Pharmacology articles list

A descriptive study on prescribing pattern of drugs and colon diseases at benghazi medical center in libya

Colon is part of the digestive system in the human body responsible for absorbing water and nutrients from food residues. There are many problems affecting the colon including irritable bowel syndrome, constipation, hemorrhoids, anal fissures, abscess, colitis and colon cancer which considered one of the most common diseases among the Libyan community. The aim of this study was to search the presence of colonic disease and the tendency of those diseases to transform into colonic cancer at Benghazi medical center in Benghazi-Libya. A survey was comprised of 15 questions concerning colon diseases, proper diagnosis and treatment type. The survey was distributed to the physician specialized in medicine at Benghazi medical center and they fill it voluntary. The initial part of the questionnaire designed to obtain demographic data concerning the physicians who diagnose the colon illness. The rest part of the questionnaire was concerning special questions to define frequency of the diagnosed disease. There were 20 participants at this study. The response to all questionnaires were collected and analyzed for drug use, patients and disease distribution. In conclusion, this study demonstrates that the correct diagnosis, prescribing the appropriate treatment for the colon disease and using the medicine properly is one of the most important things that help in treating the disease and reducing its exacerbation. In some cases, eradication procedures may be required if the medicine is not sufficient to treat the disease without the need for operations

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Behavioural effects of vitamin c with haloperidol in mice

Vitamin C causes a significant change in pharmacological effects of some drugs which may lead to unpredictable responses. Vitamin C-haloperidol interaction has not been confirmed in vivo. This study was aimed to investigate the influence of vitamin C on some pharmacological effects of haloperidol (extrapyramidal side effects caused by the antipsychotic haloperidol). Albino male mice (n = 24, body weight of 20 - 40 gm) were divided into four groups and each of consists of six mice. Group I (control): given 1% Tween 80 solution, group II: given vitamin C in a dose of 100 mg/kg, group III: given haloperidol (2 mg/kg), while group IV: given a combination of vitamin C and haloperidol. All the treatments were given by intraperitoneal route of administration. Three sub-acute doses of different treatments were given at 24:0, 5:0, 1:0 hour before scoring. Parameters scored were catalepsy, ptosis, rigidity and akinesia. The experiment was repeated using vitamin C in a dose of 500 mg/kg. Both doses of 100 and 500 mg/kg of vitamin C significantly antagonized the effect of haloperidol by decreasing all the tested parameters. The results indicate that vitamin C decreases extrapyramidal side effects caused by the antipsychotic haloperidol and show that it successfully decreases catalepsy, ptosis, rigidity and akinesia in mice.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The frequencies of allele distribution of cyp2c9 and cyp2c19 gene polymorphisms in healthy papuan population, indonesia

This study's objective was to determine the distribution of allele frequencies of CYP2C9 and CYP2C19 gene polymorphisms among the Papuan population, known as the second-largest ethnic group in Indonesia. According to recent research, there is a decrease in CYP2C9 and CYP2C19 produced by humans globally, including in Indonesia. These gene polymorphisms aid in the transmission of various endogenous and exogenous drugs in the human body. Material and Methods: A sum of 99 subjects, comprising 73 male and 26 female subjects aged 20-30 years, were used for this research. PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis using AvaII, NsiI, and SfaNI enzymes tested for the genotypes CYP2C9 and CYP2C19 administered. The distribution of genotypes was calculated in the population (P<0.05) using the Hardy-Weinberg equilibrium. The Faculty of Medicine Gadjah Mada University's Medical and Health Research Ethics Committee (MHREC) accepted this research with written consent. The results revealed that in Papua subjects, CYP2C9*2 (rs1799853) and CYP2C19*17 (rs12248560) alleles were absent while in 17 percent of the population CYP2C9*3 (rs1057910) allele frequency was. In conclusion, CYP2C9*3 has the highest polymorphism rate in Indonesia, with the absence of CYP2C9*2 and CYP2C19*17. Therefore, genetic drift can occur within this ethnic group.

Syahrul Tuba

Phytochemical evaluation and in-vitro thrombolytic activity ofsalvia hispanica

The present study was designed to investigate the in-vitro thrombolytic activity of various extracts of seeds of Salvia hispanica by Clot lysis method. In this study, Streptokinase was used as a positive control and the human blood was taken as test sample. The mean % of clot lysis for streptokinase was found to be 66.8%. Similarly the methanolic, ethanolic, aqueous and acetonic extracts of salvia hispanica exerted 48.5%, 35.8%, 33.3%, 27.7% lysis of the blood clot in thrombolytic activity test respectively. From our findings it was observed that all the extracts of Salvia hispanica revealed remarkable thrombolytic activity

Zeenath Banu

Phytochemical evaluation & pharmacological screening of didymocarpus pedicellata and ashwagandha for antiurolithiatic activity

The kidney stones are one of the most widely spreading disorders in the world. The present study was undertaken to evaluate the efficacy of ethanolic extract of Didymocarpuspedicellata and Ashwagandha for its antiurolithiatic activity in rats. Urolithiasis was induced in adult male albino wistar rats by 0.75% of ethylene glycol for 28 days. The effect of the oral administration of the ethanolicextracts has been studied and is compared with the effect of oral administration of Cystone(Himalaya) as a standard on Wistar rat. Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calciumand phosphate. Supplementation with ethanolic extract of the plants significantly reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. Both the plant extract showed significant antiurolithiatic activity

Zeenath Banu

Phytochemical evaluation and pharmacological screening of didymocarpus pedicellata and ashwagandha for antiurolithiatic activity

The kidney stones are one of the most widely spreading disorders in the world. The present study was undertaken to evaluate the efficacy of ethanolic extract of Didymocarpuspedicellata and Ashwagandha for its antiurolithiatic activity in rats. Urolithiasis was induced in adult male albino wistar rats by 0.75% of ethylene glycol for 28 days. The effect of the oral administration of the ethanolicextracts has been studied and is compared with the effect of oral administration of Cystone(Himalaya) as a standard on Wistar rat. Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calciumand phosphate. Supplementation with ethanolic extract of the plants significantly reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. Both the plant extract showed significant antiurolithiatic activity

Zeenath Banu

Use of over the counter medications among adolescents

Improper use of medicines may carry possible health dangers and more evidence continues to stand that adverse drug reactions to medicines are common but often preventable. Self-medication phenomena with over the counter medicines is common among people. It is regarded as essential issue of self-care. Over the counter medicines use such as analgesics among children and adolescents is continuously increasing in Libya. This constitutes an important public health concern. The aim of this study is to focus on adolescent's self-medication phenomena about the over the counter medicines that teens frequently used to treat minor and serious diseases. This work collected information throughout survey-comprised number of questions for the teenagers bought medicines from private pharmacies at two different secondary schools in Benghazi city, Libya, without prescription. The sample size was 120 students, 58 males and 62 females in age range of 15-18 years. Data collected from questionnaire were analyzed for pattern of medicine use. Male adolescents bought toothache and muscle-spasm medicines more frequently than female adolescents. On the other hand, female adolescents administered more over the counter medications monthly than males. The use of over the counter medicines has been found highly rated and exaggerated among secondary school teenagers. In conclusion, adolescents have to be educated regarding over the counter medicine use in Libya. The need for promoting the appropriate use of medicines healthcare system is an important issue. This can be achieved through an educational strategy involved different public sectors such as health and education authorities.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Vitamin c and human diseases: an overview

Vitamin C is associated with history of the cause of the ancient hemorrhagic disease scurvy. Vitamin C is an essential nutrient with important antioxidant properties. It is required by the body for normal physiological function. The body cannot synthesize vitamin C, it is present in nature through foods and other natural sources and it exists as a nutritional food supplement. The antioxidant activity of vitamin C protects the body from free radical damage. Vitamin C is essential for the development and maintenance of connective tissues. It is used as therapeutic agent in many diseases and disorders. Vitamin C plays an important role in several metabolic functions, as the conversion of the amino acid, tryptophan, to the neurotransmitter, serotonin, and the conversion of cholesterol to bile acids. Vitamin C supplementation resulted in a significant increase in vitamin C levels in populations; its high intake is associated with positive effects on cardiovascular risk factors. Vitamin C protects the immune system, reduces the severity of allergic reactions and helps to fight infections. It has an important role in bone formation, wound healing and the maintenance of healthy gums. There is profound beneficial effect of vitamin C in respect to human diseases as cancer, atherosclerosis, diabetes, neurodegenerative disease and many metal toxicities. Several vitamin C analogs have been produced as anticancer and antioxidant activity. Vitamin C is useful if it is used as adjuvant therapy for several chronic diseases. Thus, this review summarizes the importance of vitamin C in the body’s physiology and biochemistry, in addition, the different mechanisms that vitamin C is implicated to treat different acute and chronic diseases. Future exploration should pay attention to chronic disease management by vitamin C.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Vitamin c and human diseases: an overview

Vitamin C is associated with history of the cause of the ancient hemorrhagic disease scurvy. Vitamin C is an essential nutrient with important antioxidant properties. It is required by the body for normal physiological function. The body cannot synthesize vitamin C, it is present in nature through foods and other natural sources and it exists as a nutritional food supplement. The antioxidant activity of vitamin C protects the body from free radical damage. Vitamin C is essential for the development and maintenance of connective tissues. It is used as therapeutic agent in many diseases and disorders. Vitamin C plays an important role in several metabolic functions, as the conversion of the amino acid, tryptophan, to the neurotransmitter, serotonin, and the conversion of cholesterol to bile acids. Vitamin C supplementation resulted in a significant increase in vitamin C levels in populations; its high intake is associated with positive effects on cardiovascular risk factors. Vitamin C protects the immune system, reduces the severity of allergic reactions and helps to fight infections. It has an important role in bone formation, wound healing and the maintenance of healthy gums. There is profound beneficial effect of vitamin C in respect to human diseases as cancer, atherosclerosis, diabetes, neurodegenerative disease and many metal toxicities. Several vitamin C analogs have been produced as anticancer and antioxidant activity. Vitamin C is useful if it is used as adjuvant therapy for several chronic diseases. Thus, this review summarizes the importance of vitamin C in the body’s physiology and biochemistry, in addition, the different mechanisms that vitamin C is implicated to treat different acute and chronic diseases. Future exploration should pay attention to chronic disease management by vitamin C.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Prevalence of self-medication phenomenon with antibiotics among university pharmacy students

Self-medication with antibiotics is becoming a trend that threats the health systems worldwide through developing bacterial resistance which is associated with high health care costs and increased rate of morbidity and mortality. The main objective of this study is to assess antibiotic self-medication practice among Libyan university pharmacy students. This is a cross-sectional study conducted among pharmacy students at Sabratha University in the western region of Libya. A validated questionnaire was used to collect relevant data which were statistically analyzed. A total of 170 undergraduate Pharmacy students participated in the study during spring 2021. About 80% of the participants reported the use of antibiotics without consulting a physician. The major reason for using antibiotics was to get a quick relief of emergency conditions which was reported by 35% of the students. About 25% of the students used antibiotics to relieve their pains and aches. The most commonly used antibiotic was amoxicillin (55%). Most antibiotics were obtained over the counter from community pharmacies (85%). Half of the participants were not sure if they can advise patients to use antibiotics without a prescription, although 60% of them believed that it was good practice. In conclusion, prevalence of antibiotic self-medication among university pharmacy undergraduate students is high. Thus, serious interventions are required to ensure safe and effective use of antibiotics among the population in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Descriptive analysis to use the community pharmacy by patients and customers

Community pharmacies not only act as sites of drug purchase but also as healthcare setting. The aim of this study is to examine the extent of public’s use of community pharmacy and their reasons of visiting to Sabha, South part of Libya. Thus, a descriptive, cross-sectional survey with self-administered questionnaire was developed and validated. Data was collected during 2019 by registered pharmacists using the self-designed prepared questionnaire for community pharmacies in Sebha. Of all 600 questionnaires were handed during 2020, 462 forms were returned (77%, response rate). The majority of the respondents reported they had visited the community pharmacies at least once in a month (n = 343, 74%). The highest reason of visiting reported by the respondents was dispensing their prescription medications (n = 304, 65%) while purchasing medication without prescriptions was accounted with n = 162, (35%). The highest rate of the respondents was given advice about antibiotic use (n = 224, 48%) followed by physical exercises (n = 178, 39%) and healthy eating (n = 173, 37%). The majority of the respondents preferred to visit community pharmacy over other healthcare centers because of minor health problems (n = 358, 77%). The major factors influence the consumers choose any particular pharmacy were the professionalism of pharmacy staff (n = 254, 55%) and the availability of the medical products (n = 221, 48%). The respondents incline to choose community pharmacy as a primary health center when they faced drug related problem (n = 248, 54%). In conclusion, the current study revealed that the majority of Libyan people are regular users of community pharmacies and various services and topics of advice have been given by their staff. However, shortage of professional pharmacists in community pharmacies can undermine the opportunity of given reliable pharmaceutical care from these communications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Physicochemical properties and permeation across mouse skin of non-steroidal anti-inflammatory drugs

The skin provides an effective barrier and only limited number of drugs can penetrate in adequate amounts. This study aims to identify the relationship between the physicochemical properties and permeation across mouse skin of non-steroidal anti-inflammatory drugs in view of their feasibility to transdermal delivery. Biphenylacetic acid, diclofenac base, diclofenac sodium, indomethacin and piroxicam are the drugs studied. Number of physicochemical properties studies were performed. Drug permeation studies across hairless mouse skin were carried out using an in-vitro finite dosing diffusion cell. The relationship between physicochemical properties of the drugs studied and their percutaneous penetration was studied. Purity for the compounds studied ranged from 99.09% to 100% in which 99.89% purity was obtained for diclofenac base. At 7.4, the % ionized of piroxicam was found to be 95.12%, while for other drugs were in the range of 98.01% and 99.96%. The true partition coefficient values in the n-octanol/water system are in the range of 1.85 and 2.85, while in the n-octanol/phosphate system ranged from 2.14 to 3.70. Observed solubility in water, phosphate buffer and n-octanol ranged from 0.033 to 0.322, 0.202 to 0.329 mg per ml, and 2.19 to 16.10 mg per ml, respectively. A linear relationship was found between water solubility and melting point between steady-state rates of permeation across intact and viable skin, between n-octanol solubility and maximum predicted flux and between molecular volume and the ratio of maximum predicted flux. Predicted flux calculated was compared with the experimental data which resulted in a high correlation. Physicochemical criteria which were determined the feasibility of non-steroidal anti-inflammatory drugs studied for transdermal delivery were identified. The relationships obtained in this study provide an essential physical and chemical properties that govern transport of non-steroidal anti-inflammatory drugs across hairless mouse skin.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Therapy and characteristics of hypoglycemia in admitted diabetic patients

Hypoglycemia is a common complication of intensive diabetes mellitus therapy. This study was aimed to review the profile of admitted Libyan cases of non-pregnant adults and adolescents. A retrospective study for patients admitted to Tripoli Diabetes Hospital, Tripoli, Libya. Data were collected from medical files of diabetic patients with hypoglycemia from January 2017 to July 2018. Thus, during this period, a total of 29 cases with hypoglycemia were admitted to the hospital. Their age was ranged from 18 to 86 years in which 76.0% were female, 25.0% were non-smokers, 59.0% were married and 55.0% were non-employers. Patients with diabetes mellitus (86%) showed hypoglycemia attack per month of 3.90 ± 2.25. From the 25 cases with diabetes mellitus, 7.0% were newly diagnosed (> one year), 45.0% their duration of diabetes mellitus were more than 9 years and 35.0% were less than nine years. Their Hemoglobin A1C was on target (6.5–7.0%) in 21.0% of the cases, in which 17.0% were on below target range (< 6> 7.0%). 14.0% were on glibenclamide, 3.0% on glimepiride and 69.0% on insulin. Patients on insulin therapy twice daily in 28.0%, triple in 17.0% and basal bolus regime in 24.0%. Hypoglycemia unawareness was presented in 17.0%, hypoglycemia was major in 45.0% of the cases, and in 38.0% were in daytime. Insulin induced hypoglycemia were in 66.0%, and suicidal attempt were in 10.0%. Exercise induced hypoglycemia 10.0% and 3.0% of cases with malignancy induced hypoglycemia. Co-exist systemic illness was mainly absent in 69.0% but cardiovascular diseases in 14.0% and renal diseases in 7.0%. Majority of cases were discharged in good condition (86.0%) and 14.0% discharged against medical advice. Hypoglycemia mostly occurs in patients with diabetes mellitus treated with insulin and in most the cases were reversible and saved with good management. Thus, patient education is a fundamental issue in prevention and reducing complications of hypoglycemia in patients with diabetes mellitus.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pharmacotherapy and associated risk factors for pulmonary tuberculosis

Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Anti-inflammatory potential of medicinal plants

Inflammation is said to be a healthy component of the body immune system's reaction. Inflammation is characterised by four key symptoms: pain, redness, heat or warmth and swelling. As secondary metabolites, plants may produce a wide range of phytochemical compounds, which possess anti-inflammatory characteristics. Herbal remedies are important therapies for a wide range of ailments all over the world. There are around 7 500 species of medicinal plants, including representatives from over 17 000 flowering plant species. Even when synthetic chemistry has developed out their expectations, the use of natural ingredients in the manufacture of drugs used in contemporary medicine is unparalleled. By interfering with the biology of inflammation, anti-inflammatory medications may assist to minimise tissue damaging and increase patient’s comfort. Because of the bulky figure of species reachable for study, the effective development of novel naturally taking place anti-inflammatory drugs is mostly dependent on a multidisciplinary approach to discovering new chemicals. Despite the statistic that many review papers have been produced in this field, the conventional of them simply examined the issue from an area perspective. Several non-steroidal anti-inflammatory drugs have been shown to reduce inflammation and pain by decreasing the isoform of the cyclooxygenase enzyme's digestion of arachidonic acid, hence lowering prostaglandin production. Non-steroidal anti-inflammatory drugs have a host of harmful effects. There are, however, medicinal herbs with anti-inflammatory pharmacological properties that have few or no negative effects.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pharmacogenetic determinants of human liver microsomal aminopyrine metabolism and the role of cytochrome p450 2d6

Aminopyrine (AM) has been used as a model substrate for investigation of drug metabolism. The major metabolic route is N-demethylation that was confirmed in liver microsomes. The aim of the present study was to identify the human cytochrome P-450 enzyme (CYP) mediating the N-demethylation of 4-di-methylaminoantipyrine (4-DMAA) to 4-methylaminoantipyrine (4-MAA). The contribution of human CYP to the metabolism of (4-DMAA) to (4-MAA) in human was investigated using virus expressed human CYP, human liver microsomes with chemical inhibition studies. The substrate of 4-dimethylaminantipyrine was employed at different concentrations (11.5, 23, 46, 115 and 230 µmol per l) with varying concentrations of selective inhibitors of CYP (CYP1A2), (CYP3A4), (CYP2C8),(CYP2A6), (CYP2D6), (CYP2C19) and (CYP1A1). 4-DMAA and 4-MAA were analysed by HPLC and enzyme kinetic parameters (Km and Vmax) were calculated from the concentration data. The transformation of 4-dimethylaminoantipyrine to 4-methyaminoantipyrine by microsomes prepared from baculovirus-expressed human CYP was pronounced with CYP2D6. The metabolism of 4-dimethylaminoantipyrine was inhibited by 60.0% and 55.17% by a concentration of 100 µmo per l of the known CYP2D6 inhibitors quinidine and moclobemide. The corresponding Ki values were 0.050 and 0.11 mM, respectively. The corresponding IC50 values were 0.06 and 0.13 mM, respectively. The enzyme CYP2D6 apparently has an important role in N-demethyl-ation of 4-dimethylaminoantipyrine.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Correlation of vitamin d with glycemic control and body mass index in patients with type ii diabetes mellitus

Vitamin D deficiency and its effect have attracted a considerable research interest due to its relation to glucose homeostasis, insulin secretion, sensitivity and synthesis. The aim of this study was to evaluate vitamin D levels in patients with type II diabetes mellitus aged between 35 - 65 years and investigating their relations with glycemic control and obesity. The study included 74 Libyan patients with known history of type II diabetes mellitus (33 males and 41 females). Serum glucose, glycosylated hemoglobin (HbA1c) and vitamin D levels were biochemically estimated in these patients. Further, body mass index (BMI) was calculated for all the diabetic patients (weight in kilogram per height in meter square). The mean level of plasma glucose level was 150.58 ± 63.82 mg/dl (mean ± SD). The mean of HbA1c level was 7.90 ± 8.48% (mean ± SD). The mean level of vitamin D was 22.7 5 ± 14.97 ng/ml. The mean of BMI was 26.55 ± 4.10 Kg per m2. The findings showed that 58.10% of the cases had vitamin D deficiency (Out of which 24.24% were males and 85.36% were females). This study showed statistical significance differences in glucose, HbA1c, vitamin D and BMI between male and female patients. Moreover, elderly ages for both sexes had adverse effects on vitamin D status. Vitamin D levels have negatively been correlated with levels of glucose, HbA1c and BMI. It is concluded that vitamin D deficiency has an adverse effect on glucose homeostasis in patients with type II diabetes mellitus and this can be a contributor risk factor in complications of type II diabetes mellitus development in Libyan patients.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hematological consequences of antiepileptic drug therapy among children with epilepsy

Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer’s disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Prevalence of comorbidity and polypharmacy among hospitalized elderly patients

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142, 72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pharmaceutical situation of the pharmacological treatment of hospitalized patients with covid-19 in libya

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID-19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center’s protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines’ List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines’ list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

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