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  Subjects -> PHARMACY AND PHARMACOLOGY (Total: 518 journals)
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Journal Cover Saudi Pharmaceutical Journal
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  This is an Open Access Journal Open Access journal
     ISSN (Print) 1319-0164
     Published by Elsevier Homepage  [2563 journals]   [SJR: 0.252]   [H-I: 12]
  • Adherence to medication among outpatient adolescents with epilepsy

    • Abstract: Publication date: Available online 26 May 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Wael M. Gabr , Mohamed E.E. Shams
      Background and objective The promotion of medication adherence is considered as an integral component of pharmaceutical care practice and patient healthcare. An approach which focuses on the choice and dose of antiepileptic drug will have limited success without medication adherence. This study sought to assess medication adherence among adolescents who are suffering from epilepsy for improvement. Methods A total of 116 patients affected with idiopathic epilepsy and fulfilled the inclusion criteria were recruited in the current study. Adherence to the treatment was evaluated during patients’ hospitalization in the Department of Neurology at Riyadh National Hospital, Riyadh, Saudi Arabia, between December 2011 and January 2014. The medication adherence has been assessed during semi-structured interviews with each patient and/or his parents using a multiple choice graded questionnaire. Results From the selected group of patients, only 94 patients (81.0%) fulfilled the inclusion criteria within the study period. Thirty six of respondents (38.3%) were non adherent to antiepileptic treatment. No statistical differences were found between males and females regarding their ages, age at diagnosis of epilepsy, mother age, epilepsy duration, family numbers, number of poor-adherents or seizure frequency. The most important factors that were significantly affecting patients’ adherence to the prescribed medications were age of mother, family number, number of administered drugs, the stability of parents’ marriage, family support, and seizure frequency as well as the regularity of the relationship between patients and their healthcare providers. Forgetfulness was the most common cause of non-adherence among this group of patients followed by inability to obtain medication and fear from side effects of drugs. Our results revealed also that the number of patients who felt to be stigmatized are significantly more in non-adherents group as compared to patients with a strong sense of normality (P <0.05). A positive relationship between adherence and the necessity and benefit scales at which patients have stronger belief in the necessity of medication for controlling illness was associated with good adherence. Conclusion The assessment of medication adherence among epileptic patients should be a routine part of the management process to improve the health care and quality of lives of those patients.


      PubDate: 2014-05-31T02:18:05Z
       
  • Exploring Medication Use by Blind Patients In Saudi Arabia

    • Abstract: Publication date: Available online 26 May 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Basma Y. Kentab , Kholuod Z. Al-Rowiali , Rehab A. Al-Harbi , Nouf H. Al-Shammari , Wiam M. Balhareth , Huda F. Al-Yazeed
      Objective To explore the characteristics of medication use and challenges experienced by the blind patients. Methods This cross-sectional descriptive study included blind persons living in Saudi Arabia who were at least 18 years of age. Participants were recruited through a number of nongovernmental blind associations (in the central, western, eastern regions), universities, social networks, and specialized websites for the blind. A questionnaire was designed and administered via face-to-face meetings with participants and made available online through Google Docs. Results There were a total of 121 respondents of which 26 were excluded based on their ability to visually identify their medications or being < 18 years old. The majority of the respondents were 18-29 years old (68%), (49%) were male and (51%) were female. Around (57%) had a college degree while (27%) had a high school degree. Diagnosis with a chronic disease was reported by 71 participants (79%, 5 missing). The most common diseases were diabetes and asthma (22%) followed by hypertension (17%). Most blind patients (75%) believed that physicians were the most reliable source of medication information. The medication information and services provided by pharmacists were viewed as inadequate by (46%). The most common challenges encountered by blind patients were linked to drug identification (75%), dose recognition (82%), and identification of expiration date (92%). A large number of patients had to rely on persons with normal vision for dispensing and administering the medications. Conclusions Pharmacists can no longer ignore the medication use problems encountered by the blind people. This study may serve as an initial step for planning improvements in pharmaceutical services provided to blind patients. The government, pharmaceutical companies and pharmacists must work in collaboration to address the special needs of the blind.


      PubDate: 2014-05-31T02:18:05Z
       
  • Penetration enhancers in proniosomes as new strategy for enhanced
           transdermal drug delivery

    • Abstract: Publication date: Available online 12 May 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Gamal M. El Maghraby , Amal A. Ahmed , Mohamed A. Osman
      The aim of this work is to investigate penetration enhancers in proniosomes as a transdermal delivery system for nisoldipine. This was performed with the goal of optimizing the composition of proniosomes as transdermal drug delivery systems. Plain proniosomes comprising sorbitan monostearate, cholesterol, ethanol and small quantity of water were initially prepared. Subsequently, proniosomes containing lecithin or skin penetration enhancers were prepared and evaluated for transdermal delivery of nisoldipine. The plain proniosomes significantly enhanced the transdermal flux of nisoldipine to reach 12.18 μg cm-2 h-1 compared with saturated aqueous drug solution which delivered the drug at a rate of 0.46 μg cm-2 h-1. Incorporation of lecithin into such proniosomes increased the drug flux to reach 28.51 μg cm-2 h-1. This increase can be attributed to penetration enhancing effect of lecithin fatty acid components. Replacing lecithin oleic acid (OA) produced proniosomes of comparable efficacy to lecithin containing system. The transdermal drug flux increased further after incorporation of propylene glycol into the OA based proniosomes. Similarly, incorporation of isopropyl myristate into plain proniosomes increased drug flux. The study introduced enhanced proniosomes as a promising transdermal delivery carrier and highlighted the role of penetration enhancing mechanism in enhanced proniosomal skin delivery. The study opened the way for another line of optimization of niosome proconcentrates.


      PubDate: 2014-05-14T04:10:27Z
       
  • Drug nanocrystals: A way towards scale-up

    • Abstract: Publication date: Available online 9 May 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Mohana Raghava Srivalli Kale , Brahmeshwar Mishra
      Drug nanocrystals comprise unique drug delivery platforms playing significantly important and distinctive role in drug delivery and as such, the industry and academia are spending a lot of their time and money in developing the nanocrystal products. The current research works in this field depict a vivid shift from lab scale optimization studies to scale up focused studies. In this emerging scenario of nanocrystal technology, a review on some exemplary and progressing research studies with either scalability as their objective or upscaling as their future scope may smoothen the future upscaling attempts in this field. Hence, this paper reviews the efforts of such research works as case studies since an analysis of such research studies may input certain beneficial knowledge to carry out more scale up based research works on nanocrystals.


      PubDate: 2014-05-14T04:10:27Z
       
  • Drug Safety The Concept, Inception and its Importance in Patients’
           Health

    • Abstract: Publication date: Available online 9 May 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Thamir M. Alshammari
      Background Drug safety is one of the hottest topics in daily medical practice, particularly with regard to approving new medication or questioning the possibility of withdrawing a drug from the market. Aim The aim of this review is to highlight the importance of the drug safety concept and its impact on patients’ health. Methods A literature search was conducted using Pubmed®, EMBASE®, EBSCO and Medline in the period between 1980 and 2013. The terms used in the search included “Drug Safety,” “Medication Safety,” “Patient Safety,” “Drug Interaction,” “Drug Pharmacokinetic,” and “Adverse Drug Reaction”. All retrieved abstracts were evaluated within the context of the review objectives. The full text of the selected articles were included in this review. Studies in non-English language were excluded in this review. Results Since the early days of the past century, many acts, laws, or amendments have been created to make sure that approved drugs are first safe and then effective. Furthermore, these regulations are continuing to change to make sure that these drugs have a positive benefit–risk balance. Personalized medicine should be considered when medications are given to patients because the pharmacokinetic process inside the body varies from patient to patient and from one specific disease state to another. However, adverse drug reactions can be minimized if more precautions are taken by healthcare professionals, especially including the patient as one pillar of the therapeutic plan and providing more patient counseling, which will improve drug safety. Conclusion The drug safety concept has earned a lot of attention during the past decade due to the fact it plays a major role in patients’ health. Recent laws stress this concept should be included in the process of new medications’ approval and continued conduct of post-marketing drug evaluations. Benefit–risk assessment should be considered by all health care professionals when they need to give specific drugs to specific groups of patients. Therefore, more care should be given to some patients, such as pregnant women, children and the elderly, since they are considered vulnerable populations.


      PubDate: 2014-05-14T04:10:27Z
       
  • Blood viscosity as a sensitive indicator for paclitaxel induced oxidative
           stress in human whole blood

    • Abstract: Publication date: Available online 30 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Gamaleldin I. Harisa
      In this study, the in vitro effects of paclitaxel (PTX) and Cremophor-EL (CrEL) on blood viscosity and oxidative stress markers were investigated. Whole-blood samples were collected from healthy volunteers and co-incubated with PTX, CrEL or their combination then compared with control blood samples. After 24 h incubation time, the whole-blood viscosity (WBV), erythrocyte sedimentation rate (ESR), levels of whole-blood malondialdehyde (MDA), protein carbonyl content (PCC) and reduced glutathione (GSH) were determined. Moreover, plasma nitrite and plasma sialic acid (SA) values were measured. The present results revealed that the incubation of blood samples with PTX, CrEL or PTX plus CrEL significantly increased the values of WBV, ESR, MDA and PCC compared to control samples. In contrast, a significant decrease in levels of GSH, SA and nitrite was observed after incubation of blood samples with tested agents compared to control. The effects of tested agents on the measured parameters were more pronounced in case of blood samples treated with PTX plus CrEL. The present study demonstrates that PTX-induced oxidative stress associated with an increase of WBV.


      PubDate: 2014-05-04T16:11:02Z
       
  • Use of an Entacapone-Containing Drug Combination and Risk of Death:
           Analysis of the FDA AERS (FAERS) database

    • Abstract: Publication date: Available online 30 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Thamir M. Alshammari , Eman N. AlMutairi
      Objectives To assess the signal of death associated with the use of an entacapone-containing drug combination in the FDA Adverse Event Reporting System (FAERS) database. Methods Reports of death events submitted between January 2004 and December 2010 were retrieved and analysed by the reporting odds ratio (ROR). The ROR of case/non-case reports of death associated with an entacapone-containing drug combination was compared with the levodopa/carbidopa combination using the FDA AERS database. Results Eighty-seven reports linked the entacapone-containing drug combination to death, compared to 27 reports of death linked the levodopa/carbidopa combination. The ROR was statistically significant for the association between deaths with the use of an entacapone-containing drug combination (1.86 [95% CI 1.50- 2.31]). In contrast, the ROR of death associated with the combination of levodopa and carbidopa was not statistically significant (0.89 [95% CI 0.61-1.30)]. Conclusion Based on analysing reports in the FAERS database, there is a risk of death with the use of an entacapone-containing drug combination. These results generated a signal of death with the use of this drug. However, epidemiological studies are required to confirm this association.


      PubDate: 2014-05-04T16:11:02Z
       
  • Pain and anxiety management for pediatric dental procedures using various
           combinations of sedative drugs: A review

    • Abstract: Publication date: Available online 26 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Giath Gazal , Wamiq Musheer Fareed , Muhammad Sohail Zafar , Khalid H. Al-Samadani
      For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, antagonists for clinical dental treatment procedures.


      PubDate: 2014-04-29T08:12:01Z
       
  • Incidence of Prescribing Errors in Hospitalized Saudi Patients: A
           Methodology Challenges

    • Abstract: Publication date: Available online 24 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Mansour Adam Mahmoud , Hisham Aljadhey , Mohamed Azmi Hassali
      Medication errors are the leading cause of adverse drug events (ADEs) and most commonly occur in the prescribing stage. A systematic review of 65 studies that investigated the prevalence and incidence of prescribing errors conducted in 2009 in the UK concluded that prescribing errors occur in 7% of medication orders, 2% of patient days and 50% of hospital admissions. In Saudi Arabia majority of the studies conducted to investigate prescribing errors came from the primary care settings. However, hospitalized patients received little attention.


      PubDate: 2014-04-29T08:12:01Z
       
  • Cell cultures in drug development: Applications, challenges and
           limitations

    • Abstract: Publication date: Available online 20 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdelaziz Ghanemi



      PubDate: 2014-04-23T23:43:30Z
       
  • Practical Issues with High Dose Methotrexate Therapy

    • Abstract: Publication date: Available online 13 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Osama M. Al-Quteimat , Mariam A. Al-Badaineh
      Methotrexate (MTX) is an antifolate cytotoxic medication used to treat certain types of cancer and at lower doses for rheumatic diseases. MTX has many serious adverse effects, such as myelosuppression, hepatic, renal and pulmonary disorders. For safe and effective use of high dose methotrexate (HDMTX) certain precautions should be followed. We present this case study with short review to briefly summarize the important practical issues related to HDMTX therapy.


      PubDate: 2014-04-18T18:16:41Z
       
  • Nanogels as potential nanomedicine carrier for treatment of cancer: a mini
           review of the state of the art

    • Abstract: Publication date: Available online 16 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Govind Soni , Khushwant S. Yadav
      Nanogels are being explored as drug delivery agents for targeting cancer due to their easy tailoring properties and ability to efficiently encapsulate therapeutics of diverse nature through simple mechanisms. Nanogels are proficiently internalized by the target cells, avoid accumulating in nontarget tissues thereby lower the therapeutic dosage and minimize harmful side effects. However, there is an urgent need for relevant clinical data from nanogels so as to allow translation of the nanogel concept into a viable therapeutic application for treatment of cancer. This review highlights some of the recent progress in nanogels as carrier in the field of nanomedicine for the treatment of cancer. The present review critically analyses the use of extracellular pH targeting for nanogels, siRNA delivery, PEGylated nanogels, multi-responsive nanogels and intracellular delivery of nanogels for improved therapy of cancer.


      PubDate: 2014-04-18T18:16:41Z
       
  • Modulation of CYP2D6 and CYP3A4 metabolic activities by Ferula asafetida
           resin

    • Abstract: Publication date: Available online 3 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Fahad I. Al-Jenoobi , Areej A. Al-Thukair , Mohd Aftab Alam , Fawkeya A. Abbas , Abdullah M. Al-Mohizea , Khalid M Alkharfy , Saleh A. Al-Suwayeh
      Present study investigated the potential effects of Ferula asafetida resin on metabolic activities of human drug metabolizing enzymes: CYP2D6 and CYP3A4. Dextromethorphan (DEX) was used as a marker to assess metabolic activities of these enzymes, based on its CYP2D6 and CYP3A4 mediated metabolism to dextrorphan (DOR) and 3-methoxymorphinan (3-MM), respectively. In vitro study was conducted by incubating DEX with human liver microsomes and NADPH in presence or absence of Asafetida alcoholic extract. For clinical study, healthy human volunteers received a single dose of DEX alone (phase-I) and repeated the same dose after a washout period and four-day Asafetida treatment (phase-II). Asafetida showed a concentration dependent inhibition on DOR formation (in vitro) and a 33% increase in DEX/DOR urinary metabolic ratio in clinical study. For CYP3A4, formation of 3-MM in microsomes was increased at low Asafetida concentrations (10, 25, and 50 μg/ml) but slightly inhibited at the concentration of 100 μg/ml. On the other hand, in vivo observations revealed that Asafetida significantly increased DEX/3-MM urinary metabolic ratio. The findings of this study suggest that Asafetida may have significant effect on CYP3A4 metabolic activity. Therefore, using Ferula asafetida with CYP3A4 drug substrates should be cautioned especially those with narrow therapeutic index such as cyclosporine, tacrolimus and carbamazepine.


      PubDate: 2014-04-08T00:27:59Z
       
  • Is mapping borders between pharmacology and toxicology a necessity'

    • Abstract: Publication date: Available online 2 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdelaziz Ghanemi



      PubDate: 2014-04-02T22:28:53Z
       
  • Formulation and evaluation of new long acting metoprolol tartrate
           ophthalmic gels

    • Abstract: Publication date: Available online 2 April 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Amal El Sayeh F. Abou el Ela , Mona Mohamed El Khatib
      The rational of the present work is to formulate and evaluate metoprolol tartrate (MT), which is a beta-1 selective adrenergic blocking agent in a new ocular gel delivery system; this is our way and method to increase its contact to the cornea, giving longer time of drug contact to the eye and slow possible release from the preparation. Metoprolol tartrate is chosen as a candidate for gel formulation because although it has been available for a few years as ophthalmic solutions, it has not been marketed as an ocular gel yet. Two polymers; Carbopol 934 and Pluronic F127 (PF127) were used in two different concentrations in this study. Metoprolol tartrate was used in two concentrations, 0.5% and 1% (w/w). All formulations exposed to visual examinations, pH measurement, in vitro release, rheological study and differential scanning calorimetry (DSC). Results showed that all formulations were clear, showed pH within the acceptable range suitable to be administered in the eye, and exhibited pseudoplastic flow behavior. DSC results concluded that, MT was compatible with different polymers used. In vitro release results showed that the release rate of metoprolol tartrate from gel preparations decreased as an inverse function of polymer concentration, and the release rate of the drug increased as the initial concentration increased. Intra-ocular pressure (IOP) measurements of the rabbit’s eye treated with 1% (w/w) metoprolol tartrate in gel formulations with different concentrations of the polymer were determined. Carbopol 934 gel formulations showed that this polymer extended the duration of pressure reducing effect of MT to more than 5hr when compared with Pluronic F127 gel formulations. Area above the curve (AAC), maximum response, time of maximum response (tmax), and the duration of the drug action were also calculated.


      PubDate: 2014-04-02T22:28:53Z
       
  • Public Attitude and Justification to Purchase Antibiotics in the Eastern
           region Al Ahsa of Saudi Arabia

    • Abstract: Publication date: Available online 20 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Promise M. Emeka , Moktar Al Omar , Tahir M. Khan
      Use of non-prescription antibiotics can portend danger and predispose the populace to changes in bacterial resistance pattern. The aims of this study were to (a) evaluate the knowledge and attitudes of residents of Al-Ahsa community, Saudi Arabia on the use of non-prescriptions use of antibiotics. (b) To identify possible predictors (if any) for self-medication within the community. A cross-sectional survey study, using self-administered questionnaire was used and were in two sections; demographics and self-medication attitude (in form of self-antibiotic use). Questions contained the following outcomes; for demographics; gender, age, education level and common disease within the community. Whereas the second part evaluated sources of information, knowledge of antibiotics, frequency/duration of use, underlined illness in which drug use was employed, names of antibiotics used and awareness of adverse effects of antibiotics. Results revealed that the adult population 18-40 years age range constituted about 82.5% of the respondents. Also 18-29 age group made of 60.4% of the respondents and that 56.8% the respondents are university graduates. Cold (18.75%) and sore throat (12.93%) were diseases commonly found among the community that drove them to using non-prescribed antibiotics. Also, 19.4% of the respondents admitted to taking non-prescribed antibiotics for both prevention and treatment of illness. Moreover 32.6% of the respondents indicated that they never seek advice from pharmacist. On alarming note, 43.4% already know which type of antibiotics to buy whereas 43.6% are not aware of the dangers of using non-prescribed antibiotics. In conclusion the use of non-prescribed antibiotics in this community is evident, as a significant number use them from previous experience for prevention and treatment of illness. Therefore introduction of rational use of drugs will help in limiting the attendant development of bacterial resistance.


      PubDate: 2014-03-24T01:14:49Z
       
  • Assessment of legibility and completeness of handwritten and electronic
           prescriptions

    • Abstract: Publication date: Available online 13 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ahmed I Albarrak , EmanAbdurahman Al Rashidi , Rwaa Kamil Fatani , Shoog Ibrahim Al Ageel , Rafiuddin Mohammed
      Objectives To assess the legibility and completeness of handwritten prescriptions and compare with electronic prescription system for medication errors. Design Prospective Study Setting King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. Subjects and Methods Handwritten prescription received from clinical units of Medicine Outpatient Department (MOPD), Primary Care Clinic (PCC) and Surgery Outpatient Department (SOPD) whereas electronic prescriptions were collected from the pediatric ward. The handwritten prescription was assessed for completeness by the checklist designed according to hospital prescription and evaluated for legibility by two pharmacists. The comparison between hand written and electronic prescription errors were evaluated based on the validated checklist adopted from previous studies. Main Outcome Measures Legibility and completeness of prescriptions Results 398 prescriptions (199 handwritten and 199 e-prescriptions) were assessed. About 71 (35.7%) of handwritten and 5 (2.5%) of electronic prescription errors were identified. A significant statistical differences (P<0.001) were observed between hand written and e- prescription in omitted dose and omitted route of administration category of error distribution. The rate of completeness in patient identification in handwritten prescriptions was 80.97% in MOPD, 76.36% in PCC and 85.93% in SOPD clinic units. Assessment of medication prescription completeness was 91.48% in MOPD, 88.48% in PCC, 89.28% in SOPD. Conclusions: This study revealed high incidence of prescribing errors in handwritten prescriptions. The use of e-prescription system showed significant decline in the incidence of errors. The legibility of handwritten prescriptions was relatively good whereas the level of completeness was very low.


      PubDate: 2014-03-13T13:35:27Z
       
  • Clinical Pharmacists: Bridging the Gap Between Patients and Physicians

    • Abstract: Publication date: Available online 12 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Suja Abraham , Jolly Francis



      PubDate: 2014-03-13T13:35:27Z
       
  • Physicians’ and patients’ valuation of pharmaceutical care
           implementation in Poznan (Poland) community pharmacies

    • Abstract: Publication date: Available online 13 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): M. Waszyk-Nowaczyk , P. Nowaczyk , M. Simon
      Implementation of pharmaceutical care (PC) in Poland is of great importance to patients, who, on the one hand, often follow complex pharmacological treatment regimens recommended by several physicians of different specialties, and, on the other one, take up the decision on self-treatment due to availability of OTC medications. The aim of the present study was to assess the opinion of both patients and physicians about implementation of PC service in Polish community pharmacies. A cross sectional study was carried out from September 2009 to September 2010 by a pharmacist (author of the study) on the basis of an anonymous questionnaire, where demand of physicians (n=104) and patients (n=202) for implementation of PC in a community pharmacy was assessed. The study was planned to determine the relationship between implementation of PC, cost and time of this service and patients’ and physicians’ socio-economic information. Responding patients (85.64%) and physicians (76.92%) unanimously confirmed the need for implementation of PC. Most people convinced of the service implementation were 88.89% of physicians under the age of 35 and all the respondents over 65 years of age (p=0.027), just as 93.33% with service shorter than 5 years and 73.68% of respondents working a maximum of 20 years (p=0.023). Mainly according to 90.00% of physicians with specialty in internal medicine and 92.59% of physicians of the group “Others” (p=0.012), PC should be implemented in pharmacies. Women more frequently than men reckoned that appointments with a pharmacist should last up to 15 minutes (p=0.012). According to 77.78% of the youngest physicians and 83.33% of the oldest ones, appointments should last from 5 to 15 minutes (p=0.049), and similar opinion was shared by 80.77% of physicians without specialty and 77.78% of physicians of the group “Others” (p=0.0009). According to patients, mean cost of the visit should be USD 7. Physicians the most often assessed mean cost of the appointment at USD 14 . This study provides new data about implementation of PC in Poland. The increased patients’ and physicians’ willingness to benefit from this service provides pharmacists with opportunities to develop PC in community pharmacies.


      PubDate: 2014-03-13T13:35:27Z
       
  • Students’ attitude toward use of over the counter medicines during
           exams in Saudi Arabia

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Haya Almalak , Ala’a Ibrahim Albluwi , Dalal Ahmed Alkhelb , Hajar Mohmmed Alsaleh , Tahir Mehmood Khan , Mohamed Azmi Ahmad Hassali , Hisham Aljadhey
      Purpose To explore the use of over the counter (OTC) medicines among students during exams in Riyadh City, Kingdom of Saudi Arabia. Method A cross-sectional study was designed; using a self-administered twenty-two item online questionnaire for the students’ convenience and easy response disclosure. Data were analyzed using Statistical Package for Social Science (SPSS) version 13®. Results A total of N =1596 students participated in this survey, of whom 829 (51.9%) were university students and 767 (48.1%) were high school students. Overall, 80.0% of the respondents disclosed the use of OTC non-steroidal anti-inflammatory drugs for headache and pain relief. In addition, other substances used during the exams were Energy Drinks (5.0%), Flu Medication (5.0%), Vitamins (5.0%) and Antibiotics (5.0%). Female students were found to be more knowledgeable about safety issues concerning the use of OTC medicines (5.11±1.27, p =<0.001) than male students. Ease in access to OTC medicine, availability of pharmacist consultation and advertisement in print and electronic media were the main factors disclosed by the respondents that may result in an increase in the use of OTC products. The use of OTC medicines was generally higher among female students (p =0.001). Conclusion The use of OTC medication during exams was more among high school and university students. Gender, age and educational institution were found significantly affecting the use of OTC medicines during exams.


      PubDate: 2014-03-09T07:46:27Z
       
  • Interventions by pharmacists in out-patient pharmaceutical care

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Hussain Abdullah Mubarak Al Rahbi , Raid Mahmood Al-Sabri , Havagiray R. Chitme
      Interventions by the pharmacists have always been considered as a valuable input by the health care community in the patient care process by reducing the medication errors, rationalizing the therapy and reducing the cost of therapy. The primary objective of this study was to determine the number and types of medication errors intervened by the dispensing pharmacists at OPD pharmacy in the Khoula Hospital during 2009 retrospectively. The interventions filed by the pharmacists and assistant pharmacists in OPD pharmacy were collected. Then they were categorized and analyzed after a detailed review. The results show that 72.3% of the interventions were minor of which 40.5% were about change medication order. Comparatively more numbers of prescriptions were intervened in female patients than male patients. 98.2% of the interventions were accepted by the prescribers reflecting the awareness of the doctors about the importance of the pharmacy practice. In this study only 688 interventions were due to prescribing errors of which 40.5% interventions were done in changing the medication order of clarifying the medicine. 14.9% of the interventions were related to administrative issues, 8.7% of the interventions were related to selection of medications as well as errors due to ignorance of history of patients. 8.2% of the interventions were to address the overdose of medications. Moderately significant interventions were observed in 19.4% and 7.5% of them were having the impact on major medication errors. Pharmacists have intervened 20.8% of the prescriptions to prevent complications, 25.1% were to rationalize the treatment, 7.9% of them were to improve compliance. Based on the results we conclude that the role of pharmacist in improving the health care system is vital. We recommend more number of such research based studies to bring awareness among health care professionals, provide solution to the prescription and dispensing problems, as it can also improve the documentation system, emphasize the importance of it, reduce prescribing errors, and update the knowledge of pharmacists and other health care professionals.


      PubDate: 2014-03-09T07:46:27Z
       
  • Psychiatric neural networks and neuropharmacology: Selected advances and
           novel implications

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Abdelaziz Ghanemi
      Psychiatric disorders are often considered as simple imbalances between a limited number of cerebral neurotransmitters. In fact, it is more complicated than this “simple approach” and each psychiatric disorder constitutes network dysfunction within which several agents and factors are implicated. Thus, the therapeutical perspectives and implications are as vast and as numerous as the diversity of those network dysfunctions. Furthermore, the description of factors influencing diseases prognoses and treatment efficacy indicates new elements to consider both in therapies and drug researches.


      PubDate: 2014-03-09T07:46:27Z
       
  • Design and Evaluation of Gastroretentive Levofloxacin Floating
           Mini-tablets-in-capsule System for Eradication of Helicobacter pylori

    • Abstract: Publication date: Available online 6 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Sally.A. El-Zahaby , Abeer.A. Kassem , Amal.H. El-Kamel
      Gastroretentive Levofloxacin (LVF) floating mini-tablets for the eradication of Helicobacter pylori (H. pylori) were prepared using the matrix forming polymer hydroxypropyl methylcellulose (HPMC K100M), alone or with Carbopol 940P in different ratios by wet granulation technique. Buoyancy of mini-tablets was achieved by addition of an effervescent mixture consisting of sodium bicarbonate and anhydrous citric acid to some formulations. The prepared mini-tablets were evaluated for weight variation, thickness, friability, hardness, drug content, in-vitro buoyancy, water uptake and in-vitro release. The optimized formula was subjected to further studies: FT-IR, DSC analysis and invivo examination in healthy volunteers. The prepared mini-tablets exhibited satisfactory physicochemical characteristics. Incorporation of gas-generating agent improved the floating parameters. HPMC K100M mini-tablets formulation (F1) offered the best controlled drug release (> 8 h) along with floating lag time < 1 sec and total floating time > 24 h. The obtained DSC thermograms and FT-IR charts indicated that there is no positive evidence for the interaction between LVF and ingredients of the optimized formula. The in vivo test confirmed the success of the optimized formula F1 in being retained in the stomach of the volunteers more than 4h. LVF floating mini-tablets based on HPMC K100M is a promising formulation for eradication of H. pylori.


      PubDate: 2014-03-09T07:46:27Z
       
  • Shorter and Sturdier Bridges Between Traditional Chinese Medicines and
           Modern Pharmacology

    • Abstract: Publication date: Available online 7 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdelaziz Ghanemi , Besma Boubertakh



      PubDate: 2014-03-09T07:46:27Z
       
  • Pharmacists’ and Physicians’ perception and exposure to drug
           promotion: a Saudi Study

    • Abstract: Publication date: Available online 6 March 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Noha M. Zaki
      Introduction D rug promotion has to contribute to a more rational use of drugs. Concerns arise if promotion negatively influences prescribing/dispensing pattern. It is warranted to assess exposure and attitudes to, and acceptance of, drug promotion among pharmacists and physicians staff. Methodology Adopting a randomized, multiple site and cross-sectional survey study, questionnaires (n=250) were completed by physicians and pharmacists to investigate the exposure, acceptance or skepticism of Saudi physicians/ pharmacists to drug promotion as well as their perception of the appropriateness of gifts and to check if they had any teaching /training about dealing with physicians representatives (MRs) and Pharma promotion. Results significantly more pharmacists than physicians (32% vs. 23%; p< 0.05) reported being taught or educated about the ethics of drug promotion. The experience level was significantly associated with the teaching or training physicians and pharmacists received. Conference registration fees and drug samples were the most appropriate promotional gift for the physicians (67% and 66% respectively; p < 0.01) whereas for pharmacists, the drug sample was considered the most suitable donation (79%). More pharmacists perceived drug companies as a useful way to gain knowledge about drugs than physicians (75 vs. 65 %; p< 0.01). A higher proportion of both groups were accepting drug promotion than those skeptical about it. Conclusion The majority of physicians or pharmacists participating in this have received gifts from pharmaceutical companies. The drug samples and printed educational materials are the most widely accepted gifts. Recent graduates and those with few years experience had higher teaching/training than experienced physicians and pharmacists in pharmaceutical promotion ethics and tactics to deal with MRs. On the other hand, experienced healthcare team were more approached and targeted by pharmaceutical companies and MRs.


      PubDate: 2014-03-09T07:46:27Z
       
  • A cross sectional pilot study on assessing the knowledge, attitude and
           behavior of community pharmacists to adverse drug reaction related aspects
           in the Sultanate of Oman

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Jimmy Jose , Beena Jimmy , Aliya Said Hamed Al-Ghailani , Maryam Abdullah Al Majali
      Background and objectives Adverse drug reaction (ADR) monitoring and reporting requires a multidisciplinary approach and pharmacists have a major role to play in it. The present pilot study was conducted to assess the knowledge, attitude and behavior of community pharmacists to ADR related aspects in the Sultanate of Oman. Methods A self-administered questionnaire comprising of 21 questions were distributed to a random sample of pharmacists in two Governorates in the Sultanate of Oman. It assessed the knowledge of pharmacists on some of the selected basic aspects of drug safety. Further, the knowledge and attitude of community pharmacists toward ADR reporting and their behavior on ADR related aspects were assessed. A scoring scheme was used to estimate the median total score of participants for various parameters. Obtained scores were correlated with the demographics of the respondents. Results A total of 107 community pharmacists participated in the survey giving a response rate of 72.3%. The responses of the pharmacists to the questions on the drug safety of individual drugs were incorrect for some important and practical questions. Consequently, total median score corresponding to these questions was 5 (Inter Quartile Range, IQR 2) out of a possible maximum score of 9, which was below the acceptable score. Total median score based on knowledge, attitude and behavior was 38 (IQR 8) out of a possible maximum of 50 which shows a moderate score. Lack of awareness on how to report an ADR and concern that the report may be wrong were the most common factors discouraging pharmacists from reporting ADRs. Qualification as well as years of experience were the only demographic parameters which had an influence on the score obtained by the pharmacists. Conclusions Even though the pharmacists had an acceptable knowledge, attitude and behavior on ADR reporting and related aspects, a good number of them had below than acceptable knowledge on drug safety related aspects of specific drugs. Educational programs have to be continued to generate awareness on how to report ADR and stimulate pharmacists’ more active participation in the pharmacovigilance program. There is a genuine need to have training programs to improve the knowledge of pharmacists on ADR related aspects which are of benefit on a daily basis which could greatly have an impact on patient safety.


      PubDate: 2014-03-09T07:46:27Z
       
  • Synthesis and biological evaluation studies of novel quinazolinone
           derivatives as antibacterial and anti-inflammatory agents

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Mohamed F. Zayed , Memy H. Hassan
      Some novel 6,8-diiodo-2-methyl-3-substituted-quinazolin-4(3H)-ones bearing sulfonamide derivatives (4–11) were synthesized in good yields and evaluated for their possible antibacterial, anti-inflammatory activities and acute toxicity. The structures of the synthesized compounds were confirmed on the basis of their spectral data and elemental analysis. Their antibacterial activities were evaluated by the agar well diffusion method while their anti-inflammatory activities were evaluated by the carrageenan-induced hind paw edema test. All the tested compounds showed considerable antibacterial activities and high to moderate anti-inflammatory activities that last for 12h compared to ibuprofen. All the tested compounds showed no toxic symptoms or mortality rates 24h post-administration at tested anti-inflammatory doses. In addition, LD50 for all tested compounds was higher than that for ibuprofen implying their good safety margin. The obtained results showed that the most active compounds could be useful as a template for future design, modification and investigation to produce more active analogs.


      PubDate: 2014-03-09T07:46:27Z
       
  • Formulation of immediate release pellets containing famotidine solid
           dispersions

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Mohamed Abbas Ibrahim , Mahmoud El-Badry
      Famotidine (FM) is a potent H2-receptor antagonist used for the treatment of peptic ulcer. It has a low and variable bioavailability which is attributed to its low water solubility. In this study, the dissolution of the drug was enhanced by a preparation of solid dispersion using two hydrophilic carriers, namely Gelucire 50/13 and Pluronic F-127. The prepared solid dispersions were characterized by differential scanning calorimetry (DSC), which indicated that there were no signs of interaction of the drug with the carriers used in the case of solid dispersions containing higher polymeric contents (1:3 and 1:5). FM solid dispersions in the matrices of Gelucire 50/13 and Pluronic F-127 (1:3) were used to prepare pellets. The scanning electron microscope (SEM) images of pellets showed that the pellets have spherical shape and their size depends on the carrier used. The dissolution of the drug from either solid dispersion or pellets was performed. The dissolution study depicted that, the presence of the drug in solid dispersion enhanced its dissolution in comparison with the drug itself. Also, the drug release from the manufactured pellets was found to be improved in the case of solid dispersions (drug:carrier 1:3). A complete drug release occurred after 30min from pellets containing solid dispersions, while only about 30% of the loaded FM was released from pellets containing untreated drug after 2h.


      PubDate: 2014-03-09T07:46:27Z
       
  • Comparative in vitro dissolution study of carbamazepine immediate-release
           products using the USP paddles method and the flow-through cell system

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): José Raúl Medina , Dulce Karina Salazar , Marcela Hurtado , Alma Rosa Cortés , Adriana Miriam Domínguez-Ramírez
      Dissolution profiles of four carbamazepine immediate-release generic products (200mg tablets) and the reference product Tegretol® were evaluated using the USP paddles method and an alternative method with the flow-through cell system, USP Apparatus 4. Under official conditions all products met the Q specification, dissolution profiles of generic products were similar to the dissolution profile of the reference product (f 2 >50) and model-independent parameters showed non significant differences to the reference product except mean dissolution time for product A (p <0.05). On the other hand, when the flow-through cell system was used, none of the products met the pharmacopeial specification at 15min and product A did not reach dissolution criteria at 60min, dissolution profiles of all generic products were not similar to the reference product profile (f 2 <50) and all model-independent parameters showed significant differences compared to the reference product (p <0.05). Weibull’s model was more useful for adjusting the dissolution data of all products in both USP apparatuses and Td values showed significant differences compared to the reference product (p <0.05) when USP Apparatus 4 was used. These results indicate that the proposed method, using the flow-through cell system, is more discriminative in evaluating both, rate and extent of carbamazepine dissolution process from immediate-release generic products.


      PubDate: 2014-03-09T07:46:27Z
       
  • Formulation and optimization of coated PLGA – Zidovudine
           nanoparticles using factorial design and in vitro in vivo evaluations to
           determine brain targeting efficiency

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): G.V. Peter Christoper , C. Vijaya Raghavan , K. Siddharth , M. Siva Selva Kumar , R. Hari Prasad
      In the current study zidovudine loaded PLGA nanoparticles were prepared, coated and further investigated for its effectiveness in brain targeting. IR and DSC studies were performed to determine the interaction between excipients used and to find out the nature of drug in the formulation. Formulations were prepared by adopting 23 factorial designs to evaluate the effects of process and formulation variables. The prepared formulations were subjected for in vitro and in vivo evaluations. In vitro evaluations showed particle size below 100nm, entrapment efficiency of formulations ranges of 28–57%, process yield of 60–76% was achieved and drug release for the formulations were in the range of 50–85%. The drug release from the formulations was found to follow Higuchi release pattern, n–value obtained after Korsemeyer plot was in the range of 0.56–0.78. In vivo evaluations were performed in mice after intraperitoneal administration of zidovudine drug solution, uncoated and coated formulation. Formulation when coated with Tween 80 achieved a higher concentration in the brain than that of the drug in solution and of the uncoated formulation. Stability studies indicated that there was no degradation of the drug in the formulation after 90days of preparation when stored in refrigerated condition.


      PubDate: 2014-03-09T07:46:27Z
       
  • Evaluation of Defined Daily Dose, percentage of British National Formulary
           maximum and chlorpromazine equivalents in antipsychotic drug utilization

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Waleed M. Sweileh , Jihad Bani Odeh , Naser Y. Shraim , Sa’ed H. Zyoud , Ansam F. Sawalha , Samah W. Al-Jabi
      Objective The present study was carried out to investigate and compare the three methods for calculating total antipsychotic dose among outpatients with schizophrenia attending primary psychiatric health care centers. The three methods were: Defined Daily Doses (DDDs), chlorpromazine equivalents (CPZeq) and percentages of the British National Formulary (BNF) maximum. Methodology Antipsychotic drug dosing data for 250 patients with schizophrenia were investigated by calculating Spearman’s rank correlation coefficients. Factors associated with antipsychotic dose, expressed as DDDs, CPZeq and percentages of the BNF maximum recommended daily dose, were investigated by means of linear regression analysis. Results Spearman’s correlation showed that there is a significant relationship between all pairs of the three dosing methods. In all three methods, coherence was strongest when dealing with first generation antipsychotics (FGA). Linear regression analyses showed a high degree of coherence between antipsychotic doses expressed as DDDs, CPZeq and percentages of the BNF maximum recommended daily dose. Conclusion All three tested methods are reliable and coherent for calculating antipsychotic dosing.


      PubDate: 2014-03-09T07:46:27Z
       
  • General public knowledge, perceptions and practice towards pharmaceutical
           drug advertisements in the Western region of KSA

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Mahmoud S. Al-Haddad , Fayez Hamam , Sami M. AL-Shakhshir
      This study aims to examine general public knowledge and behavior toward pharmaceutical advertisements in the Western part of KSA. A cross sectional convenience sampling technique was used in this study. A total of 1445 valid questionnaires were received and analyzed using SPSS version 16 at alpha value of 0.05. Majority of respondents were aware of different types of drugs to be advertised and drug advertisements should seek approval from the health authorities. Television and Internet showed the highest effect on consumers. Almost half of the participants preferred an advertised drug over non-advertised one. Most of the respondents indicated that the quality of frequently advertised drugs is not better than those prescribed by the doctors. Majority of participants had positive beliefs toward advertised drugs concerning their role in education and spreading of awareness among the public. Pharmaceutical advertisements harm the doctor–patient relationship as evidenced by one-third of the investigated sample. Moreover, majority of the participants mentioned that they would consult another doctor or even change the current doctor if he/she refused to prescribe an advertised medication. Results of this study could be used to develop awareness programs for the general public and try to enforce the regulations and policies to protect the general public and patients from the business oriented pharmaceutical companies and drug suppliers.


      PubDate: 2014-03-09T07:46:27Z
       
  • Perceptions, attitudes and practices toward research among senior medical
           students

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Khalid M. AlGhamdi , Noura A. Moussa , Dana S. AlEssa , Nermeen AlOthimeen , Adwa S. Al-Saud
      We aimed to explore perceptions, attitudes and practices toward research among medical students. A self-administered questionnaire was distributed among senior medical students at the King Saud University, Riyadh, Saudi Arabia. Hundred and seventy two students participated in the study, with 97 males (65.5%). The majority of the students agreed that research is important in the medical field (97.1%, 167/172). A total of 67.4% (116/172) believed that conducting research should be mandatory for all medical students. During medical school, 55.3% (88/159) participated in research. The obstacles that prevented the students from conducting research included lack of professional supervisors (84.7%, 143/169), lack of training courses (88.8%, 151/170), lack of time (72.3%, 123/172) and lack of funding (54.1%, 92/170). Although the majority of students believe that research is important in the medical field, only around half of the students participated in research during medical school.


      PubDate: 2014-03-09T07:46:27Z
       
  • Inside Front Cover - Editorial Board

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2




      PubDate: 2014-03-09T07:46:27Z
       
  • Factors affecting the development of adverse drug reactions (Review
           article)

    • Abstract: Publication date: April 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 2
      Author(s): Muaed Jamal Alomar
      Objectives To discuss the effect of certain factors on the occurrence of Adverse Drug Reactions (ADRs). Data Sources A systematic review of the literature in the period between 1991 and 2012 was made based on PubMed, the Cochrane database of systematic reviews, EMBASE and IDIS. Key words used were: medication error, adverse drug reaction, iatrogenic disease factors, ambulatory care, primary health care, side effects and treatment hazards. Summary Many factors play a crucial role in the occurrence of ADRs, some of these are patient related, drug related or socially related factors. Age for instance has a very critical impact on the occurrence of ADRs, both very young and very old patients are more vulnerable to these reactions than other age groups. Alcohol intake also has a crucial impact on ADRs. Other factors are gender, race, pregnancy, breast feeding, kidney problems, liver function, drug dose and frequency and many other factors. The effect of these factors on ADRs is well documented in the medical literature. Taking these factors into consideration during medical evaluation enables medical practitioners to choose the best drug regimen. Conclusion Many factors affect the occurrence of ADRs. Some of these factors can be changed like smoking or alcohol intake others cannot be changed like age, presence of other diseases or genetic factors. Understanding the different effects of these factors on ADRs enables healthcare professionals to choose the most appropriate medication for that particular patient. It also helps the healthcare professionals to give the best advice to patients. Pharmacogenomics is the most recent science which emphasizes the genetic predisposition of ADRs. This innovative science provides a new perspective in dealing with the decision making process of drug selection.


      PubDate: 2014-03-09T07:46:27Z
       
  • The Impact of Clinical Pharmacist and ID intervention in Rationalization
           of Antimicrobial Use

    • Abstract: Publication date: Available online 26 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Niaz Al-Somai , Mohamaed Al Muhr , Osama Qutimat , Nashaat Hamzah
      What is known and Objective There is little research on the impact of implementing and monitoring antimicrobial policy in Saudi hospitals. The purpose of this study is to measure the impact of the clinical pharmacist (CP) and infectious disease consultant (ID) interventions on the use of three antimicrobials (Caspofungin, imipenem, meropenem) in hospitalized patients in King Abdullah Medical City hospital. Methods The study was carried out in King Abdullah Medical City, in Mekkah, Saudi Arabia. The hospital is a tertiary center that provide CCU, CSICU, Cardiac, Hematology, ICU, Medical, Neuroscience, Oncology, and specialized surgery services. The use of three antimicrobials (Caspofungin, Imipenem, Meropenem) was reviewed by the clinical Pharmacist for four periods, pre and post implementation of policy. Relevant data were collected in four periods. In the first period, before policy implementing, the data were collected retrospectively to be used as baseline status reference, and in the three remaining periods that followed data were collected prospectively, and compared to base line data, to evaluate role of clinical pharmacist and ID interventions in optimizing antimicrobial therapy. Results and discussion Caspofungin duration of therapy was not affected significantly by the intervention. Statistically significant reduction in antimicrobial therapy duration was observed in imipenem (37%) and meropenem (37%) from baseline, which indicate better control on antimicrobial use and reduction in antimicrobial resistance. What is new and Conclusion The impact of the clinical pharmacist and ID interventions, in reducing antimicrobial therapy duration using imipenem and meropenem, is clear from the result presented above. However, lack of restriction and follow up in the antimicrobial policy in case of negative culture makes antimicrobial use uncontrollable in these cases. Establishing good and accepted policy may help reduce consumption and total cost of therapy.


      PubDate: 2014-03-04T01:59:28Z
       
  • Antiepileptic drugs toxicity: a case of toxic epidermal necrolysis in
           patient with phenytoin prophylaxis post-cranial radiation for brain
           metastases

    • Abstract: Publication date: Available online 25 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Khalid AlQuliti , Basem Ratrout , Alaa AlZaki
      Background Treatment of epilepsy with antiepileptic drugs (AED) is effective and remains the principal mode of management. A group of Adverse effects and drug toxicity can develop immediately or later in course of treatment. AEDs also have the potential of precipitating idiosyncratic adverse effects including serious cutaneous, hematological and hepatic events. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse reactions that are related to or caused by a variety of medications including AEDs, they carry a high mortality and morbidity rate, accurate diagnosis and rapid treatment may improve the prognosis. Objective To characterize the clinical features and methods of differentiating Stevens-Johnson syndrome from toxic epidermal necrolysis using a case study and to identify other factors that may contribute to this critical illness. Conclusion Clinical knowledge of potential sever adverse reaction of AEDs is essential and may overcome treatment failure with major impact on health-related quality of life in people with epilepsy.


      PubDate: 2014-02-26T19:20:47Z
       
  • Role of medium-chain fatty acids in the emulsification mechanistics of
           self-micro-emulsifying lipid formulations

    • Abstract: Publication date: Available online 25 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Naser M.Y. Hasan
      Purpose The objective of the present study was to design and develop stable o/w microemulsions comprising Miglyol 812, Imwitor 988 and Tagat TO as a non ionic surfactant. This was based on particle size measurements and phase behaviour studies. The empirical role of incorporating medium-chain mono/di-glycerides in the lipid matrix in the mechanistic processes of emulsification was also established in various simulating physiological conditions. Methods The efficiency of self-emulsification was evaluated under conditions of varying key compositions in the lipid mixtures; oil, cosurfactant and surfactant. Droplet diameter was measured using laser diffraction and light scattering techniques. Equilibrium phase studies were performed and phase boundaries were determined for the lipid-water systems. Results Microemulsion systems were produced from blends of Miglyol 812, Imwitor 988 and Tagat TO. An optimized formulations consisted of {Miglyol 812/Imwitor 988} and Tagat TO spontaneously self-emulsified in water producing dispersions with droplet diameters of ∼50nm. Phase equilibrium diagrams have revealed significant enhancement in the water-solubilized region (L2) without any presence of liquid crystalline materials. Conclusions Potential SMEDDS formulations for the bioavailability enhancement of poorly water-soluble compounds were developed by mixing blends of {Miglyol 812/Imwitor 988} and Tagat TO as a non-ionic surfactant. ‘Diffusion and Stranding’ appears to be the dominant mechanism of emulsification.


      PubDate: 2014-02-26T19:20:47Z
       
  • An influence of Adrenaline (1:80,000) containing Local Anesthesia (2%
           Xylocaine) on glycemic level of patients undergoing tooth extraction in
           Riyadh

    • Abstract: Publication date: Available online 26 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Naveed A. Khawaja , Hesham Khalil , Kauser Parveen
      Objective Aim is to compare the glycemic level among patients before, and after local anaesthesia containing adrenaline 1: 80, 000 among patients who needs dental extraction. Material and method 60 randomly selected patients including 30 healthy and 30 with diabetes history for this study in Riyadh city. First measure the blood glucose level before the local anaesthesia containing adrenaline after taking history with glucocheck according to instructions, then recorded Blood Sugar level after local anesthesia containing adrenaline 1: 80, 000 concentrations. Blood sugar level also checked 5 min after the tooth extraction procedure. Result There was no significant results found after administration of local anesthesia containing adrenaline in both healthy and diabetic patient (p >0.05). However, the significance change (p <0.05) was noticed in diabetic patient who had not taken their hypoglycaemic medication; rise in their blood glucose level after extraction Conclusion The study concluded no significant effect on glycemic level of patients after administration of local anesthesia containing adrenaline 1: 80,000 in healthy and diabetic patients whether taken or not taken hypglycaemic medication but rise in blood suger level found among diabetic patients who did not take their hypoglycaemic medications undergoing tooth extraction.


      PubDate: 2014-02-26T19:20:47Z
       
  • Stability of chronic medicines in dosage administration aids. How much
           have been done'

    • Abstract: Publication date: Available online 25 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Joyce Zhen Yin Tan , Yu Heng Kwan
      Background The prevalence of chronic diseases is increasing in Asia, therefore compliance to the medications is of utmost importance to slow disease progression and improve outcomes. Dosage administration aids (DAAs) serve as important tool to improve the compliance of patients. However, there is a dearth of data on stability of chronic medications in DAAs. Furthermore, data presented by our Western counterparts may not be applicable to us because of our extreme humidity and temperature. In this study, we aim to summarize the data available in the literature on stability of chronic medications in DAA. Methods We performed a literature search using electronic databases and related keywords. Results In total, 24336 articles were retrieved and 21 articles were found to be relevant to our topics. This commentary stratified drugs according to their treatment categories and key stability conclusions, DAA and conditions used and recommendations were presented. Conclusion Due to the lack of specific data, pharmacists have to exercise their professional judgment with the help from professional guidelines when using DAA in repackaging medication. Manufacturers and regulators can play a greater role in filling the gap needed to provide pharmacists with necessary information to fulfill their function.


      PubDate: 2014-02-26T19:20:47Z
       
  • The Role of Pharmacists in Developing Countries: The Current Scenario in
           the United Arab Emirates

    • Abstract: Publication date: Available online 25 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ibrahim Khalid Rayes , Mohamed Azmi Hassali , Abduelmula R. Abduelkarem
      Pharmacy practice has passed several rounds of advancements over the past few years. It had changed the traditional positioning criteria of pharmacists as business people into patient-centered healthcare professionals. This worldwide shift is increasingly accumulating pressure on UAE pharmacists to turn up into better level of service providing accompanied with higher demand of inter-personal skills and intellectual capabilities. This can be accomplished through stressing the significance of continuing pharmacy education in basic sciences as well as social and administrative pharmacy techniques and its collaboration in elevating the quality of pharmacy practice in the UAE.


      PubDate: 2014-02-26T19:20:47Z
       
  • Calcipotriol Delivery into the Skin as Emulgel for Effective Permeation

    • Abstract: Publication date: Available online 25 February 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): V. Naga Sravan Kumar Varma , P.V. Maheshwari , M. Navya , Sharath Chandra Reddy , H.G. Shivakumar , D.V. Gowda
      The objective of this work is to formulate and evaluate an emulgel containing calcipotriol for treatment of psoriasis. Emulgels have emerged as a promising drug delivery system for the delivery of hydrophobic drugs. Isopropyl alcohol and polyethylene glycol have been employed as permeation enhancers. Formulation chart is made with seven formulations, evaluated for physical parameters, drug content, viscosity, thixotropy, spreadability, extrudability, mucoadhesion, diffusion studies, Skin irritation test along with Short term stability studies. Carbopolis reported to have a direct influence on appearance and viscosity of final formulation. The photomicroscopic evaluations showed the presence of spherical globules in size range of 10 to 15μm. Rheogarms revealed that all the formulations exhibited pseudoplastic flow. Optimized formulation (F6) had shown 86.42±2.0% drug release at the end of 8hr study. The release rate through dialysis membrane and rat skin is higher when compared to commercial calcipotriol ointment. Hence it is concluded that calcipotriol can be delivered topically with enhanced penetration properties when formulated as emulgel.


      PubDate: 2014-02-26T19:20:47Z
       
  • Emergency department visits and admissions due to drug related problems at
           Riyadh military hospital (RMH), Saudi Arabia

    • Abstract: Publication date: January 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 1
      Author(s): Mohamed Al-Arifi , Hanan Abu-Hashem , Mohamed Al-Meziny , Ragab Said , Hisham Aljadhey
      Objectives Aim of this study was to prospectively determine the incidence and types of emergency department (ED) visits and admissions due to drug related problems (DRPs) at Riyadh Military Hospital (RMH), to assess the severity and preventability of these drug related admissions or visits, and to identify the drugs and patient groups that are most commonly involved. Method Patients (n =300) were selected randomly from patients presented to the ED during the study period (one month). Computerized randomization program was used to select ten beds daily on different areas and times. Patient was eligible to be included if either visited ED or admitted through it due to DRPs. Results During the study period, 300 patients presented to ED were randomly selected with a mean age of 47.8±27.7years. One hundred and forty of them were females (46.67%) and 160 were male patients (53.33%). Of these 300 patients, 56 (18.7%) were presented to ED due to DRPs, and 244 (81.3%) patients were presented to ED due to non-drug related problems (NDRPs). About ninety-three percent (n =52) of the DRP group were exposed to hospital admission while only 7.1% (n =4) were ED visits (Fig. 2). Male to female ratio in ED visits was 3:1 while it was 9.7:8.9 in the ED admission group. Conclusion The prospective design of this study, sample size, and randomization increases the likelihood that our estimates are accurate and increase the generalizability of our findings. Most DRPs attributed to hospital admissions or visits were avoidable. Direct patient contact with pharmacist and family physician was beneficial in providing a safe and effective therapy. Corrective, preventive and educational strategies should concentrate on the most frequently reported populations, diseases and medications. The study addresses the proper use of medications to ensure the best outcomes of pharmacological interventions. Finally, more studies with longer duration focusing on DRPs in Saudi Arabia are needed.


      PubDate: 2014-01-28T04:42:15Z
       
  • Medications prescribing pattern toward insured patients

    • Abstract: Publication date: January 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 1
      Author(s): Ameen Al-Mohamadi , Atika Mohammed Al-Harbi , Areej Mansour Manshi , Mona Majdi Rakkah
      Background and Objective The rising costs of health care continue to make health insurance important for many countries. Health insurance may cover different aspects of health care in Saudi Arabia including the prescribed drugs. Physicians usually have different personal attitudes toward insured and uninsured patients. This study is to investigate the prescribing behavior of physicians to those groups of patients in the private setting. Design and Setting A prospective study was conducted during the period between October 2011 and January 2012, in three Saudi private hospitals. Method Prescriptions for insured and uninsured patients were randomly selected and analyzed. Data regarding diagnosis, age, gender, co-morbidity, number of items and the total cost of the medication in Saudi Riyals (SR) were collected through a chart review form. Results Three thousand sixty six patients’ prescriptions were included in this study, 34.7% of them were females. 273 patients (75.2%) were insured while 90 were not. 24.8% were patients who paid cash. Majority (57.6%) of the patients were with diabetes plus hypertension and other co-morbidity. 20.7% of patients were taking three medications or less, while 67.8% were taking 4–10 and 11.6% were taking more than 10 medications. Analysis of differences showed that, patients who were insured have a higher number of prescribed medications (p ⩽0.001), and a higher total price of prescription than those who were paying cash only (p ⩽0.001). In a more confirmatory step, all uninsured patients (n =90) were closely matched in the age, gender, diagnosis and hospital with similar 90 insured patients. Results of this matching process confirmed the above findings. Conclusion Physicians in private setting are more likely to prescribe more drugs and/or brand drugs to insured patients than for uninsured patients. Further studies to view the reasons behind this behavior and strategies to prevent such actions are needed.


      PubDate: 2014-01-28T04:42:15Z
       
  • Biological properties and perspective applications of
           “Bio-neuter” chemicals'

    • Abstract: Publication date: January 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 1
      Author(s): Abdelaziz Ghanemi



      PubDate: 2014-01-28T04:42:15Z
       
  • Targeting cancer using cholesterol conjugates

    • Abstract: Publication date: January 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 1
      Author(s): Awwad A. Radwan , Fares K. Alanazi
      Conjugation of cholesterol moiety to active compounds for either cancer treatment or diagnosis is an attractive approach. Cholesterol derivatives are widely studied as cancer diagnostic agents and as anticancer derivatives either in vitro or in vivo using animal models. In largely growing studies, anticancer agents have been chemically conjugated to cholesterol molecules, to enhance their pharmacokinetic behavior, cellular uptake, target specificity, and safety. To efficiently deliver anticancer agents to the target cells and tissues, many different cholesterol–anticancer conjugates were synthesized and characterized, and their anticancer efficiencies were tested in vitro and in vivo.


      PubDate: 2014-01-28T04:42:15Z
       
  • Inside Front Cover - Editorial Board

    • Abstract: Publication date: January 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 1




      PubDate: 2014-01-28T04:42:15Z
       
  • Importance of Quality Risk Management in Pharmaceutical Quality Systems:
           Recent Trends and Harmonization

    • Abstract: Publication date: Available online 2 January 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ildikó Mohammed-Ziegler , Ildikó Steff , Mária Halmai-Varényi
      In July of 2013, the World Health Organiazation (WHO) of the United Nations finalized the Annex 2 of the new Technical Report 981, that is the WHO guideline on the implementation of a Quality Risk Management system. In general, alignment of the WHO requirements with the harmonized guidelines means consensus with the harmonized European, US and Asian regulations. In this short communication some aspects and the role of Quality Risk Management (QRM) in the Pharmaceutical Quality Systems (PQS) are discussed.


      PubDate: 2014-01-04T01:04:05Z
       
  • Systematic review and meta-analysis of efficacy and safety of
           combinational therapy with metformin and dipeptidyl peptidase-4 inhibitors
           

    • Abstract: Publication date: Available online 3 January 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdulrahman S. Alanazi
      Combinational therapies are often required in the management of type 2 diabetes mellitus (T2DM). Among the important candidates, dipeptidyl peptidase-4 inhibitors (DPPIs) and metformin combination (DPPI-MET) have shown promising endeavors. In order to examine the efficacy and safety of such a combination therapy in T2DM patients finding inadequate control with metformin, this systematic review and meta-analysis has been conducted. Literature search was made in multiple electronic databases. Inclusion criteria included; RCTs examining the efficacy and safety of DPPI-MET against placebo-MET or MET-only groups of T2DM patients by observing changes in disease endpoints including HbA1c and FPG, and the length of trial be at least 12 weeks. Mean differences based metaanalyses were performed and heterogeneity assessment was carried out. Nineteen studies were selected and included in the meta-analyses. DPPI-MET significantly improved all disease endpoints and the difference could be noticed up to 2 years in the majority of outcome measures. In comparison with PBO-MET, the DPPI-MET combinational therapy resulted in the percent HbA1c changes from baseline with a mean difference [95% CI] of −0.77 [−0.86, −0.69] in 3-month (P<0.00001), −0.67 [−0.76, −0.59] in 6-month (P<0.00001), −0.67 [−0.88, −0.47] in 1-year (P<0.00001) and −0.36 [−0.53, −0.20] in 2-year trials (P<0.0003). Reduction in body weight and safety profile in the treated and control groups was not different. A combinational therapy with DPPI and metformin significantly improves diabetes clinical indicators and this effect has observed for up to two years herein. Safety and tolerability of DPPI-MET combination has been found well-manageable with a very similar adverse event profile in both treated and control groups.


      PubDate: 2014-01-04T01:04:05Z
       
  • Systemic delivery of β-blockers via transdermal route for
           hypertension

    • Abstract: Publication date: Available online 3 January 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdul Ahad , Fahad I. Al-Jenoobi , Abdullah M. Al-Mohizea , Naseem Akhtar , Mohammad Raish , Mohd. Aqil
      Hypertension is the most common cardiovascular disease worldwide. Moreover, management of hypertension requires long-term treatment that may result in poor patient compliance with conventional dosage forms due to greater frequency of drug administration. Although the availability of a plethora of therapeutically effective antihypertensive molecules, inadequate patient welfare is observed; this arguably presents an opportunity to deliver antihypertensive agents through a different route. Ever since transdermal drug delivery came into existence, it has offered great advantages including non-invasiveness, prolonged therapeutic effect, reduced side effects, improved bioavailability, better patient compliance and easy termination of drug therapy. Attempts were made to develop transdermal therapeutic system for various antihypertensive agents, including β-blockers, an important antihypertensive class. β-blockers are potent, highly effective in the management of hypertension and other heart ailments by blocking the effects of normal amounts of adrenaline on the heart and blood vessels. The shortcoming associated with β-blockers such as more frequent of dose administration, extensive first pass metabolism and variable bioavailability, make them an ideal candidate for transdermal therapeutic systems. The present article gives the brief view on different β-blockers formulated as transdermal therapeutic system in detailed to enhance the bioavailability as well as to improve the patient compliance. Constant improvement in this field holds promise for the long-term success in technologically advanced transdermal dosage forms being commercialized sooner rather than later.


      PubDate: 2014-01-04T01:04:05Z
       
 
 
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