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1.
Mumtaz Hussain Shariza Sahudin Nor Hayati Abu Samah Nor Khaizan Anuar 《Saudi Pharmaceutical Journal》2019,27(2):274-282
Objective
To investigate students perception of an industry based approach problem based learning (PBL) and their performance in drug delivery courses in pharmaceutics.Methods
PBL was implemented within two drug delivery courses in 2015, in anticipation that the use of formulation or industrial instead of clinical or pharmacy practice based triggers, would open up student interest and understanding towards learning pharmaceutics in relation to industrial pharmacy. Two cohorts were monitored through final year examination results and PBL feedback to evaluate student perception and acceptance of the use of PBL. Previous cohorts were only exposed to conventional tutorials.Results
Both cohorts showed better performance in their final examination results (2015 & 2016) compared to the previous year (2014) when students were only exposed to tutorials. The maximum and average marks obtained were also higher. There was significant difference between the maximum marks for Drug Delivery Systems 2 and the average marks for Drug Delivery Systems 1 with P?<?0.05. It was also noted that although the cGPA of student intake for Cohort 2014 is higher than Cohorts 2015 and 2016, the performance of students were better seen in the two latter cohorts. In addition, student feedback showed positive acquiescence towards using PBL as part of the course.Conclusions
Introduction of PBL in the drug delivery courses has shown to improve student academic performance either directly or indirectly by increasing student’s interest and understanding of the subjects taught. It also enhanced student soft skills and confidence. Students were happy with the implementation of PBL which improved their understanding of the subject, enhancing their abilities to think critically and improved their time management abilities. 相似文献2.
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Aim:
The study was designed to establish relationship between the plasma concentration and QTc interval prolonging effect of fexofenadine and demonstrate the phenomenon of anticlockwise hysteresis.Materials and Methods:
Six subjects were given fexofenadine 60 mg tablet orally under stable conditions, and their drug concentrations were measured at regular intervals. At predetermined time, their ECGs were recorded. Data were analyzed and plotted graphically.Design and Setting:
Randomized parallel design, single group study conducted at clinical research organization of Ahmadabad.Results:
In all subjects time taken for maximum plasma concentration of fexofenadine (Tmax) was around 3 h and the value of average maximum plasma concentration was 460.63 ng/mL, the effect of fexofenadine on the heart (measured as QTc interval prolongation) was maximum (Emax) after 6 h and average QTc interval was 469.75 ms. Thus, the time to maximum concentration of fexofenadine did not match with the maximum effect on the heart as measured by QTc interval.Conclusion:
The relationship between the drug concentration and drug effect on the heart are at two different time scales. It can be understood by two-compartment model of pharmacokinetics, and this retardation or lagging of an effect behind the concentration is known as hysteresis. The increase of QTc was not beyond 500 ms and not sustained, demonstrating overall cardiac safety of fexofenadine. 相似文献4.
Ezgi Öztaş Tugba Ekiz Yılmaz Elif Güzel Zehra Sezer Alper Okyar Gül Özhan 《Saudi Pharmaceutical Journal》2019,27(3):422-431
Objectives
Type 2 diabetes (T2DM) is one of the most serious challenges of the 21th century with life-threatening complications and excessive health care costs. In diabetic patients, the main goal in T2DM treatment is the regulation of both blood glucose and lipid levels. For that, Gliclazide (GLZ), an oral antidiabetic, and Atorvastatin (ATV), a lipid lowering agent, are widely used drugs as combination. Diabetes has been reported severe impacts on male reproductive system; however, data obtained about ATV and GLZ treatment alone or in combination are conflicted or insufficient. Herein the effects of ATV and GLZ on male reproductive system in type 2 diabetic male rats have been investigated in the present study.Methods
T2DM was induced by high-fat diet and single injection of streptozotocin (STZ) (35?mg/kg) in young adult male Sprague-Dawley rats. The diabetic rats were given ATV (10?mg/kg), GLZ (10?mg/kg) and ATV/GLZ (1:1, 10?mg/kg) combination by oral gavage for 28?days. The hormone levels were determined in the cardiac blood samples; and the histopathological and ultrastructural analyses were conducted in the testicular tissues and epididymal sperms.Results
It was observed that diabetes had severe effects on testicular tissue and spermatogenesis. ATV treatment did not affect sperm count and testes structure (p?>?0.05), however ameliorated sperm morphology (p?<?0.05). GLZ treatment increased sperm count, and improved sperm morphology, testes structure and spermatogenesis (p?<?0.05). ATV/GLZ combination treatment enhanced sperm morphology and improved testicular structure (p?<?0.05) while did not affect sperm count (p?>?0.05).Conclusion
GLZ treatment regenerated testicular damage and sperm parameters whether alone or in combination with ATV in diabetic rats without affecting hypothalamic-pituitary-gonadal axis. 相似文献5.
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Mohamed A. Ibrahim Gamal A. Shazly Fadilah S. Aleanizy Fulwah Y. Alqahtani Gehan M. Elosaily 《Saudi Pharmaceutical Journal》2019,27(1):49-55
Objective
The aim of the present study was to formulate the anticancer drug; docetaxel (DOX) as nanoparticles to enhance its biological activity.Methodology
Solvent precipitation method was used to prepare DOX-loaded nanoparticles and was stabilized by different concentrations of hydroxypropyl methylcellulose (HPMC, E5) and sodium deoxycholate (SDC).Results
The results showed that the particle size of the prepared DOX nanoparticles stabilized by SDC was small in comparison to those stabilized by the corresponding HPMC concentrations. The smallest particle size (83.97?nm) was obtained by using SDC as stabilizer at 5% level with zeta potential of ?13.6?mV. It was concluded that increasing the stabilizer concentration resulted in increase in both initial and overall cumulative drug release. The release rate in case of nanoparticles stabilized by 5% SDC was 33% and 87% after 1 and 24?h respectively. The results showed that a significant reduction in the viability of FRO cells was observed at all tested time intervals in case of nanoparticles stabilized by 5% SDC at concentrations of 100 and 1000?μM/ml. In contrast, no signs of cytotoxicity was observed for nanoparticles stabilized by 5% HPMC at 10 and 100?μM/ml concentrations. 相似文献7.
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Heleen van der Sijs Ravi Kowlesar A. Peter J. Klootwijk Stefan P. Nelwan Arnold G. Vulto & Teun van Gelder 《British journal of clinical pharmacology》2009,67(3):347-354
AIMS
To investigate whether, in patients in whom drug–drug interaction (DDI) alerts on QTc prolongation were overridden, the physician had requested an electrocardiogram (ECG), and if these ECGs showed clinically relevant QTc prolongation.METHODS
For all patients with overridden DDI alerts on QTc prolongation during 6 months, data on risk factors for QT prolongation, drug class and ECGs were collected from the medical record. Patients with ventricular pacemakers, patients treated on an outpatient basis, and patients using the low-risk combination of cotrimoxazole and tacrolimus were excluded. The magnitude of the effect on the QTc interval was calculated if ECGs before and after overriding were available. Changes of the QTc interval in these cases were compared with those of a control group using one QTc-prolonging drug.RESULTS
In 33% of all patients with overridden QTc alerts an ECG was recorded within 1 month. ECGs were more often recorded in patients with more risk factors for QTc prolongation and with more QTc overrides. ECGs before and after the QTc override were available in 29% of patients. Thirty-one percent of patients in this group showed clinically relevant QTc prolongation with increased risk of torsades de pointes or ventricular arrhythmias. The average change in QTc interval was +31 ms for cases and −4 ms for controls.CONCLUSIONS
Overriding the high-level DDI alerts on QTc prolongation rarely resulted in the preferred approach to subsequently record an ECG. If ECGs were recorded before and after QTc overrides, clinically relevant QTc prolongation was found in one-third of cases. ECG recording after overriding QTc alerts should be encouraged to prevent adverse events. 相似文献9.
Yang FD Wang XQ Liu XP Zhao KX Fu WH Hao XR Zhang XL Huang GS Qu SC Bai JS Huang XF Kosten TR Zhang XY 《Psychopharmacology》2011,216(1):9-16
Objective
The rate-corrected electrocardiographic QT (QTc) interval may significantly increase in patients with schizophrenia taking antipsychotics. The objective of this naturalistic study was to assess the prevalence of prolonged QTc interval in a large population of inpatients with chronic schizophrenia and to explore QTc relationship with demographic variables and prescribed treatments.Materials and methods
Electrocardiograms were obtained from age- and sex-matched 456 controls and 1,006 inpatients with schizophrenia (male/female?=?689/317) taking antipsychotics. QTc prolongation was defined as a mean value of two standard deviations above the controls. The adjusted relative risk was calculated using logistic regression analysis.Results
QTc prolongation was present in 45 (4.5%) of 1,006 patients overall. Fewer men (3.2%, 22 of 689) than women (7.3%, 23 of 317) displayed QTc prolongation (p?<?0.004). Moreover, QTc intervals were shorter in male (391?±?31?ms) than female subjects (400?±?37?ms) (p?<?0.001). Clozapine was found to produce a longer QTc intervals compared to risperidone and typical antipsychotics. Furthermore, multiple regression analysis showed that significant predictors for QTc prolongation were comorbid cardiovascular disease, antipsychotic types, sex, and age (all p?<?0.01).Conclusion
Our present findings suggest that there are sex differences in the prevalence of QTc prolongation and QTc lengthening in schizophrenia. Antipsychotic types are risk factors for QTc prolongation, and risks are substantially higher for clozapine. 相似文献10.
Objectives
To examine the knowledge and attitude towards dentist-industry relationship including accepting gifts, influence on decisions, and accuracy of given information among dentists working in Saudi Arabia. In addition, to examine the association of such knowledge and attitude of dentists' behavior with industry, including sorts of interaction and accepting industrial gifts.Methods
A cross-sectional study was conducted among dental practitioners working in the private and governmental hospitals located in the various regions of Saudi Arabia. A self-administrated questionnaire was developed and distributed to all participants. Fourteen questions assessed the socio-demographic, economic, and occupational characteristics of the participants including age, gender, nationality, monthly revenue, income satisfaction, hospital setting, job rank, specialty, and patients' socio- economic status. Seventeen questions assessed the interaction with DSRs, acceptance and characteristics of gifts and opinion of dentists regarding gift acceptance in dental practice. One-Way ANOVA and t-test was used to examine differences in transformed scores by socio-demographic, occupations and outcome characteristics. All P-values were two-tailed. P-value?<?0.05 was considered as significant.Results
Total of 672 participants responded to general questions related to the knowledge and attitude. The mean of the overall knowledge and attitude score was 64.3?±?7.2, general questions score was 63.1?±?8.6 and interaction questions score was 66.9?±?8.0. Approximately, 40% of participants disagreed that accepting industrial gifts can affect their own decisions but slightly lower proportion (25%) disagreed that accepting industrial gifts can affect decisions of other dentists. Only 25% of participants thought it is ethical to accept industrial gifts and even fewer proportions (20%) believed that dental supply representatives (DSRs) always provide accurate information about their new materials. Almost two-thirds of participants trusted information from other sources than from DSRs. On the other hand, 40% of the participants were against banning industrial gifts to dentists and approximately 50% were against informing the patients about the industrial gifts given to their dentist by dental companies.Conclusions
There was insufficient knowledge and an overall positive attitude towards the dental industry among the sample of dentists in Saudi Arabia. Well-designed ethical education programs should be implemented to enhance knowledge and attitudes about the interactions with dental industry. 相似文献11.
Ariadna Lafourcade Prada Hady Keita Tatiane Pereira de Souza Emerson Silva Lima Leonard Domingo Rosales Acho Márcia de Jesus Amazonas da Silva José Carlos Tavares Carvalho Jesus Rafael Rodriguez Amado 《Saudi Pharmaceutical Journal》2019,27(2):191-199
Purpose
This study aimed to evaluate the hypoglycemic effect, antioxidant, α-glucosidase and lipase inhibitory activity, and the cytotoxicity of the Cassia grandis nanodispersion (CgND).Methods
The hypoglycemic effect was evaluated in alloxan-induced diabetic mice. The particle size, polydispersion index, ζ-potential, and conductivity, as well as the drug-loaded content, were monitored in shelf-live, along a year. The delivery profile was evaluated in simulated intestinal fluids at pH 6.5 and 7.4. The antioxidant effect was evaluated as DPPH and ABTS inhibition. The murine α-glucosidase inhibitory activity and the lipase-inhibitory effect were evaluated in vitro. Cytotoxicity was evaluated by the Alamar blue test.Results
CgND remained stable for a year in shelf conditions. The hypoglycemic effect in a dose of 10?mg/kg was not statistically different from glibenclamide 25?mg/kg. Nanoparticles released 100% of extract in 120?min at pH 6.5 and 7.4. Nanodispersion exhibited a potent α-glucosidase and lipase-inhibitory effect with IC50 of 3.96 and 0.58?µg/mL, respectively. A strong antioxidant activity against DPPH (IC50 0.65?µg/mL) and ABTS (0.48?µg/mL) was also observed. The hypoglycemic effect could occur, at least in part, via antioxidant and α-glucosidase inhibition. CgND is non-cytotoxic in MRC-5 line cell. This nanodispersion is a promising nanotechnological product that could be used in pharmaceuticals for the treatment of Type II diabetes and related complications as obesity. 相似文献12.
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Background
Elevated prolactin levels are associated with increased cardiometabolic risk. No previous study has compared the effect of hypolipidemic therapy on plasma levels of lipids and other cardiometabolic risk factors in patients with and without hyperprolactinemia.Methods
The study included three age-, weight-, blood pressure- and lipid-matched groups of premenopausal women: 18 women with untreated hyperprolactinemia, 19 women with bromocriptine-treated hyperprolactinemia and 20 drug-naïve women with normal prolactin levels. Because of concomitant atherogenic dyslipidemia, all patients were treated with fenofibrate (200?mg daily) for 12 weeks. Plasma lipids, glucose homeostasis markers, as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen were assessed at baseline and at the end of hypolipidemic treatment.Results
Unlike similar baseline lipid levels, plasma concentrations of the remaining investigated cardiometabolic risk factors were higher in women with elevated prolactin levels than in patients with normal prolactin levels. The impact of fenofibrate on total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels, as well as on uric acid, hsCRP, homocysteine, and fibrinogen was less pronounced in women with untreated hyperprolactinemia than in women with bromocriptine-treated hyperprolactinemia and drug-naïve women with normal prolactin levels.Conclusions
The results of our study indicate that cardiometabolic effects of fenofibrate depend on plasma prolactin levels. 相似文献15.
Kyle R. Frazier Kimberly C. McKeirnan Sorosh Kherghehpoush Lisa J. Woodard 《Journal of the American Pharmacists Association》2019,59(2):210-216
Objective
To understand rural patient opinions regarding their willingness to participate in pharmacist-provided chronic condition management.Design
Qualitative semi-structured key informant interview using The Concept of Access as a theoretical framework.Setting
Three community pharmacies serving patients in rural Washington State from November 2016 to November 2017.Participants
Current patients from 3 rural independent community pharmacies.Main Outcome Measures
Qualitative analysis of patient attitudes, acceptance, perceptions, and preferences regarding pharmacist-provided chronic condition management services in a community pharmacy.Results
Eighteen key informant interviews were conducted between November 2016 and November 2017. Five themes were identified: trust between the pharmacist, patient, and physician is key; patients already value pharmacists’ knowledge about chronic condition medications; participants identified the pharmacist as the first point of contact with regard to understanding appropriate use of medications to treat medical conditions; implementing clinical services in the community pharmacy setting may reduce the need for doctors’ visits and improve timely patient care; and creating designated clinical space, appointment options, and efficient service may increase patient accommodation.Conclusion
Management of chronic conditions continues to be one of the largest health care expenditures in the United States. One promising method of addressing this public health concern is through sustainable clinical pharmacy services. The themes identified in this study provide insight into factors that community pharmacists might consider as medical provider status continues to gain momentum and the use of clinical pharmacy services becomes more prominent. 相似文献16.
Majdoleen Al alawneh Nabeel Nuaimi Iman A. Basheti 《Research in social & administrative pharmacy》2019,15(2):164-172
Background
Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health management.Objectives
To assess the impact of the HMMR service on the type and frequency of Treatment Related Problems (TRPs) among Syrian refugees living in Jordan.Methods
This prospective randomized single blinded intervention-control study was conducted in three main cities in Jordan, between May and October 2016. Syrian refugees with chronic conditions were recruited and randomized into intervention and control groups. The HMMR service was conducted for all patients to identify TRPs at baseline. Data were collected via two home visits for all study participants. Clinical pharmacist's recommendations were written in a letter format to the physicians managing the patients in the intervention group only. Physicians' approved recommendations were conveyed to the patients via the pharmacist. Interventions at the patient level were delivered by the pharmacist directly. Patients were reassessed for their TRPs and satisfaction 3 months after baseline.Results
Syrian refugees (n?=?106) were recruited with no significant differences between the intervention (n?=?53) and control groups (n?=?53). A total of 1141 TRPs were identified for both groups at baseline, with a mean number of 10.8?±?4.2 TRPs per patient. At follow-up, there was a significant decrease in the number of TRPs among the intervention group (P?<?0.001, paired sample t-test) but not among the control group (P?=?0.116). Physicians' approval rate of the pharmacist's recommendations was high (82.9%), and more than 70.0% of refugees in the intervention group reported high satisfaction with the HMMR service.Conclusion
Identified TRPs are high amongst Syrian refugees living in Jordan. The HMMR service significantly reduced the number of TRPs, and was highly accepted by the physicians. Refugees reported high satisfaction with this service. 相似文献17.
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Joshua L. Akers Geoffrey Meer Jeffrey Kintner Anna Shields Laurel Dillon-Sumner Jennifer L. Bacci 《Journal of the American Pharmacists Association》2019,59(2):243-251
Objectives
To describe one independent pharmacy group’s experience delivering and being reimbursed for in-home medication coaching, or home visits, to high-risk and high-complexity community-dwelling patients.Setting
A nondispensing clinical division of an independent community pharmacy in Seattle, Washington.Practice innovation
A community pharmacist–led in-home medication coaching program delivered through partnerships with 3 community-based organizations for referrals and payment over a 4.5-year period. Community-based partners included a state comprehensive care management program, a local health system’s cardiology clinic, and the local Area Agency on Aging.Evaluation
A retrospective analysis of patient demographics, drug therapy problems, interventions, and pharmacy and technician time was conducted with the use of the pharmacy’s internal patient care documentation and billing systems from January 1, 2012, to June 31, 2016.Results
A total of 462 home visits (142 initial, 320 follow-up) were conducted with 142 patients. Patients averaged 13 disease states (range 3–31) and 16 medications (range 1–44) at their initial visit. Pharmacists identified an average of 11 drug therapy problems per patient (range 1–36) and performed an average of 13 interventions per patient (range 1–48). The most common drug therapy problem identified was nonadherence, and the most common intervention performed was education. The median pharmacist time in the home was 1.5 hours (range 0.67–2.75) for an initial visit and 1 hour (range 0.08–2.25) for a follow-up visit.Conclusion
Home visits can be successfully implemented by community pharmacists to provide care to high-risk and high-complexity community-dwelling patients. Our experience may inform other community pharmacy organizations looking to develop similar home visit services. 相似文献20.
Aaron J. Heffernan Fekade B. Sime Jeffrey Lipman Jayesh Dhanani Katherine Andrews David Ellwood Keith Grimwood Jason A. Roberts 《International journal of antimicrobial agents》2019,53(3):234-245