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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]
  • Therapeutic approaches to drug targets in atherosclerosis

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Prasad G. Jamkhande , Prakash G. Chandak , Shashikant C. Dhawale , Sonal R. Barde , Priti S. Tidke , Ram S. Sakhare
      Non-communicable diseases such as cancer, atherosclerosis and diabetes are responsible for major social and health burden as millions of people are dying every year. Out of which, atherosclerosis is the leading cause of deaths worldwide. The lipid abnormality is one of the major modifiable risk factors for atherosclerosis. Both genetic and environmental components are associated with the development of atherosclerotic plaques. Immune and inflammatory mediators have a complex role in the initiation and progression of atherosclerosis. Understanding of all these processes will help to invent a range of new biomarkers and novel treatment modalities targeting various cellular events in acute and chronic inflammation that are accountable for atherosclerosis. Several biochemical pathways, receptors and enzymes are involved in the development of atherosclerosis that would be possible targets for improving strategies for disease diagnosis and management. Earlier anti-inflammatory or lipid-lowering treatments could be useful for alleviating morbidity and mortality of atherosclerotic cardiovascular diseases. However, novel drug targets like endoglin receptor, PPARα, squalene synthase, thyroid hormone analogues, scavenger receptor and thyroid hormone analogues are more powerful to control the process of atherosclerosis. Therefore, the review briefly focuses on different novel targets that act at the starting stage of the plaque form to the thrombus formation in the atherosclerosis.


      PubDate: 2014-07-26T17:49:36Z
       
  • Methylphenidate vs. resperidone in treatment of methamphetamine
           dependence: A clinical trial

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Hassan Solhi , Hamid Reza Jamilian , Amir Mohammad Kazemifar , Javad Javaheri , Akram Rasti Barzaki
      Background and aims Currently, there is no widely accepted evidence-based pharmacotherapy regime for the treatment of psychostimulant dependence. Yet, different pharmacological approaches have been tried in the treatment of MA addiction. The present study was conducted to compare efficiency of methylphenidate which is relatively easily accessible in our country, with resperidone for this purpose. Methods Eighty-six patients with MA dependence according to criteria defined by DSM IV-TR were divided into two groups. Patients in group R were given oral resperidone 1mg daily for 1week; then 2mg daily in a divided dose for 3weeks. Patients in group M were given oral methylphenidate 10mg daily for 2weeks, 7.5mg daily for 1week, then 5mg daily for 1week. They were evaluated for drug craving, psychological, neurologic and somatic symptoms at the start and end of the study. Findings Both drugs were useful for lowering drug craving in patients; however resperidone was more effective (6.31±8.31 vs.19.6±12.45 cravings per week, respectively). The effects of resperidone were more notable in lowering frequency and intensity of psychiatric, neurologic, cardiac and somatic symptoms of the patients after discontinuation of MA abuse; however methylphenidate was effective too; though with a lower potency. Conclusion The present study confirmed that both methylphenidate and resperidone can successfully be used for treatment of MA dependence, in order to reduce drug craving and psychological, neurologic, and somatic problems in patients. However, the efficacy of methylphenidate was estimated to be less than that of resperidone for this purpose.


      PubDate: 2014-07-26T17:49:36Z
       
  • Inside Front Cover - Editorial Board

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3




      PubDate: 2014-07-26T17:49:36Z
       
  • Skin care: Historical and contemporary views

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Khalid M. AlGhamdi , Fahad A. AlHomoudi , Huma Khurram
      Primary prevention, specifically skin care, is an important principle in Islamic theology just as it is emphasized in contemporary medicine. Many skin diseases can be prevented by a proactive approach to skin care, such as proper hygiene and routine inspections, principles that are constantly highlighted in the Islamic literature. Islam promotes primary prevention of disease, including recommendations for skin care practices. The recommendations for skin care practices in Islamic teachings are analogous to current medical guidelines. Sun avoidance, which is recommended by Islam, is mandatory for diseases such as systemic lupus erythematosus, melasma and skin cancers. Skin care and hygiene practices are recommended in Islam and it is considered an important mechanism for reducing the transmission of infections in modern medicine. The body creases and hair are ideal sites for malicious infestations to grow. The practice of “Wudu” includes washing the hands, feet, and hair with clean water. It is an indispensible part of daily prayers which is mandatory for every Muslim. Oral hygiene is also an integral part of both preventive medicine and Islamic teachings. Genital hygiene, particularly after urination and defecation, is recommended in Islamic teachings and is known to prevent urinary and vaginal infections in contemporary medicine. Male circumcision is an Islamic practice. Recently, it was proven that circumcised men are less likely to have sexually transmitted diseases, including HIV. This paper reviews skin care from an Islamic perspective and its relevance to contemporary medicine by translating the simple self care principles into practical guidelines in everyday use.


      PubDate: 2014-07-26T17:49:36Z
       
  • Pilot testing of a pharmacist led care program for asthma patients in
           Saudi Arabia

    • Abstract: Publication date: Available online 2 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Alotaby Meshal , Azmi Sarriff , Mousa El-shamly
      This study aimed at evaluating the usefulness of a structured patient counseling program on clinical outcomes of asthma patients in Saudi Arabia. This cross sectional study enrolled 10 asthma patients and all were evaluated for their baseline knowledge on asthma, quality of life, compliance, patient satisfaction and drug related problems among randomly selected 5 (of the total 10) patients. The median (IQR) age of the patients was 46 (33.5–56.2)years. The baseline knowledge scores was 9 (8–11), the maximum possible scores to be 21. Cronbach alpha of the KQ was 0.65. The overall total median (IQR) compliance (Morisky) score was 4 (3–5), the maximum possible score was 5. The patient satisfaction median (IQR) score was 35.5 (32–46.25), the maximum possible score was 70. Of the total patients 3 (30%) had a history of allergy. There were total 18 allergens observed in these patients. There has been no drug–drug or drug–food interactions observed between among the prescribed drugs of the patients. Altogether 2 patients reported a total of 2 ADRs. The knowledge of the asthma patients was found to be poor. Missing the dose was the most commonly encountered drug taking behavior. The compliance was found to be good and the patient satisfaction was average.


      PubDate: 2014-07-26T17:49:36Z
       
  • Comparative evaluation of metered-dose inhaler technique demonstration
           

    • Abstract: Publication date: Available online 2 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Muhammad Adnan , Shahid Karim , Shamshir Khan , Naser A. Al-Wabel
      Title Comparative evaluation of metered-dose inhaler technique demonstration among community pharmacists in Al Qassim and Al Ahsa regions, Saudi Arabia. Background Patients rely on the information about use of proper inhaler technique when dispensed by community pharmacists however; several studies have shown that patients are unable to show correct inhalation technique. The aim of this study is to assess the ability of community pharmacists in Al Qassim region to demonstrate proper inhalation technique of metered dose inhaler and compare the baseline outcomes with a similar study at Al-Ahsa region. Method We approach 96 pharmacies in Al Qassim region as mock patient (Investigator). The investigator asks the Pharmacist to guide him about proper inhalation technique of metered dose inhaler. Investigator completes a standardized and validated checklist of 8 steps of inhaler device use immediately after leaving the pharmacy. Baseline data were compared between the two study groups et al. Ahsa and Al-Qassim for variables for effectiveness of pharmacist handling of patient queries. Result A total number of 96 community pharmacies were approached in five cities of the Al Qassim province in Saudi Arabia This study has found that majority (93.7%) of community pharmacists failed to demonstrate proper inhalation technique of pMDI inhaler. Conclusion The pharmacists demonstrated particularly poor skills involving steps for coordination of the actuation process with the mechanics of inhalation with MDI. The errors detected in this simple assessment session, if translated to patient self-medication errors, are potentially significant.


      PubDate: 2014-07-26T17:49:36Z
       
  • Adverse Drug Reactions and quality deviations monitored by spontaneous
           reports

    • Abstract: Publication date: Available online 2 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Marília Berlofa Visacri , Cinthia Madeira de Souza , Catarina Miyako Shibata Sato , Silvia Granja , Mécia de Marialva , Priscila Gava Mazzola , Patricia Moriel
      Objectives The aim of this study was to determine the frequency and profile of spontaneous reports of Adverse Drug Reactions (ADRs) and quality deviations in a Brazilian teaching hospital and propose a consistent classification to study quality deviations. Methods This is a descriptive and retrospective study involving the analysis of spontaneous reports of ADRs and quality deviations in 2010. ADRs were classified according to the reaction mechanism, severity, and causality. The drugs were classified according to their therapeutic classes and symptoms according to the affected organ. The quality deviations were classified according to the type of deviation and type of medicine available in the Brazilian market. Results A total of 68 forms were examined; ADRs accounted for 39.7% of the notifications, while quality deviations accounted for 60.3%. ADRs occurred more frequently in men (51.9%) and adults (63.0%). The skin (28.0%) was the most affected organ, while anti-infectives (40.7%) were the therapeutic class that caused the most ADRs. The most common ADRs were type B (74.0%), moderates (37.0%), and probables (55.6%). In relation to quality deviations, the most frequent notifications were breaks, splits and leaks (20.9%) and related to generic drugs (43.9%). Conclusion The classification system to study quality deviations was clear and consistent. This study demonstrated that practices and public policies related to more effective pharmacovigilance need to be implemented so that the number of spontaneous reports increases.


      PubDate: 2014-07-26T17:49:36Z
       
  • Neonatal parenteral nutrition: Review of the pharmacist role as a
           prescriber

    • Abstract: Publication date: Available online 2 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Mohamed H. Ragab , Mohammed Y. Al-Hindi , Meshari M. Alrayees
      Introduction In the context of the continuous quest to improve the care of the neonates especially the critically ill premature infants, the extended role of pharmacists in the process of parenteral nutrition order writing and effective participation in decision-making especially in the neonatal population is increasingly important. This review aims to present results from the literature review of available evidence on the pharmacist role in neonatal parenteral nutrition therapy. Material and methods Key medical, clinical, and review databases were searched; relevant articles were retrieved and evaluated. Results and discussion A total of 19 papers out of 7127 searched papers met the criteria for inclusion, discussing the review topic. The main focus of the selected papers was on parenteral nutrition practice as related to the pharmacy practice. The overall quality of studies was mixed. Conclusion Overall, the review presents the up-to-date status of the most recent analysis being undertaken on the topic of pharmacist involvement in the parenteral nutrition order writing practices and more specific in the neonatal population over the period from 1979 to 2013. The overall impression is that the practice of pharmacist writing neonatal parenteral nutrition orders already exists, but still limited if compared with the practice of pharmacist writing adult parenteral nutrition orders which is much more established in many countries. There was no single clinical study evaluating this practice, as we were able to retrieve only two surveys, which make it difficult to evaluate the pharmacist role in this area. Nevertheless, despite the wide variation in literature types, characteristics and quality, there are consistent patterns across all the reviewed literatures that competencies of the pharmacist in this field are well represented, which make it very important to carry out good quality clinical studies in this field. Finally, we are currently conducting a prospective clinical study to evaluate the impact of clinical pharmacist as a neonatal PN prescriber, this impact will be judged through the study outcomes as reducing the metabolic and electrolyte complications and increasing the mean daily weight gain during PN therapy and reducing the average number of days of PN till enteral feeding is achieved.


      PubDate: 2014-07-26T17:49:36Z
       
  • Cationic Nanoemulsions As Potential Carriers For Intracellular Delivery

    • Abstract: Publication date: Available online 18 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): P.V. Khachane , A.S. Jain , V.V. Dhawan , G.V. Joshi , A.A. Date , R. Mulherker , M.S. Nagarsenker
      Successful cytosolic delivery enables opportunities for improved treatment of various genetic disorders, infectious diseases and cancer. Cationic nanoemulsions were designed using alternative excipients and evaluated for particle size, charge, effect of sterilization on its stability, DNA condensation potential and cellular uptake efficiency. Various concentrations of non-ionic and ionic stabilizers were evaluated to design formula for colloidally stable cationic nanoemulsion. The nanoemulsion comprised of 5% Capmul MCM, 0.5% Didodecyldimethylammonium bromide (DDAB), 1% phospholipid, 1% Poloxamer 188 and 2.25% glycerol and possessed particle size of 81.6 ± 3.56 nm and 137.1 ± 1.57 nm before and after steam sterilization, respectively. DNA condensation studies were carried out at various nanoemulsion: DNA ratios ranging from 1:1 to 10:1. Cell uptake studies were conducted on human embryonic kidney (HEK) cell lines which are widely reported for transfection studies. The nanoemulsions showed excellent cellular uptake as evaluated by fluorescence microscopy and flow cytometry. Overall, a colloidally stable cationic nanoemulsion with good DNA condensation ability was successfully fabricated for efficient cytosoloic delivery and potential for in vivo effectiveness.


      PubDate: 2014-07-26T17:49:36Z
       
  • Refining Knowledge, Attitude and Practice of Evidence-Based Medicine (EBM)
           among Pharmacy Students for Professional Challenges

    • Abstract: Publication date: Available online 18 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Eman Abu-Gharbieh , Doaa Al Khalidi , Mirza R. Baig , Saeed A. Khan
      Practicing Evidence Based Medicine (EBM) is a professional need for the future clinical pharmacist in UAE and around the world. An attempt was made to evaluate pharmacy student’s knowledge, attitude and proficiency in practice of EBM. A within-subjects study design with pre and post survey and skills test was conducted using case based practice of EBM through a validated questionnaire. The results were tabulated and there was a statistically significant increase in pharmacy students’ perceived ability to go through steps of EBM, namely: formulating PICO questions (95.3%), searching for evidence (97%), appraising the evidence (81%), understanding statistics (78.1%), and applying evidence at point of care (81.2%). In this study, workshops and (Problem Based Learning) PBLs were used as a module of EBM teaching and practices, which has been shown to be an effective educational method in terms of improving students’ skills, knowledge and attitude towards EBM. Incorporating hands on experience, PBLs will become an impetus for developing EBM skills and critical appraisal of research evidence alongside routine clinical practice. This integration would constitute the cornerstone in lifting EBM in UAE up to the needed standards and would enable pharmacy students to become efficient pharmacists that rely on evidence in their health practice.


      PubDate: 2014-07-26T17:49:36Z
       
  • The Effect of Pioglitazone on Pharmacokinetics of Carbamazepine in Healthy
           Rabbits

    • Abstract: Publication date: Available online 8 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Issam Abushammala
      Introduction Drug-drug interactions can lead to serious and potentially lethal adverse events. In recent years, several drugs have been withdrawn from the market due to interaction-related adverse events. The objective of this study was to evaluate the pharmacokinetic interaction between pioglitazone (PG) and carbamazepine (CBZ) in healthy male rabbits. Methods A randomized, two-crossover design study was conducted in six healthy male rabbits. The study was consisted of two periods: period one, when each rabbit received a single dose of 70 mg CBZ-suspension. Period two, when each rabbit received a single dose of 70 mg CBZ-suspension co-administered with a single dose 1.5 mg PG with a washout period of one week between the two periods. Serial blood samples were collected over a period of 48 hours. Chemiluminescent enzyme immunoassay (CLEIA) was used to measure CBZ in serum. Pharmacokinetic (PK) parameters Cmax, Tmax, t 1/2, AUC0-t, AUC 0-∞, and ke were determined for the two periods using non-compartmental analysis. Results In the two periods of treatment, the Cmax, Tmax, AUC0-t, AUC0-∞, t ½ and the ke for CBZ administered alone and in combination with PG were, for Cmax, the mean peak plasma concentration were 4.33 ± 2.4 μg/mL versus 4.76 ± 2.1 μg/ml, for tmax, times taken to reach, were 2.91 ± 1.11 h versus 3.6 ± 1.83 h, for the total areas under the curve AUC0-t were 64.90 ± 43.6 μg·h/ml versus 102.90 ± 66.9 μg·h/ml, for the AUC0-∞ were 74.0 ± 52.6 μg·h/ml versus 124.3 ± 85 μg·h/mL, the t ½ were 14.10 ± 2.5 h versus 16.43 ± 6.43 h and the elimination rate constant ke were 0.050 ± 0.009 h-1 versus 0.057 ± 0.049 h-1, respectively. No statistical differences were found in pharmacokinetic of CBZ in both cases (P > 0.05). Conclusion The result of the study demonstrated that PG does not affect pharmacokinetic parameters of CBZ. Therefore, no cautions regarding dose or administration pattern of CBZ with PG should be taken.


      PubDate: 2014-07-26T17:49:36Z
       
  • Determination and characterization of Metronidazole- Kaolin interaction

    • Abstract: Publication date: Available online 8 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Fadilah Sfouq Aleanizy , Fulwah Alqahtani , Omaimah Al Gohary , Eram El Tahir , Rania Al Shalabi
      The needs for safe, therapeutically effective antidiarrheal combination continuously lead to effective treatment. When administered simultaneously, Metronidazole–Kaolin interactions have been reported by FDA but not studied. This paper is the first to study the Metronidazole–Kaolin interactions. Adsorption isotherms of metronidazole–kaolin antidiarrheal combination from aqueous solutions at an in-vivo simulated pHs conditions were obtained at 37+0.5 °C. Langmuir constants for the adsorption are 10.8225, 41.3223 mg.gm-1 and 11.60, 2.56 l.gm-1 aimed at the monolayer capacity, and the equilibrium constant at (pH 1.2 and 6.8), respectively. pH effect on adsorption of known concentration of metronidazole by kaolin was also studied over the range 1.2–8. A gradual increase in the adsorbed amount was noted with increasing the pH. Elution studies by different eluents showed that drug recovery from adsorbent surface was pH-dependent via competitive mechanism. The elution followed the sequence: 0.1M HCl > 0.1M NaCl >H2O. Adsorption–desorption studies revealed physical adsorption. The equilibrium concentration of metronidazole decreased as the adsorbent concentration was increased in the systems. The dissolution profiles (USP) of commercially available tablets (Riazole®500mg) were obtained alone and in the presence of either (ORS®) rehydration salts and 9 or 18 gm of kaolin powder. The percentage drug released versus time: (95.01%) in 25 min, (101.02%) in 30 min, (67.63%) in 60 min, (60.59%) in 60 min, respectively. The percentage drug released versus time was increased with (ORS®) due to common ion effect [Cl-], whilst, it was decreased with kaolin due to adsorption. The mechanism of reaction of (Riazole®500mg) tablets in the different dissolution media, confirms with Korsmeyer –Peppas model. The interaction between metronidazole and kaolin was characterized by melting point determinations, differential scanning colorimetry analysis and infrared spectroscopy. The results obtained were suggestive of physical interaction between metronidazole and kaolin.


      PubDate: 2014-07-26T17:49:36Z
       
  • Knowledge and Awareness of Adverse Drug Reactions and Pharmacovigilance
           Practices among Healthcare Professionals in Al-Madinah Al-Munawwarah,
           Kingdom of Saudi Arabia

    • Abstract: Publication date: Available online 9 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Mohamed M.M. Abdel-Latif , Basel A. Abdel-Wahab
      Adverse Drug Reactions (ADRs) are scantly reported with poor contribution by healthcare professionals worldwide and in particular in developing countries. The aim of this study was to assess the knowledge and awareness of adverse drug reactions (ADRs) reporting and pharmacovigilance system among healthcare professionals in Al-Madinha Al-Munawwarah hospitals, Kingdom of Saudi Arabia. A questionnaire was designed addressing; awareness of ADRS, knowledge of pharmacovigilance system, availability of ADRs reporting system, patient counseling about ADRs and documentation of ADRs. The questionnaire was distributed to a randomly selected healthcare professionals (n=585) of physicians, pharmacists, nurses and pharmacists’ technicians of hospitals. Complete questionnaires were collected and data were analyzed. Data was expressed in number as well as percentage. Of the 585 questionnaires circulated, a total of 384 healthcare professionals were responded. Healthcare professionals categories involved in the study were 148 physicians, 37 pharmacists, 158 nurses and 41 pharmacist technicians. The percent of the respondents who accepted to enroll in the study was 65.64%. Most of the respondents were unable to correctly define the pharmacovigilance term, but they were aware of ADRs. The awareness among healthcare professionals of the national pharmacovigilance system was 39.6%. Pharmacists had a good knowledge of pharmacovigilance and ADRs terminology and showed a more positive attitude to report ADRs. A greater number of the healthcare professionals were aware of ADRs reporting, but practically it is not implemented in hospitals. Most hospitals had follow-up documentations systems, but did not include ADRs reporting. There was no distinct pharmacovigilance system in place. Our study has demonstrated a lack of knowledge and awareness of pharmacovigilance and ADRs reporting among healthcare professionals in hospitals. The poor knowledge of ADRs reporting emphasized the urgent need to implement the appropriate strategies to improve the awareness of pharmacovigilance practices and ADRs reporting in Al-Madinah Al-Munawwarah hospitals.


      PubDate: 2014-07-26T17:49:36Z
       
  • Ehrlich tumor inhibition using Doxorubicin containing liposomes

    • Abstract: Publication date: Available online 10 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Nihal Saed Elbialy , Mohsen Mahmoud Mady
      Ehrlich tumors were grown in female balb mice by subcutaneous injection of Ehrlich ascites carcinoma cells. Mice bearing Ehrlich tumor were injected with saline, DOX in solution or DOX encapsulated within liposomes prepared from DMPC/CHOL/DPPG/PEG-PE (100:100:60:4) in molar ratio. Cytotoxicity assay showed that the IC50 of liposomes containing DOX was greater than that DOX only. Tumor growth inhibition curves in terms of mean tumor size (cm3) were presented. All the DOX formulations were effective in preventing tumor growth compared to saline. Treatment with DOX loaded liposomes displayed a pronounced inhibition in tumor growth than treatment with DOX only. Histopathological examination of the entire tumor sections for the various groups revealed marked differences in cellular features accompanied by varying degrees in necrosis percentage ranging from 12% for saline treated mice to 70% for DOX loaded liposomes treated mice. The proposed liposomal formulation can efficiently deliver the drug into the tumor cells by the endocytosis (or passive diffusion) and lead to a high concentration of DOX in the tumor cells. The study showed that the formulation of liposomal doxorubicin improved the therapeutic index of DOX and had increased anti-tumor activity against Ehrlich tumor models.


      PubDate: 2014-07-26T17:49:36Z
       
  • Pharmacist’s knowledge, practice and attitudes toward
           pharmacovigilance and adverse drug reactions reporting process

    • Abstract: Publication date: Available online 10 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Maysa Suyagh , Doaa Farah , Rana Abu Farha
      Background Adverse drug reactions (ADRs) are a major cause of drug related morbidity and mortality. Pharmacovigilance is the science that plays an essential role in the reduction of ADRs, thus the evolution and growth of this science are critical for effective and safe clinical practice. Objectives This study is considered the first study in the region to evaluate pharmacist’s knowledge, practice and attitudes toward ADRs reporting after establishing the national ADRs reporting center in Jordan. Method A cross sectional study was used to evaluate pharmacist knowledge and attitude toward ADRs reporting. A structured validated questionnaire was developed for this purpose and a total of 208 pharmacists were recruited to participate in this study. Results The majority of pharmacists have insufficient awareness and lack of knowledge about pharmacovigilance and ADRs reporting. Also the rate of reporting of ADRs was extremely poor. Several factors were found to discourage pharmacists from reporting ADRs, which include inadequate information available from the patient, unavailability of pharmacist ADRs form when needed, unawareness of the existence of the national ADRs reporting system. Also pharmacists think that ADRs are unimportant or they did not know how to report them. Conclusion The results of this study suggest that pharmacists have insufficient knowledge about the concept of pharmacovigilance and spontaneous ADRs reporting. On the other hand, pharmacists had positive attitudes toward pharmacovigilance, despite their little experience with ADRs reporting. Educational programs are needed to increase pharmacist’s role in the reporting process, and thus to have a positive impact on the overall patient caring process.


      PubDate: 2014-07-26T17:49:36Z
       
  • Factors influencing community pharmacist decision to dispense generic or
           branded medicines; Eastern Province, Alahsa, Saudi Arabia

    • Abstract: Publication date: Available online 10 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Yaser Albadr , Tahir Mehmood Khan
      Background Rising costs of medicines have increased the interest of policy makers in generic medicines. However, consumers’ and health care providers’ perception and attitude towards generic medicine act as a main barrier to the promotion of generic medicines. Objective To explore the factors community pharmacists consider while dispensing branded or generic medicines to consumers. Method A qualitative study was planned; twenty community pharmacists (ten hospital affiliated pharmacies and ten non-hospital affiliated pharmacies) were approached using a convenient sampling method. Interviews were recorded and later were coded into themes. Result Overall, it is seen that generic medicine stock was available for antibiotics, pain killers, cough syrups, antihistaminics and antacids. Pharmacists working in hospital affiliated pharmacies were more concerned about the quality of drug before dispensing it to the consumer and they believe that what is prescribed is best for them and substitution or switching is unnecessary while for pharmacists in the non-hospital affiliated pharmacies, appearance of the client was found to be the main factor influencing them to dispense generic (low cost) or branded (expensive) medicines. Conclusion Physical appearance of the consumer is revealed to be one of the main factors affecting the pharmacist decision to dispense generic or branded medicine. Pharmacists practising in hospital affiliated pharmacies were found to be influenced by physicians’ recommendation, and prefer to dispense good quality medicines.


      PubDate: 2014-07-26T17:49:36Z
       
  • Community pharmacists’ attitudes toward dispensing errors at
           community pharmacy setting in Central Saudi Arabia

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Mohamed N. Al-Arifi
      Purpose The main objective of this study was to survey pharmacists’ attitudes toward dispensing errors in community pharmacy settings in Saudi Arabia. Methods A cross-sectional survey of community pharmacists in Riyadh region, Saudi Arabia was conducted over a period of 6months from March through September 2012. A stratified random sample of eight hundred registered pharmacy practitioners was collected all over Riyadh region. Statistical analysis was done using SPSS version19.0 for windows (SPSS Inc., Chicago, Illinois). Results The response rate was almost 82%. The majority of the respondents are young adults (90.2%). The median for years of registration of respondent pharmacists was 9years (range 1–37years). About 62% (407) of the respondents have a positive response while only 37.8% (n =248) have a negative response in this respect. The major factors identified were pharmacist assistant (82.2%) and high workload (72.5%). The most appreciated factors that help reducing dispensing errors are improving doctors’ hand writing and reducing work load of the pharmacist (82.9% and 82.8% respectively), having drug names that are distinctive (76.1%) and having more than one pharmacist in duty (75.5%). Conclusion In conclusion, majority of community pharmacists indicated that the risk of dispensing errors was increasing and most of them were aware of dispensing errors. It is obvious from the study results that dispensing errors is a big concern for community pharmacy practice in Saudi Arabia. Therefore, there is an urgent need for the professional organizations and Pharmacy Boards in Saudi Arabia to determine standards for the profession.


      PubDate: 2014-07-26T17:49:36Z
       
  • Glycemic control in diabetic patients in King Khalid University Hospital
           (KKUH) – Riyadh – Saudi Arabia

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Norah Abdullah Al-Rowais
      Objectives To evaluate glycemic control of diabetic patients at the King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. Methods A cross sectional study was conducted among diabetic patients attending KKUH, Riyadh. Patients were identified through the hospital pharmacy records, over a one year period (January–December, 2009). A total of 20,000 patients were identified, and 1520 patients were selected by a simple random method. Medical charts were reviewed, the data were collected in a specially designed data sheet: and entered in a computer, and finally analyzed using a SPSS program. Results About 90% of patients were older than 40years old and 90% were overweight or obese. Fasting blood sugar was above 7.2mmol/L in 60% of the patients and random blood sugar was more than 10mmol/L in about 70% of patients. The overall glycemic control as evaluated by HBA1C was acceptable in about 40% of the patients. Cholesterol level was normal in more than 70% of patients while triglyceride was normal in 56% of patients. In about half of the patients systolic blood pressure was not controlled, while in 27% the diastolic blood pressure was above the target level. Conclusion The control of diabetes and its associated cardiovascular risk factors in this hospital – based survey, in Riyadh is far from optimal. Further studies are needed to find out the possible causes for this defective care of diabetic patients.


      PubDate: 2014-07-26T17:49:36Z
       
  • Evaluating factors affecting the implementation of evidence based medicine
           in primary healthcare centers in Dubai

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Ahmed I. Albarrak , Suhair Aqil Ali Abbdulrahim , Rafiuddin Mohammed
      Objectives To assess the current evidence based medicine (EBM) knowledge, attitude and perceptions of physicians at Dubai Primary Health Care Sector (PHCS). Further to evaluate barrier and facilitator factors toward implementing the EBM practice. Methodology A cross-sectional study, at Dubai PHCS, UAE between June and August 2010. The survey was composed of two phases. The first phase was a self administrated questionnaire employed for data collection and the second phase was qualitative method, which was in the form of individual interviews. Statistical Package for Social Sciences (SPSS) was used for data analysis. Results In total 48 participants responded to the survey questionnaire and 13 responded to individual interviews. The response rate was 70.0%. Mean age was 42.18 (SD 10.46). The majority were females (64.6%). The physicians who attended EBM courses reported 70.30% using EBM and showed statistical significance (p =0.002) from those who did not attend the EBM courses. 65.0% believe that 50–75% of the patients are capable of participating in clinical decision while 71.8% disagreed that the concept of EBM is not applicable to their culture. In addition they showed significance (p =0.03) between physician beliefs with regard to patient capacity to take decision. About 67.0% of the family physicians were knowledgeable and followed systematic review as the strongest evidence. They had no access to the EBM resources (37.0%) and had no time to practice the EBM (38.0%). Nearly 40.0% interviewees reported lack of encouragement to attend EBM courses. EBM activities (22.0%) and active audit (18.0%) were top rated facilitating factors. Conclusions EBM is not fully utilized by indefinite physicians in the Dubai PHC sector. Factors associated with non-utilization of EBM in the PHCS are lack of encouragement to attend EBM courses, senior physicians resist adoption of EBM, lack of time and insufficient dissemination process for implementing the clinical guideline.


      PubDate: 2014-07-26T17:49:36Z
       
  • Saudi school students’ knowledge, attitude and practice toward
           medicines

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Ahmed S. Eldalo , Mirghani A. Yousif , Mustafa Awad Abdallah
      The current study was aimed to assess Saudi school students’ knowledge, attitude and practice about medicines. A pretested self-administered questionnaire was used anonymously among 15–20year-old adolescents attending tertiary schools in Taif City, KSA. A total of 1022 students completed the questionnaires. Only 15.4% of the respondents knew the medicines’ uses. Most of the students 79.6% affirmed that they used to take medicines after consulting physicians, and 45.1% of the students thought that tablet size affects the medicine’s efficacy. More than half of the students knew that high temperatures affect the efficacy of medicines, there was a significant difference between rural and urban areas (P =0.005). Physicians (50.6%) and community pharmacists (15.7%), were the main students’ reliable sources of information about medicines. The majority of the students 70.5% were interested in learning more about medicines. The younger students ⩽18years wish to learn more than the older ones (P< 0.014). The study showed that Saudi school students aged 15–20years old have poor knowledge, misconception and negative attitudes about medicines. Low level of knowledge may expose adolescents to health-related problems. Educational efforts are important to improve students’ practice toward medicines.


      PubDate: 2014-07-26T17:49:36Z
       
  • Nanoprecipitation is more efficient than emulsion solvent evaporation
           method to encapsulate cucurbitacin I in PLGA nanoparticles

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Aws Alshamsan
      Cucurbitacin I is a hydrophobic molecule that exerts a degree of polarity, which is expected to complicate its loading in PLGA nanoparticles by the classical emulsion solvent evaporation technique. In the current study, variants of emulsion solvent evaporation method were used to prepare PLGA nanoparticles of cucurbitacin: CI-NP1 (single emulsion starting with 1000μg drug), CI-NP2 (double emulsion starting with 250μg drug), and CI-NP3 (double emulsion starting with 500μg drug). On the other hand, CI-NP4 was prepared by nanoprecipitation (starting with 1000μg drug). In CI-NP1, cucurbitacin I encapsulation efficiency (EE) was 1.29%. The employment of double emulsion, in CI-NP2 and CI-NP3, increased cucurbitacin I EE to 4.8% and 7.96%, respectively. Nanoprecipitation significantly increased the EE of cucurbitacin I to 48.79% in CI-NP4. It is likely that cucurbitacin I escapes with the organic solvent after the emulsification step to the aqueous phase leading to ineffective entrapment in the polymeric matrix. Avoiding emulsification seems efficient in increasing cucurbitacin I disposition in the instantly-precipitating NPs. Therefore, nanoprecipitation method increases cucurbitacin I entrapment in PLGA NPs and possibly other water-insoluble polar drugs.


      PubDate: 2014-07-26T17:49:36Z
       
  • Engineering erythrocytes as a novel carrier for the targeted delivery of
           the anticancer drug paclitaxel

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Gamaleldin I. Harisa , Mohamed F. Ibrahim , Fars Alanazi , Gamal A. Shazly
      Paclitaxel (PTX) is formulated in a mixture of Cremophor EL and dehydrated alcohol. The intravenous administration of this formula is associated with a risk of infection and hypersensitivity reactions. The presence of Cremophor EL as a pharmaceutical vehicle contributes to these effects. Therefore, in this study, we used human erythrocytes, instead of Cremophor, as a pharmaceutical vehicle. PTX was loaded into erythrocytes using the preswelling method. Analysis of the obtained data indicates that 148.8μg of PTX was loaded/mL erythrocytes, with an entrapment efficiency of 46.36% and a cell recovery of 75.94%. Furthermore, we observed a significant increase in the mean cell volume values of the erythrocytes, whereas both the mean cell hemoglobin and the mean cell hemoglobin concentration decreased following the loading of PTX. The turbulence fragility index values for unloaded, sham-loaded and PTX-loaded erythrocytes were 3, 2, and 1h, respectively. Additionally, the erythrocyte glutathione level decreased after PTX loading, whereas lipid peroxidation and protein oxidation increased. The release of PTX from loaded erythrocytes followed first-order kinetics, and about 81% of the loaded drug was released into the plasma after 48h. The results of the present study revealed that PTX was loaded successfully into human erythrocytes with acceptable loading parameters and with some oxidative modification to the erythrocytes.


      PubDate: 2014-07-26T17:49:36Z
       
  • Design of liposomal colloidal systems for ocular delivery of ciprofloxacin

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Ehab I. Taha , Magda H. El-Anazi , Ibrahim M. El-Bagory , Mohsen A. Bayomi
      Ophthalmic drug bioavailability is limited due to protective mechanisms of the eye which require the design of a system to enhance ocular delivery. In this study several liposomal formulations containing ciprofloxacin (CPX) have been formulated using reverse phase evaporation technique with final dispersion of pH 7.4. Different types of phospholipids including Phosphatidylcholine, Dipalmitoylphosphatidylcholine and Dimyristoyl-sn-glycero-3-phosphocholine were utilized. The effect of formulation factors such as type of phospholipid, cholesterol content, incorporation of positively charging inducing agents and ultrasonication on the properties of the liposomal vesicles was studied. Bioavailability of selected liposomal formulations in rabbit eye aqueous humor has been investigated and compared with that of commercially available CPX eye drops (Ciprocin®). Pharmacokinetic parameters including Cmax, Tmax, elimination rate constant, t1/2, MRT and AUC0–∞, were determined. The investigated formulations showed more than three folds of improvement in CPX ocular bioavailability compared with the commercial product.


      PubDate: 2014-07-26T17:49:36Z
       
  • A novel approach to formulation factor of aceclofenac eye drops efficiency
           evaluation based on physicochemical characteristics of in vitro and in
           vivo permeation

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Vivek Dave , Sarvesh Paliwal
      The purpose of the present study was to evaluate aceclofenac eye drop through excised goat cornea. Raising pH of the formulation from 6.0 to 8.0, effect of different preservatives or effect of viscosity enhancer decreases apparent permeability coefficient. Topical ophthalmic NSAID are used to treat ocular surface and anterior segment inflammation as well as post operative management of pain and inflammation. Aceclofenac’s unique chemical structure makes it both a potent anti inflammatory drug and lipophilic molecule that penetrates ocular tissue, ensuring relief of pain in cataract and refractive surgery and corneal abrasion. The octanol/water partition coefficient of aceclofenac drug is 1.86±0.75. Permeation characteristics of the drug were evaluated by putting 1ml formulation on freshly excised goat cornea fixed between donor and receptor compartments of an all-glass modified Franz diffusion cell and measuring the drug permeated in the receptor by spectrophotometry at 275nm, after 120min. The results suggest that aceclofenac ophthalmic solution (pH 7) containing BAC provides increased in vitro ocular availability through goat corneas. The combination of methyl paraben and propyl paraben MP–PP preservative in aceclofenac ophthalmic eye drop 0.1% formulated in phosphate buffer increases transcorneal permeation. The developed formulations were evaluated for their pharmacodynamics in albino rabbits, by measuring in-vivo study and were compared to a marketed voltrane ophthalmic solution.


      PubDate: 2014-07-26T17:49:36Z
       
  • Enhanced solubility and intestinal absorption of candesartan cilexetil
           solid dispersions using everted rat intestinal sacs

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): S. Gurunath , Baswaraj K. Nanjwade , P.A. Patila
      Objective Candesartan cilexetil (CAN) is a poor aqueous soluble compound and a P-glycoprotein (P-gp) efflux pump substrate. These key factors are responsible for its incomplete intestinal absorption. Methods In this study, we investigated to enhance the absorption of CAN by improving its solubility and inhibiting intestinal P-gp activity. A phase solubility method was used to evaluate the aqueous solubility of CAN in PVP K30 (0.2–2%). Gibbs free energy ( Δ G tr o ) values were all negative. Solubility was enhanced by the freeze drying technique. The in vitro dissolution was evaluated using the USP paddle method. The interaction between drug and carrier was evaluated by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and Differential scanning calorimetry (DSC) studies. Naringin was selected as P-gp inhibitor. Absorption studies were performed using the everted gut sac model from rat jejunum. The drug analysis was performed by HPLC. Results FTIR spectra revealed no interaction between drug and PVP K30. From XRD and DSC data, CAN was in the amorphous form, which explains the cumulative release of drug from its prepared systems. We noticed an enhancement of CAN absorption by improving its solubility and inhibiting the P-gp activity. The significant results (p <0.05) were obtained for freeze dried solid dispersions in the presence of P-gp inhibitor than without naringin (15mg/kg) with an absorption enhancement of 8-fold. Conclusion Naringin, a natural flavonoid, has no undesirable side effects. Therefore, it could be employed as an excipient in the form of solid dispersions to increase CAN intestinal absorption and its oral bioavailability.


      PubDate: 2014-07-26T17:49:36Z
       
  • Evaluation of the hepatroprotective and nephroprotective activities of
           Scrophularia hypericifolia growing in Saudi Arabia

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Saleh I. Alqasoumi
      The hepatroprotective and nephroprotective effects of the ethanol extract of the aerial parts of Scrophularia hypericifolia growing in Saudi Arabia were evaluated at 250 and 500mgkg−1 doses using Wistar albino rats as experimental animal model. Toxic doses of paracetamol were used to induce liver and kidney toxicities, while the standard drug silymarin was used as reference. The biochemical parameters such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT) and total bilirubin were estimated as reflections of the liver condition. Kidney condition was investigated through measurement of serum urea, serum creatinine, sodium and potassium levels. Liver and kidney samples of rats treated with 500mgkg−1 of the extract were subjected to the histopathological study. The ethanol extract of the aerial parts of S. hypericifolia showed dose dependent moderate level of protection against paracetamol induced hepatrotoxicity and nephrotoxicity as indicated from the obtained results. The reduction of the sodium and potassium levels by the higher dose of the extract exceeded that obtained by silymarin.


      PubDate: 2014-07-26T17:49:36Z
       
  • Combating oxidative stress as a hallmark of cancer and aging:
           Computational modeling and synthesis of phenylene diamine analogs as
           potential antioxidant

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Laila Abou-zeid , Hany N. Baraka
      The cross talk between the over expression of oxygen-free radicals is known as reactive oxygen species (ROS) that is associated with the excessive telomerase activity (TA). Telomerase activity is an invariable finding where human telomerase (hTERT) has been implicated in tumor oxidative stress and redox-mediated malignancy. The hTERT over expression is a novel tumor marker and is promising as a novel class of therapeutic weapons to fight against cancer. A new series of phenylene diamines were designed, synthesized, and evaluated for their in vitro antioxidant as an indicator of inhibiting the oxidative stress tumor. Compounds 3b and 7b proved to be the most active antioxidants with high percentage ABTS inhibition ranged from 89.40% to 88.59% respectively. Molecular modeling studies indicated that the crest configuration of phenylene diamine nucleus with substitutions of trimethoxy benzamido functional proved to be crucial for enhancing the free radical scavenging activity. Molecular modeling exploration indicated the proper binding selectivity of the 3b and 7b to the 3KYL pocket with promising hTERT inhibitors as a hallmark of cancer.


      PubDate: 2014-07-26T17:49:36Z
       
  • Plackett–Burman randomization method for Bacterial Ghosts
           preparation form E. coli JM109

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Amara A. Amro , Mounir M. Salem-Bekhit , Fars K. Alanazi
      Plackett–Burman randomization method is a conventional tool for variables randomization aiming at optimization. Bacterial Ghosts (BGs) preparation has been recently established using methods other than the E lysis gene. The protocol has been based mainly on using critical concentrations from chemical compounds able to convert viable cells to BGs. The Minimum Inhibition Concentration (MIC) and the Minimum Growth Concentration (MGC) were the main guide for the BGs preparation. In this study, Escherichia coli JM109 DEC has been used to produce the BGs following the original protocol. The study contained a detail protocol for BGs preparation that could be used as a guide.


      PubDate: 2014-07-26T17:49:36Z
       
  • Anaphylaxis to lidocaine with tolerance to articaine in a 12year old girl

    • Abstract: Publication date: July 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 3
      Author(s): Khalid Al-Dosary , Ahmad Al-Qahtani , Abdullah Alangari
      True allergic reactions to local anesthetics are extremely rare and constitute less than 1% of all reactions. In addition, many of those allergic reactions are caused by the preservative constituents of the local anesthetics. Here we report a 12year old girl with anaphylaxis to lidocaine (an amide local anesthetic) on two occasions. The allergy was confirmed by positive skin prick test to the drug. Skin testing and challenge to another amide local anesthetic (articaine) were negative. Subsequently, its use was well tolerated in a dental procedure. Up to our knowledge, this is the first report of a patient who is allergic to lidocaine and tolerant to articaine.


      PubDate: 2014-07-26T17:49:36Z
       
  • Development and validation of stability-indicating high performance liquid
           chromatography method to analyze gatifloxacin in bulk drug and
           pharmaceutical preparations

    • Abstract: Publication date: Available online 28 June 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ibrahim A. Aljuffali , Mohd. Abul Kalam , Yasmin Sultana , Ahamad Imran , Aws Alshamsan
      Quantitative determination of gatifloxacin in tablets, solid lipid nanoparticles (SLNs) and eye-drops using a very simple and rapid chromatographic technique was validated and developed. Formulations were analyzed using a reverse phase SUPELCO® 516 C-18-DB, 50306-U, HPLC column (250mm×4.6mm, 5μm) and a mobile phase consisting of disodium hydrogen phosphate buffer:acetonitrile (75:25, v/v) and with orthophosphoric acid pH was adjusted to 3.3 The flow rate was 1.0mL/min and analyte concentrations were measured using a UV-detector at 293nm. The analyses were performed at room temperature (25±2°C). Gatifloxacin was separated in all the formulations within 2.767min. There were linear calibration curves over a concentration range of 4.0–40μg.mL−1 and correlation coefficients of 0.9998 with an average recovery above 99.91%. Detection of analyte from different dosage forms at the same Rt indicates the specificity and stability of the developed method.


      PubDate: 2014-07-26T17:49:36Z
       
  • An example of using a decision making framework designed for non-medical
           prescribers as a method for enhancing prescribing safety for inhaled
           corticosteroids (ICS)

    • Abstract: Publication date: Available online 17 June 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Saja Almarshad
      Non-medical prescribing is needed especially with the increased demand for health care and the physicians’ time constrains. Also, it is not well regulated in Saudi Arabia unlike the United Kingdom. This report aims to demonstrate the urged need for regulations to maintain a safe non-medical prescribing process. It also adapts the single competency framework provided by the United Kingdom national prescribing centre (NPC, 2012) to be utilised by the respiratory therapist for a safe prescribing process for inhaled corticosteroids (ICS) to control adult asthma as an example. The framework is thought to be an effective tool for safe non-medical prescribing and it is highly recommended to develop a national Saudi framework to maintain the patients’ safety and utilise resources.


      PubDate: 2014-07-26T17:49:36Z
       
  • A review on the strategies for oral delivery of proteins and peptides and
           their clinical perspectives

    • Abstract: Publication date: Available online 16 June 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Abdul Muheem , Faiyaz Shakeel , Mohammad Asadullah Jahangir , Mohammed Anwar , Neha Mallick , Gaurav Kumar Jain , Musarrat Husain Warsi , Farhan Jalees Ahmad
      In the modern world, a number of therapeutic proteins such as vaccines, antigens, and hormones are being developed utilizing different sophisticated biotechnological techniques like recombinant DNA technology and protein purification. However, the major glitches in the optimal utilization of therapeutic proteins and peptides by the oral route are their extensive hepatic first-pass metabolism, degradation in the gastrointestinal tract (presence of enzymes and pH-dependent factors), large molecular size and poor permeation. These problems can be overcome by adopting techniques such as chemical transformation of protein structures, enzyme inhibitors, mucoadhesive polymers and permeation enhancers. Being invasive, parenteral route is inconvenient for the administration of protein and peptides, several research endeavors have been undertaken to formulate a better delivery system for proteins and peptides with major emphasis on non-invasive routes such as oral, transdermal, vaginal, rectal, pulmonary and intrauterine. This review article emphasizes on the recent advancements made in the delivery of protein and peptides by a non-invasive (peroral) route into the body.


      PubDate: 2014-07-26T17:49:36Z
       
  • Formulation and optimization of potassium iodide tablets

    • Abstract: Publication date: Available online 16 June 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Antoine Al-Achi , Binit Patel
      The use of potassium iodide (KI) as a protective agent against accidental radioactive exposure is well established. In this study, we aimed to prepare a KI tablet formulation using a direct compression method. We utilized Design of Experiment (DoE)/mixture design to define the best formulation with predetermined physical qualities as to its dissolution, hardness, assay, disintegration, and angle of repose. Based on the results from the DoE, the formulation had the following components (%w/w): Avicel 48.70%, silicon dioxide 0.27%, stearic acid (1.00%), magnesium stearate 2.45%, and dicalcium phosphate 18.69%, in addition to potassium iodide 28.89% (130mg/tablet). This formulation was scaled-up using two tablet presses, a single-punch press and a rotary mini tablet press. The final scaled-up formulation was subjected to a variety of quality control tests, including photo-stability testing. The results indicate that potassium iodide tablets prepared by a rotary mini tablet press had good pharmaceutical characteristics and a shelf-life of 25days when stored at room temperature protected from light.


      PubDate: 2014-07-26T17:49:36Z
       
  • Charge–transfer reaction of 2,3-dichloro-1,4-naphthoquinone with
           crizotinib: Spectrophotometric study, computational molecular modeling and
           use in development of microwell assay for crizotinib

    • Abstract: Publication date: Available online 14 June 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Nourah Z. Alzoman , Jamilah M. Alshehri , Ibrahim A. Darwish , Nasr Y. Khalil , Hamdy M. Abdel-Rahman
      The reaction of 2,3-dichloro-1,4-naphthoquinone (DCNQ) with crizotinib (CZT; a novel drug used for treatment of non-small cell lung cancer) was investigated in different solvents of varying dielectric constants and polarity indexes. The reaction produced a red-colored product. Spectrophotometric investigations confirmed that the reaction proceeded through charge–transfer (CT) complex formation. The molar absorptivity of the complex was found to be linearly correlated with the dielectric constant and polarity index of the solvent; the correlation coefficients were 0.9567 and 0.9069, respectively. The stoichiometric ratio of DCNQ:CZT was found to be 2:1 and the association constant of the complex was found to be 1.07×102 l/mol. The kinetics of the reaction was studied; the order of the reaction, rate and rate constant were determined. Computational molecular modeling for the complex between DCNQ and CZT was conducted, the sites of interaction on CZT molecule were determined, and the mechanism of the reaction was postulated. The reaction was employed as a basis in the development of a novel 96-microwell assay for CZT in a linear range of 4–500μg/ml. The assay limits of detection and quantitation were 2.06 and 6.23μg/ml, respectively. The assay was validated as per the guidelines of the International Conference on Harmonization (ICH) and successfully applied to the analysis of CZT in its bulk and capsules with good accuracy and precision. The assay has high throughput and consumes a minimum volume of organic solvents thus it reduces the exposures of the analysts to the toxic effects of organic solvents, and significantly reduces the analysis cost.


      PubDate: 2014-07-26T17:49:36Z
       
  • 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
       
  • Inside Front Cover - Editorial Board

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




      PubDate: 2014-03-09T07:46:27Z
       
 
 
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