Clinical Pharmacology articles list

Using off-label drugs in obstetric-gynecology patients requires caution because of the high risk of pregnancy. Although there is still debate, data profiling its use in clinical practice is lacking. This study aims to observe the use of off-label drugs in obstetrics and gynecology patients in private hospitals, especially the pill Misoprostol. This study used a descriptive observational approach to hospital medical record data. Retrieval of research data retrospectively at Bunda General Hospital (X Hospital) for July 2017 – December 2017 and Sinar Kasih Hospital (Y Hospital) for January 2018 – December 2018. The number of samples was determined using the Slovin formula, with a systematic random sampling technique at X Hospital and total sampling at Y Hospital. The samples were 220 RM at X 130 Hospital and Y 90 Hospital. The research was conducted in the period January 2019 - March 2019. The results were analyzed univariately using several related references. The results showed 26.92% of misoprostol off-label use in X Hospital and 4% in Y Hospital. The off-label drug found was Misoprostol which belongs to the category of off-label indications (Missed Abortion, Incomplete Abortion, Blighted Ovum, and Induction of labor in cases of Serotinus, KPD, and IUFD), off-label doses (50 µg, 100 µg, and 400 µg), and off-label routes of administration (sublingual and vaginal). ​

Much Ilham Novalisa Aji Wibowo

Pharmacists are expected to play major roles as members of diverse perioperative care teams besides implementing medication safety standards, pharmacist’s roles include optimizing drug therapy and other clinical interventions. Yet, developing general perioperative management as another crucial role operation room, pharmacists play and incorporating it into pharmaceutical education would be important. Enriching perioperative care provided by pharmacists can contribute toward improving the clinical competence of these professionals. Presently, there are no pharmacists in Zawia who participate in perioperative care. The objective of this study was to assess the pharmacist's knowledge of general anesthesia and drugs used to anesthetize patients who suffer from hypertension. A cross-sectional study was conducted in Zawia City, Tripoli in 2023. A self-designed questionnaire was distributed to 100 pharmacists. The study found that more than half of the pharmacists have humble knowledge about the drugs used in anesthesia, the findings indicated weakness in their information about drugs used to manage hypertension in surgery, and 36.0% know that sodium nitroprusside is used to control blood pressure during the operation. In conclusion, this study reported that some of the study's pharmacist participants had weak points that contributed to a high percentage of incorrect knowledge. These weak points may be attributable to poor educational preparation or a lack of training before the pharmacists began working in hospitals.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Chronic kidney disease is a public health problem affecting people worldwide. This study was aimed to examine the characteristics of patients with chronic kidney disease and to identify prevalence of drug-related problems among Libyan patients. This is a descriptive retrospective study carried out in Southern-west part of Libya, Sebha City. Information abstraction forms were used for collection of data. The investigators reviewed the medications, medical records and laboratory data to identify drug-related problems.1 000 patients' files during 2019-2020 were examined and only 120 files were selected for this study. The majority of the participants were male (73, 61.0%) and the mean age was 56.1 years. 576 comorbidities among the selected patients were identified (73.61%) and the average number per patients was 4.8 concurrent diseases. There were 1 350 medications prescribed and the average of prescribed drugs per patient was 11.25. The majority of patients use more than 10 drugs (64, 53.3%) and the average length of staying in the hospital was 5.58 days. 502 drug-related problems were identified with an average of 4.18 per patient. Untreated conditions such as Hyponatremia and anemia were the highest rate of drug-related problems identified (199, 39.6%) followed by improper drug selection (82, 16.3%) such as cefotaxime, vancomycin and aminoglycoside for chronic kidney disease and drug use without indications such as antibiotics (68, 13.5%) and over-therapeutic dose such as metoclopramide(63, 12.5%). In conclusion, all the patients have polypharmacy and the majority have comorbid conditions and chronic kidney disease with frequent drug-related problems, thus, to lower the incidence rate of drug-related problems, therapeutic interventions are needed. Subsequently, it is a crucial to involve clinical pharmacist in hospital to improve the care of patient with chronic kidney disease.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Acenocoumarol is the only oral antivitamin K anticoagulant prescribed and marketed in Algeria for the prevention and treatment of thromboembolic diseases. Nevertheless, the difficulty of handling this drug linked to a narrow therapeutic index and to great inter- and intra- individual variabilities of the response to the treatment poses a major public health issue because of its iatrogenic risk. To improve the management of patients on acenocoumarol and optimize its dosage adjustment and reduce iatrogenic secondary to vitamin K antagonists, our main objective work is to assess the knowledge, attitude and practice of health care professionals regarding this anticoagulant agent. We conducted a multicenter descriptive cross-sectional study from April to May 2021. We interrogated 152 health professionals of all ages, all sexes and all grades from different health departments in Oran City (Algeria) prescribing anticoagulants, through a validated questionnaire made up of 26 questions. Statistical analysis was achieved by SPSS version 20 software. Thus, 59.9% were women with a sex ratio of 0.67, 92.8% knew that acenocoumarol belongs to the antivitamin K class, 45.0% chose INR and PT as follow-up parameters, 36.0% chose INR alone and 78.9% were unaware of acenocoumarol dose adjustment algorithms as well as 82.0% were unaware of the existence of pharmacogenetics testing. 54.0% use the recommendations of the HAS for dosage adjustment of patients on acenocoumarol. 07.9% suggested using pharmacogenetic tests to improve the dosage adjustment of acenocoumarol, 06.6% suggested patient follow-up and 05.9% suggested therapeutic patient education as well as 74.3%, wanted to do training on. Therefore, this study highlighted gaps in the medical practice of physicians in terms of dosage adjustment, pharmacogenetics and its impact on dosage optimization. However, the evaluation of their knowledge was considered unsatisfactory. To overcome this lack of knowledge, it seems necessary to make physicians aware of the contribution of pharmacogenetics of acenocoumarol in Algeria.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Febrile convulsions have been defined as any convulsion associated with a fever of more than 38 oC without central nervous system infection in a child aged six months to five years. Febrile convulsion can be divided into two groups of simple and complex seizures. This study aimed to determine the prevalence of febrile convulsions in Libyan children and to investigate the associated risk factors related to this type of seizure in children. 120 cases of febrile convulsions with one day - 12 years old were collected during from April to August 2022. A study has conducted in the Pediatrics Hospital in Bayda City, Libya about the prevalence of febrile convulsions in children, the data collection tool was a self-designed pre-tested validated questionnaire including general information such as age, gender, family history, and admission to the hospital. In addition, data such as body temperature, recurrent convulsion attacks, the condition of hospital admission, discharge status, the treatment in-hospital and out-hospital. The collected data were analyzed by using descriptive methods. Among the 120 children, the majority of the cases were aged between two years and five years old. The gender prevalence rate in this study was 55.0% in males and 97 of the children were hospitalized due to simple febrile seizure (80.8%), 92 of the cases with no family history of febrile convulsions (75.0%) and respiratory tract infections is the main cause of febrile convulsions. In conclusion, this study indicated that respiratory tract infections is the most common cause of febrile convulsions among Libyan children, however, a large sample study is needed to support this issue in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Diabetes mellitus (DM) is a complex and chronic illness requiring continuous medical care. Type 2 diabetes (T2D) is commonly associated with obesity, hypertension, and a tendency to develop thrombosis, and an increase risk of cardiovascular diseases (CVD). Diabesity is a term used to indicate the coexistence of obesity and DM. Diabesity increases as obesity is an emerging epidemic in modern societies, the co-incidence with DM is also rising, so a joint plan of anti-obesity and anti-hyperglycemia for the management approaches. Therefore, this study aimed to identify the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on body weight and glycemic response in obese Libyan patients with T2D at the National Diabetes Centre in Tripoli, between July 2013 and May 2022. This prospective study included obese adults with T2D who were newly prescribed GLP-1RA therapy for six months with dulaglutide once weekly or liraglutide once daily. The study included 170 diabetic patients who were started on GLP1-RA as add on therapy to their treatment, with a regular follow-up with dietitian and their physicians to adjust their glucose-lowering medications, then comparing the effect of these agents on body weight and the level of glycated hemoglobin before and after 24 weeks of treatment. Most of the patients (n = 99, 58.23%) were in the age period from 54 to 74 years old and 101 of whom were female subjects (59.4%), with a mean duration of DM equal to 8.8 ± 7.3 years. The patients were divided randomly into two groups, the first group included 110 patients who received liraglutide pens showed a significant reduction in HbA1c from 9.6% (± 1.54) to 7.4% (± 1.03) by p < 0.001 and a significant weight loss from 88.3 kg (± 10.68) to 80.8 kg (± 11.83) by p < 0.001. The reported adverse events were in 23 cases of minor hypoglycemia due to gastrointestinal upset. The other group included 60 patients for dulaglutide pens and showed significant decrease in HbA1c = 9.6% (± 1.54) to 7.1% (± 1.2) by p < 0.05 and a significant reduction of bodyweight from 88.3 kg (± 10.68) to 83.8 kg (± 16.3) by p < 0.05. The reported adverse events were mild transient gastrointestinal distress for the initial week of a start and then subside with regular intake. Whereas, 115 patients (67.6%) with HbA1c above 10.0% before starting therapy, no patient with HbA1c above 10.0% after six months of both GLP-RA agents therapy. Thus, the uses of GLP-RA as add-on therapy for obese patients with T2D significantly improved glycaemic control with less hypoglycaemia, accordingly, reduce insulin requirement for blood glucose control and loss in body weight. It can thus be concluded that GLP-1RA therapy is an effective treatment option when used in obese patients with DM.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences