Pharmacy Practice articles list

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

Over the years, pharmacy has developed from a simple floor stock system to a complex unit dose, I.V. additive, and clinical pharmacy program. This development would have never been possible without the support of the nursing, medical, and administrative staff. The support of obtained slowly by developing services that increase the pharmacist's credibility as a team member concerned with the pediatric and neonate patients. These services include a unit dose program, I.V. additive program, drug information services, and pharmacy medication program. One area in which pharmacist does not obtain a background from generalized training is the area of pediatric dosing. Pediatric pharmacists must learn in clinical practice the proper dosing of the pediatric patient and neonate patient. The dose must be checked periodically. In the premature or newborn infant, the pharmacist must consider the immature renal and hepatic function so that he/she does not overdose initially and then underdose as the infant grows and matures. Neonates are a special group of children, they are less than 30 days, and within this group preterm babies (that means less than 37 weeks). Determining the correct dose for drugs used to treat neonates is a critically vital factor. Prematurity affects kidney and liver function and the proper adjustment of drug doses is crucial [1]. The absence of drug level necessitates the adjustment of drug doses and the presence of qualified oriented dependable pharmacists. Drug doses are not numbers, or decimals used within the therapeutic range. Neonatal Intensive Care Unit (NICU) needs a system for the calculation and preparation of drugs [2].

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The anti-emetic activity of the leaves methanolic extracts of Cassia angustifolia Vahl., Cassia holosericea Fresen., Cassia italica Miller. Lam. ex F.W. Ander and Cassia purpurea Roxb., was evaluated in young chicks. Emesis was induced by copper sulfate (50 mg/kg), and the extracts were tested orally at a dose of 150 mg/kg. All the extracts significantly decreased the number of retching (p < 0.05 and p < 0.01) compared with standard chlorpromazine.

Dr. Salman Ahmed

The current study was designed to explore the antiemetic effect of the methanolic extracts of Acalypha fimbriata Schumach. & Thonn., Acalypha ornata Hochst., and Acalypha wilkesiana cv. godseffiana Muell Arg., aerial parts using chick emesis model to validate their folk use in G.I. disorders. Emesis was induced by the oral administration of copper sulfate to male chicks. All the extracts (150 mg/kg orally) showed an antiemetic effect and were compared with the reference drug chlorpromazine. Among all the extracts, Acalypha ornata Hochst., leaves extract showed the highest (94.51%) and Acalypha fimbriata Schumach. & Thonn., stem extract showed the lowest (35.04%) antiemetic effect.

Dr. Salman Ahmed

The conservation of traditional medicinal knowledge opens the door towards modern aspects of herbal drug discovery. It started with knowledge exchange through ethnic groups through oral tradition and then in the documented form. Herbaria conserving identified and authenticated plants for future correspondence play an important role. In presenting the review, the authors have declared different auxiliary aspects of herbaria for phytomedicinal research.

Dr. Salman Ahmed

Medicinal plants are the gift of nature and play an important role as a part of our diet to maintain health. They also serve as a versatile weapon to combat several diseases. Every civilization has its own experience and knowledge of the therapeutic uses of plants. The belief and observations regarding traditionally used medicinal plants increase people's interest in using them against urolithiasis. Urolithiasis is a common problem that has been afflicted for centuries and has a high recurrence. Of the world's population, about 12% suffer from urolithiasis. All over the world, in different countries and cultures, people use plants to prevent and cure kidney stones according to their ethnopharmacological information. These formulations are very effective. That's why they have been used for hundreds of years. This review covers the eighty (80) medicinal plants of the most cited family Asteraceae against urolithiasis and their historical antiurolithiatc background shared in well-known books of Dioscorides, Pliny the Elder, Al Razi and Ibn Sina. This information was extracted to compose antiurolithiatic plants with their parts and formulations used in 21 countries such as Algeria, America, Australia, China, India, Iran, Italy, Jordan, Jordan, Kyrgyzstan, Lebanon, Libya, Mexico, Morocco, Pakistan, Palestine, Philippine, Spain, Tunisia, Turkey and Uzbekistan. Scientifically proven pharmacological activities of the same part of the plant have direct (litholytic) and direct pharmacological effects like analgesic, anti-inflammatory, antioxidant, astringent, demulcent, diuretic, litholytic, lithotriptic, antiurolithiatic, antispasmodic, ACE inhibition and Phospholipase A2 inhibition also shared as a plausible mechanism of action. The route of administration is oral in all cases. Hopefully, this book will be useful for the general public and attract the scientific world for antiurolithiatic drug discovery. This valuable ethnopharmacological information will provide opportunities for the future research and development of new natural antiurolithiatic compounds.

Dr. Salman Ahmed

Brushites are the most commonly found phosphate stones in the kidneys, ureters and urinary bladder. The study was conducted to observe the possible growth patterns of brushite crystals in the gel for 14 days. The crystal formation was observed as a bullet, needle, platy, columnar shaped and their aggregates. Magono and Lee's meteorological classification further explained these shapes. Besides the morphology, the average size, number and weight of crystals were also observed on the 7th and 14th days. Energy Dispersive X-ray, Fourier Transform Infra Red spectroscopy and Scanning Electron Microscopy were used to characterize the crystals. These results can help to determine the promotion, modulation and inhibition of the crystals, which will be helpful in evaluating the risk factors and prophylactic management of brushite-type urinary stones.

Dr. Salman Ahmed

Background: Phaseolus vulgaris, commonly known as kidney bean, has been studied previously for pharmacological properties such as antidiabetic, antioxidant, analgesic, anti-inflammatory, antifungal, and antibacterial properties. Various extracts of the seeds have been researched except fixed oils. Objective: Therefore, the present study aims to investigate the behavioral activity of fixed oil extracted from Phaseolus vulgaris seeds. Methodology: Hole board, light and dark, stationary rod and open field tests were used for behavioral evaluation. Four groups were made with seven mice in each : (1) Control = Normal saline 2ml/kg (2) Phaseolus vulgaris fixed oil = PVFO 2ml/kg (3) PVFO 4ml/kg (4) Diazepam (1mg/kg) as standard. All treatments were given orally 30 minutes before the performance of tests. In the hole board test, PVFO 4ml/kg decreased the number of head poking (p≤0.01). Results: In light and dark tests, PVFO in both doses reduced the time spent in the light compartment (p≤0.01). In the open field test, the number of peripheral lines crossed was decreased (p≤0.05), whereas in the stationary rod test, no effect was observed by any dose of PVFO. Conclusion: Results indicate that Phaseolus vulgaris fixed oil does not affect memory or learning in mice and may possess a dose-dependent sedative hypnotic effect.

Dr. Salman Ahmed

Cardiovascular disorders are known as one of the leading health problems which are associated with mortality worldwide. Myocardial ischemia (MI) is the improper blood supply to the myocardium, which leads to severe complications to life-threatening problems like AMI, atherosclerosis, hypertension, cardiac hypertrophy, as well as diabetic-associated complications such as diabetic atherosclerosis/cardiomyopathy/hypertension. Despite several efforts, the current therapeutic platforms are unrelated to significant results. Hence, it seems that developing novel therapies is required. Increasing evidence indicates that curcumin (CRC) acts as a cardioprotective agent. Given that CRC and its analogues exert their cardioprotective effects via affecting various cardiovascular disease-related mechanisms (i.e., Inflammation and oxidative stress). Herein, we have highlighted the protective impacts of CRC against MI for the first time. This review might be a stepping stone for further investigation into the clinical implications of the CRC against MI. Furthermore, it highlights a legitimate concern for the scientific community, seeking novel techniques and characteristic dynamic biopharmaceuticals against myocardial ischemia.

Dr. Salman Ahmed

The current study explored the anti-emetic activity of six aromatic medicinal plants viz Carissa carandus L.. Cichorium intybus Cinnamomum tamala L.. Lallemantia royleana Benth. Matricaria chamomilla L., and Piper metysticum G. Forst . Anti-emetic activity was assessed using a chick as an anti-emetic model. The ethanol extracts of these plants were administered at 150 mg/kg BW orally. Lallemantia royleana and Piper metysticum showed a significant (P <0.001 ) decrease in retches induced by copper sulphate pentahydrate given orally at 50 mg/kg BW. Domperidone was given at 100 mg/kg as a reference drug.

Dr. Salman Ahmed

The analgesic activity Of the crude hexane and ethanol extracts of the leaves and male flowers of Luffa cylindrica (L.) Roem., (sponge gourds) was carried out at dose of 500 mg /kg b.w., (p.o.) in mechanically induced pain in rats by using analgesy-meter. These extracts produced significant analgesic effect results of the present study revealed the analgesic properties of the leaves and male flowers of Luffa cylindrica.

Dr. Salman Ahmed

The current study was conducted to determine the insoluble, soluble, and total dietary fiber content of Macrotyloma uniflorum (Lam.) Verdc., Phaseolus lunatus Linn. , and Phaseolus vulgaris Linn. , and legume flours by using AOAC enzymatic-gravimetric analysis. The results showed that M. uniflorum, P. lunatus, and P. vulgaris legume flours contained 155.91, 120.01, and 90.80 mg/g insoluble dietary fiber, respectively. At the same time, soluble dietary fiber was not found in any tested sample.

Dr. Salman Ahmed

Prostate cancer (PCa) is the leading cause of cancer death in men, and its treatment is commonly associated with severe adverse effects. So, new treatment modalities are needed. In this context, natural compounds have been widely explored for their anti-PCa properties. Aquatic organisms contain numerous potential medications. Anticancer peptides are less toxic to normal cells and provide a productive treatment approach via multiple mechanisms, including altered cell viability, apoptosis, cell migration/invasion, suppression of angiogenesis and microtubule balance disturbances. This review sheds light on marine peptides as efficacious and safe therapeutic agents for PCa.

Dr. Salman Ahmed

Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in the country's healthcare landscape. By exploring these different aspects, it is possible to gain a comprehensive understanding of Libya's status and potential advancements in PE. In Libya, the earliest records related to PE trace back to the late 19th century, specifically around 1835 during the Turkish colonization. During that time, various documents documented details such as drug prices, direct costs associated with specific diseases, expenditures on essential pharmaceuticals, and annual inventories of health and pharmaceutical institutions [2]. Over the past 80 years since modern Libya’s establishment after the colonial era, Libyan authorities have consistently published annual statistical reports. These reports cover expenditures on medicines, pharmaceuticals, and therapeutic materials, as well as the stock levels in healthcare facilities [3]. However, despite this data, there remains a significant lack of literature on PE, with a few exceptions that do not meet the standards expected of PE studies.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe CPs must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The labeling of medications includes the provision of information and instructions as well as a unique identity for the medical product. It is one of the most important sources of information for patients. Good labeling practice is critical to ensuring patients' safe and effective use of products. Misreading the label, insufficient data on the label, inappropriate labeling font, writing style, and placement on the dosage form can all have disastrous consequences. The objective of this study was to assess medication labeling practices among community pharmacists in Libya. A simulated client method (SCM) was used, and the study was carried out in the City of Zawia, where 146 local pharmacies were visited over three months for the investigation (January to March 2023). These visits were made at random, without the pharmacist's knowledge. The findings revealed that all dispensed drugs were not labeled, and none of the practicing pharmacists in any pharmacies visited displayed any drug label, printed or handwritten. The majority of pharmacists did not address or explain significant information to the patient in an effective manner, which led to inappropriate and harmful consumption of medications. The absence of dispensed drug labels reduces the patient's knowledge of the necessary information about the medicine, resulting in a treatment deficit or unsuccessful therapy. Thus, more effort should be made by health authorities to instruct pharmacists to use and work according to international labeling standards or to establish local labeling specifications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences