconomics.

Publications

Publication Type: Journal Article

Year of Publication Title

2019

R. Antony, Fernandez, A., Lekshmi, S., Velayudhan, S., Jose, S., and Meenu Vijayan, “Case Report on Fluconazole Induced Stevens - Johnson Syndrome”, Research Journal of Pharmacy and Technology, vol. 12, no. 8, pp. 3735-3738, 2019.[Abstract]


Stevens-Johnson syndrome (SJS) is a rare cutaneous reaction characterised by mucosal erosions and epidermal detachment of about less than 10% of the total area of body skin. The incidence of SJS is approximately 1-6 cases per million person-years. The incidence of fluconazole induced SJS is less than 1%. Here the patient came with complaints of scaly lesions over chest and axilla following which he was started on topical antifungals (Lulliconazole) and antihistamines with the suspicion of Tinea versicolor. Though few lesions resolved on treatment, the patient later developed a small scaly macule over the left upper arm. Thus the patient upon further evaluation was given a stat dose of Tablet Fluconazole 400mg. Following this, the patient developed swelling of lower lips and tip of the glans and erythema over palms. This was later confirmed as Stevens-Johnson syndrome. The reaction was suspected to have occurred in association with Fluconazole. Fluconazole had a probable causal relationship with Stevens Johnson Syndrome as per ALDEN Algorithm in the EuroSCAR study. As per the Naranjo ADR probability scale, the causality assessment score for this reaction was found to be 5 which indicates a probable causal relationship. Clinicians must be more vigilant while prescribing Fluconazole by conducting regular monitoring of such patients and carrying out early diagnosis of such reactions.

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2019

P. Thomas, Vincent, B., George, C., Joshua, J. Mariam, Dr. Pavithran K., and Meenu Vijayan, “A comparative study on erlotinib & gefitinib therapy in non-small cell lung carcinoma patients”, Indian J Med Res, vol. 150, no. 1, pp. 67-72, 2019.[Abstract]


Background & objectives: Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) have been evaluated in patients with advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib are the first-generation EGFR-TKIs for patients with NSCLC. However, there is a paucity of studies comparing the effectiveness of these two drugs. Hence, this study was aimed to compare the effectiveness and safety of erlotinib and gefitinib in NSCLC patients.
Methods:This study included 71 NSCLC patients who received EGFR-TKIs between 2013 and 2016. Adverse drug reaction of both erlotinib (n=37) and gefitinib (n=34) was determined and graded according to Common Terminology Criteria for Adverse Events grading system. Effectiveness was measured using response evaluation criteria in solid tumours and progression-free survival (PFS). Pharmacoeconomic analysis was performed by cost-effective analysis.
Results: When comparing safety profile, both the drugs had similar adverse events except for dermal side effects such as acneiform eruption (51.4%), rash (54.05%) and mucositis (59.5%) for erlotinib and 20.6, 26.5 and 29.4 per cent for gefitinib, respectively. The PFS of the two drugs was compared to differentiate the effectiveness of erlotinib and gefitinib. There was no significant difference between the effectiveness of the two drugs. The pharmacoeconomic analysis showed that gefitinib was more cost-effective than erlotinib.

Interpretation & conclusions:This study showed that erlotinib and gefitinib had similar effectiveness but gefitinib had a better safety profile compared to erlotinib. Therefore, gefitinib could be considered a better option for NSCLC patients compared to erlotinib. However, further studies need to be done with a large sample to confirm these findings.

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2019

J. Mariam Joshua, Meenu Vijayan, and Kumar, G., “A retrospective analysis of patients treated with intravesical BCG for high-risk nonmuscle invasive bladder cancer”, Ther Adv Urol, vol. 11, p. 1756287219833056, 2019.[Abstract]


Background:Adjuvant intravesical immunotherapy with Bacillus Calmette-Guerin (BCG) is considered as the first-line agent in patients with high-risk nonmuscle invasive bladder cancer (NMIBC) after surgery. There are no data in India where there is a high prevalence of tubercle bacillus and inherent immunity against sp. The present study aims to evaluate the outcomes of intravesical BCG in the Indian population.

Methods: A retrospective study of 101 patients who underwent intravesical BCG for high-risk NMIBC between January 2006 and December 2015 was carried out in a single centre. We compared the recurrence-free rate and progression rate of patients who received induction alone and induction with maintenance BCG therapy. The safety profile of intravesical BCG therapy was also assessed in the study.

Results: After a median follow up of 2 years, the disease-free survival (DFS) rates of the induction group and maintenance group were 82% and 88% respectively ( = 0.233). There was no difference in progression-free survival (PFS) rates at 2 years in those who receive maintenance BCG (95%) and those with induction BCG (94.7%; = 0.721). A total of 69.36% of our patients had local adverse events.

Conclusion: </b>Our results suggest that maintenance therapy does not enhance the therapeutic effects of BCG in patients who respond favourably to 6 weeks of induction. Additional prospective studies are warranted in those countries where tuberculosis exposure is prevalent.

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2017

Meenu Vijayan, Jose, R., Jose, S., Abraham, S., and Joy, J., “Study on quality of life assessment in diabetic retinopathy among patients with type 2 diabetic patients”, Asian Journal of Pharmaceutical and Clinical Research, vol. 10, pp. 116-119, 2017.[Abstract]


Objective: The aim was to study the vision-related quality of life (QOL) for diabetic retinopathy (DR) among patients with Type 2 diabetes and to assess the direct medical cost of different treatment modalities. Methods: It was based on an individual-based analysis of QOL before and after the treatment for DR. The main objective of the study was to compare QOL between patients based on the different treatment modalities using vision function questionnaire (VFQ)-25, to evaluate the direct medical cost for DR patients undergoing different treatment modalities and to compare the cost and QOL of different treatment modalities in samples with non-proliferative DR (NPDR)/proliferative diabetic retinopathy (PDR) macular edema. The population included were patients with Type 2 diabetes with NPDR, with clinically significant macular edema and PDR, patients diagnosed to have diabetes above 5-year duration, adult patients, ocular pain those who are on regular follow-up and those who are willing to be a part of study. A total of 256 patients were selected out, of which 141 patients were satisfied the study criteria and participated in the study. Data relevant to the voice-related QOL study were obtained and recorded using VFQ-25 questionnaire. Other data relevant to the study were obtained and recorded in a semistructured data collection form by interviewing the patient or their caregivers and by direct examination of patient’s medical record. Expenditure was calculated in Indian Rupees. Results: After comparing the baseline QOL with QOL after treatment, it was found that the overall QOL of the study samples in accordance with the treatment undergone was found to be improved. The overall QOL had improved after the treatment for all samples and major improvement was seen on dependency, social functioning (SF), and mental health (MH). Conclusion: The overall QOL had improved after the treatment for all samples and major improvement were seen on dependency, SF, and MH. In conclusion, the study analyzed that intravitreal bevacizumab therapy is the cheapest one and with the comparatively same clinical outcome when compared with intravitreal ranibizumab therapy for macular edema cases in patients with NPDR and PDR. © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd.

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2017

J. M. Philip and Meenu Vijayan, “Liposomal amphotericin B induced pancytopenia-a rare case report”, Journal of Pharmaceutical Sciences and Research, vol. 9, pp. 867-868, 2017.[Abstract]


Liposomal amphotericin B (L-AmB) is a lipid-associated formulation of amphotericin B, a broad spectrum anti fungal agent. Even though studies have shown L-AmB to have a much better safety record than the other formulations, several adverse events limits the use of L-AmB to some extent such as hepatotoxicity and also dose dependent anemia and thrombocytopenia. However liposomal amphotericin B induced pancytopenia is rarely seen. Here we report a 58 year old male diagnosed to have hydropneumothorax for which he was treated with IV antibiotics, steroids and oxygen supplementation. Injection Liposomal amphotericin B 5mg/kg was started as prophylaxis for fungal infection. Over a period of 15 days, the blood reports progressively showed abnormal blood counts appearing to be pancytopenia. Hemoglobin levels had dropped to 7.1 g/dl, RBC count decreased to 2.5 M/uL, platelet count to 38,000 cells/mm3, WBC count to 1.53 K/uL and Injection L-AmB was stopped. Management was initiated with several blood transfusions, iron supplementation and a stat dose of s/c erythropoetin injection 4000 IU and Inj Grafeel 300mcg once daily. As the drug was withheld, blood counts gradually improved. Physician should be aware of the risk of hematological toxicities with amphotericin B liposomal and should ensure frequent monitoring of blood counts while administering this drug. © 2017, Pharmainfo Publications. All rights reserved.

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2016

Meenu Vijayan, Karakkattu, J., Thambi, S. P., A. S. Nair, and , “Prescribing patterns in schizophrenic patients attending a tertiary care hospital, Kerala”, International Journal of Pharmaceutical Sciences Review and Research, vol. 41, pp. 27-32, 2016.[Abstract]


Schizophrenia is a mental disorder that affects millions around the world, both males and females. A combination of genetic and environmental factors can play a role in the development of schizophrenia. The treatment of schizophrenia consists of an acute phase, a maintenance phase. The purpose of this study is to retrospectively evaluate the prescribing pattern in schizophrenic patients, to classify the various types of schizophrenia, evaluate the various symptoms associated, and to study the ADRs associated with antipsychotic treatment. A retrospective 8-month study conducted on inpatients diagnosed with schizophrenia at psychiatric department in a tertiary care hospital in Kerala. Patients who satisfied the inclusion criteria were included in the study. Data collection was carried out for a period of 2 years from 2013 January to 2014 December. A total of 156 patients were included in the study for which majority of the patients (28.8%) belong to the age group of 21-30 years. Olanzapine (32.46%) was the most commonly prescribed drug followed by Risperidone (22.07). 98% of patients were prescribed with antipsychotics combination therapy to improve their therapeutic outcomes and to reduce associated side-effects. Lorazepam was the most commonly prescribed drug that accounts for about 35.89% of total prescriptions, followed by clonazepam to produce a calming effect in aggressive patients. Lithium &amp; bupropion (5.12%) was the most commonly prescribed mood stabilizer, followed by sodium valproate (3.84%). A single case of olanzapine induced pancytopenia was observed having a score of 8 (probable) using the Naranjo causality assessment scale. From this study, we observe that atypical drug use has been continuously expanding. The rapidly increasing use of this newer class of antipsychotics needs a better evaluation regarding their safety profile. So, monitoring of adverse drug reactions is necessary for patient safety. This study also plays an important role in planning the budget of a health care system. © 2016, International Journal of Pharmaceutical Sciences Review and Research.

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2015

Remya Reghu, Keerthana, P. C. Sai, A. Das, M, N. C., Joseph, T., Meenu Vijayan, and Roshni P. R., “A case report on carbimazole induced myositis”, International Journal of Pharmaceutical Sciences Review and Research, vol. 32, no. 1, pp. 268-269, 2015.[Abstract]


Carbimazole is an anti-thyroid drug commonly used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents the thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T 4. Here we are presenting a case report of carbimazole induced myositis © 2015, Global Research Online. All rights reserved.

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2014

Roshni P. R., Thomas, N. R., Remya Reghu, and Meenu Vijayan, “Application of pharmacogenomics in health care”, International Journal of Pharmaceutical Sciences Review and Research, vol. 26, pp. 131-133, 2014.[Abstract]


Pharmacogenomics is the study of how genetic factors relate to inter-individual variability of drug response. With the initiation of Human Genome Project on 1991, it will have an important effect on the development and utilization of drug which is based on the person's genotype that ensure the rational use of medicine. The pharmacokinetic and pharmacodynamic characters of the drug may influenced by various genetic factors, so the effect of a drug may vary from person to person. Genetic polymorphism of single gene affect a numerous drug metabolizing enzymes, thus leads to altered drug metabolism and produce adverse effects or inefficiency. It has relevance in case of population carries genetic variation-polymorphism that may alter the drug response such as in the case of warfarin. A reduction in warfarin metabolism due to genetic polymorphism in CYP2C9 system may explain the increased warfarin response and bleeding episodes in some patients. The impact of genetic polymorphism has bee also important in case of drugs which are metabolized through CYP2D6 subfamily, such as codeine, nortriptyline, metoprolol, simvastatin, abacavir, carbamazepine, selective serotonin reuptake inhibitors and tamoxifen. This review is mainly focused on the importance of pharmacogenomic testing for certain drugs.

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2013

R. Reghu, Meenu Vijayan, and Roshni P. R., “Procurement and distribution of medicines in government hospitals of Tamil Nadu - An overview”, International Journal of Research in Pharmaceutical Sciences, vol. 4, pp. 96-100, 2013.[Abstract]


It is an established truth that the drug availability in the Indian public health system is always remaining as a prob-lem. One can attribute many reasons like shortage of fund, inefficient indenting procedures, poor inventory man-agement and others for the problem. Recognizing the shortage of medicines in government hospitals, many Indian states have introduced exclusive set ups for the purchase of medicines for the hospitals. They procure medicines through centralized pooled purchases. Kerala, Delhi, and Tamil Nadu governments were introduced such pooled procurement system for drug purchase. Tamil Nadu, a major state in India started a corporation styled as Tamil Nadu Medical Service Corporation (TNMSC) registered under the Companies Act 1956 in July 1994. With the help of a well-designed and scientifically planned scheme TNMSC could introduce many innovations and thereby revo-lutionize the public drug procurement system in the country. Articles about the drug purchase systems followed in hospitals are rare. In this article mainly focusing the procurements methods adopted by the Tamil Nadu State. ©JK Welfare &amp; Pharmascope Foundation.

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2011

V. K. Shini, Revikumar, K. G., Meenu Vijayan, Roshni, P. R., and Shahina, P. T., “A Study on Dispensing Errors in a Tertiary Care Hospital”, Journal of Pharmaceutical Research & Clinical Practice, vol. 1, no. 2, 2011.

2010

Emmanuel James, Meenu Vijayan, K., S. V., and D., D. A., “Prevalence, clinical profile and prescribing pattern for psoriasis in a tertiary care referral hospital”, International Journal of Pharmacy & Technology , pp. 1241-52, 2010.

Publication Type: Conference Paper

Year of Publication Title

2012

Roshni P. R., Remya Reghu, James, E., and Meenu Vijayan, “Study of Cardiovascular Risk Factors in Diabetic Patients in a Tertiary Care Teaching Hospital”, in 64th Indian Pharmaceutical Congress (selected as Best Paper), SRM university, Chennai, 2012.

2012

Remya Reghu, Meenu Vijayan, and Roshni P. R., “A Survey on Prescribing Mode of Antibiotics and NSAIDs in Communicable Diseases Especially Chikungunya”, in 64th Indian Pharmaceutical Congress (selected as Best Paper), SRM university, Chennai, 2012.

Faculty Research Interest: