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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  [2566 journals]   [SJR: 0.252]   [H-I: 12]
  • Vancomycin therapy in critically ill patients on continuous renal
           replacement therapy; are we doing enough'

    • Abstract: Publication date: Available online 7 September 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ali S. Omrani , Alaa Mously , Marylie P. Cabaluna , John Kawas , Mohammed M. Albarrak , Wafa A. Alfahad
      BACKGROUND Recommendations regarding vancomycin dosing and monitoring in critically ill patients on continuous renal replacement therapy (CRRT) are limited. This is a retrospective study to assess the adequacy of current vancomycin dosing and monitoring practice for patients on CRRT in a tertiary hospital in Riyadh, Saudi Arabia. METHODS Retrospective chart review of adult patients admitted between 1 April 2011 and 30 March 2013 to critical care and received intravenous vancomycin therapy whilst on CRRT. RESULTS A total of 68 patients received intravenous vancomycin therapy whilst on CRRT, of which 32 met the inclusion criteria. Fifty one percent were males and median (range) age was 62.5 (19 – 90) years. Median APACHE II score was 33.5 (22 - 43) and median Charlson Comorbidity Score of 4 (0 - 8). The mean (± standard deviation) dose of vancomycin was 879.9 mg (± 281.2 mg) for an average duration of 5.9 days (± 3.7 days). All patient received continuous veno-venous hemofiltration (CVVH). A total of 55 vancomycin level readings were available from the study population, ranging from 6.6 to 41.3, with wide variations within the same sampling time frames. Vancomycin levels of >15 mg/L or were achieved at least once in 24 patients (75.0%), but only 11 patients (34.3%) had 2 or more serum vancomycin level readings of 15 mg/L or more. Conclusion Therapeutic vancomycin levels are difficult to maintain in critically ill patients who are receiving IV vancomycin therapy whilst on CRRT. Aggressive dosing schedules and frequent monitoring is required to ensure adequate vancomycin therapy in this setting.


      PubDate: 2014-09-07T14:07:46Z
       
  • Ketorolac tromethamine floating beads for oral application:
           Characterization and in vitro/in vivo evaluation

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Amal El Sayeh F. Abou el Ela , Maha A. Hassan , Dalia A. El- Maraghy
      The floating beads have been employed to make a sustained release of the drug in the stomach and to decrease the dose of the drug and hence overcome its side effects. The common benefits of the floating beads were it is easy preparation, without the need of a high temperature, and high percentage of the drug entrapment. In the present work, the Ketorolac tromethamine (KT) floating beads were prepared by extrusion congealing method utilizing calcium carbonate as a gas forming agent. The physical characters of the produced beads were investigated such as KT yield, KT loading, and entrapment efficiency of the drug. In addition, floating behavior, swelling, particle size, morphology and KT stability were also evaluated. In vitro drug release study was carried out, and the kinetics of the release was evaluated using the linear regression method. Furthermore, the in vivo analgesic effect of KT after oral administration of the selected formula of floating beads (F10) was carried out using hot plate and tail flick methods. Oral commercial KT tablets and KT solution were used for the comparison. The prepared beads remained floated for more than 8h. The optimized formulation (F10) exhibited prolonged drug release (more than 8h) and the drug release follows the Higuchi kinetic model, with a Fickian diffusion mechanism according to Korsmeyer-Peppas (n =0.466). Moreover, F10 showed a sustained analgesic effect as compared to the commercial tablet.


      PubDate: 2014-09-03T13:50:09Z
       
  • SEDDS of gliclazide: Preparation and characterization by in-vitro, ex-vivo
           and in-vivo techniques

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Tanzina Sharmin Nipun , S.M. Ashraful Islam
      In the study, self emulsifying drug delivery system (SEDDS) of gliclazide, a poorly soluble drug, was developed and evaluated by in-vitro, ex-vivo and in-vivo techniques. Oil and surfactant were screened out according to their solubilizing capacity. Among the tested components Transcutol HP and Tween-80 showed good solubilizing capacity. These two components were used in different ratios to prepare gliclazide SEDDS. The SEDDS formulations were transparent and clear. Droplet size of the emulsion was determined by Laser Diffraction Technology of Malvern. Formulation F1 containing 1:1 (m/m) mixture of Transcutol HP/Tween-80 showed minimum mean droplet size (50.959μm). In-vitro drug release from F1 was higher (99% within 20min) than other formulations. The developed SEDDS was also evaluated for ex-vivo permeability profile by using chicken intestinal sac. Formulation F1 showed optimal drug diffusion. In-vivo performance of SEDDS was evaluated in albino mice using plasma glucose level as a pharmacodynamic marker parameter. The test formulation (F1) showed significant reduction in plasma glucose level, after oral administration. So SEDDS may be an alternative technique for the oral administration of gliclazide.


      PubDate: 2014-09-03T13:50:09Z
       
  • Dosage uniformity problems which occur due to technological errors in
           extemporaneously prepared suppositories in hospitals and pharmacies

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Éva Kalmár , Jason Richard Lasher , Thomas Dean Tarry , Andrea Myers , Gerda Szakonyi , György Dombi , Gabriella Baki , Kenneth S. Alexander
      The availability of suppositories in Hungary, especially in clinical pharmacy practice, is usually provided by extemporaneous preparations. Due to the known advantages of rectal drug administration, its benefits are frequently utilized in pediatrics. However, errors during the extemporaneous manufacturing process can lead to non-homogenous drug distribution within the dosage units. To determine the root cause of these errors and provide corrective actions, we studied suppository samples prepared with exactly known errors using both cerimetric titration and HPLC technique. Our results show that the most frequent technological error occurs when the pharmacist fails to use the correct displacement factor in the calculations which could lead to a 4.6% increase/decrease in the assay in individual dosage units. The second most important source of error can occur when the molding excess is calculated solely for the suppository base. This can further dilute the final suppository drug concentration causing the assay to be as low as 80%. As a conclusion we emphasize that the application of predetermined displacement factors in calculations for the formulation of suppositories is highly important, which enables the pharmacist to produce a final product containing exactly the determined dose of an active substance despite the different densities of the components.


      PubDate: 2014-09-03T13:50:09Z
       
  • Influence of the use of phosphate binders on serum levels of calcium
           phosphate in patients with chronic kidney disease undergoing hemodialysis:
           A retrospective and prospective study

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Lusi Setiani Agus , Imam Effendi , Syamsudin Abdillah
      Hypercalcemia–hyperphosphatemia is an unavoidable consequence of end-stage chronic kidney disease and common in hemodialytic patients. Calcium carbonate (CaCO3) is one type of phosphate binder used widely and prescribed in patients undergoing hemodialysis, aiming to control the levels of calcium and phosphate. These drugs are most effective if taken with meals. This study aimed to evaluate the use of phosphate binders in hemodialysis patients and the factors that influence the success of phosphate binder therapy by experimental studies with retrospective data collection through the medical records and prospectively through the questionnaire and interviews with patients. The research was conducted in the Unit Hemodialysis building floor 8 of Cipto Mangunkusumo Hospital, Jakarta. The data were collected in a retrospective way for two months (January–February 2013) and a prospective study in March–April 2013. Patients included were stage 5 chronic kidney disease patients who underwent hemodialysis in hemodialysis ward of Cipto Mangunkusumo Hospital. Patients who had data of serum levels at the beginning of the use of calcium phosphate and the final data in 2013 got the phosphate binder therapy. Results Ninety six patients with stage 5 chronic kidney disease who underwent hemodialysis had been using phosphate binder for 3years in average. Patient evaluation showed that hypocalcemia was obtained in 23%; normokalemia in 42.7% and hypercalcemia in 34.3%. While the percentage of patients with hipofosfatemia14, 6%, normofosfatemia 32.3% and 53.1% hyperphosphatemia. Results obtained by the prospective analysis of factors that affect the success of the use of phosphate binder therapy are related to how the routine use of phosphate binders is made by the patient. Chi square test showed a significance of 0.000 (p <0.05), the effect of 54%. Conclusion We can conclude there are many events happening such as hyperphosphatemia in hemodialysis patients that use phosphate binders. Monitoring of serum levels of calcium phosphate in patients with chronic kidney disease undergoing hemodialysis should be performed every month. Education and the role of clinical staff required to assist compliance and therapeutic efficacy of phosphate binder are necessary.


      PubDate: 2014-09-03T13:50:09Z
       
  • Practical issues with high dose methotrexate therapy

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      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: 2014-09-03T13:50:09Z
       
  • Antiepileptic drugs toxicity: A case of toxic epidermal necrolysis in
           patient with phenytoin prophylaxis post-cranial radiation for brain
           metastases

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Khalid AlQuliti , Basem Ratrout , Alaa AlZaki
      Background Treatment of epilepsy with antiepileptic drugs (AED) is effective and remains the principal mode of management. A group of adverse effects and drug toxicity can develop immediately or later in the course of treatment. AEDs also have the potential of precipitating idiosyncratic adverse effects including serious cutaneous, hematological and hepatic events. Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse reactions are related to or caused by a variety of medications including AEDs, they carry a high mortality and morbidity rate, accurate diagnosis and rapid treatment may improve the prognosis. Objective To characterize the clinical features and methods of differentiating Stevens–Johnson syndrome from toxic epidermal necrolysis using a case study and to identify other factors that may contribute to this critical illness. Conclusion Clinical knowledge of potential sever adverse reaction of AEDs is essential and may overcome treatment failure with major impact on health-related quality of life in people with epilepsy.


      PubDate: 2014-09-03T13:50:09Z
       
  • Chemical delivery systems and soft drugs: Retrometabolic approaches of
           drug design

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Yashumati Ratan Bhardwaj , Ashutosh Pareek , Vivek Jain , Dharma Kishore
      Inclusion of metabolic considerations in the drug design process leads to 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 a soft drug approach. Present review recapitulates an impression of RMDD giving reflections on the chemical delivery system and the 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.


      PubDate: 2014-09-03T13:50:09Z
       
  • Inside Front Cover - Editorial Board

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4




      PubDate: 2014-09-03T13:50:09Z
       
  • An overview on in situ micronization technique – An emerging novel
           concept in advanced drug delivery

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): K.R. Vandana , Y. Prasanna Raju , V. Harini Chowdary , M. Sushma , N. Vijay Kumar
      The use of drug powders containing micronized drug particles has been increasing in several pharmaceutical dosage forms to overcome the dissolution and bioavailability problems. Most of the newly developed drugs are poorly water soluble which limits dissolution rate and bioavailability. The dissolution rate can be enhanced by micronization of the drug particles. The properties of the micronized drug substance such as particle size, size distribution, shape, surface properties, and agglomeration behaviour and powder flow are affected by the type of micronization technique used. Mechanical communition, spray drying and supercritical fluid (SCF) technology are the most commonly employed techniques for production of micronized drug particles but the characteristics of the resulting drug product cannot be controlled using these techniques. Hence, a newer technique called in situ micronization is developed in order to overcome the limitations associated with the other techniques. This review summarizes the existing knowledge on in situ micronization techniques. The properties of the resulting drug substance obtained by in situ micronization were also compared.


      PubDate: 2014-09-03T13:50:09Z
       
  • Use of fine particle ethylcellulose as the diluent in the production of
           pellets by extrusion-spheronization

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Rama Mallipeddi , Kalyan K. Saripella , Steven H. Neau
      The effect of small ethylcellulose particle size on the manufacture and properties of pellets produced by extrusion-spheronization was investigated. A factorial design revealed the effects of microcrystalline cellulose (MCC), polyethylene oxide (PEO), water, and spheronization speed and time on pellet properties. Response surface modeling allowed optimization of the responses with expansion to a central composite design. Pellet yield, size, shape, friability and drug release profile were studied, along with surface and interior morphology. Pellets were spherical irrespective of the formulation and process variables and exhibited physical and mechanical characteristics appropriate for further processing. Yield in the 12/20 mesh cut was lower with FPEC than observed with coarse particle ethylcellulose (CPEC), but FPEC-containing pellets were more rugged and the PEO to obtain optimal pellets was lower for FPEC compared to CPEC. Immediate release products were obtained and ethylcellulose particle size was of no consequence to drug release. Observed responses for the optimized product agreed with predicted values, demonstrating the success of the optimization procedure. These results suggest that FPEC is a good diluent for extrusion-spheronization.


      PubDate: 2014-09-03T13:50:09Z
       
  • Synthesis and evaluation of a pyrazinoic acid prodrug in Mycobacterium
           tuberculosis

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): João Paulo-dos Santos Fernandes , Fernando Rogerio Pavan , Clarice Queico Fujimura Leite , Veni Maria Andres Felli
      Tuberculosis (TB) is a disease caused mainly by infection of Mycobacterium tuberculosis affecting more than ten million people around the world. Despite TB can be treated, the rise of MDR-TB and XDR-TB cases put the disease in a worrying status. As pyrazinamide-resistant strains exhibit low or none pyrazinamidase activity, it is proposed that the active form of pyrazinamide (PZA) is pyrazinoic acid (POA), although this acid has poor penetration in mycobacteria. In this work, we present a convenient one-pot synthesis of 2-chloroethyl pyrazinoate, and its activity in M. tuberculosis H37Rv (ATCC27294) in MIC assay using the MABA technique. The obtained MIC of the compound was 3.96g/mL, and discussion about the activity profile of some previously evaluated pyrazinoates is also performed.


      PubDate: 2014-09-03T13:50:09Z
       
  • Do insulin cartridges really provide a lower risk of potential diabetes
           complications than traditional vials'

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Mohammad G. Al-Sharayri , Tariq M. Aljbori , Qusai M. Migdadi , Marwa B. Al-Omoush , Ayman R. Jaarah
      Scope Recently, many publicly funded healthcare organizations suffered from an economical crisis. This forced some organizations to utilize less costly alternatives where possible. Insulin cartridges and vials are examples. Many patients are questioning the difference between the two alternatives as they contain the same active ingredient. Objective To find out if insulin cartridges really provide a lower risk of potential diabetes complications than traditional vials. Method A questionnaire was used to ask two random samples of diabetic patients about the development of some diabetes complications. The first sample (n =41) consisted of patients using cartridges; the second sample (n =40) consisted of patients using vials. Patients were randomly selected from the endocrine clinic and the out-patient pharmacy in Al-Hussein Hospital in King Hussein Medical Center in Amman- Jordan. Results 44% of respondents in the first sample did not suffer from any complication; on the other hand, the percentage was only 15% of respondents in the second sample. All respondents (100%) in the first sample suffered from only 2 complications or less; however, 25% of the respondents in the second sample suffered from 3 or more complications. Nephropathy complications, were slightly higher in the first sample; 22% compared to 15% in the second sample. On the other hand, all complications reported in the second sample were higher; 30% for neuropathy, 65% for retinopathy complications and 42.5% for extremities damage compared to only 9.7%, 7.3% and 26.8% respectively in the first sample. Conclusion In general, respondents who were using cartridges reported a lesser incidence of diabetes complications. Although many organizations suffered from an economical crisis, the cost-effectiveness aspect should be taken into consideration when purchasing medical alternatives. This will provide higher quality of life for patients and eventually lower hidden and future costs for the organizations.


      PubDate: 2014-09-03T13:50:09Z
       
  • Challenges to and the future of medication safety in Saudi Arabia: A
           qualitative study

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Hisham Aljadhey , Mansour Adam Mahmoud , Mohamed Azmi Hassali , Alian Alrasheedy , Amjad Alahmad , Fahad Saleem , Aziz Sheikh , Michael Murray , David W. Bates
      Background Medication safety is a global concern among healthcare providers. However, the challenges to and the future of medication safety in Saudi Arabia have not been explored. Objectives We explored the perspectives of healthcare practitioners on current issues about medication safety in hospitals and community settings in Saudi Arabia in order to identify challenges to improving it and explore the future of medication safety practice. Methods A total of 65 physicians, pharmacists, academics and nurses attended a one-day meeting in March 2010, designed especially for the purpose of this study. The participants were divided into nine round-table discussion sessions. Three major themes were explored in these sessions, including: major factors contributing to medication safety problems, challenges to improving medication safety practice, and participants’ suggestions for improving medication safety. The round-table discussion sessions were videotaped and transcribed verbatim and analyzed by two independent researchers. Results The round-table discussions revealed that major factors contributing to medication safety problems included unrestricted public access to medications from various hospitals and community pharmacies, communication gaps between healthcare institutions, limited use of important technologies such as computerized provider order entry, and the lack of medication safety programs in hospitals. Challenges to current medication safety practice identified by participants included underreporting of medication errors and adverse drug reactions, multilingualism and differing backgrounds of healthcare professionals, lack of communication between healthcare providers and patients, and high workloads. Suggestions for improving medication safety practices in Saudi Arabia included continuous education for healthcare professionals and competency assessment focusing on medication safety, development of a culture that encourages medication error and adverse drug reactions reporting, use of technology proven to decrease medication errors, and promotion and implementation of national patient safety initiatives. Conclusions Healthcare professionals have identified major challenges and opportunities for medication safety in Saudi Arabia. Policy makers and practitioners should consider these factors when designing future programs aimed at improving the safe use of medications.


      PubDate: 2014-09-03T13:50:09Z
       
  • Community pharmacist perception and attitude toward ethical issues at
           community pharmacy setting in central Saudi Arabia

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Mohamed N. Al-Arifi
      Objective The purpose of this study is to identify the community pharmacist perceptions and attitudes toward ethical issues at community pharmacy setting in Saudi Arabia. Method A cross-sectional, descriptive, and qualitative survey of community pharmacists was conducted and the survey questions were pre-tested by a pharmacist with extensive experience in ethical issues. Based on the result of a pilot study the questionnaire was used with some modifications and the final questionnaire was sent to the participants by handing over in person, mail or Email. Results 45.7% Often discuss ethical issues with their patients, while only 2.1% never discuss it. 40.6% often record the ethical concern whereas only 1.9% of them never do so. 31.5% reported that patients initiate ethical issues. Discussion 28.3% of the pharmacists initiate the discussion. The barriers that limit discussing ethical issues with their patients were lack of time due to other obligations assigned to the community pharmacist (69.2%), lack of reliable resources (10.7%), not interested in the subject (10.1%), lack of knowledge on ethical issues (4.8%), and other reasons (5.3%). Recourses are books (37.7%), internet web sites (31.1%), and brochures (26.8%). Only a minority of respondents had access to computer databases (15.8%) and other resources (1.3%). Most perceived ethical problems were: being asked for hormonal contraception, dispensing a drug for unreported indication (69.2%), dispensing dose of medicine for a child that is outside the SNF limits (68.9%), unwanted professional behavior about controlled drugs (66.6%), a colleague insisting on unethical behavior (65.0%), a colleague has done something unethical for the first time (64.7%), suspecting that a child is being abused (63.3%) prescribing on private scripts for suspected medications of possible abuse (60.7%) and terminally ill patient asks for a diagnosis or prognosis (52.9%). Conclusion The findings of this study assured the need of Saudi health authorities to implement a code of ethics for pharmacy practicing to cover all aspects of ethical issues.


      PubDate: 2014-09-03T13:50:09Z
       
  • A prospective study on Adverse Drug Reactions of antibiotics in a tertiary
           care hospital

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): M. Shamna , C. Dilip , M. Ajmal , P. Linu Mohan , C. Shinu , C.P. Jafer , Yahiya Mohammed
      Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. The main aim of this study was to detect and analyze Adverse Drug Reactions of antibiotics in inpatients of a tertiary care hospital. A prospective spontaneous reporting study by active and passive methods was carried out for a period of six months. A total of 49 ADRs were reported during the study period with male predominance (53.06%) and geriatric age group. More number of ADRs was from General Medicine and Pediatric departments in which the most affected organ systems were the GIT (38.77%) and the skin (30.61%). The antibiotic classes mostly accounted were cephalosporins (34.69%) followed by fluoroquinolones and others in which type A reactions were more compared to type B and 59.18% of them were predictable. The severity assessment revealed that most of them were moderate (63.26%) followed by mild and severe reactions. Of the reported reactions, 55.10% were definitely preventable and causality assessment was done which showed that 71.42% of the reactions were probable, possible (18.36%), definite (10.20%) and no reactions were unlikely. The study concluded that Adverse Drug Reactions to antibiotics are common and some of them resulted in increased healthcare cost due to the need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of Adverse Drug Reactions to antibiotics, proper documentation and periodic reporting to regional pharmacovigilance centers to ensure drug safety.


      PubDate: 2014-09-03T13:50:09Z
       
  • Pharmacy education instruction: Preference and practices, Saudi
           students’ perception

    • Abstract: Publication date: September 2014
      Source:Saudi Pharmaceutical Journal, Volume 22, Issue 4
      Author(s): Mirghani A. Yousif , Ahmed S. Eldalo , Mustafa A. Abd Allah , Mohammed A. Al-Sawat , Haitham M. Al-Wahaibi , Abd Allah S. Al-Osaimi , Salman H. Al-Gethami
      Aim/Background The methods of instruction in pharmacy education are crucial and meant to suit the professional development and encompass the advanced variety of services and functions provided by the pharmacists to serve individual patients. The aim of this study was to determine the students’ opinions on the adopted and preferred methods of instruction in pharmacy colleges in Kingdom of Saudi Arabia. Methods Opinions of Saudi pharmacy students regarding the adopted methods of learning were measured using a pretested questionnaire combined with Likert-type scales. Results Three hundred pharmacy students were interviewed. Direct type of lecturing was dominant (53.7%). The most frequently used language of instruction was combined English and Arabic (48.8%), that was mostly preferred by 52.5% of the students. Handouts were the most adopted post-lecture learning method (48.3%), while only 5.9% used student’s self-written notes. A cocktail of traditional and electronic aids was used as admitted by 68.7% and 59.3% of the students who preferred this lecture delivery method. Almost half (49.3%) of the students agreed of having a routine fair guidance and support when referring to their lecturers. Conclusion The study outcomes had revealed a practical guidance to be considered for instituting preferred modes of instruction to upgrading students’ capacities for better understanding and acquiring academic and professional skills.


      PubDate: 2014-09-03T13:50:09Z
       
  • Effect of different polymers on in vitro and ex vivo permeability of
           Ofloxacin from its mucoadhesive suspensions

    • Abstract: Publication date: Available online 9 August 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Chakraborti Chandra Kanti , Sahoo Subhashree , Behera Pradipta Kumar
      Considering the importance of drug permeation from formulations, in vitro and ex vivo drug permeation characteristics of three oral mucoadhesive suspensions of Ofloxacin were designed and compared. Three suspensions of Ofloxacin were prepared by taking two grades of Carbopol polymer such as Carbopol 934 (C934) and Carbopol 940 (C940); and Hydroxypropyl methylcellulose. The permeability study was performed by using a Franz diffusion cell through both synthetic cellulose acetate membrane and excised goat gastrointestinal membranes in acidic as well as alkaline pH. To know the permeability of drug from control/formulations through different membranes in acidic/alkaline pH, cumulative percentage drug permeation, apparent permeability (Papp) and flux (J) were calculated. In addition, enhancement ratio (ER) of each formulation was also determined. From our results, it is evident that formulation containing C940 was the best suspension considering Papp and J values of all formulations. Moreover, it was the most beneficial formulation for improving permeation and diffusivity of Ofloxacin even after 16 h. Hence, this suspension was probably the most suitable formulation to obtain prolonged release action of the drug. The ER values of all formulations through excised goat intestinal mucus membrane in alkaline pH were higher than those formulations through goat stomach mucosal membrane in acidic pH. ER values of those formulations indicate that the permeability of the drug was more enhanced by the polymers in the intestinal part, leading to more bioavailability and prolonged action in that portion of the gastrointestinal tract. It may also be concluded from our results that in addition to formulation containing C940, other formulations may also show effective controlled release action.


      PubDate: 2014-08-14T04:10:47Z
       
  • Microemulgel an overwhelming approach to improve therapeutic action of
           drug moiety

    • Abstract: Publication date: Available online 9 August 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Kalpesh C. Ashara , Jalpa S. Paun , M.M. Soniwala , J.R. Chavda , Vishal P. Mendapara , Nitin M. Mori
      As compared to gel and other topical preparations microemulgel has been prepared by screening of oils, emulsifier, and co-emulsifier on bases of solubility of API in it. So API has high solubility and oil may also have more or less pharmacological property, so may assist therapeutic action of API. Due to oil portion was present; it leads to more penetration of API in skin. Oil Micelle Size was less than 500 nm which provides more area for absorption of API in skin so more penetration and more effective than micro-emulsion. Microemulgel has advantage of emulgel that has dual benefits of micro-emulsion and gel and several the other desirable properties like good consistency, thyrotrophic, greaseless, easily spreadable as well as removable, emollient, non-staining, water soluble, longer shelf-life, bio-friendly, transparent, pleasant appearance, ability of patients for self-medication and termination of medications will be easy etc.


      PubDate: 2014-08-14T04:10:47Z
       
  • Knowledge, attitudes and Quality of Life of type 2 diabetes patients in
           Saudi Arabia

    • Abstract: Publication date: Available online 8 August 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Ibrahim Suliman ALAboudi , Mohammed Azmi Hassali , AsrulAkmal Shafie , Khalid AlRubeaan , Asim Hassan
      Objective The purpose of this study was to investigate the association between knowledge and attitude with health related quality of life in patients with type 2 diabetes mellitus in Saudi Arabia. Method & setting A cross-sectional descriptive study was undertaken with a cohort of 75 patients attending the University Diabetic Centre at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. In addition to a questionnaire used to collect demographic and disease related information, the EuroQoL (EQ-5D) scale was used to assess health related quality of life. EQ-5D was scored using values derived from the UK general population survey. The brief diabetic knowledge test.in questionnaire format developed by the University of Michigan Diabetes Research and Training Centre (MDRTC) and the attitude towards self-care questionnaire based on the diabetic care profile were used. Descriptive statistics were used to display demographic and disease related information. Inferential statistics were applied to evaluate associations between study variables. The Statistical Package for Social Sciences version 20.0 was used for data analysis; p<0.05 was taken as significant. Results Fifty eight (77.35%) respondents were male with a mean 12.6±8.4 years of a history of diabetes. Thirty four (45.3%) were in the age group of 45-55 years with a mean age of 54±9.2 years. A moderate level of health related quality of life (0.71±0.22) was recorded in the study cohort. The mean EQ-5D score was lower in females compared to male patients (0.58±0.23vs 0.74±0.20). The mean score of MDKT was 8.96 ± 2.1 and the median score was 9.00. Out of 75 diabetic patients, 14.7% had poor knowledge; 72% had moderate knowledge; and only 13.3% had good knowledge. The average attitude score of all respondents was 6.38 ± 2.11. There was a significant positive association between attitude and EQ-5D score. Conclusion Health related quality of life and knowledge scores were moderate in type 2 diabetic patients in Saudi Arabia. Patient attitude towards the disease was positive and this was positively associated with HRQoL; most respondents believed they are responsible for their care. It is likely that a high quality of Diabetes Self-Management Education programme will provide benefits and impact significantly on type 2 diabetes patients to change their lifestyle and habits, which will improve their quality of life.


      PubDate: 2014-08-09T02:03:52Z
       
  • An evolving role of Clinical pharmacists in managing diabetes: Evidence
           from the literature

    • Abstract: Publication date: Available online 7 August 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Samia Alhabib , Maha Aldaimly , Ali Alfarhan
      Background Diabetes mellitus is a rapidly growing disease world-wide that is estimated to be present in 6.6% of the international population and projected to be increased by 7.8% in 2030. Treating diabetic patients is multifaceted in all aspects and they require objectives and optimum information in order to obtain the maximum benefits of their treatment and avoid complications. Pharmacists are increasingly considered as a part of the health care system. Hence, the aim of this review is to address and summarize the effectiveness of clinical pharmacists in managing diabetic patients. Method This is a narrative review of the evidence from the literature in order to answer the present question of what is the evidence of the role of clinical pharmacist in managing diabetic patients. We searched five databases including: the Cochrane library, MEDLINE, EMBASE, TRIP, and Science direct. We will also try to look for other potentially eligible trials or ancillary publications by searching the reference lists of retrieved included trials, (systematic) reviews, meta-analyses and health technology assessment reports. Outcomes included short-term and long-term measures. Results Final search revealed nine studies. They were heterogeneous in terms of interventions, participants, settings and outcomes. Studies varied in their quality and/or reporting of their findings conducted in several settings. Majority of the studies were conducted in Western countries, one in Hong Kong and one in South India. In the majority of the studies, pharmacists’ role was mainly to specify all drug-related problems including poor drug compliance and side effects and communicating these to the physician. We found that those who received the pharmacists care had a statistically significant reduction in coronary heart disease, blood pressure, HA1c, quality of life and lipids profile. Conclusion Our review demonstrated the important role of clinical pharmacists in managing diabetic patients at diverse settings worldwide. There is an urgent need to recognize and change regulations to allow shared practice agreements among physicians, pharmacists, and other allied health professionals. These mutual agreements would allow more streamlined provision of health care delivery from non-physician health professionals to participants with common health conditions


      PubDate: 2014-08-09T02:03:52Z
       
  • Evidence-Based Pharmaceutical Care: The Next Chapter in Pharmacy Practice

    • Abstract: Publication date: Available online 4 August 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Osama Mohammad Al-Quteimat , Amer Mostafa Amer
      Introduction Pharmacy is a very dynamic profession and the role of the pharmacist is improving with the expansion of the scope of services and the introduction of new subspecialties over the time. Moving from being medication dispensers to outcome-oriented and patient-focused care providers; pharmacists will carry more responsibility and commitment to improve their knowledge and practice. Being updated and evidence-based is a key tool to achieve effective pharmaceutical care services. The primary purpose of this article is to highlight the concept of “evidence based pharmaceutical care” as professional practice to improve the quality of pharmaceutical care. Methods Literature for relevant evidence was searched by Medline (through PubMed), Cochrane library using the keywords: pharmaceutical care, evidence-based and pharmacy practice. Also a manual search through major journals for articles referenced in those located through PubMed was done. Results and Discussion There is strong data showing that pharmaceutical care lead to improvement in health outcomes and cost-effective therapy. More efforts, polices and qualified staff are needed to establish the “evidence-based pharmaceutical care” as new daily professional practice.”Evidence to support pharmacists in their emerging role as care providers is available to improve the efficacy and the quality of pharmaceutical care. Education and specialized training practicing evidence based approach is vital to prepare the pharmacists to provide high quality pharmaceutical care. Conclusion As care providers, pharmacists are effective in providing high quality patient care and being members in multidisciplinary clinical teams is needed to give them the opportunity. Evidence based pharmaceutical care is a natural and logical emerging concepts in the modern pharmacy practice to achieve high quality and more effective pharmaceutical care but still more efforts and resources are needed to promote new attitude toward more professional career.


      PubDate: 2014-08-04T23:19:14Z
       
  • Design, Synthesis and Antibacterial Potential of
           

    • Abstract: Publication date: Available online 28 July 2014
      Source:Saudi Pharmaceutical Journal
      Author(s): Mohammed F. El-Behairy , Tarek E. Mazeed , Aida A. El-Azzouny , Mohamed N. Aboul-Enein
      A series of 5-(Benzo[d][1,3]dioxol-5-yl)-3-tert-butyl-1-substituted-4,5-dihydropyrazole derivatives 4a-e and 6a-g have been synthesized and spectrally characterized. The antibacterial activity of the novel candidates has been screened using agar diffusion test. These compounds were endowed with high antibacterial activity against different Gram +ve and Gram -ve bacteria when compared with standard antibacterial drugs. In the light of zone of inhibition and MIC results, Sarcina and S. aureus are the most sensitive bacteria where pyrrolidinomethanone derivative 4e showed MICs at 80 and 110 nM respectively. While the hydroxypiperidinoethanone derivative 6c showed MIC at 90 nM for Sarcina.


      PubDate: 2014-07-31T21:23:22Z
       
  • 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
       
  • 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
       
 
 
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