Abstract: Publication date: Available online 10 May 2013
Source:Saudi Pharmaceutical Journal
Author(s): K.C. Bhuvan , Alian A. ALrasheedy , Mohamed Izham Mohamed Ibrahim
A 46-year-old female patient developed severe abdominal pain shortly after taking levofloxacin, 1000 mg for acute bacterial sinusitis. The pain started after taking the first dose of levofloxacin and became worse after the second dose. The patient was unable to do daily physical activities. The pain resolved upon discontinuation of levofloxacin and symptomatic therapy. Other factors that may cause abdominal pain were ruled out. This case is of interest as it documents severe abdominal pain due to levofloxacin requiring discontinuation of therapy and describes its appropriate management. In addition, it highlights the vital role that community pharmacists could play in managing adverse drug reactions (ADRs) and preventing potential Drug Related Problems (DRPs).
Abstract: Publication date: Available online 11 May 2013
Source:Saudi Pharmaceutical Journal
Author(s): Prasad G. Jamkhande , Prakash G. Chandak , Shashikant C. Dhawale , Sonal 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 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 has 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 plaques form to the thrombus formation in the atherosclerosis.
Abstract: Publication date: Available online 9 May 2013
Source:Saudi Pharmaceutical Journal
Author(s): Yashumati Ratan , Ashutosh Pareek , Vivek Jain , Dharm Kishore
Inclusion of metabolic considerations in the drug design process lead to the significant development in the field of chemical drug targeting and the design of safer drugs during past few years which is a part of an approach now designated as Retro metabolic drug design (RMDD). This approach represents systematic methodologies that integrate structure- activity and structure-metabolism relationships and are aimed to design safe, locally active compounds with an improved therapeutic index. It embraces two distinct methods, chemical delivery systems and soft drug approach. Present review recapitulates an impression of RMDD giving reflection on chemical delivery System and soft drug approach and provides a variety of examples to embody its concepts. Successful application of such design principles has already been applied to a number of marketed drugs like esmolol; loteprednol etc and many other candidates like beta blockers, ACE inhibitors, alkylating agents, antimicrobials etc. are also under investigation.
Abstract: Publication date: Available online 9 May 2013
Source:Saudi Pharmaceutical Journal
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. 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 2 groups. The patients in group R were given oral resperidone 1mg daily for 1 week; then 2 mg daily in divided dose for 3 weeks. The patients in group M were given oral methylphenidate 10 mg daily for 2 weeks, 7.5 mg daily for 1 week, then 5 mg daily for 1 week. They were evaluated for the 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 the 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 lower potency. Conclusion 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 the patients. However, the efficacy of methylphenidate was estimated less than resperidone for this purpose.
Abstract: Publication date: Available online 3 May 2013
Source:Saudi Pharmaceutical Journal
Author(s): Hussain Abdullah Mubarak Al Rahbi , Raid Mahmood Al-Sabri , H.R. Chitme
Interventions by the pharmacists has always been considered as an valuable input by the health care community in patient care process by reducing the medication errors, rationalize the therapy and reduce 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 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 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 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 : Interventions by the pharmacists has always been considered as errors, and update the knowledge of pharmacists and other health care professionals.
Abstract: Publication date: Available online 3 May 2013
Source:Saudi Pharmaceutical Journal
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 100 nm, entrapment efficiency of formulations ranges from 28 – 57%, process yield of 60 – 76% was achieved and drug release for 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 were in the range of 0.56 to 0.78. In vivo evaluations performed in mice after intraperitoneal administration of Zidovudine drug solution, uncoated and coated formulation. Formulation when coated with Tween 80 achieved higher concentration in brain than that of drug in solution and uncoated formulation. Stability studies indicated that there was no degradation of drug in the formulation after 90 days of preparation when stored in refrigerated condition.
Abstract: Publication date: Available online 16 April 2013
Source:Saudi Pharmaceutical Journal
Author(s): Shaheen Sultana , Sushama Talegaonkar , Devender Singh , Riyaz Ahmad , Venu Manukonda , Aseem Bhatnagar , F.J. Ahmad
The present work deals with various attempts to prepare a gastroretentive formulation of lacidipine for treating gastroparesis. High density sucrose beads were modified by coating with certain polymers, but unfortunately sustained released could not be achieved. Granules were prepared by wet granulation technology using different combinations of polymers and a release of the drug was observed. The method failed to release the drug as per desired specifications. Polymeric coating followed by wet granulation was thought to be a better process to sustain thedissolution rate. The release rate can be modified by incorporation of different polymeric coatings, but mucoadhesive potential of granules was only 4.23% which might be due to its large size and the presence of other ingredients. Further, the lacidipine loaded microparticles were prepared by different methods such as compression, ionic gelation with TPP, ionic gelation with TPP and glutaraldehyde, spray drying and coacervation technique. The formulations were evaluated for average particle size, surface morphology, entrapment efficiency,% yield and mucoadhesive potential. The microparticles prepared by compression method using HPMC K4M and SCMC as mucoadhesive polymers and BaSO4 as high density diluent showed poor bioadhesion (8.3%) and poor release characteristics (100% in 120 minutes). Ionic gelation with tripolyphosphate yielded microspheres with poor mechanical strength. In order to improve its mechanical strength, TPP ionic gelation was combined with step-wise cross-linking with glutaraldehyde. The additional solidification step to improve mechanical strength left this procedure tedious, time consuming and cytotoxic. Spray drying method gave a very low yield with 46.67% bioadhesion. The method using CaCl2 for ionotropic gelation showed the best results with regard to physical characteristics (well formed discrete, spherical surface microcapsule), particle size (88.57±0.51), in vitro bioadhesion (67.33%), yield (>85%) and loading (>70%).
Abstract: Publication date: Available online 8 April 2013
Source:Saudi Pharmaceutical Journal
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 PVPK30 (0.2 – 2%). Gibbs free energy (ΔGotr) values were all negative. Solubility was enhanced by freeze drying technique. The in-vitro dissolution was evaluated using 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 everted gut sac model from rat jejunum. The drug analysis was performed by HPLC. Results FTIR spectra revealed no interaction between the drug and PVPK30. 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 (15 mg/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.
Abstract: Available online 6 April 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Some novel 6,8-diiodo-2-methyl-3-substituted-quinazolin-4(3H)-ones bearing sulfonamide derivatives (4-11) were synthesized in good yield 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 lasts for 12 hours compared to ibuprofen. All the tested compounds showed no toxic symptoms or mortality rates 24 h post-administration at tested anti-inflammatory doses. In addition, LD50 for all tested compounds was higher than that for ibuprofen which 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.
Abstract: Available online 6 April 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
This study aims to examine general public knowledge and behavior toward pharmaceutical advertisements in 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 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 believes toward advertised drugs concerning their role in education and spreading of awareness among the public. Pharmaceutical advertisements harm 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.
Abstract: Available online 6 April 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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.
Scope Many studies have provided evidence that favor the use of insulin pens over traditional insulin vials due to lower overall costs. The cost of insulin in the Royal Medical Services in Jordan is subject to other considerations due to the favorable tender prices and the process of dispensing of insulin within the Royal Medical Services. Objective To highlight further cost considerations associated with the wastage in the use of insulin vials and cartridges in the Jordanian Royal Medical Services. Methods Two random samples were selected from prescriptions dispensed for diabetic patients using insulin in January 2012 from the outpatient pharmacy in Al-Hussein Hospital, King Hussein Medical Center, Amman, Jordan. First sample was selected from prescriptions of patients using vials; second sample was selected from prescriptions of patients using pens and cartridges. Average costs for insulin and wastage were calculated per patient from the Royal Medical Services perspective. Results The average direct cost per patient using vials was JD 5.197 and for those using cartridges was JD 22.135. The average wasted quantity per patient in the first sample was more than ten times that of the second sample. The cost of the average wasted quantity per patient in the first sample (1.022 JD) was more than the double that in the second sample (0.441 JD). Conclusion Although, the direct cost of insulin per patient by using vials was lower than cartridges, there was a substantial reduction in the cost of wastage by using the cartridges in the Jordanian Royal Medical Services outpatients.
Albendazole (ABZ), a broad-spectrum anthelmintic agent, is poorly absorbed after oral administration due to its low aqueous solubility. The aim of this study was to improve albendazole dissolution rate by formulating avicel pellets loaded with 10% w/w drug using extrusion/spheronization technique. In addition the wet masses were characterized by mix torque rheometry (MTR) prior to pelletization process. Different additives (i.e., lactose, Tween 80 and low molecular weight chitosan) were formulated with avicel to enhance the dissolution rate of ABZ from the produced pellets. Moreover, mix torque rheometer was used to quantitatively determine the suitable moisture content in the pastes before the extrusion process. The produced pellets were characterized for their ABZ content, particle size, particle shape, dissolution profile and thermal behaviors. The maximum consistencies (the peak torques) of the wet granules were obtained using 0.667–1.333ml/g of water or water containing surfactant. Also, the produced pellets have size range from 1036 to 1246μm. The calculated drug RDR30 for 10%, 30% and 50% lactose concentrations were 1.08, 1.08 and 2.03, respectively, while that calculated for 10%, 30% and 50% w/w chitosan concentrations were 1.71, 3.62 and 3.62, respectively. The results revealed also that increasing the weight ratio of lactose and chitosan was accompanied by a significant reduction of the peak torque magnitude and this was accompanied by an enhanced ABZ dissolution rate.
The objective of this present investigation was to develop and formulate sustained release (SR) matrix tablets of Itopride HCl, by using different polymer combinations and fillers, to optimize by Central Composite Design response surface methodology for different drug release variables and to evaluate drug release pattern of the optimized product. Sustained release matrix tablets of various combinations were prepared with cellulose-based polymers: hydroxy propyl methyl cellulose (HPMC) and polyvinyl pyrolidine (pvp) and lactose as fillers. Study of pre-compression and post-compression parameters facilitated the screening of a formulation with best characteristics that underwent here optimization study by response surface methodology (Central Composite Design). The optimized tablet was further subjected to scanning electron microscopy to reveal its release pattern. The in vitro study revealed that combining of HPMC K100M (24.65 MG) with pvp(20mg)and use of LACTOSE as filler sustained the action more than 12h. The developed sustained release matrix tablet of improved efficacy can perform therapeutically better than a conventional tablet.
The present investigation deals with the development of controlled release tablets of lamivudine using acetylated sago starch. The acetylated starch was synthesized with acetic anhydride in pyridine medium. The acetylated sago starch was tested for acute toxicity and drug–excipient compatibility study. The formulations were evaluated for physical characteristics like hardness, % friability, % drug content and weight variations. The in vitro release study showed that the optimized formulation exhibited highest correlation (R) value in the case of higuchi kinetic model and the release mechanism study proved that the formulation showed a combination of diffusion and erosion processes. There was a significant difference in the pharmacokinetic parameters (T max, C max, AUC, V d, T 1/2 and MDT) of the optimized formulation as compared to the marketed conventional tablet Lamivir® which proves the controlled release property of acetylated sago starch.
Uremia means excess nitrogenous waste products in the blood & their toxic effects. An acute acetaminophen (paracetamol, N-acetyl p-aminophenol; APAP) overdose may result into potentially fatal hepatic and renal necrosis in humans and experimental animals. The aims of this present study were to investigate the protective effect of alpha-lipoic acid (ALA) on oxidative stress & uremia on male albino rats induced by acetaminophen. The study was performed by 24 albino male Wister strain rats which were randomly divided into four groups: Group I, control – receives normal food and water, Groups II, III & IV receive acetaminophen interperitoneally at the dose of 500mg/kg/day for 10days, from 11th day Groups III & IV were treated with ALA at the dose of 5mg & 10mg/100g/day for 15days, respectively. After 25days of treatment, it was observed that there was a significant increase in plasma urea, creatinine, sodium and malondialdehyde (MDA) levels (p <0.05) but a significant decrease in super oxide dismutase (SOD) & catalase activity & potassium level in uremic group is compared with control group & there was a significant increase in SOD & catalase (p <0.05) & a significant decrease in serum urea, creatinine & Na and MDA (p <0.05) in Group III & Group IV is compared with Group II & significant changes were observed in high ALA dose group. In conclusion it was observed that the ALA has nephroprotective activities by biochemical observations against acetaminophen induced uremic rats.
The present investigation was designed with the intention to formulate a versatile 5-fluorouracil(5-FU) matrix tablet surpassing issues associated with current conventional chemotherapeutic drug delivery systems. The novel 5-FU matrix tablet fulfills therapeutic needs by engineering matrix tablets utilizing chitosan–sodium alginate interpolyelectrolyte complex (IPEC). IPEC was characterized by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and X-ray diffraction (XRD). The matrix tablets were formulated utilizing IPEC alone and in combination with chitosan, sodium alginate and sodium deoxycholate as permeation enhancer. Pharmaceutical properties, swelling studies, in vitro dissolution and diffusion studies, mucoadhesive studies and in vivo studies were performed for formulated 5-FU. The selected chitosan–sodium alginate IPEC offers pH independent 5-FU release in comparison to alone or physical mixture of chitosan and sodium alginate. Furthermore, novel matrix tablets demonstrated significantly higher bioadhesive properties with controlled 5-FU release without the initial burst effect and also demonstrated a higher permeation of 5-FU. To conclude, the developed novel 5-FU matrix tablets pave way as an excellent alternative for cancer treatment which could potentially minimize the dose dependent side effects and provide better patient compliance.
Several methods and techniques are potentially useful for the preparation of microparticles in the field of controlled drug delivery. The type and the size of the microparticles, the entrapment, release characteristics and stability of drug in microparticles in the formulations are dependent on the method used. One of the most common methods of preparing microparticles is the single emulsion technique. Poorly soluble, lipophilic drugs are successfully retained within the microparticles prepared by this method. However, the encapsulation of highly water soluble compounds including protein and peptides presents formidable challenges to the researchers. The successful encapsulation of such compounds requires high drug loading in the microparticles, prevention of protein and peptide degradation by the encapsulation method involved and predictable release, both rate and extent, of the drug compound from the microparticles. The above mentioned problems can be overcome by using the double emulsion technique, alternatively called as multiple emulsion technique. Aiming to achieve this various techniques have been examined to prepare stable formulations utilizing w/o/w, s/o/w, w/o/o, and s/o/o type double emulsion methods. This article reviews the current state of the art in double emulsion based technologies for the preparation of microparticles including the investigation of various classes of substances that are pharmaceutically and biopharmaceutically active.
Aim The hypothesis that postoperative pain would be reduced by using 1μg/kg/min of ketamine, both intra- and post-operatively, for lumbar microdiscectomy surgery was assessed by measuring morphine consumption. Patient side effects were reported. Methods Forty-five patients undergoing microdiscectomy surgery were randomized under double-blind conditions into three groups: Group1 (G1) received normal saline, Group 2 (G2) ketamine (1μg/kg/min) intra-operatively and Group 3 (G3) ketamine (1μg/kg/min) both intra- and post-operatively. Morphine consumption, pain scores, nausea and vomiting, CNS disorders were recorded for 24h post surgery. This study was conducted by applying the concept of a clinical pharmacist intervention. Results The time for the first analgesia demand dose was significantly shorter (P <0.05) in G117±1.7min than for G2 and G3. In G3 morphine consumption 6, 12, and 24h after surgery was 3±2.26, 9.2±2.11 and 26.9±2.71mg. Total morphine consumption was significantly lower for G3 than for G1 or G2 (P <0.05). The visual analog scale score (VAS) values were significantly lower in G3 (P <0.05) than for the other groups during the first 24h. The rate of nausea and vomiting was significantly higher in G1 vs G3 (P <0.05). No difference in drug induced CNS disturbances was observed among the groups. Conclusions Using 1μg/kg/min of ketamine hydrochloride intra- and post-operatively for microdiscectomy surgery could be an adjunct therapy to reduce postoperative morphine consumption minimizing its side effects. Collaborative clinical pharmacy practice on the basis of pharmacology had an effective role in improving the general outcome of microdiscectomy surgery.
Aim/Background Treatment of DVT with LMWHs has been shown recently to be as effective as UFH with suggested lower costs. This study was conducted to determine and compare the cost of in-patient hospital treatment versus outpatient hospital treatment of patients with DVT. Method All adult patients with acute proximal DVT referred to the Emergency Department of King Khalid University Hospital, Riyadh, Saudi Arabia between August 2009 and August 2010 were invited to the study. An economic analysis was performed to compare the cost impact of outpatients versus hospital treatment. Results Sixty-one patients were included in the study, 31 were followed in the outpatient setting and 30 as the control group (inpatients). There were no significant differences in the outcome between the outpatient and inpatient group; three patients (9.7%) in the outpatient group and four patients (13.3%) in the inpatient group had recurrent DVT. Mean nursing cost was $55 for the outpatient group and $215 for the inpatient group, mean laboratory monitoring cost was $638 for outpatient group and $1511 for the inpatient group. Hospital stay and doctor’s fees amounted to a mean of $1000 for outpatient treatment and $2387 for inpatient treatment, p <0.0001. The mean outpatient cost was significantly lower than the inpatient cost ($1750 vs. $4338, p <0.0001). Conclusion Outpatient treatment of patients with DVT using LMWHs is cost-effective with no significant differences in the outcome of patients. OPD treatment of DVT is feasible in Saudi Arabia provided there is enough logistic support from thrombosis clinics and those involved in DVT care.
Background Medication errors in hospitals are a worldwide concern. The World Health Organization has recommended the implementation of basic applications in healthcare systems to improve medication safety, but it is largely unknown whether these recommendations are adhered to by hospitals. We assessed the presence of core medication safety practices in Saudi Arabian hospitals. Methods We developed and validated a survey to assess medication safety practices in hospitals. Major headings included Look-Alike Sound-Alike (LASA) medications, control of concentrated electrolyte solutions, transitions in care, information technology, drug information and other medication safety practices. Trained pharmacists visited samples of hospitals from all regions of Saudi Arabia. Results Seventy-eight hospitals were surveyed. Only 30% of the hospitals had a medication safety committee and 9% of hospitals had a medication safety officer. Only 33% of hospitals had a list of LASA medications and 50% had a list of error-prone abbreviations. Concentrated electrolytes were available in floor stock in 60% of the hospitals. No hospital involved pharmacists in obtaining medication histories and only 37% of the hospitals provided a medication list to the patients at discharge. While 61% of hospitals used a computer system in their pharmacy to enter prescriptions, only 29% of these hospitals required entry of patient’s allergies before entering a drug order. Conclusions Core practices to improve medication safety were not implemented in many hospitals in Saudi Arabia. In developing countries, an effort must be made at the national level to increase the adoption of such practices.
A good number of abstracts and research articles (in total 74) published, so far, for evaluating antioxidant activity of various samples of research interest were gone through where 407 methods were come across, which were repeated from 29 different methods. These were classified as in vitro and in vivo methods. And those are described and discussed below in this review article. In the later part of this review article, frequency of in vitro as well as in vivo methods is analyzed with a bar diagram. Solvents are important for extracting antioxidants from natural sources. Frequency of solvents used for extraction is also portrayed and the results are discussed in this article. As per this review there are 19 in vitro methods and 10 in vivo methods that are being used for the evaluation of antioxidant activity of the sample of interest. DPPH method was found to be used mostly for the in vitro antioxidant activity evaluation purpose while LPO was found as mostly used in vivo antioxidant assay. Ethanol was with the highest frequency as solvent for extraction purpose.
The current study aims to assess the community pharmacist’s skills to make correct use of metered dose inhalers (MDIs). Seventy-four pharmacists were approached using six clusters from the most populous areas of Alahsa, Eastern region Saudi Arabia. Of whom n =71, responses were taken in consideration to perform the statistical analysis. Scoring of pharmacist demonstration was done using a nine-step checklist for the appropriate use of inhaler. A simulated patient approach was used to assess pharmacist’s skill. Majority, 98.6% of the pharmacists were Egyptian nationals with a mean age of 38.74±SD 4.52. Overall, pharmacists were found to have a poor recognition (mean score=4.2±SD 2.08) with the steps considered while using an inhaler. However, significantly better knowledge differences were observed among the pharmacists aged 30–35years (5.52±2.14, t =2.851, p =0.009∗). In addition, job experience (3–4years) was found significantly (p =0.003∗) associated with a better knowledge toward the appropriate use of inhaler. It was seen that the young pharmacists working on chain pharmacies have comparatively better knowledge than the other groups.
Drug discovery programs for preclinical oncology typically select compounds which have a predilection for inducing cytotoxic effects in cancer cell lines and subsequently, for inhibiting the growth of the transplanted cancer cells in vivo (Winquist et al., 2010). Unfortunately, the cytotoxic effect in vitro and inhibition of tumor growth in animal models are not the end story for curing cancer in preclinical models. The reason behind that is the exciting of small sub type of cells that are relatively resistance to therapy and able to repopulate in vivo, called cancer stem cells (CSCs). O leis et al. recently reported that the pluripotency gene Sox2 but not Oct4 or Nanog is expressed in early stage of breast tumor. Furthermore, the authors demonstrated that Sox2 downregulation, inhibited mammosphere formation and delayed tumor formation in xenograft tumor initiation models (Leis et al., 2012). In this review, we will shed the light on the importance of Sox2 in breast and other tissue tumorigenesis and associated aggressiveness.
Abstract: Available online 30 March 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 preservative or effect of viscosity enhancer decrease 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 unique chemical structure makes it both a potent anti inflammatory drug and lipophlic molecules that penetrate ocular tissue, ensuring relief pain and cataract and refractive surgery and corneal abrasion. The octanol/water partition coefficient of aceclofenac drug is 1.86 ± 0.75. Permeation characteristics of drug were evaluated by putting 1 ml 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 275 nm, after 120 min. The results suggest that aceclofenac ophthalmic solution (pH 7) containing BAC provides increased in vitro ocular availability through goat corneas. Combination of methyl paraben and propyle paraben MM-PP preservative in aceclofenac ophthalmic eye drop 0.1% formulated in phosphate buffer increase 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.
Abstract: Available online 21 March 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 was used for the student’s convenience and easy response disclosure. Data analysis was 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.
Abstract: Available online 14 March 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
We aimed to explore the perceptions, attitudes and practices toward research among medical students.A self-administered questionnaire were distributed among senior medical students at King Saud University, Riyadh, Saudi Arabia. 172 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.
Abstract: Available online 14 March 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Primary prevention, specifically skin care, is an important principal 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, principals that are constantly highlighted in 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 principals into practical guidelines in everyday use.
Abstract: Available online 13 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Background The purpose of this national survey is to evaluate hospital pharmacy practice in the Riyadh region of Saudi Arabia. The results of the survey pertaining to the monitoring and patient education of the medication use process were presented. Methods We have invited pharmacy directors from all 48 hospitals in the Riyadh region to participate in a modified-American Society of Health-System Pharmacists (ASHP) survey questionnaire. The survey was conducted using similar methods to those of the ASHP surveys. Results The response rate was 60.4% (29/48). Most hospitals (23, 79%) had pharmacists regularly monitor medication therapy for patients. Of these hospitals, 61% had pharmacists monitoring medication therapy daily for less than 26% of patients, 17% monitored 26-50% of patients and 22% monitored more than half of patients daily. In 41% of hospitals, pharmacists routinely monitored serum medication concentrations or their surrogate markers; 27% gave pharmacists the authority to order initial serum medication concentrations, and 40% allowed pharmacists to adjust dosages. Pharmacists routinely documented their medication therapy monitoring activities in 52% of hospitals. Overall, 74% of hospitals had an adverse drug event (ADE) reporting system, 59% had a multidisciplinary committee responsible for reviewing ADEs, and 63% had a medication safety committee. Complete electronic medical record (EMR) systems were available in 15% of hospitals and 81% had a partial EMR system. The primary responsibility for performing patient medication education lay with nursing (37%), pharmacy (37%), or was a shared responsibility (26%). In 44% of hospitals, pharmacists provided medication education to half or more inpatients and in a third of hospitals, pharmacists gave medication education to 26% or more of patients at discharge. Conclusion Hospital pharmacists in the Riyadh region are actively engaged in monitoring medication therapy and providing patient medication education, although there is considerable opportunity for further involvement.
Abstract: Available online 11 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 PubDate: 2013-02-26T16:41:30Z
Abstract: Available online 24 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 to 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 social 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 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 give the best advice to the patients. Pharmacogenomics is the most recent science which emphasizes the genetic predisposition of ADRs. This innovative science provides a new prospective in dealing with the decision making process of drug selection.
Abstract: Available online 15 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 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 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 its 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 drug in solid dispersion enhanced its dissolution with comparison with drug itself. Also, the drug release from the manufactured pellets was found to be improved in case of solid dispersions (drug: carrier 1:3). A complete drug release occurred after 30 minutes from pellets containing solid dispersions, while only about 30% of loaded FM was released from pellets containing untreated drug after 2 hours.
Abstract: Available online 14 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
The aim of this commentary is to investigate the interplay of Biopharmaceutics Classification System (BCS), Biopharmaceutics Drug Disposition Classification System (BDDCS) and Salivary Excretion Classification System (SECS). BCS first classified drugs based on permeability and solubility for the purpose of predicting oral drug absorption. Then BDDCS linked permeability with hepatic metabolism and classified drugs based on metabolism and solubility for the purpose of predicting oral drug disposition. On the other hand, SECS classified drugs based on permeability and protein binding for the purpose of predicting salivary excretion of drugs. The role of metabolism, rather than permeability, on salivary excretion is investigated and results are not in agreement with BDDCS. Conclusion The proposed Salivary Excretion Classification System (SECS) can be used as a guide for drug salivary excretion based on permeability (not metabolism) and protein binding.
Abstract: Available online 9 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 neural networks 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 networks dysfunctions. Furthermore, the description of factors influencing diseases prognoses and treatment efficacy indicates new elements to consider both in therapies and drugs researches.
Abstract: Available online 9 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Background Varicose and ectatic cutaneous vessels are common chronic conditions that might need surgical treatment. There are several treatment modalities, but all can cause complications and have significant recurrence rates. A new effective and safe treatment with low or no recurrence is needed. Phenol seems to be a potential therapeutic agent. Objective To assess the efficacy and safety of phenol as a sclerosing agent in the treatment of varicose veins and other vascular ectatic conditions. Methods The dorsal ear veins of white New Zealand rabbits were injected with 0.1 ml of a sclerosing agent. Four experimental groups were used to test the sclerosant efficacy of different concentrations of phenol (1, 5, 20 and 50%). Sodium tetradecyl sulphate (STS), a commonly used sclerosing agent, was used as a positive control, while normal saline was used as a negative control. The blood vessels of the treated ears were photographed before and 1 hour, 2 days, 8 days and 45 days after treatment. Biopsies from the treated areas were obtained for histologic examinations. Results A concentration of 1% phenol was too low to cause significant vascular changes, whereas a concentration of 5% phenol caused 90% lumen narrowing. Interestingly, 1% STS only caused 25% lumen narrowing. Concentrations of 20 and 50% phenol caused 100% lumen narrowing but caused haemorrhage and necrosis. Toxicity monitoring showed no apparent haematologic, cardiac, pulmonary, hepatic or renal toxicity associated with the concentrations of phenol used in this study. Conclusion A concentration of 5% phenol appears to be a potent and safe sclerosing agent for ectatic small vessels. This provides a significant new therapeutic option, which may eventually advance to the clinic and have an impact on the treatment of patients suffering from varicose veins and other vascular ectatic conditions.
Abstract: Available online 9 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
The purpose of this study was to use stochastic simulation and estimation method to evaluate the effects of sample size and number of samples per individual on the model development and evaluation. The pharmacokinetic parameters and inter- and intra-individual variation were obtained from a population pharmacokinetic model of clinical trials of amlodipine. Stochastic simulation and estimation were performed to evaluate the efficiencies of different sparse sampling scenarios to estimate compartment model. Simulated data were generated a thousand times and three candidate models were used to fit the 1000 data sets. Fifty-five kinds of sparse sampling scenarios were investigated and compared. The results showed that, 60 samples with 3 points and 20 samples with 5 points are recommended, and the quantitative methodology of stochastic simulation and estimation is valuable for efficiently estimating compartment model and can be used for other similar model development and evaluation approaches.
Abstract: Available online 9 February 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
The present study aimed to formulate orodispersible tablets of Flutamide (FTM) to increase its bioavailability. Orodispersible tablets were prepared by direct compression technique using three different approaches namely; super-disintegration, effervescence and sublimation. Different combined approaches were proposed and evaluated to optimize the tablets characteristics. Sodium starch glycolate (SSG) was used as the superdisintegrant. The prepared powder mixtures were subjected to both pre and post compression evaluation parameters including; IR spectroscopy, micromeretics properties, tablets hardness, friability, wetting time, disintegration time and in- vitro drug release. IR studies indicated that there was no interaction between the drug and the excipients used except Ludipress. The results of micromeretics studies revealed that all formulations were of acceptable to good flowability. Tablets hardness and friability indicated good mechanical strength. Wetting and dispersion times decreased from 46 to 38 sec by increasing the SSG concentration from 3.33 to 6.66%w/w in tablets prepared by superdisintegration method. The F8 formulation which was prepared by combined approaches of effervescence and superdisintegrant addition gave promising results for tablet disintegration and wetting times but failed to give faster dissolution rate. The incorporation of 1:5 solid dispersion of FTM: PEG 6000 instead of the pure drug in the same formulation increased the drug release rate from 73.12 to 96.99% after 15 minutes. This increase in the dissolution rate may be due to the amorphization of the drug during the solid dispersion preparation. The presence of the amorphous form of the drug was shown in the IR spectra.
Abstract: Available online 31 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 behaviour, 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.
Abstract: Available online 30 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 towards 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 363 patients’ prescriptions were included in this study, 34.7% of them were female. 273 patients (75.2%) were insured while 90 (24.8%) were patients whom paid cash. Majority (57.6%) of the patients were with diabetes plus hypertension and other co-morbidity. 20.7% of patients were taking 3 medications or less, while 67.8% were taking 4 to 10 and 11.6% were taking more than 10 medications. Analysis of differences showed that, patients who were insured have 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 that for uninsured patients. Further studies to view the reasons behind this behavior and strategies to prevent such actions are needed.
Abstract: Available online 25 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Gelatin is an extensively studied biopolymer hydrogel drug carrier due to its biocompatibility, biodegradability and non-toxicity of its biodegraded products formed in vivo. But with the pristine gelatin it is difficult to achieve a controlled and desirable drug release characteristics due to its structural and thermal lability and high solubility in aqueous biofluids. Hence it is necessary to modify its solubility and structural stability in biofluids to achieve controlled release features with improved drug efficacy and broader carrier applications. In the present explorations an effort is made in this direction by cross linking gelatin to different extents using hitherto not studied isocyanate terminated poly(ether) as a macrocrosslinker prepared from poly(ethylene glycol) and isophorone diisocyanate in dimethyl sulfoxide. The crosslinked samples were analyzed for structure by fourier transform-infrared spectroscopy, thermal behavior through thermogravimetric analysis and differential scanning calorimetry. The cross linked gelatins were biodegradable, insoluble and swellable in biofluids. They were evaluated as a carrier for in vitro drug delivery taking theophylline as a model drug used in asthma therapy. The crosslinking of gelatin decreased the drug release rate by 10-20% depending upon the extend of crosslinking. The modeled drug release characteristics revealed an anomalous transport mechanism. The release rates for ampicillin sodium, 5-fluorouracil and theophylline drugs in a typical crosslinked gelatin carrier were found to depend on the solubility and hydrophobicity of the drugs, and the pH of the fluid. The observed results indicated that this material can prove its mettle as a viable carrier matrix in drug delivery applications.
Abstract: Available online 25 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Objective The objective of this study was to compare the effect of long acting anesthetics on postoperative pain in teeth with irreversible pulpitis. Methodology Forty patients were randomly assigned into two groups of twenty patients each. Each patient who fit the inclusion criteria was administered local anesthesia before undergoing root canal treatment. The anesthetic solution was either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine. Patients were instructed to complete a VAS pain score at 6, 12, 24 hours after single visit root canal treatment. Data were analyzed by Mann-Whitney, Cochrane Q analysis and t test to compare qualitative and quantitative data between the groups. Results The results showed that the levels of pain of the patients who received lidocaine as the anesthetic agent had significantly more postoperative pain after root canal treatment (P < 0.05) but had significantly decreased by 24 hours compared to the bupivacaine group patients who had significantly lower postoperative pain levels at 6 and 12 hours. Conclusion The use of long acting local anesthetic can significantly reduce the postoperative pain in teeth with irreversible pulpitis.
Abstract: Available online 19 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
Objective To determine the affect of providing different format about side effect information (verbal versus numerical) to acne patients in Saudi Arabia that are newly prescribed Roaccutane. Design A prospective study assessing patients’ degree of estimation about side effect information. Participants 141 Acne patients newly prescribed Roaccutane. Settings Four dermatology clinics in Riyadh. Two in tertiary Hospitals and the other two in private clinics. Intervention Each Patient received information about two different side effects for Roaccutane. The side effect provided was supplemented with the probability of occurrence, which was written either in words or in numbers. (Dry eye “very common” or “30%”; Loss of hair “rare” or “0.01%”). Main outcome measures Patient estimation of side effect occurrence. Other outcomes were the likelihood of experiencing the side effect, the severity of the side effect, their perception of risk of the side effects to their general health, their satisfaction with the information provided and, whether the information provided will influence their decision to take the medicine. Result The mean estimate for side effect occurrence for the dry eyes was 46% in the verbal group and 41% in the numerical group (p=0.5); for loss of hair it was 50% in the verbal group and 39%in the numerical group (p=0.03). There are no significant differences between verbal and numerical group regarding the remaining measures. Conclusion Patients overestimate the probability of occurrence of side effect. Verbal format of probability of occurrence is associated with higher estimation than numerical format.
Abstract: Available online 17 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
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 mean age of 47.8 ± 27.7 years. A hundred forty of them were female (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 DRPs group were exposed to hospital admission while only 7.1%(n=4) were ED visits (figure 2). Male to female ratio in ED visits was 3:1 while it was 9.7:8.9 in ED admissions group. Conclusion The prospective design of this study, sample size, and randomization increase 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 safe and effective therapy. Corrective, preventive and educational strategies should concentrate on the most frequently reported populations, diseases and medications. The study addresses 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.
Abstract: Available online 9 January 2013 Publication year: 2013
Source:Saudi Pharmaceutical Journal
The objective of the article is to highlight various roles of glutamic acid like endogenic anticancer agent, conjugates to anticancer agents, and derivatives of glutamic acid as possible anticancer agents. Beside these emphases are given specially on two endogenous derivatives of glutamic acid such as glutamine and glutamate. Glutamine is a derivative of glutamic acid and is formed in the body from glutamic acid and ammonia in an energy requiring reaction catalyzed by glutamine synthase. It also possesses anticancer activity. So the transportation and metabolism of glutamine are also discussed for better understanding the role of glutamic acid. Glutamates are the carboxylate anions and salts of glutamic acid. Here the roles of various enzymes required for the metabolism of glutamates are also discussed.
In Malaysia, therapeutic drug monitoring (TDM) service was started in the 1980s. Since then, the number of hospitals that offer the service has increased. In this paper, we report the findings of a nationwide survey describing the practice of TDM in these hospitals. Questionnaires were mailed to 128 government hospitals. Data were collected for general characteristics of the hospitals, administrative, and laboratory activities related to TDM service. One hundred and twenty-one hospitals responded to the survey. Thirty-four hospitals (28.1%) provided the service with their own TDM laboratories, 44 hospitals (36.4%) provided the service using other hospitals’ laboratories and 43 hospitals (35.5%) did not provide the service at all. TDM services were more likely to be offered in larger hospitals with various medical specialties. Since it is managed entirely by hospital pharmacists, these pharmacists assume an important role in ensuring optimum use of the TDM service.
Quinoline or 1-aza-naphthalene is a weak tertiary base. Quinoline ring has been found to possess antimalarial, anti-bacterial, antifungal, anthelmintic, cardiotonic, anticonvulsant, anti-inflammatory, and analgesic activity. Quinoline not only has a wide range of biological and pharmacological activities but there are several established protocols for the synthesis of this ring. The article aims at highlighting these very diversities of the ring.
Objective To investigate the dispensing behavior of pharmacists in retail pharmacy practice and to assess their attitude toward dispensing non-OTC drugs and scrutinize the causes of their malpractice; if in fact was perceived. Method Between December 2010 and January 2011 retail pharmacies in Jeddah-KSA were visited randomly by a number of voluntary collaborators who played the role of asking for one or more of the following medications without providing a prescription: Co-amoxiclav (Augmentin) or Cefaclor (Ceclor), Captopril (Capoten) and Fluoxetine (Prozac). Results A total of 60 pharmacies were randomly included in this study; 100% of the pharmacists working were male, 96.7% of them were non-Saudis and only 2 (3.3%) were Saudis. In a total of 119 drug requests, almost all pharmacists (97.9%) handed out the antibiotic immediately, 100% dispensed captopril and 89.5% gave the antipsychotic simply by following the collaborator’s request without even asking for a doctor’s prescription. In the second part of the study (where a mini-questionnaire is administered), 85% of the pharmacists agreed to answer the mini-questionnaire, and 15% refused to participate. The highest reason given for their wrongdoing, was for that if the pharmacist did not, others – of neighboring pharmacies – would do the same, followed by that there is no available OTC list. Conclusion The study confirmed that pharmacists are still violating the law, which is leading to a profound malpractice in retail pharmacies around the country. Consequently, regulations should be reviewed and structured educational campaigns are a must to both pharmacists and public. The OTC list should be generated, implemented, and monitored by Saudi regulators and penalize violators.
PubDate: 2013-01-02T12:03:54Z
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