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Journal Cover   Saudi Pharmaceutical Journal
  [SJR: 0.417]   [H-I: 14]   Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1319-0164
   Published by Elsevier Homepage  [2588 journals]
  • Remote loading of doxorubicin into liposomes by transmembrane pH gradient
           to reduce toxicity towards H9c2 Cells

    • Abstract: Publication date: Available online 14 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Mohamed Alyane , Gillian Barratt , Mesbah Lahouel
      The use of doxorubicin (DOX) is limited by its dose-dependent cardiotoxicity. Entrapped DOX in liposome has been shown to reduce cardiotoxicity. Results showed that about 92% of the total drug was encapsulated in liposome. The release experiments showed a weak DOX leakage in both culture medium and in PBS, more than 98% and 90% of the encapsulated DOX respectively was still retained in liposomes after 24h of incubation. When the release experiments were carried out in phosphate buffer pH5.3, the leakage of DOX from liposomes reached 37% after 24h of incubation. Evaluation of cellular uptake of the liposomal DOX indicated the possible endocytosis of liposomes because the majority of visible fluorescence of DOX was mainly in the cytoplasm, whereas the nuclear compartment showed a weak intensity. When using unloaded fluorescent-liposomes, the fluorescence was absent in nuclei suggests that liposomes can not cross the nuclear membrane. MTT assay and measurement of LDH release suggest that necrosis is the form of cellular death predominates in H9c2 cells exposed to high doses of DOX, while for weak doses apoptosis could be the predominate form. Entrapped DOX reduced significantly DOX toxicity after 3 and 6h of incubation, but after 20h entrapped DOX is more toxic than free one.


      PubDate: 2015-03-19T01:20:43Z
       
  • In vitro and in vivo targeting effect of folate decorated paclitaxel
           loaded PLA-TPGS nanoparticles

    • Abstract: Publication date: Available online 11 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ha Phuong Thu , Nguyen Hoai Nam , Bui Thuc Quang , Ho Anh Son , Nguyen Linh Toan , Duong Tuan Quang
      Paclitaxel is one of the most effective chemotherapeutic agents for treating various types of cancer. However, the clinical application of paclitaxel in cancer treatment is considerably limited due to its poor water solubility and low therapeutic index. Thus, it requires an urgent solution to improve therapeutic efficacy of paclitaxel. In this study, folate decorated paclitaxel loaded PLA-TPGS nanoparticles were prepared by a modified emulsification/solvent evaporation method. The obtained nanoparticles were characterized by Field Emission Scanning Electron Microscopy (FESEM), Fourier Transform Infrared (FTIR) and Dynamic Light Scattering (DLS) method. The spherical nanoparticles were around 50 nm in size with a narrow size distribution. Targeting effect of nanoparticles was investigated in vitro on cancer cell line and in vivo on tumor bearing nude mouse. The results indicated the effective targeting of folate decorated paclitaxel loaded copolymer nanoparticles on cancer cells both in vitro and in vivo.


      PubDate: 2015-03-15T01:11:52Z
       
  • Preparation and in vitro evaluation of enteric-coated tablets of
           rosiglitazone sodium

    • Abstract: Publication date: Available online 7 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Xin-mei Pan , Jie Li , Run Gan , Xiang-nan Hu
      The aim of this study was to prepare the rosiglitazone sodium enteric-coated tablets and investigate its release rate.The rosiglitazone sodium enteric-coated tablet was prepared by single punch tablet press using substituted hydroxypropyl cellulose and polyvinylpyrrolidone (PVP). The release rate from the enteric-coated tablet of rosiglitazone sodium was evaluated. The release rate study showed that few rosiglitazone sodium was released from enteric coated formulation within 2 h in simulated gastric juice, while it released more than 80% of the labeled amount in 30 min in simulated intestinal juice. The preparing method of rosiglitazone sodium enteric-coated tablets was simple and had a good reproducibility. The release condition and determined methods could be used for the routine determinations of rosiglitazone sodium enteric-coated tablets.


      PubDate: 2015-03-11T01:06:22Z
       
  • A review of polymers as multifunctional excipients in drug dosage form
           technology

    • Abstract: Publication date: Available online 7 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Bożena Karolewicz
      In the article, groups of multifunctional polymers used in drug dosage form technology were classified and evaluated. These compounds, in addition to their basic function as excipients, may have additional properties, e.g. stimuli sensitivity, enzyme inhibition, intestinal epithelium penetration enhancement, efflux pump inhibition, taste-masking, pharmacological activity and the ability to interact with enzymes responsible for drug metabolism. While classifying specific groups of multifunctional polymers, special emphasis was placed on the advantages of using them when designing new drug. Such advantages include, i.a., increasing substance bioavailability, improving substance stability during formulation and the possibility of obtaining forms of controlled or localized release to a specific site in the organism.


      PubDate: 2015-03-11T01:06:22Z
       
  • Orally disintegrating films: A modern expansion in drug delivery system

    • Abstract: Publication date: Available online 10 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Muhammad Irfan , Sumeira Rabel , Quratulain Bukhtar , Muhammad Imran Qadir , Farhat Jabeen , Ahmed Khan
      Over the past few decades, tendency towards innovative drug delivery systems has majorly increased attempts to ensure efficacy, safety and patient acceptability. As discovery and development of new chemical agents is a complex, expensive and time consuming process, so recent trends are shifting towards designing and developing innovative drug delivery systems for existing drugs. Out of those, drug delivery system being very eminent among pediatrics and geriatrics is orally disintegrating films (ODFs). These fast disintegrating films have superiority over fast disintegrating tablets as the latter are associated with the risks of choking and friability. This drug delivery system has numerous advantages over conventional fast disintegrating tablets as they can be used for dysphasic and schizophrenic patients and are taken without water due to their ability to disintegrate within a few seconds releasing medication in mouth. Various approaches are employed for formulating ODFs and among which solvent casting and spraying methods are frequently used. Generally, hydrophilic polymers along with other excipients are used for preparing ODFs which allow films to disintegrate quickly releasing incorporated active pharmaceutical ingredient (API) within seconds. Orally disintegrating films have potential for business and market exploitation because of their myriad of benefits over orally disintegrating tablets. This present review attempts to focus on benefits, composition, approaches for formulation and evaluation of ODFs. Additionally, the market prospect of this innovative dosage form is also targeted.


      PubDate: 2015-03-11T01:06:22Z
       
  • Microsponges based novel drug delivery system for augmented arthritis
           therapy

    • Abstract: Publication date: Available online 7 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Riyaz Ali M. Osmani , Nagesh H. Aloorkar , Dipti J. Ingale , Parthasarathi K. Kulkarni , Umme Hani , Rohit R. Bhosale , Dandasi Jayachandra Dev
      The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug-polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and particle size analysis, and evaluated for morphology, drug loading and in-vitro drug release as well. There were no chemical interactions between drug and polymers used as revealed compatibility studies outcomes. The drug polymer ratio reflected notable effect on drug content, encapsulation efficiency and particle size. SEM results revealed spherical microsponges with porous surface, and had 7.21 μm mean particle size. The microsponges were then incorporated in gel; which exhibited viscous modulus along with pseudoplastic behavior. In-vitro drug release results depicted that microsponges with 1:2 drug-polymer ratio were more efficient to give extended drug release of 75.88% at the end of 8 h; while conventional formulation get exhausted incredibly earlier by releasing 81.11% drug at the end of 4 h only. Thus the formulated microsponge-based gel of diclofenac diethylamine would be a promising alternative to conventional therapy for safer and efficient treatment of arthritis and musculoskeletal disorders.


      PubDate: 2015-03-11T01:06:22Z
       
  • Synthesis, molecular properties, toxicity and biological evaluation of
           some new substituted Imidazolidine derivatives in search of potent
           Anti-inflammatory agents

    • Abstract: Publication date: Available online 9 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Asif Husain , Aftab Ahmad , Shah Alam Khan , Mohd Asif , Rubina Bhutani , Fahad A. Al-Abbasi
      The aim of this study was to design and synthesize pharmaceutical agents containing imidazolidine heterocycyclic ring in hope of developing potent, safe and orally active anti-inflammatory agents. A number of substituted-imidazolidine derivatives (3a-k) were synthesized starting from ethylene diamine and aromatic aldehydes. The imidazolidine derivatives (3a-k) were investigated for their anticipated anti-inflammatory, ulcerogenic and analgesic activity in Wistar albino rats and Swiss albino mice, respectively. Bioactivity score, molecular and pharmacokinetic properties of the imidazolidine derivatives were calculated by online computer software programs viz. Molinspiration and Osiris property explorer. The results of biological testing indicated that among the synthesized compounds only three imidazolidine derivatives namely 4-[1,3-Bis(2,6-dichlorobenzyl)-2-imidazolidinyl]phenyl-diethylamine (3g), 4-[1,3-Bis(3-hydroxy-4-methoxybenzyl)-2-imidazolidinyl]phenyl-diethylamine(3i) and 4-(1,3-Bis(4-methoxybenzyl)-4-methylimidazolidin-2-yl)-N,N-diethylbenzamine (3j) possess promising anti-inflammatory and analgesic actions. Additionally these derivatives displayed superior GI safety profile (low severity index) with respect to the positive control, Indomethacin. All synthesized compounds showed promising bioactivity score for drug targets by Molinspiration software. Almost all the compounds were predicted to have very low toxicity risk by Osiris online software. Compound number (3i) emerged as a potential candidate for further research as it obeyed Lipinski’s rule of five for drug likeness, exhibited promising biological activity in vivo and showed no risk of toxicity in computer aided screening.


      PubDate: 2015-03-11T01:06:22Z
       
  • Oral Antimicrobial Peptides: Types and Role in the Oral Cavity

    • Abstract: Publication date: Available online 6 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Zohaib Khurshid , Mustafa Naseem , Zeeshan Sheikh , Shariq Najeeb , Sana Shahab , Muhammad Sohail Zafar
      Antimicrobial peptides (AMPs) are a wide-ranging class of host-defense molecules that act early to contest against microbial invasion and challenge. These are small cationic peptides that play an important in the development of innate immunity. In the oral cavity, the AMPs are produced by the salivary glands and the oral epithelium and serve defensive purposes. The aim of this review is to discuss the types and functions of oral AMPs and their role in combating microorganisms and infections in the oral cavity.


      PubDate: 2015-03-11T01:06:22Z
       
  • Impact of a pharmacist led diabetes mellitus intervention on HbA1c,
           medication adherence and quality of life: a randomised controlled study

    • Abstract: Publication date: Available online 6 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Mubashra Butt , Adliah Mhd Ali , Mohd Makmor Bakry , Norlaila Mustafa
      Malaysia is situated in Western Pacific region which bears 36.17 % of total diabetes mellitus population. Pharmacist led diabetes interventions have been shown to improve the clinical outcomes among diabetes patients in various parts of the world. Despite high prevalence of disease in this region there is a lack of reported intervention outcomes from this region. The aim of this study was to evaluate the impact of a pharmacist led intervention on HbA1c, medication adherence, quality of life and other secondary outcomes among type 2 diabetes patients. Method Type 2 diabetes mellitus patients (n = 73) attending endocrine clinic at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were randomised to either control (n = 36) or intervention group (n = 37) after screening. Patients in the intervention group received an intervention from a pharmacist during the enrolment, after three and six months of the enrolment. Outcome measures such as HbA1c, BMI, lipid profile, Morisky scores and quality of life (QoL) scores were assessed at the enrolment and after 6 months of the study in both groups. Patients in the control group did not undergo intervention or educational module other than the standard care at UKMMC. Results HbA1c values reduced significantly from 9.66 % to 8.47 % (P = 0.001) in the intervention group. However, no significant changes was noted in the control group (9.64 % to 9.26%, P = 0.14). BMI values showed significant reduction in the intervention group (29.34 kg/m2 to 28.92 kg/m2; P = 0.03) and lipid profiles were unchanged in both groups. Morisky adherence scores significantly increased from 5.83 to 6.77 (P = 0.02) in the intervention group; however, no significant change was observed in the control group (5.95 to 5.98, P = 0.85). QoL profiles produced mixed results. Conclusion This randomised controlled study provides evidence about favourable impact of a pharmacist led diabetes intervention programme on HbA1c, medication adherence and QoL scores among type 2 diabetes patients at UKMMC, Malaysia.


      PubDate: 2015-03-11T01:06:22Z
       
  • Pharmacist, the Pharmaceutical Industry and Pharmacy Education in Saudi
           Arabia”: A Questionnaire-based Study

    • Abstract: Publication date: Available online 7 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ghada Saleh , Naser L. Rezk , Laila Laika , Anna Ali , Ashraf Elmetwally
      Background In Saudi Arabia there is an estimated need of more than 100,000 pharmacy graduates to cover all present sectors. The shortage of pharmacists has affected many of these sectors especially the pharmaceutical industry. The contribution of Saudi pharmacists to local pharmaceuticals industry would be extremely beneficial and important for shaping the future of the drug industry within the Kingdom. It is not clear whether future Saudi pharmacists are willing to contribute to local pharmaco-industrial fields. Methods A cross-sectional, questionnaire-based survey was conducted on all final-year pharmacy students in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA). Results Out of a total of 130 students registered in the final-year of the pharmacy program in KSU, 122 (93.8%) were able to complete the questionnaire. The results showed that the majority (83%) of Saudi pharmacy students indicated that they had not receive practical training in the pharmaceutical companies, while only 17.2% of the students felt that they had the knowledge and the skills to work in the pharmaceutical industry after graduation. The majority of the students (66.7%) chose clinical pharmacy as their future career field while only 10.9% indicated willingness to work in a pharmaceutical industry career. Only 8.2% selected working in the pharmaceutical industry. The significant predictor of possibly choosing a career in the local drug industry is a student with a bachelor’s degree (compared to Pharm. D degree) in pharmacy (OR=2.7 [95% CI 1.1 – 6.3]). Conclusion Pharmacy students who are enrolled in the capital city of Riyadh are not properly trained to play an influential role in local drug companies. As a result, their level of willingness to have a career in such important business is not promising (more among Pharm D program). Future research in other pharmacy colleges within Saudi Arabia is needed to confirm such results.


      PubDate: 2015-03-11T01:06:22Z
       
  • Fabrication and In vivo evaluation of Nelfinavir loaded PLGA Nanoparticles
           for enhancing oral bioavailability and therapeutic effect

    • Abstract: Publication date: Available online 11 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): D. Nagasamy Venkatesh , Mahendran Baskaran , V.V.S. Narayana Reddy Karri , Sai Sandeep Mannemala , Kollipara Radhakrishna , Sandip Goti
      Nelfinavir mesylate (NFV) is an anti-viral drug, used in the treatment of Acquired immunodeficiency syndrome (AIDS). Poor oral bioavailability and shorter half-life (3.5 to 5 h) remains a major clinical limitation of NFV leading to unpredictable drug bioavailability and frequent dosing. In this context, the objective of the present study was to formulate NFV loaded poly (lactic-co-glycolic acid) (PLGA) nanoparticles (NPs), which can increase the solubility and oral bioavailability along with sustained release of the drug. NFV loaded PLGA-NPs were prepared by nanoprecipitation method using PLGA and Poloxomer 407. The prepared NPs were evaluated for particle size, zeta potential, morphology, drug content, entrapment efficiency (EE) and in vitro dissolution studies. Oral bioavailability studies were carried out in New Zealand rabbits by administering developed NFV PLGA-NPs and pure drug suspension. PLGA-NPs prepared by using 1:4 ratio of drug and PLGA, with a stirring rate of 1500 rpm for 4 h. The prepared NPs were in the size of 185±0.83nm with a zeta potential of 28.7±0.09 mV. The developed NPs were found to be spherical with uniform size distribution. The drug content and EE of the optimized formulation was found to be 36±0.19% and 72±0.47% respectively. After oral administration of NFV PLGA-NPs, the relative bioavailability was enhanced about 4.94 fold compared to NFV suspension as a control. The results describe an effective strategy for oral delivery of NFV loaded PLGA NPs that helps in enhancing bioavailability and reduce the frequency of dosing.


      PubDate: 2015-03-11T01:06:22Z
       
  • Full Factorial Design for Optimization, Development and Validation of Hplc
           Method to Determine Valsartan in Nanoparticles

    • Abstract: Publication date: Available online 3 March 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Lalit Kumar , M. Sreenivasa Reddy , Renuka S. Managuli , K. Girish Pai
      High performance thin layer chromatographic method was optimized, developed and validated as per the ICH guidelines. In this study the 20 mM ammonium formate and acetonitrile in the 57:43 ratio were used as mobile phase for the analysis of valsartan. Full factorial design was used to optimize the effect of variable factors. The responses were peak area, tailing factor and number of theoretical plates. The quadratic effect of flow rate and wavelength individually as well as in interaction was most significant (p < 0.0001 and p < 0.0086, respectively) on peak area, the quadratic effect of pH of buffer was also most significant effect (p < 0.0001) on tailing factor (5%) while the quadratic effect of flow rate and wavelength individually was significant (p = 0.0006 and p = 0.0265, respectively) on the number of theoretical plates. The high-performance thin layer chromatographic separation was performed at the flow rate 1.0 min/mL, UV detector wavelength 250 nm and pH of the buffer 3.0 as optimized parameters using design of experiments. The Rf values of valsartan was found to be 10.177 min. Percent recovery in terms of accuracy for the prepared valsartan nanoparticles was found in the range of 98.57 to 100.27%.


      PubDate: 2015-03-05T23:11:53Z
       
  • In-vitro and in-vivo evaluation of repaglinide loaded floating
           microspheres prepared from different viscosity grades of HPMC polymer

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Megha Sharma , Seema Kohli , Agnimitra Dinda
      During the study repaglinide encapsulated floating microspheres were formulated and characterized for enhancing residence time of drug in git and there by increasing its bioavailability. Floating microspheres of ethylcellulose (EC) and hydroxypropyl methyl cellulose (HPMC) (5 & 100 cps) were prepared by emulsion solvent diffusion technique. During process optimization various parameters were studied such as: drug: polymer ratio, polymer ratio, concentration of emulsifier and stirring speed. Selected optimized formulations were studied for SEM, entrapment, floating behavior, drug release and kinetics. In-vivo floating ability (X-ray) study and in-vivo antidiabetic activity was performed on alloxan induced diabetic rats. Microspheres prepared with different viscosity grade HPMC were spherical shaped with smooth surface. Size of microspheres was in the range of 181.1 – 248 μm. Good entrapment and buoyancy was observed for 12 hrs. X-ray image showed that optimized formulation remained buoyant for more than 6 hrs. Optimized formulation treated group shows significant (p<0.01) reduction in blood glucose level as compared to pure drug treated group. Repaglinide loaded floating microspheres expected to give new choice for safe, economical and increased bioavailable formulation for effective management of NIDDM.


      PubDate: 2015-02-28T21:57:57Z
       
  • Patient Adherence to Warfarin Therapy and Its Impact on Anticoagulation
           Control

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ahmed Y. Mayet
      Background Warfarin is a commonly prescribed oral anticoagulant in Saudi Arabia and yet patient adherence to warfarin therapy and its impact on anticoagulation control has not been well researched here. Methods A cross-sectional survey was conducted over 6 weeks at the outpatient anticoagulant clinic on patients who were receiving warfarin. Adherence was assessed using the translated Arabic version of the Morisky Medication Adherence Scale (MMAS-8). Levels of adherence were classed as low (score ⩽7), or high (score=8) based on the scores. Good anticoagulation control was defined as percent Time INR in Therapeutic Range (TTR) ⩾75% using the Rosendaal method. Results A total of 192 patients completed a questionnaire with a response rate of 68.1%. It was established that no association was found between adherence to warfarin therapy and INR control groups. Among the 89 (46.4%) patients who had high adherence, only 34 (38.2%) had an acceptable INR control. This was versus 103 (53.6%) patients who had low adherence but also 34 (33.0%) had good INR control. Multivariate logistic regression (MLR) analysis showed that when studying females and occupational status of unemployment, they were independently associated with poor INR control with an OR 2.31, 95% CI 1.10 – 4.92, and OR 2.71, 95% CI 1.12 – 6.61 respectively. MLR analysis also showed that age < 50 years alongside no formal education were independently associated with low adherence to warfarin therapy with an OR 2.67, 95% CI 1.29 – 5.52 and OR 2.63, 95% CI 1.01 – 6.93 respectively. Conclusions The demographic background influences adherence and INR control, but no association was found between adherence and anticoagulation control.


      PubDate: 2015-02-28T21:57:57Z
       
  • Cost-Minimization Analysis of Imipenem/Cilastatin versus Meropenem in
           

    • Abstract: Publication date: Available online 28 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Imraan Joosub , Andy Gray , Analyn Crisostomo , Abdul Salam
      Aim The aim of this study was to compare the costs of management of moderate to severe infections in patients treated with imipenem/ cilastatin (IC) and meropenem (MEM). Pharmacoeconomic studies in Saudi Arabia are scarce. The current hospital formulary contains 2 carbapenems: IC and MEM. These antibiotics share a similar spectrum of activity. There are conflicting reviews with regard to the relative cost-effectiveness of these two agents. Methods A retrospective, single-centre cohort study of 88 patients of IC versus MEM in moderate to severe infections was performed, applying cost-minimization analysis (CMA) methods. In accordance with CMA methods, the assumption of equivalent efficacy was first demonstrated by literature retrieved and appraised. Adult patients (⩾ 18 years old) diagnosed with moderate to severe infections, including skin and skin structure infections (SSIs), sepsis, intra-abdominal infections (IAIs), respiratory tract infections, urinary tract infections (UTIs) and hospital-acquired infections (HAIs), who were prescribed IC 500mg every six hours intravenously (2 gram per day) or MEM 1 gram every eight hours (3 gram per day), were included in the study. Only direct costs related to the management of the infections were included, in accordance with a payer perspective. Results Overall there was no difference in the mean total daily costs between IC (SAR 4784.46, 95% CI 4140.68, 5428.24) and MEM (4390.14, 95% CI 3785.82, 4994.45;, p = 0.37). A significantly lower medicine acquisition cost per vial of IC was observed when compared to MEM, however there was a significantly higher cost attached to administration sets used in the IC group than the MEM group. Consultation, nursing and physician costs were not significantly different between the groups. No differences were observed in costs associated with adverse drug events (ADEs). Conclusion This study has shown that while acquisition costs of IC at a dose of 500mg q6h may be lower than for MEM 1 gram q8h, mean total costs per day were not significantly different between IC and MEM, indicating that medicine costs are only a small element of the overall costs of managing moderate to severe infections.


      PubDate: 2015-02-28T21:57:57Z
       
  • Factors Influencing Warfarin Response in Hospitalized Patients

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Mahmoud I. Abdel-Aziz , Mostafa A. Sayed Ali , Ayman K.M. Hassan , Tahani H. Elfaham
      Objective The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Methods Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Results Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ±0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p = .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72-0.94]), being a male patient (OR, 2.86 [95% CI, 1.05-7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07-0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73[95% CI, 1.28-10.9]). Conclusion Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered.


      PubDate: 2015-02-28T21:57:57Z
       
  • Akathisia with Erythromycin: Induced or Precipitated '

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ankur Sachdeva , Ruchika Rathee
      Objective A 28-year-old male diagnosed with schizophrenia, maintaining well on Olanzapine, developed akathisia soon after addition of Erythromycin for Pityriasis Rosea. This prompted us to evaluate the relationship of erythromycin and akathisia. Method We report the case and the literature focusing on akathisia as a possible adverse event of erythromycin Results Akathisia resolved after Erythromycin was stopped following 5 days of treatment. Akathisia was possibly induced or precipitated with use of Erythromycin. Possible etiological reasons of this clinically significant association were discussed. Conclusion Erythromycin, by itself, may induce akathisia or precipitate akathisia in individuals by interfering with metabolism of other culprit drugs.


      PubDate: 2015-02-28T21:57:57Z
       
  • Levetiracetam induced psoriasiform drug eruption: a rare case report

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Onur Serdar Gencler , Bilgen Gencler , Cemile Tugba Altunel , Nur Arslan



      PubDate: 2015-02-28T21:57:57Z
       
  • The beneficial roles of Lupineus luteus and lifestyle changes in
           management of metabolic syndrome: A case study

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Gamaleldin I. Harisa , Fars K. Alanazi
      Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including obesity, hypertension, dyslipidemia and hyperuricemia. Here, we report a 43-year-old man with obesity, hypertension, hypercholesterolemia, hyperuricemia and mild liver dysfunctions. Lupid (Lupineus luteus) and therapeutic lifestyle change (TLC) were suggested as therapeutic intervension for the present case for 6 months. The body weight, body mass index (BMI), blood pressure, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), triacylglycerol (TAG), uric acid (UA) and alanine transaminase (ALT) were markedly decreased by 26.85%, 26.95%, 13 %, 53.84%, 57.84%, 36.14 %, 47.58 % and 61.62 % respectively, compared to those at baselines. However, high density lipoprotein cholesterol (HDL-C) value was markedly increased by 30.77%. The present results concluded that administration of lupin a with TLC are good intervention for prevention and treatment of MetS.


      PubDate: 2015-02-28T21:57:57Z
       
  • Evaluation of a Biosimilar Recombinant Alpha Epoetin in the Management of
           Anemia in Hemodialysis Patients

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Fatemeh Beiraghdar , Yunes Panahi , Behzad Einollahi , Eghlim Nemati , Amirhossein Sahebkar , Arash Hassanzadeh , Hamid T. Khosroshahi , Sima A. Azar , Javid Safa , Sadroddin R. Hashemi , Jalal Etemadi , Eisa T. Marzony , Hamid Noshad
      Background The efficacy of human recombinant erythropoietins (rHuEPOs) in the treatment of anemia with different etiologies is proven. Development of biosimilar rHuEPO products with lower cost and wider availability is important for the care of anemic patients. Objective The aim of the present study was to determine the bioequivalence and safety of a biosimilar rHuEPO (Pastopoitin®) and compare it with the innovator product Eprex®, as a standard rHuEPO. Methods One hundred and seven anemic patients on stable hemodialysis were recruited to this randomized double-blind comparative trial and assigned to either subcutaneous Pastopoitin (n = 50) or Eprex (n = 57). Each study group received rHuEPO at a dose of 80-120 IU/kg/week in 2-3 divided doses for a period of 3 months. Hematologic parameters including Hemoglobin, hematocrit, RBC, EBC, platelet, MCV, MCH and MCHC were checked every 2 weeks. Blood iron, ferritin, TIBC, creatinine, BUN and electrolytes (Na, K, Ca and P) were evaluated monthly over the 3 months. Results A significant increase in hemoglobin, hematocrit and RBC was observed by the end of study in both Pastopoitin and Eprex groups (p < 0.001). However, these factors were not significantly different between the groups, neither at baseline nor at the end of study (p > 0.05). Likewise, the groups were comparable regarding MCV, MCH, MCHC, iron, ferritin, TIBC, creatinine, BUN and electrolytes at baseline as well as at the end of trial. Adverse events were not serious and occurred with the same frequency in the study groups. Conclusion Pastopoitin showed comparable efficacy and safety profile with Eprex in anemic patients on hemodialysis. Hence, Pastopoitin may be considered as a rHuEPO with a lower cost and wider availability compared with the innovator product Eprex.


      PubDate: 2015-02-28T21:57:57Z
       
  • Neonatal Outcomes after Oral Administration of Antenatal Corticosteroid: A
           Case Report

    • Abstract: Publication date: Available online 27 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Doua AlSaad , Palli Valapila Abdulrouf , Hussain Parappil , Asma Tarannum , Binny Thomas
      The use of antenatal corticosteroids is associated with reduction in morbidity and mortality rates in preterm delivery. A 34 year-old pregnant woman, gravida 2 para1, was planned for elective cesarean section at 36 weeks of gestation as ultrasound study showed intrauterine growth retardation. She has idiopathic thrombocytopenia and anemia, with suspected hypoplastic anemia. Due to mother’s low platelet count, antenatal intramuscular corticosteroids injection was avoided. Instead, oral dexamethasone was given for fetal lung maturity. Baby’s Apgar score at 1-min and 5-min was 9 and 10, respectively. The baby girl did not develop respiratory distress syndrome. She had mild transient tachypnea of newborn that needed only mild respiratory support with nasal cannula in room air.


      PubDate: 2015-02-28T21:57:57Z
       
  • Public’s perception and satisfaction on the roles and services
           provided by pharmacists - Cross sectional survey in Sultanate of Oman

    • Abstract: Publication date: Available online 28 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Jimmy Jose , Marwa Nasser Al Shukili , Beena Jimmy
      Background and Objectives An important factor that will help in advancement of the pharmacy services in any country would be to understand the public needs, expectation and satisfaction. There are limited published studies conducted in Sultanate of Oman regarding the perception and satisfaction of public on the role and services provided by pharmacists. The present study was conducted to assess the perception and satisfaction of general public in Sultanate of Oman on the roles, and services received from the pharmacists. Methods The survey was conducted among public in the Governorates of A’Dahera and Muscat in Oman during 2013. The questionnaire had items to assess two aspects; perception on the roles and responsibilities of pharmacists and satisfaction on the services provided. The responses to the questions marked in a five point likert scale were assessed using a scoring scheme. Accordingly, the median perception, and satisfaction score and median total score for the participants was estimated. The median scores of the participants were related with the demographics of the participants and frequency of visit to pharmacy. Results A total of 390 completed questionnaires were obtained. The median total score of the participants based on all the questions was 79 (Inter Quartile Range (IQR), 12) which represents a moderate score. The median perception and satisfaction score was 44 (IQR 5) and 34 (IQR 7) which represent a good and moderate score, respectively. Perception of the participants differed based on employment status, frequency of visit to pharmacy and governorate represented by participants; while satisfaction was influenced by educational qualification and frequency of visit to pharmacy. Conclusions Public had a good perception regarding the roles of the pharmacists while they were only moderately satisfied with the services provided. Steps have to be taken to improve the services and relationship of pharmacists and thereby improve the satisfaction of the customers. An extended study in a broader population involving more governorates will provide an enhanced representation regarding this important aspect.


      PubDate: 2015-02-28T21:57:57Z
       
  • Design, optimization and evaluation of glipizide solid
           self-nanoemulsifying drug delivery for enhanced solubility and dissolution
           

    • Abstract: Publication date: Available online 19 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Rajendra Narayan Dash , Mohammed Habibuddin , Touseef Humaira , Devi Ramesh
      A solid self-nanoemulsifying drug-delivery system (Solid SNEDDS) has been explored to improve the solubility and dissolution profile of glipizide. SNEDDS preconcentrate was systematically optimized using a circumscribed central composite design by varying Captex 355 (Oil), Solutol HS15 (Surfactant) and Imwitor 988 (Co-surfactant). The optimized SNEDDS preconcentrate consisted of Captex 355 (30% w/w), Solutol HS15 (45% w/w) and Imwitor 988 (25% w/w). The saturation solubility (SS) of glipizide in optimized SNEDDS preconcentrate was found to be 45.12 ± 1.36 mg/ml, indicating an improvement (1367 times) of glipizide solubility as compared to its aqueous solubility (0.033 ± 0.0021 mg/ml). At 90% SS, glipizide was loaded to the optimized SNEDDS. In-vitro dilution of liquid SNEDDS resulted in a nanoemulsion with a mean droplet size of 29.4 nm. TEM studies of diluted liquid SNEDDS confirmed the uniform shape and size of the globules. The liquid SNEDDS was adsorbed onto calcium carbonate and talc to form solid SNEDDS. PXRD, DSC, and SEM results indicated that, the presence of glipizide as an amorphous and as a molecular dispersion state within solid SNEDDS. Glipizide dissolution improved significantly (p < 0.001) from the solid SNEDDS (∼100% in 15 minutes) as compared to the pure drug (18.37%) and commercial product (65.82) respectively.


      PubDate: 2015-02-23T21:31:22Z
       
  • Investigation for the quality factors on the tablets containing medicated
           pellets

    • Abstract: Publication date: Available online 10 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Xueying Tan , Jingbo Hu
      Sustained and controlled pellets are considered as one of the ideal dosage forms. Due to the large coverage area of pellets, loaded drugs can be absorbed completely in the body and bioavailability is improved correspondingly. Coated pellets-containing tablet is a special oral formulation consisting of various pellets with different release rate. Desired rate of drug release rate can be achieved by adjusting the proportion of pellets. However, this formulation faces strict requirements in the process of preparation. Several factors will influence release behavior of tablets, including pellet cores, coating, tableting, and so on. Therefore, these factors will be investigated sufficiently in this review to provide valuable information for manufacturing process.


      PubDate: 2015-02-12T04:33:21Z
       
  • Enhancement Of Dissolution Rate Of Class II Drugs (Hydrochlorothiazide); A
           Comparative Study Of The Two Novel Approaches; Solid Dispersion And
           Liqui-Solid Techniques

    • Abstract: Publication date: Available online 7 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Amjad Khan , Zafar Iqbal , Yasar Shah , Lateef Ahmad , Ismail , Zia Ullah , Aman Ullah
      Liqui-solid technique and solid dispersion formation are two novel approaches for enhancement of dissolution rate of BCS class II drugs. Liqui-solid compact converts a liquid drug or drug solution into a free flowing powder with enhanced dissolution rate. In case of solid dispersion drug is molecularly dispersed in a hydrophilic polymer in solid state. In the present study, Liqui-solid and solid dispersion techniques were applied to enhance the dissolution of the hydrochlorothiazide. Three formulations of Hydrochlorothiazide were prepared by liqui-solid technique using micro crystalline cellulose as carrier material and colloidal silicon dioxide as coating material. Water, poly ethylene glycol-400 and Tween-60 were used as solvent system. Solid dispersions of Hydrochlorothiazide were prepared by solvent fusion method using PEG-4000 as carrier polymer. Tablets were subjected to evaluation of various physical and chemical characteristics. Dissolution profiles of tablets prepared by the novel techniques were compared with marketed conventional tablets. Model independent techniques including similarity factor, dissimilarity factor and dissolution efficiency were applied for comparison of dissolution profiles. The results obtained indicated that liqui-solid compact formulations were more effective in enhancing the dissolution rate compared with solid dispersion technique. The liqui-solid compacts improved the dissolution rate up to 95% while the solid dispersion increased it to 88%.


      PubDate: 2015-02-12T04:33:21Z
       
  • Pharmacovigilance on Sexual Enhancing Herbal Supplements

    • Abstract: Publication date: Available online 7 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Akshaya Srikanth Bhagavathula , Asim Ahmed Elnour , Abdulla Shehab
      The use of herbal medicines continues to expand rapidly across world and many people show positive interest to use herbal products for their health. The safety of herbal supplements has become a globally major concern in national and international health authorities due to increasing adverse events and adulterations. It is difficult to analyze herbal products that cause adverse events due to lack of sufficient information and expertise. Inadequate regulatory measures, weak quality control system and uncontrolled distribution channels are some of reasons that enhance the informal pharmaceutical market. In recent years, the unfulfilled desire for sex has been a subject that has aroused increasing public interest with respect to improve sexual functions. The use of herbal medicines substantially increased due to escalated prevalence and impact of sexual problems worldwide and estimates predicting the incidence to raise over 320 million by year 2025. The various reasons to use herbal supplements in men may be due to experiencing changes in erectile dysfunction (ED) due to certain medical conditions such as diabetes and hypertension and bodily changes as a normal part of life and aging. There is a lack of adequate evidence, no impetus to evaluate and absence of any regulatory obligations to undertake rigorous testing for safety and efficacy of herbal supplements before they sold over-thecounter (OTC). Pharmacovigilance on herbal supplements is still not well established. Sexual enhancing herbals are on demand in men health but informal adulteration is growing issue of concern. Recently, increase in use of herbal supplements for erectile dysfunction has laid a path for many illegal compositions. This paper explores facts and evidences that were observed in different countries attempting to demonstrate the importance of strengthening regulatory system to strengthen the application of pharmacovigilance principles on sexual enhancing supplements. We hereby explore the problem of sexual herbal supplements from pharmacovigilance perspectives. We provide insights into the various concerns and call for collaboration to resolve the problem. We highly recommend to include herbal medicines in national pharmacovigilance systems and to establish comprehensive national pharmacovigilance program to raise the awareness about herbal medicines particularly those used in enhancing sexual desire.


      PubDate: 2015-02-12T04:33:21Z
       
  • Comparison of different serum sample extraction methods and their
           suitability for mass spectrometry analysis

    • Abstract: Publication date: Available online 10 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Thamir M. Alshammari , Ahmed Ali Alhassan , Taibi B. Hadda , Mohamad Aljofan
      Mass spectrometry has been widely used, particularly in pharmacokinetic investigations and for therapeutic drug monitoring purposes. Like any other analytical method some difficulties exist in employing mass spectrometry, mainly when it is used to test biological samples, such as to detect drug candidates in mammalian serum, which is rich in proteins, lipids and other contents that may interfere with the investigational drug. The complexity of the serum proteome presents challenges for efficient sample preparation and adequate sensitivity for mass spectrometry analysis of drugs. Enrichment procedures prior to the drug analysis are often needed and as a result, the study of serum or plasma components usually demands either methods of purification or depletion of one or more. Selection of the best combination of sample introduction method is a crucial determinant of the sensitivity and accuracy of mass spectrometry. The aim of this study is to determine the highest serum protein precipitation activity of five commonly used sample preparation methods and test their suitability for mass spectrometry. We spiked three small molecules into rabbit serum and applied different protein precipitation methods to determine their precipitation activity and applicability as a mass spectrometry introductory tool.


      PubDate: 2015-02-12T04:33:21Z
       
  • Synthesis and evaluation of the structural and physicochemical properties
           of carboxymethyl pregelatinized starch as a pharmaceutical excipient

    • Abstract: Publication date: Available online 4 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Sonia Lefnaoui , Nadji Moulai-Mostefa
      A pregelatinized starch (PGS) was derivatized with sodium chloroacetate (SCA) in alcoholic medium under alkaline condition to produce carboxymethyl pregelatinized starch (CMPGS) with various degrees of substitution (DS). Influence of the molar ratio of SCA to the glucopyranose units (SCA/GU), reaction time, temperature and the amount of sodium hydroxide on the degree of substitution (DS) and the reaction efficiency (RE) was studied. An optimal concentration of 30% of NaOH, for a reaction time of 1h at 50°C and molar ratio (SCA/GU) equal to 1.0, yielded an optimal DS of 0.55 and a RE of 55%. SEM micrographs revealed that the carboxymethylation assigned the structural arrangement of CMPGS and caused the granular disintegration. Wide angle diffraction X-ray (XRD) showed that the crystallinity of starch was obviously varied after carboxymethylation. New bands in FTIR spectra at 1417 and 1603 cm-1 indicated the presence of carboxymethyl groups. The solubility and viscosity of CMPGS increased with an increase in the degree of modification. In order to investigate the influence of DS on physical and drug release properties, CMPGS obtained with DS in the range of 0.12-0.55 was evaluated as tablet excipient for sustained drug release. Dissolution tests performed in phosphate buffer (pH 6.8), with Ibuprofene as drug model (25% loading) showed that CMPGS seems suitable to be used as sustained release excipient since the drug release was driven over a period up to 8 h. The in vitro release kinetics studies revealed that all formulations fit well with Korsmeyer-Peppas model and the mechanism of drug release is non-Fickian diffusion.


      PubDate: 2015-02-06T03:50:41Z
       
  • Preparation, Validation and User-Testing of Pictogram-Based Patient
           Information Leaflets for Hemodialysis Patients

    • Abstract: Publication date: Available online 4 February 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Uday Venkat Mateti , Anantha Naik Nagappa , Ravindra Prabhu Attur , Manohar Bairy , Shankar Prasad Nagaraju , Surulivelrajan Mallayasamy , Rajesh Vilakkathala , Vasudev Guddattu , Rajesh Balkrishnan
      Background Patient information leaflets are universally-accepted resources to educate the patients/users about their medications, disease and lifestyle modification. Objectives The objective of the study is to prepare, validate and perform user-testing of pictogram-based patient information leaflets (P-PILs) among hemodialysis (HD) patients. Methods The P-PILs are prepared by referring to the primary, secondary and tertiary resources. The content and pictograms of the leaflet have been validated by an expert committee consisting of three nephrologists and two academic pharmacists. The Baker Able leaflet design has been applied to develop the layout and design of the P-PILs. Results Quasi-experimental pre- and post- test design without control group was conducted on 81 HD patients for user-testing of P-PILs. The mean Baker Able Leaflet Design assessment score for English version of the leaflet was 28, and 26 for Kannada version. The overall user-testing knowledge assessment mean scores were observed to have significantly improved from 44.25 to 69.62 with p value < 0.001. Conclusion The overall user opinion of content and legibility of the leaflets was good. Pictogram- based patient information leaflets can be considered an effective educational tool for HD patients.


      PubDate: 2015-02-06T03:50:41Z
       
  • “Safety and Efficacy of Lacosamide in children with refractory
           partial epilepsy”

    • Abstract: Publication date: Available online 24 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ismail Pasha , Mahesh Kamate , D.K. Suresh
      Objectives The study was carried out to investigate tolerability and the safety of lacosamide on children with refractory partial epilepsy. Materials & Methods The study was carried out at a tertiary care hospital after obtaining approval from the Institutional ethics committee. Patients aged between 5- 15 years taking oral lacosamide (LCM) tablets were given orally as an adjunctive anti-epileptic drug were enrolled for assessing tolerability and its effect on the behavioural life at every visit of titration, during the treatment period (3 months) and at 2 follow up visits that were done at monthly intervals. Adverse events reported by caregiver or by investigator were recorded. Patients/caregivers also completed a 25 items on Connor’s behavioural rating clinical scale at every visit. Results Out of 531 screened patients, 79 patients with refractory partial epilepsy were enrolled after they fulfilled the inclusion and exclusion criteria. Mean age of the children was 8.84 ± 3.09 years (5-15 years); of which 53 were males and 26 females. The mean age at onset of seizures in males was 6.46 ± 3.57 and in females, 6.38 ± 3.39 years. Seventy six children of 79, completed 3 months of treatment period showed significant (p<0.001) decrease in the frequency of seizures, significant improvement in behaviour and showed good tolerability. Three (3.79%) patients dropped out of the study due to hyperactive behaviour, vomiting and lack of seizure control respectively. Conclusions Lacosamide is a well-tolerated newer antiepileptic drug that is effective in refractory partial epilepsy pediatric patients and concurrently improved patient’s behaviour.


      PubDate: 2015-01-25T17:39:41Z
       
  • Why sildenafil and sildenafil citrate monohydrate crystals are not
           stable'

    • Abstract: Publication date: Available online 24 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Somchai Sawatdee , Chaveng Pakawatchai , Kwanjai Nitichai , Teerapol Srichana , Hirihattaya Phetmung
      Sildenafil citrate was crystallized by various techniques aiming to determine the behavior and factors affecting on the crystal growth. There are only 2 types of sildenafil obtaining from crystallization: sildenafil (1) and sildenafil citrate monohydrate (2). The used techniques were (i) crystallization from saturated solutions, (ii) addition of an antisolvent, (iii) reflux and (iv) slow solvent evaporation method. By pursuing these various methods, our work pointed that the best formation of crystal (1) was obtained from technique no. (i). Surprisingly, the obtained crystals (1) was perfected if the process was an acidic pH at a cold temperature then perfect crystals occurred within a day. Crystals of compound (2) grew easily using technique no. (ii) which are various polar solvents over a wide range of pH and temperature preparation processes. The infrared spectroscopy and nuclear magnetic resonance spectra fit well with these two X-ray crystal structures. The crystal structures of sildenafil free base and salt forms were different from their different growing conditions leading to stability difference.


      PubDate: 2015-01-25T17:39:41Z
       
  • Safety of Pregabalin among Hemodialysis Patients Suffering from Uremic
           Pruritus

    • Abstract: Publication date: Available online 24 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Tahir Mehmood Khan , Abdul Aziz Alhafez , Syed Azhar Syed Sulaiman , David Wu Bin Chia
      Objectives The current study aim of this study was to assess the safety and probability of adverse events associated with the use of 75mg pregabalin post hemodialysis (pHD) among patients with UP. Methods A cross-sectional study done among the hemodialysis patients suffering from uremic pruritus (UP) Aljaber Kidney Center (AJKC), Al-Ahsa, Eastern Province, Saudi Arabia. Assessment for the safety profile of pregabalin was done using Naranjo’s algorithm. A predictive model was developed using binary multiple logistic regression to explore association of patients’ demographics and risk factors with the occurrence of AEs. Throughout statistical significance level was considered significant at 0.05. Key findings Assessment of safety of pregabalin revealed that somnolence and dizziness were the two frequents adverse events followed by constipation, weight gain and edema. However, it was noticed that female patients aged less than 50 years were found to be at a higher risk in comparison to men. Moreover, those patients having one comorbid complication (i.e. hypertension or diabetes mellitus alone) were at a higher risk of somnolence, weight gain and dry mouth. Conclusion Naranjo’s quantification for the possibility and probability of adverse events reflect that all the events were probable. Age, gender and comorbid medical conditions are some of the factors that might have clinical association with the occurrence of the AEs.


      PubDate: 2015-01-25T17:39:41Z
       
  • Mycosynthesis of silver nanoparticles bearing antibacterial activity

    • Abstract: Publication date: Available online 21 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Azmath Pasha , Syed Baker , D. Rakshith , S. Satish
      Mycosynthesis of silver nanoparticles was achieved by endophytic Colletotrichum sp. ALF2-6 inhabiting Andrographis paniculata. Well dispersed nanoparticles were characterized using UV-Visible spectrometry with maximum absorption conferring at 420 nm. FTIR analysis revealed possible biomolecules reducing the metal salt and stabilization of nanoparticles. XRD analysis depicted the diffraction intensities exhibiting between 20 to 80°C at 2theta angle thus conferring the crystalline nature of nanoparticles. Morphological characteristic using TEM revealed the polydispersity of nanoparticles with size ranging from 20 to 50 nm. Synthesized nanoparticles exhibited bactericidal activity against human pathogens. Nanoparticles mode of action was carried out to reveal DNA damage activity. Thus the present investigation reports facile fabrication of silver nanoparticles from endophytic fungi.


      PubDate: 2015-01-22T17:15:02Z
       
  • Validation of the knowledge, attitude and perceived practice of asthma
           instrument among community pharmacists using rasch analysis

    • Abstract: Publication date: Available online 21 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Waqas Akram , Maryam S.E. Hussein , Sohail Ahmad , Mohd N. Mamat , Nahlah E. Ismail
      There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software ® ) for dichotomous and polythomus data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.


      PubDate: 2015-01-22T17:15:02Z
       
  • Optimization of HPLC method for determination of cefixime using
           2-thiophencarboxaldehyde as derivatizing reagent: A new approach

    • Abstract: Publication date: Available online 16 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Madan Lal Maheshwari , Ayaz Ali Memon , Shahabuddin Memon , Fakhar-un-Nisa Memon , Ubed Ur Rahman Mughal , Abdullah Dayo , Naheed Memon , Mohammed Ali Ghoto , M. Khan Leghari
      The determination of cefixime 1 has clinical and analytical importance due to its broad spectrum antimicrobial activity and stability. Cefixime is a significant member of orally active third generation cephalosporin and has excellent activity against many pathogens. It is for first time that we have developed a new HPLC-DAD method for analysis of imine derivative 3 of cefixime by using reflux method at 100 oC for 50 minutes without any buffer solution. 2 thiophencarboxaldehyde (2TCA) 2 was used first time as a derivatizing reagent for cefixime drug. Furthermore, separation of three components, i.e. drug (cefixime), reagent (2TCA) and derivative was carried out using kromasil 100 C-18 (15 mm×0.46 mm, 5 μm) column with isocratic elution of methanol: 0.1% aqueous formic acid (70:30 v/v) with flow rate of 1 mlmin-1 at retention time of 1.8, 2.4 and 3.3 min, respectively; while, total run time was 5 min. The developed method was repeatable with a relative standard deviation (RSD) of 0.81-1.88% for imine derivative. The limit of detection and quantification of imine derivative 3 were obtained within the range of 0.132-0.401 μgml-1 and compared with cefixime drug as 0.30-0.90 μgml-1, respectively. However, the formation of imine derivative 3 was confirmed by comparing peak height, retention time and spectral changes. The method is rapid, simple, very stable and accurate for the separation and determination of imine derivative 3 of cefixime 1.


      PubDate: 2015-01-17T16:55:22Z
       
  • Hyperphosphatemia Management in Patients with Chronic Kidney Disease

    • Abstract: Publication date: Available online 12 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ahmed M Shaman , Stefan R Kowalski
      Hyperphosphatemia in chronic kidney disease (CKD) patients is a potentially life altering condition that can lead to cardiovascular calcification, metabolic bone disease (renal osteodystrophy) and the development of secondary hyperparathyroidism (SHPT). It is also associated with increased prevalence of cardiovascular diseases and mortality rates. To effectively manage hyperphosphatemia in CKD patients it is important to not only consider pharmacological and nonpharmacological treatment options but also to understand the underlying physiologic pathways involved in phosphorus homeostasis. This review will therefore provide both a background into phosphorus homeostasis and the management of hyperphosphatemia in CKD patients. In addition, it will cover some of the most important reasons for failure to control hyperphosphatemia with emphasis on the effect of the gastric pH on phosphate binders efficiency.


      PubDate: 2015-01-17T16:55:22Z
       
  • Investigation of the Efficacy of Generic and Brand-Name Tiotropium Bromide
           in the Management of Chronic Obstructive Pulmonary Disease: A Randomized
           Comparative Trial

    • Abstract: Publication date: Available online 12 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Yunes Panahi , Mostafa Ghanei , Mohammad Behzadi , Maryam Salehi , Sara Saffar Soflaei , Amirhossein Sahebkar
      Introduction The beneficial effects of tiotropium bromide, a long acting anticholinergic bronchodilator, in the management of chronic obstructive pulmonary disease have been shown in previous studies. The present study aimed to compare the efficacy and safety of generic (Tiova®) and brand-name (Spiriva®) tiotropium preparations in patients with COPD. Methods and materials In this randomized double-blind parallel-group trial, 79 patients with documented COPD were assigned to Tiova® or Spiriva® for a period of 4 weeks. Assessment of pulmonary function (using spirometry), quality-of-life (using St. George respiratory Questionnaire [SGRQ]) and severity of respiratory symptoms (using breathlessness, cough and sputum scale [BCSS]) was performed at baseline and at the end of treatment period. Results There were significant increases in FEV1 and reductions in FVC by the end of study in both Tiova® and Spiriva® groups. FEV1/FVC ratio did not change significantly neither in the Tiova® nor in Spiriva® group. Overall SGRQ score as well as subscale scores of symptoms, activity and impacts were improved by both drugs. In the BCSS scale, the frequency and severity of three main symptoms (dyspnea, cough and sputum) was decreased by both drugs. Baseline as well as post-treatment values of spirometric parameters, SGRQ and BCSS scores was comparable between the groups, apart from a lower post-treatment frequency of cough and sputum in the Spiriva® versus Tiova® group. There was no report of adverse events in either of the study groups. Conclusion The findings of this comparative trial showed equivalent efficacy and safety of Spiriva® and Tiova® in lessening the symptoms as well as improving the quality of life in patients with COPD. This finding has an important translational value given the significantly lower costs of generic versus brand-name products.


      PubDate: 2015-01-17T16:55:22Z
       
  • Permeation measurement of gestodene for some biodegradable materials using
           Franz diffusion cells

    • Abstract: Publication date: Available online 12 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Danhua Liu , Chong Zhang , Xiaowei Zhang , Zhu Zhen , Ping Wang , Jianxin Li , Dongxu Yi , Ying Jin , Dan Yang
      Biodegradable poly(D,L-lactide) (PDLLA), Poly(trimethylene carbonate) (PTMC), polycaprolactone (PCL), poly(caprolactone-co-D,L-lactide) (PCDLLA) and poly(trimethylene carbonate-co-caprolactone) (PTCL) are recently used for clinical drug delivery system such as subcutaneous contraceptive implant capsule due to their biodegradable properties that they could possess long-term stable performance in vivo without removal, however their permeation rate is unknown. In the work, biodegradable material membranes were prepared by solvent evaporation using chloroform, and commercial silicone rubber membrane served as a control. Gestodene was used as a model drug. Gestodene has high biologic progestational activity which allows for high contraceptive reliability at very low-dose levels. The permeation rate of gestodene for several biodegradable materials was evaluated. In vitro diffusion studies were done using Franz diffusion cells with a diffusion area of 1.33 cm2. Phosphate buffer solution (PBS, pH 7.4), 10% methanol solution and distilled water were taken in donor and receiver chambers at temperature of 37°C respectively. The in vitro experiments were conducted over a period of 24 h during which samples were collected at regular intervals. The withdrawn samples were appropriately diluted and measured on UV-vis spectrophotometer at 247 nm. Conclusion Data from our study showed that permeation rate of PCDLLA with CL ratio more than 70% could be more excellent than commercial silicone rubber membrane. They may be suitable as a candidate carrier for gestodene subcutaneous contraceptive implants in contraceptive fields.


      PubDate: 2015-01-17T16:55:22Z
       
  • Perception and Attitude of physicians towards local generic medicines in
           Saudi Arabia: A questionnaire-based study

    • Abstract: Publication date: Available online 16 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Huda O. Salhia , Anna Ali , Naser L. Rezk , Ashraf El Metwally
      Objectives The current study aimed to explore the knowledge, perception, and attitude of physicians towards generic medicines in Saudi Arabia. Background The local market of generic medicine share in Saudi Arabia is low compared to global and regional statistics. The reason for this low market share and the role of physicians has not previously been investigated. The purpose of this study was to assess health practitioner level of perceived knowledge, opinions and attitudes about local generic medication, and identify factors that influence infrequency of generic prescriptions. Methods A random sample of 231 physicians was recruited from two hospitals in Riyadh (one government one private) and 178 (77%) responded. Information on the physicians’ perceived knowledge, opinions and attitude towards local generic medication was extracted, analyzed and interpreted. Factors that influence infrequent prescription of local generic drugs were identified. Results Among the 178 participants in the physicians’ survey, 76% and 47% reported that they are knowledgeable about the terms “generic” and “bioequivalence respectively, while 44% reported that they are able to explain bioequivalence to their patients. Approximately 52% of physicians reported that local generics should be substituted for brands if suitable for the case, and 21.9% reported that they believe SFDA approved local generics are therapeutically equivalent to their brands. Clinical effectiveness was reported by 71.9% of physicians as the most influential factor effecting prescription of brand over local generic medication. The three independent significant predictors for infrequent prescription of local generics among physicians: Government sector employment (OR=3.74, [95%CI 1.50-9.43]), consultant level (OR=3.94, [95%CI 1.50-10.31]) and low level of knowledge about local generics (OR=4.11, [95%CI 1.56-10.84]). Conclusion The low market share of local generics medicines attributed to low prescription rates is significantly more among senior-level physicians working in governmental hospitals. Low level of knowledge about generic drugs among physicians was the strongest predictive factor for low prescription. Future bigger studies are needed to confirm these results.


      PubDate: 2015-01-17T16:55:22Z
       
  • Tau protein as a target for Alzheimer’s disease management

    • Abstract: Publication date: Available online 16 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Ahmed Abdalla



      PubDate: 2015-01-17T16:55:22Z
       
  • The Practical Approach to the Evaluation of Methods Used to Determine the
           Disintegration Time of Orally Disintegrating Tablets (ODTs)

    • Abstract: Publication date: Available online 16 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Witold Brniak , Renata Jachowicz , Przemysław Pełka
      Even that orodispersible tablets (ODTs) have been successfully used in therapy for more than 20 years, there is still no compendial method of their disintegration time evaluation other than the pharmacopoeial disintegration test conducted in 800-900 mL of distilled water. Therefore, several alternative tests more relevant to in vivo conditions were described by different researchers. The aim of this study was to compare these methods and correlate them with in vivo results. Six series of ODTs were prepared by direct compression. Their mechanical properties and disintegration times were measured with pharmacopoeial and alternative methods and compared with the in vivo results. The highest correlation with oral disintegration time was found in the case of own-construction apparatus with additional weight and the employment of the method proposed by Narazaki et al. The correlation coefficients were 0.9994 (p < 0.001), and 0.9907 (p < 0.001) respectively. The pharmacopoeial method correlated with the in vivo data much worse (r=0.8925, p < 0.05). These results have shown that development of novel biorelevant methods of ODT’s disintegration time determination is eligible and scientifically justified.


      PubDate: 2015-01-17T16:55:22Z
       
  • Dilemmas of the causality assessment tools in the diagnosis of adverse
           drug reactions

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Lateef M Khan , Sameer E Al-Harthi , Abdel-Moneim M Osman , Mai A AbdulSattar , Ahmed S Ali
      Importance Basic essence of Pharmacovigilance is prevention of ADRs and its precise diagnosis is crucially a primary step, which still remains a challenge among clinicians. Objective This study is undertaken with the objective to scrutinize and offer a notion of commonly used as well as recently developed methods of causality assessment tools for the diagnosis of adverse drug reactions and discuss their pros and cons. Evidence review Overall 49 studies were recognized for all assessment methods with five major decisive factors of causality evaluation, all the information regarding reasons allocating causality, the advantages and limitations of the appraisal methods were extracted and scrutinized. Findings From epidemiological information a past prospect is designed and subsequent possibility merged this background information with a clue in the individual case to crop up with an approximation of causation. Expert judgment is typically based on the decisive factor on which algorithms are based, nevertheless in imprecise manner. The probabilistic methods use the similar principle; however connect probabilities to each measure. Such approaches are quite skeptical and liable to generate cloudy causation results. Causation is quite intricate to ascertain than correlation in Pharmacovigilance due to numerous inherent shortcomings in causality assessment tools. Conclusions and Relevance We suggest that there is a need to develop a high quality assessment tool which can meticulously establish suitable diagnostic criteria for ADRs with universal acceptance to improvise the fundamental aspect of drug safety and evades the impending ADRs with the motive to convert Pharmacovigilance into a state of art.


      PubDate: 2015-01-11T22:41:30Z
       
  • Association between Total Daily Doses with Duration of Hospitalisation
           among Readmitted Patients in a Multi-Ethnic Asian Population

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Teo Vivien , Toh Ming Ren , Kwan Yu Heng , Raaj Sreemanee , Tan Su-Yin Doreen , Tan Joyce Zhen Yin
      Increased length of stay (LOS) in the hospital incurs substantial financial costs on the healthcare system. Multiple factors are associated with LOS. However, few studies have been done to associate the impact of total daily doses (TDD) and LOS. Hence, the aim of this study is to examine the association between patients’ LOS upon readmission and their TDD before readmission. A retrospective cross-sectional study of readmission cases occurring from 1st January to 31st March 2013 was conducted at a regional hospital. Demographics and clinical variables were collected using electronic medical databases. Univariable and multiple linear regressions were used. Confounders such as comorbidities and drug related problems (DRP) were controlled for in this study. There were 432 patients and 649 readmissions examined. The average TDD and LOS were 18.04 ± 8.16 and 7.63 days ± 7.08 respectively. In the univariable analysis, variables that were significantly associated with the LOS included age above 75 year-old, race, comorbidity, number of comorbidities, number of medications, TDD and thrombocytopenia as DRPs. In the multiple linear regression, there was a statistically significant associations between TDD (β = 0.0733, p = 0.030) and LOS. Variables that were found significant were age above 75 year-old (β = 1.5477, p = 0.008), Malay (β = -1.5123, p = 0.033), other races (β = -2.6174, p = 0.007), depression (β = 2.1551, p = 0.031) and thrombocytopenia as a type of DRP (β = 7.5548, p = 0.027). When TDD was replaced with number of medications, number of medications (β = 0.1487, p=0.021), age of 75 year-old (β = 1.5303, p = 0.009), Malay (β = -1.4687, p = 0.038), race of others (β = -2.6499, p = 0.007), depression (β = 2.1951, p = 0.028) and thrombocytopenia as a type of DRP (β = 7.5260, p = 0.028) were significant. In conclusion, a significant relationship between TDD and number of medications before readmission and the LOS upon readmission was established. This finding highlights the importance of optimising patients’ TDD in the attempt of reducing their LOS.


      PubDate: 2015-01-11T22:41:30Z
       
  • Clinical treatment of pandrug-resistant bacterial infection consulted by
           clinical pharmacist

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Yang Zhi-Wen , Zhang Yan-Li , Yuan Man , Fang Wei-Jun
      Objective Pandrug-resistant (PDR) bacterial infections are associated with considerable prolongation of hospitalization and mortality in clinical practice. Method This case-series study was conducted during a 3-year period from 2011 to 2013. A total of 30 PDR patients consulted by clinical pharmacist were recorded to evaluate the anti-infection treatment. Results All isolates of PDR bacteria from patients were identified as pan-drug resistant acine-tobacter baumannii (63.3%), pan-drug resistant klebsiella pneumonia (20.0%), and pandrug-resistant pseudomonas aeruginosa (16.7%). Of the 30 patients, 96.7% therapeutic regimens supposed by clinical pharmacists were applied to treat the infectious patients up to 82.8% clinical cure rates. 30 patients completed the prescribedtreatment,of which 19 underwentmonotherapy that the clinical cure rate was 78.9%, and 10 underwent combination therapy that the clinical cure rate was 90.0%. In the following therapy, doxycycline, cefoperazone shubatan and amikacin have the certain effect on anti-infection therapy. Combination therapy combinedwith doxycycline was better treatmentoption for PDR infectious patients. Conclusion In a word, it appears to be effective for the successful therapy of PDR infections upon tetracyclines administration.


      PubDate: 2015-01-11T22:41:30Z
       
  • Designing polymeric microparticulate drug delivery system for hydrophobic
           drug Quercetin

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Moumita Hazra , Dalia Dasgupta Mandal , Tamal Mandal , Saikat Bhuniya , Mallika Ghosh
      The aim of this study was to investigate pharmaceutical potentialities of a polymeric microparticulate drug delivery system for modulating the drug profile of poorly water-soluble quercetin. In this research work two cost effective polymers sodium alginate and chitosan were used for entrapping the model drug quercetin through ionic cross linking method. In vitro drug release, swelling index, drug entrapment efficiency, Fourier Transforms Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD) and Differential Scanning Calorimetric (DSC) studies were also done for physicochemical characterization of the formulations. Swelling index and drug release study were done at a pH of 1.2, 6.8 and 7.4 to evaluate the GI mimetic action which entails that the swelling and release of the all the Formulation1(F1), Formulation2(F2) and Formulation3(F3) at pH 1.2 were minimal confirming the prevention of drug release in the acidic environment of stomach. Comparatively more sustained release was seen from the formulations F2&F3 at pH 6.8 and pH 7.4 after 7hrs of drug release profiling. Drug entrapment efficiency of the formulations shows in F1 (D: C: A= 2:5:30) was approximately 70% where as the increase in chitosan concentration in F2 (D: C: A= 2:10:30) have shown an entrapment efficiency of 81%. But the comparative further increase of chitosan concentration in F3 (D: C: A= 2:15:30) have shown a entrapment of 80% which is not having any remarkable difference from F2. The FTIR analysis of drug, polymers and the formulations indicated the compatibility of the drug with the polymers. The smoothness of microspheres in F2 & F3 was confirmed by scanning electron microscopy (SEM).However F1 microsphere have shown more irregular shape comparatively. The DSC studies indicated the absence of drug-polymer interaction in the microspheres. XRD studies have shown while the pure drug having crystalline structure with less dissolution profile could be changed to a more amorphous form in the formulations which can promise for more drug dissolution. The findings of the study suggest that the microsphere formulations were a promising carrier for quercetin delivery and can be considered as a favorable oral controlled release dosage form for hydrophobic drug quercetin.


      PubDate: 2015-01-11T22:41:30Z
       
  • Attitude of Future Healthcare Provider towards Vitamin D Significance in
           Relation to Sunlight Exposure

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Aysha Zia Qureshi , Zubia Zia , Mehnaz Nuruddin Gitay , Muhammad Umair Khan , Muhammad Saad Khan
      Objective Nature is the kindest of all to provide man with all the necessary components for a healthy life at easily accessible lengths. The deprivation arises with unawareness and lack of correct measures to extract the benefits. Medical education makes the youth aware of the numerous disorders and diseases, as well as their preventions and treatments. This awareness needs to be realized and implemented in the society, and it is not possible without the advisers acting on the same lines. Since doctors are the most trusted and their advice is adopted without much thought, it is extremely inevitable to analyze the attitude of medical students of various levels to understand the cause of their negligence towards their own deficiencies, the focus for this study being vitamin D (VD). Method A cross sectional descriptive study was done on undergraduate medical students of health profession from different universities of Pakistan to access the awareness regarding VD deficiency associated with sunlight. Informed consent was duly signed by each participant after which self-constructed questionnaire was provided to them and data is collected. SPSS 17 was used for Statistical analysis. Results Final students are well aware of VD significance, take food rich in VD but still suffer from fatigue and muscular pain. No treatment was taken for fatigue and muscular pain by majority of these sufferers and those who took treatment were VD supplement. The health sufferers were mostly those who avoided sunlight highlighting the role of VD in maintaining an active lifestyle as well as the significance of sunlight in maintaining VD levels. Conclusion It can be concluded that in spite of awareness, the role of sunlight exposure and the proper time and duration of exposure cannot be ignored to create a healthy and active society.


      PubDate: 2015-01-11T22:41:30Z
       
  • Antiproliferative effects of aspirin and diclofenac against the growth of
           cancer and fibroblast cells: In vitro comparative study

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Marwan S.M. Al-Nimer , Huda G. Hameed , Majid M. Mahmood
      Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the growth of several cancer cell lines. The aim of this study is to compare the cytotoxic effect of aspirin with diclofenac on the growth of HeLa cell, mammary cell carcinoma, rhabdomyosarcoma and fibroblast cell lines in the culture media. The cells are cultured in RPMI-1640 culture media supplemented with 5% fetal calf serum and antibiotics. Aspirin (5mg/well) and diclofenac (0.625mg/well) significantly inhibit the growth of Hela, rhabdomyosarcoma and fibroblast cells. The cytotoxic effect of aspirin against rhabdomyosarcoma is significantly (p < 0.001) higher than that of diclofenac with a potency approximated 2.6. It concludes that aspirin and diclofenac inhibit the growth of fibroblast and cancer cell by inhibiting the up-regulation of cyclooxgenases enzymes in cancer cells. Aspirin is more effective than diclofenac against the growth of rhabdomyosarcoma cell line.


      PubDate: 2015-01-11T22:41:30Z
       
  • Assessing prescribing patterns for the prevention of chemotherapy-induced
           nausea and vomiting in the national center for cancer care and research

    • Abstract: Publication date: Available online 10 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Manal Zaidan , Lana Soufi , M. Hafeez , M. Abdelwahid , Kakil I. Rasul
      Purpose Chemotherapy is the mainstay of cancer treatment; however, chemotherapy treatment may cause nausea and vomiting, which could cause 25 -50% of patients to consider delaying or refusing further cancer treatment. Chemotherapy-induced nausea and vomiting (CINV), can be prevented in 70-80% of patients with evidence. –based anti-emetic regimen. The purpose of this study is to assess prescribing patterns with regard to prevention of CINV, in the national center for cancer care and research (NCCCR), and develop and implement a standardized evidence-based guideline for the management of CINV. Methods 25 anti-emetic prescriptions were audited to assess their conformity with either of the published guidelines; Multinational Association of Supportive Care in Cancer (MASCC), American Society of Clinical Oncology (ASCO), or the National Comprehensive Cancer Network (NCCN), to establish baseline data. A multidisciplinary team of clinical pharmacists and oncologists developed and implemented a guideline for the prevention of CINV. The guideline was promoted using a variety of strategies; education, pocket cards, academic detailing and pharmacist intervention. Physician anti-emetic orders were audited by pharmacists, to assess their conformity with NCCCR anti-emetic guidelines. A data collection form was developed to capture relevant information including; patient demographics, type and emetogenic level of chemotherapy, and the conformity of anti-emetic order with NCCCR guidelines. SPSS statistical software was used to analyze the data. Results The conformity of anti-emetic physician order with NCCCR anti-emetic guidelines increased from 0% baseline in June 2008 to an average of 60.006% (n=331) by December 2010 and consistently increased reaching 94.3827% (n=792) by December 2013, (p value 0.0002). Conclusion The introduction of anti-emetic guidelines succeeded in standardizing CINV management, towards an evidence-based approach.


      PubDate: 2015-01-11T22:41:30Z
       
  • The possible antianginal effect of allopurinol in vasopressin-induced
           ischemic model in rats

    • Abstract: Publication date: Available online 7 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Yahya A. Al-Zahrani , Sameer E. Al-Harthi , Lateef M. Khan , Hani M. El-Bassossy , Sherif M. Edris , Mai A. Abdulsattar
      The anti-anginal effects of Allopurinol were assessed in experimental model rats of angina and their effects were evaluated with Amlodipine. In the vasopressin-induced angina model, oral administration of Allopurinol in dose of 10 mg /kg revealed remarkably analogous effects in comparison to Amlodipine like dose-dependent suppression of vasopressin-triggered time, duration and severity of ST depression. In addition, Allopurinol produced dose dependent suppression of plasma Malandialdehyde (MDA) level, systolic blood pressure, cardiac contractility and cardiac oxygen consumption; while in contrast, Amlodipine minimally suppressed the elevation of plasma MDA level. Endothelial NO synthase (eNOS) expression, serum nitrate were strikingly increased, however lipid profile were significantly reduced. Seemingly, Allopurinol was found to be more potent than Amlodipine – a calcium channel antagonist. To conclude, it was explicitly observed and verified that on the ischemic electrocardiography (ECG) changes in angina pectoris model in rats, allopurinol exerts a significant protective effects, reminiscent of enhancement of vascular oxidative stress, function of endothelial cells, improved coronary blood flow in addition to the potential enhancement in myocardial stress. Moreover, our findings were in conformity with several human studies.


      PubDate: 2015-01-07T21:53:08Z
       
  • Evaluation of Anti-metastatic Potential of Cisplatin Polymeric
           Nanocarriers on B16F10 Melanoma Cells

    • Abstract: Publication date: Available online 6 January 2015
      Source:Saudi Pharmaceutical Journal
      Author(s): Shruti S. Shrikhande , Darshana S. Jain , Rajani B. Athawale , Amrita N. Bajaj , Peeyush Goel , Zahid Kamran , Yuvraj Nikam , Rajiv Gude
      Nanoparticles are being increasingly used in the field of cancer treatment due to their unique properties and advantages. The aim of the present research work was to prepare and characterize a polymeric albumin nanosystem for Cisplatin and evaluate its in-vitro efficacy against B16F10 melanoma. The developed nanoparticles were almost spherical in shape with a particle size in the range of 150-300 nm, low polydispersity values and about 80% drug entrapment efficiency. Albumin nanocarriers sustained the release of Cisplatin for more than 48 hours, suggesting the reduction in dosing schedule for this drug. The results from in-vitro cell line studies indicated the dose dependent cytotoxic potential of drug loaded albumin nanoparticles, their potential to inhibit cell proliferation and induce morphological changes. In addition, these nanoparticles exhibited superiority to Cisplatin in hampering the cell migration. Developed nanoparticles caused cell cycle arrest along with time and concentration dependent cellular uptake in B16F10 cell line. These results signify that the prepared Cisplatin albumin nanoparticles could serve as a promising approach for B16F10 melanoma treatment.


      PubDate: 2015-01-07T21:53:08Z
       
 
 
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