Pharmaceutical Sciences articles list

Community pharmacist plays an essential role in educating the epileptic patients about their disease and medications. Improving the patient’s awareness may lead to improve their compliance and decrease drug-drug interaction and ultimately improve their quality of life. Pharmacist can detect the emergence of health problems and can help prevent progression of comorbidities. Considering the complexity of treating epilepsy and the lack of information about pharmacists’ contributions to epilepsy management, pharmacist performed pharmaceutical counselling, pharmaco-therapeutic follow-up and systematic measurement and evaluation of findings and increase medication adherence of patient with epilepsy. This study was aimed to assess the community pharmacist's knowledge about epilepsy and their treatment by antiepileptic drugs in Libya. The design of the study is a cross sectional study. The knowledge was collected through a questionnaire which included 35 questions divided into three sections: demographic data, general information about epilepsy and information about epilepsy and antiepileptic drugs. The questionnaire was prepared and validated by consultant training in Ali Omer Asker Hospital in Tripoli for two months. The findings indicate that over 200 patients are altered viewed, of whom, only epileptic patients were observed. The majority of the participants were female, qualification degree BSc and years of experience from one to five years. Unfortunately, some of the participants (40.0%) had poor knowledge and about 60.0% of them had good knowledge. This study indicates that the importance of community pharmacist in Libya requires more improvement to achieve the existing function and that the impact of continuous study of everything related to diseases and medicines is important to obtain a qualified pharmacist who can become an effective agent for a change.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Consumption of energy drinks was significantly associated with sleep problems, which are progressively used regardless of negative health effects particularly among adolescents and young adults. The goal of this study is to examine the relationship between energy drinks and sleep patterns on college students by more than one parameter. Target number of students was taken to be 1 000 participants and the study reached 434 participants were invited via self-administered questionnaire at Libyan International Medical University students during 2020 and 2021 in all levels which consisted of 20 questions and the main measurements are dependency, negative effect of energy drink and effect of energy drink on sleep. The results showed that the consumption prevalence rate of energy drinks amongst participants is 59.4%. The majority of participants enrolled in this study are male (52.5%) and 47.5% were female students. In conclusion: energy drinks consumption is a risk factor of poor sleep quality between Libyan International Medical University students. An awareness must be increased about energy drinks consumption to confirm the relation to sleep quality and general health.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Attempts have been made to formulate controlled release drug dosage forms using chitosan as a release controlling polymer. Granules of combination of chitosan, hydroxylpropyl cellulose, lactose, starch and Ibuprofen were prepared by wet granulation method using 1.0% lactic acid solution. The granules were physico-chemically characterized in terms of density, porosity, angle of repose, carr’s index and housner ratio and was found to be free flowing with good compressibility. FTIR spectroscopy was used and confirmed that there is no interaction between the drug and the added polymers. In vitro release of Ibuprofen, in phosphate buffer at pH 7.4, showed a steady and slow increase in the percentage of drug released over 24 hours as the percentage of chitosan was increased in the formulations compared to that from commercial tablets which released over 80.0% of their content in only two hours. The kinetic analysis using different mathematical models of the data revealed that the release kinetics of the drug form these formulations is somewhere between diffusion controlled, Fickian (anomalous) and non-Fickian which refers to a combination of diffusion and erosion controlled release. Thus, the high correlation coefficient of the data of drug release from most granules when zero order kinetics was applied revealed that there is a constant drug release with time for 24 hours.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The application of clinical pharmacokinetic is the responsibility of all pharmacists providing pharmaceutical care. An appropriately applied clinical pharmacokinetic is expected to result in improved patient outcomes: decreased mortality, reduced length of treatment, reduced length of hospital stays and cost-savings. Data on the extend of pharmacokinetic application in Libyan hospitals remain scarce but available subjective evidence suggests that services related to clinical pharmacokinetic are mostly provided and performed by professionals other than clinical pharmacists. To explore the training background and perceptions of pharmacists on the pharmacokinetic course contents they received during their undergraduate pharmacy programs. Also, to determine the attitudes and barriers experienced by the pharmacists when applying pharmacokinetic principles in their current practice. This is a cross-sectional, descriptive study that was conducted between July 2018 and November 2019 using a self-administered survey. The study targeted hospital pharmacists practicing in different hospitals in Libya. A total of 104 pharmacists completed the questionnaire and submitted it back. The majority of participants learned pharmacokinetic courses as a mandatory course during undergraduate courses 81.0% with 37.0% selecting that course was taught as a separate course or courses. Around 80.0% of the participants agreed or strongly agreed that pharmacokinetic courses received in undergraduate studies are useful in pharmacy practice with over 75.0% of the participants agreeing or strongly agreeing on relevance of those course to their current clinical practice. About 40.0% of the participants described their current skills in allowing optimal patient care as can be better. Different barriers were highlighted by the participants to allow sufficient clinical pharmacokinetic practice including lack of sufficient information, lack of awareness of pharmacists’ role and skills in applying clinical pharmacokinetic by other pharmacists and by other health care providers. Thus, this study shows that most practicing pharmacists showed a positive attitude of current pharmacokinetic practice and to the impact of their undergraduate studies on their successful practice. However, they have clearly addressed the room for improvement.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The prevalence rate of vitamin D deficiency over the last decades has grown up rapidly worldwide among young adults. Therefore, the aim of this study is to explore knowledge, attitude and practice of Libyan medical students of Sebha University regarding vitamin D deficiency. Out of a total of 200 questionnaires, 148 completed questionnaires were returned (74.0% response rate). The majority of respondents did not measure their vitamin D levels (62.1%). Participants who indicated they exposing to sunlight for less than 15 min were 47.2% while 74.9% exposing to less than 30 min with highly significant difference in gender (p < 0.001). All the males did not use sunscreen creams compared with females (43.5%). Nearly two-thirds of the participants (61.4%) denied drink milk almost daily with significant differences based on the gender (p < 0.005) while 56.0 % of the participants reported eat fish, 60.8% of the students denied eating fast food and 74.3% eating eggs daily or weekly. However, 49.3% of the students are usually drinking of tea and coffee after meals, and do not usually practice exercise (53.3%), however, disagreed that their food has a low amount of calcium (30.4%). Most of the students agreed with the benefits of vitamin D (72.0%). Based on the assessment of awareness of the participants about vitamin D information, the average of correct answers percentage of the respondents was 47.1%. The most frequent sources of vitamin D information were the internet which accounted for 49.3%, followed by relatives and friends (31.7%). Some of the respondents (58.7%) reported that unawareness is the main cause of vitamin D deficiency. This study highlights the lack of awareness about the importance of vitamin D among medical students. This finding provides the institutions of medical education in Libya with an evidence base for a deficit knowledge regarding young health which could be utilized it to draw a strategy to correct health behaviors of students and community through medical education programs.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Various quality control tests are employed for solid dosage forms such as uniformity, dissolution and drug contents in order to assess their pharmaceutical equivalence. The objective of the current study was to assess and contrast five distinct metformin hydrochloride brands that are offered for sale in the Libyan market. The physicochemical equivalence of the five brands of metformin hydrochloride tablets (500 mg) were determined through the evaluation of official and non-official standards according to the USP including uniformity of weight, friability, hardness, dissolution rate and drug content. All the examined brands available in the Libyan market passed the official weight variation, friability, dissolution and disintegration tests and were equivalent. The friability test was found within the specified limit. All the formulations were disintegrated within 09 - 15 min. The tested brands were non-equivalent to the innovator Glucophage® according to their dissolution evaluation. The percentage content of the active ingredient of five brands of metformin tablets showed values within the monograph specifications (95% - 105%). In conclusion, all the five brands available in the Libyan market which were evaluated in this study cannot be substituted with the innovator product in clinical practice.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The propagation of using drugs on the road was the main reason for focusing on the development of the rapid methods which are used to detect the presence of drugs which may have been taken. Oral fluid has become a popular specimen to test for the presence of drugs. In vitro tongues were prepared with different concentrations of hydroxypropyl methyl cellulose (HPMC E4M); one of these concentrations was chosen to be used for tests. Chemical reagents were prepared which included: cobalt thiocyanate, fast blue B test, Marquis, Mandelin and Zimmerman reagents which were used to examine eight drugs in three different concentrations, each of 10.0 mg/mL, 05.0 mg/mL and 01.0 mg/mL where each reagent was used for a particular drug. The drugs were amphetamine, cannabis, cocaine, 3,4-methylenedioxymethamphetamine (MDMA), codeine, diazepam, heroin, methadone and morphine. Each drug was tested by a specific reagent. The difference in the concentrations gave various results in terms of achieving positive results and the ratio of the clarity of the colour. The amount of the drug on the tongue was between 20 μg and 400 μg. Positive and negative results were obtained in this study. Most of the high concentrations gave positive results; however, the low concentrations gave different results which were between positive, negative and light or very light in colour. In conclusion, there is an explanation of the difference in sensitivity of the effects of the different kinds of reagents in the drug, such as cobalt thiocyanate which was more sensitive at the low concentration of heroin and gave a clear result.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hemodialysis patients suffer from poor health-related quality of life which results in a higher risk of hospitalization and mortality. This study investigates the importance of pharmaceutical care and role of pharmacist for hemodialysis patients to optimize drug therapy, minimize drug related problems and thereby improving their health-related quality of life. The study was conducted to evaluate the impact of pharmaceutical care interventions on health-related quality of life of hemodialysis patients in Benghazi, Libya. Randomized control study was carried out after getting an ethical approval from the committee of the hospital. Health-related quality of life was assessed using SF-36 instrument for all the patients (n = 80). Among them, 40 patients were received the normal care along with brief medication review and counselled by pharmacists for two months. Then, health-related quality of life was assessed again for those 40 patients who received the pharmaceutical care. Data was analyzed using an appropriate methods. The results showed that the quality of life for hemodialysis patients was poor in both physical and emotional aspects. After implementation of appropriate pharmaceutical care to the patients, their quality of life improved significantly. Health-related quality of life is an important determinant of treatment effectiveness in dialysis patients

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hepatitis B virus infection is a major health problem worldwide. More than 400 million people are suffering from this infectious disease. Alhagi Maurorum (camel thorn, CTE) is used in Libyan folk medicine for hepatitis. The aim of this study is to investigate the effect of the camel thorn on the hepatitis B virus. After a pharmacological and toxicological screening of camel thorns on experimental animals in our laboratories, in an open-label study, 15 patients of either gender were chosen at random with their consent (consent form signed). The patients had no liver cirrhosis and were not alcoholics. Following clinical testing, the patients were given a low, safe dose of camel thorn powder (2.6 g soaked in boiling water for 10 minutes) three times per day for six months. The viral load was measured before treatment and three and six months after the beginning of the experiment by polymerase chain reaction. The complete blood picture, the level of transaminases, bilirubin, creatinine, blood glucose, lipid profile, thyroid function, and prothrombin were assessed before and after three months after the beginning of the experiment. Our data showed no significant changes in the complete blood picture, creatinine, blood urea, glucose level, bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lipid profile, prothrombin, and thyroid function. The levels of viral load before, three months after, and six months after the beginning of our study were 1689 ± 289, 558 ± 160, and 271 ± 026 IU per mL, respectively. From this study, we may conclude that the camel thorn is safe and showed activity against viral hepatitis B, however, further investigations are needed by increasing the number of patients and using higher doses of plant extract to explore its mechanism of action. Finally, the mechanism of camel thorn may be related either to its antiviral effect or to the stimulation of either endogenous interferon or the immune system.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The diversity of reactogenicity and its variation in terms of risk and prevalence among populations had raised the need to study and evaluate the reactogenicity of different COVID-19 vaccines in our region. Thus, this study aimed to estimate the prevalence of reactogenicity of COVID-19 vaccines and compare the three vaccines (AstraZeneca-Oxford, Sinovac and sputnik V). An analytical cross-sectional study was conducted using a semi-structured telephonic interview with a sample size of 430 individuals who received one of the included COVID-19 vaccines (AstraZeneca, Sinovac or sputnik V) and were recorded at one of the vaccination centers' records that were affiliated with Aljamail Department of the National Centre for Disease Control, Libya. 410 Libyan participants met the inclusion criteria and were enrolled in the final analysis. The study has shown that 57.3% (CI 52.7-62) of the participants had at least one reactogenic event. Pyrexia (40.7%), headache (27.3%) and fatigue (19.5%) were the most common reactogenic events. In conclusion: the study found that reactogenic events were mild to moderate and the COVID-19 vaccines were safe and encouraged our community to be vaccinated. However, prospective studies with larger sample sizes, longer follow-up and inclusion of important laboratory parameters such as IgG and IgM immunoglobulins are recommended to better understand the relationship between the reactogenicities of COVID-19 vaccines with immunity system development and the factors associated with it.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Obesity is a complex and challenging global public health concern. It is a major disease involving excessive fat accumulation that may impair health. Obesity is dangerous and has been related to a range of long-term health issues that can impact adults and children. According to the World Health Organization, more than one billion people worldwide are obese as of March 2022. In the Libyan situation, the prevalence of obesity has increased among the public over the last decade. This cross-sectional survey-based study is conducted by using self-structured designed questionnaire to evaluate the use of anti-obesity drugs and herbal products among Libyan people. Additionally, considered as an indirect method, pharmacist performance in obesity management was also evaluated. The investigators collected interview data from three different cities in the Northwest of Libya over a period of five months, 2019. A total of 170 participants who use weight loss products were randomly selected to participate in the study after obtaining their verbal consent. The participants' experience with weight reduction agents revealed that more than half of the participants (52.3%) used herbal products while 32.0% of the participants have used drugs of chemical origin and 15.6% have used both (herbal and drugs). The majority of the participants (91.4%) used these products without medical consultation which in turn led to failure to lose and maintain weight with 74.2% gaining weight after stopping using these products. In conclusion, poor pharmacist intervention in obesity management was revealed where the majority of the participants reported that Libyan community pharmacists had not been offering weight management services, monitoring weight loss progress, or explaining the risks of being overweight or obese.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Drug-drug interaction is an important issue for the development of safe pharmaceutical drugs. Propranolol is a non-selective, competitive antagonist at beta-adrenergic receptors. Propranolol is used to control hypertension, pheochromocytoma, myocardial infarction, cardiac arrhythmias, angina pectoris and hypertrophic cardiomyopathy. Also, it is used to control symptoms of sympathetic overactivity in management of hyperthyroidism, anxiety disorders and tremor. Phenytoin is a voltage-gated sodium channel blocker, it is a major anti-convulsant drug that is very effective in controlling a wide variety of seizure disorders. In this study, elevated plus maze test was applied using five groups of male Albino mice, where each group consists of six mice. The first group is control and given 01.0% tween 80 with a dose of 5.0 ml/kg, the second group received propranolol 10 mg/kg, the third group received phenytoin 20 mg/kg, the fourth group received a combination of propranolol and phenytoin and the fifth group received diazepam (1.0 mg/kg) as a standard. It was found that propranolol alone produces anti-anxiety effect which is abolished when administered with phenytoin. Thus, the combined treatment of propranolol and phenytoin showed no significant difference compared to phenytoin alone or propranolol alone. It can be concluded that propranolol has anti-anxiety like effect an phenytoin antagonizes the propranolol anxiolytic effect when administered together. Propranolol, phenytoin and the combination of both decrease the spontaneous motor activity of mice. Propranolol and phenytoin partially antagonize each other on the spontaneous motor activity.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Evidence demonstrates that inappropriate drug disposal creates a significant risk to global environmental safety. Study participants' knowledge, attitude and practice regarding the disposal of unwanted and expired medications were assessed. The study was carried out at Sebha city, in southwestern Libya, from October 2021 to April 2022. A self-administered questionnaire designed explicitly to be completed by a respondent without an interviewer's assistance was used. Out of 650, only 500 completed questionnaires was returned. The majority of the respondents admitted they have at least one medication stored at home (71.6%). Keeping expired drugs were reported by 28.2% of the respondents compared with unused medications in their house (51.2%). Almost half of the respondents (47.4%) declared that their medication were taking from the private pharmacies. “I’ll need it in the future” (48.8%), "Medicines change" (37.2%) and "Symptoms improve and recover" (32.6%) were the top three explanations given by participants. The majority of drugs reported were antibiotics (41.0%). This is followed by antipyretic and analgesic drugs, which were used by 29.8% and 27.8% of respondents, respectively. 52.2% of the respondents agreed that disposing of medicines in the garbage is the most appropriate method. Concordantly, the majority of them indicated they discarded unused or expired medicines whether they were solid (82.6%), liquid (58.4%), or semisolid (79.6%). The majority of participants indicated they were aware of the negative impact of drug waste on the environment (80.6%). More than three quarters of the participants said they had never been given instructions on how to properly dispose of medications and 60.8% thought a medical team would be the best source of knowledge. Despite acknowledging being aware of the harmful effects on the environment, the majority of participants admitted to keeping unneeded pharmaceuticals in their homes and throwing them out in the trash. The government should support the pharmacists' role in educating the public about how to properly dispose of their medications and establish the Return Unwanted Medicines Project in order to raise awareness and create cost-effective medication waste management programs.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

A simple, precise, accurate, sensitive, specific and reliable stability indicating RP-HPLC method was developed for the simultaneous estimation of Miconazole (MIC) and Ornidazole (ORN) in pharmaceutical dosage form. The method was developed with mobile phase containing buffer (0.05M potassium dihydrogen ortho phosphate, ph3.5): Methanol in the ratio of 25:75, C18 (250 x 4.6mm, 5µm) as a stationary phase and flow rate was 1 ml/min. Detection was carried out at 236nm in UV-2000 detector. The selected chromatographic conditions were found effectively to separate Miconazole and Ornidazole at 6.58 and 3.26 min respectively. The proposed method has been validated for precision, accuracy, robustness. Thus, the statistical analysis confirms that developed methods were successfully used for analysis of formulation and thereby can be used for routine analysis of drugs in Quality Control laboratories.

Prachi Barbhaiya

Stability studies ensuring the maintenance of product quality, safety and efficacy throughout the shelf life are considered as pre-requisite for the acceptance and approval of any pharmaceutical product. These studies are required to be conducted in a planned way following the guideline issused by ICH, WHO and or other agencies. Importance of various methods followed for stability testing of pharmaceutical products, guideline issued for stability testing and other aspects related to stability of pharmaceutical products have been presented in a present review.

Prachi Barbhaiya

Cisplatin, cisplatinum, or cis-diamminedichloroplatinum (II), is a well-known chemotherapeutic drug. It is one of the most widely used chemotherapeutic agents for various solid tumors in the clinic due to its high efficacy and broad spectrum. The antineoplastic activity of cisplatin is mainly due to its ability to cross-link with DNA, thus blocking transcription and replication, Subsequently inducing apoptosis in cancer cells. However, because of drug resistance and numerous undesirable side effects such as severe kidney problems, allergic reactions, decreased immunity to infections, gastrointestinal disorders, hemorrhage, and hearing loss especially in younger patients. Other common side effects include ototoxicity, neurotoxicity, gastrointestinal toxicity, hematological toxicity, cardiotoxicity, and hepatotoxicity. These side effects together reduce the life quality of patients and require lowering the dosage of the drug, even stopping administration, thus weakening the treatment effect Therefore, substantial effort has been made to explore the complicated biochemical processes involved in the toxicology of cisplatin, aiming to identify effective ways to reduce or eradicate its toxicity. This review summarizes and reviews the updated advances in the toxicological research of cisplatin.

Nehal

Impurity is something that is impure or makes something else impure. An impure substance may be defined as follows: a substance of interest mixed or impregnated with an extraneous or usually inferior substance, from the standpoint of its usage, the drug substance is compromised in terms of purity even if it contains another material with superior pharmacological or toxicological properties. The impurity may be developed either during formulation, or upon aging of both API’s and formulated API’s in medicines. The presence of these unwanted chemicals, even in small amount, may influence the efficacy and safety of the pharmaceutical products. The impurities are not necessarily always inferior. Highly sophisticated instrumentation, such as mass spectra meters attached to a Gas Chromatography or HPLC, are inevitable tools in the identification of minor components (drugs, impurities, degradation products, metabolites) in various matrices. Present article reveals different impurities found in the API’s, methods for identifying them and the possible measures to deal with the interferences caused by them in pharmaceutical analysis.

Prasanna Pradhan

ABSTRACT Objective: The objective of the present study was to develop an HPLC analytical method and to perform in vivo study of Emblica officinalis and Aegle marmelos extracts for antioxidant and antidiabetic activity. Methods: The phytochemical analyses, total phenolic content (TPC), TLC, DPPH assay were performed for freeze-dried Emblica officinalis fruits aqueous extract (EOFAE) and Aegle marmelos leaves ethyl acetate extract (AMLEAE). The active constituents present in both extracts were estimated by using HPLC system having Hibar® Results: Tannins, saponins, carbohydrate, glycosides are found in EOFAE; coumarins and flavonoids are found in AMLEAE and quinones, phenols are present in both extracts. The values of TPC present in standard gallic acid, EOFAE and AMLEAE were found to be 485.7, 315.6, 300.7 mgGAE/g, respectively. R C18 column [250 x4.6 mm, 5 µm] and UV detector (264 nm). A gradient mobile phase (acetonitrile and water with 0.1% trifluoroacetic acid) was used at a flow rate of 0.8 ml/min. In vivo antioxidant, antidiabetic activity of both extracts was conducted on male albino Wistar rats for 21 d in streptozotocin-induced diabetic rats (42 rats; n=6). The antidiabetic activity was measured by blood glucose level and biochemical parameters i.e. total cholesterol, triglycerides and total protein. Oxidative stress was measured by antioxidant biomarkers i.e. SOD, GSH, lipid peroxidation by thiobarbituric acid reactive substances method on the liver of the experimental rat. f Conclusion: The present study showed that the EOFAE and AMLEAE treated group III with (EOAM) low dose of 500 mg/kg body weight has potent antioxidant and antidiabetic activity. values obtained by TLC of EOFAE and AMLEAE were found to be 0.41 and 0.50, respectively. The values of % inhibition shown by EOFAE and AMLEAE in DPPH assay were found to be 97.8%±2 and 95.2%±2, respectively. The values of retention time of EOFAE and AMLEAE by HPLC analysis were found to be 4.59 and 5.28 min, respectively. Histopathological examination of the liver was revealed that low dose EOAM (containing of EOFAE 250+AMLEAE 250 mg/kg body weight) administered once a daily for 21 d showed significant activity (P˂0.001) with biochemical parameters and antioxidant biomarkers. Keywords: Emblica officinalis, Aegle marmelos, Antioxidant, Antidiabetic activity, streptozotocin, HPLC

Snehal

In this work a set of some cyclic peroxy ketals were tested for their antimalarial activities. Quantitative structure activity relationship (QSAR) analysis was applied to 20 organic compounds of the above mentioned derivatives using Physicochemical, informational and 2D-autocorelation parameters and modeled their antimalarial activity (logIC 50) values. The multiple regression analysis clearly indicates that 5 BIC, 1 IC, MATS4v and ST parameters yielded the best model having R 2 value of 0.9515. The predictive powers of the models were explained using LOO (Leave-One-Out) Cross validation procedure. The results are also discussed on the basis of ridge regression.

Dr. Shweta Sharma

Worldwide, the threat created by antibiotic resistance to public health calls for immediate action. Antibiotic resistance is one of the main causes of the emergence and spread of dispensing of antibiotics without a prescription. This study aims to investigate the dispensing of antibiotics without a prescription and the reason behind that in the community pharmacy in Libya. The study was randomized analytical conducted between March and April 2023 among pharmacists and assistant pharmacists employed by community pharmacies in various Libyan areas Tripoli, Zawia, and Sabratha. The data were analyzed by Fisher's exact and Chi-square tests to predict the determinations of dispensing antibiotics without prescriptions. In this study, a total of 293 participants were included, 63 had been excluded because they did not meet the inclusion of the study. The remaining 230 were enrolled for final analysis, most of them were female subjects (70.7%). Findings showed that 78.7% of the participants consulted with patients about the reason for requesting a specific type of antibiotic, while 68.7% dispensed antibiotics with probiotics. Study participants with 2 - 4 years' work experience were 76.6% higher toward dispensing of antibiotics without a prescription (P=0.683). The major reason for dispensing antibiotics without prescriptions were pharmacists knowledgeable enough to give a patient antibiotics without a prescription (68.3%). In Libya, misuse of antibiotics by the public is widespread. People can purchase antibiotics without prescription. Thus, dispensing of antibiotics without a prescription in community pharmacies is an alarming issue in Libya which can increase antibiotics resistance. Pharmacists' knowledgeable is high in dispensing patients antibiotics without a prescription, but patient pressure and financial issues are the major reasons behind dispensing antibiotics without a prescription. It can be recommended that the importance of antimicrobial stewardship and the need for ongoing education support for community pharmacy professionals is of importance.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences