Journal of Pharmaceutical Care

A Realistic Case Confirming the Significance of Clinical Pharmacist Role Inside Community Pharmacies

Ahmed Amer — 2024-10-02

Diclofenac and ketorolac are prescribed as nonsteroidal anti-inflammatory drugs (NSAIDs) used to manage pain and inflammation. However, co-administration of them could lead to serious health problems. We seek to highlight the potential dangers of their concurrent use. We discuss the increased risk of severe gastrointestinal complications, including ulceration, bleeding, and perforation, associated with combining these medications. The case emphasizes the importance of clinician awareness of this drug interaction and advocates for safer prescribing practices. Also, we shed light on the significant role of clinical pharmacists in each community pharmacy, hospital, and medical centre.

Pattern of Adverse Drug Reactions and Performed Monitoring Laboratory-Tests in Patients Receiving Anti Tuberculosis Treatment in an Endemic Region, Zabol

Mandana Moradi — 2024-10-02

Background: Efficient anti TB treatment considered crucial globally. Anti TB drugs can cause various adverse drug reactions (ADRs). Clinical and laboratory monitoring will decrease rate of these ADRs, improve patient safety as well as drug adherence and treatment outcome.
Methods: In this cross-sectional study total of 136 newly diagnosed TB patients were included. All patients received standard anti-TB 4 drug regimen. Predesigned data collection forms were used to gather patient’s lab data as well as clinical symptoms they experienced during treatment course. Monthly follow up visits or phone calls were also performed by investigators and all health issues were recorded.
Results: The majority of our patients aged over 70-year-old. About 54% of them were female. We recorded at least one ADR in 80.8% of patients, and hepatic-gastrointestinal (GI) ADRs ranked first (64.7%). Although ADRs were more common in women and patients over 70-year-old, but there was no statistically significant relationship between sex or age and rate of ADRs (P> 0.05). We also observed that recommended baseline laboratory tests for monitoring anti TB treatment was not performed in any of our patients, except complete blood count (CBC) that was performed in 11 cases. This led to diagnoses of anemia and thrombocytopenia in one case.
Conclusion: The majority of our patients experienced ADR. Recommended drug monitoring tests that could guarantee safe and effective treatment were not performed routinely in our TB management centres. These facts highlighted the importance of improving surveillance system for TB management based on national standards.

Medication Adherence and Practices in Pediatric Patients

Sweta Shanbhag — 2024-10-02

Background: Improper medication practices and non-adherence are the biggest challenges faced by pediatricians in outpatient practice. Hence this study was aimed at determining the medication practices and factors affecting adherence.
Methods: A cross sectional descriptive study was conducted at a tertiary care hospital in Southern India over a period of 3 months (January to March 2023), to study medication adherence and parental medication practices in pediatric patients. A pre structured questionnaire was administered to parents of 320 children.
Results: Majority of the parents (55%) had children aged 1-5 years of age. It was noted that most of the families (89%) were above poverty line (APL). About 34% parents were educated till graduate level and 17% were educated beyond post graduate level. Frequency of medication adherence in our study was found to be 78%. It was noted that parents with education of graduate level and above, those belonging to APL families and the ones with no fear of adverse drug reactions showed higher medication adherence as compared to other parents and this association was found to be statistically significant (p <0.001). Majority of the parents (80%) reported that their children preferred liquid formulations, of which 57% preferred fruit flavoured ones. Around 51% parents preferred twice daily dosing of medications. While 47% parents used previous prescriptions, 39% bought over the counter medicines, especially paracetamol.
Conclusion: Knowledge about medication practices and factors affecting adherence is important in order to provide quality health care. Actively involving children and parents while prescribing medications with health education goes a long way in improving adherence.

Evaluation of Knowledge, Attitude and Practice of Pharmacists in Tehran Pharmacies regarding Environmental Health Issues to Increase Good Pharmacy Practice

Mohammad-Javad Niazi — 2024-10-02

Background: In addition to being the most accessible medical center in the community, the pharmacy is a center for storing and providing medicines and cosmetics that are directly related to people's health. Therefore, observing environmental health issues in the pharmacy, which is managed by the pharmacist, is considered necessary. In this study, considering the direct and high impact of observing various aspects of environmental health on the good pharmacy practice and its value, it has been tried by examining the level of knowledge, attitude and practice of pharmacists in the pharmacies of Tehran city and presenting it, the necessary ground for promotion The environmental health status of pharmacies should be provided.
Methods: In this research, standard researcher-made questionnaires were designed and after checking its validity by clinical pharmacists, environmental health and biostatistics experts and its reliability with Cronbach's alpha test, It was completed by the pharmacists of Tehran community pharmacies in the period of April to September 2022, observing ethical points and preserving their identity, in order to show their knowledge, attitude and performance towards environmental health issues in the pharmacy where they operate. Then the obtained data were analyzed in SPSS version 23.0 statistical software.
Results: Examination of the data obtained from this study showed that the pharmacists in the study have the appropriate level of knowledge and attitude, but their performance in pharmacies is different.
Conclusion: Observation of the results of the study shows that due to the lack of appropriate practical training and the lack of strict rules by regulatory authorities, despite the appropriate level of knowledge of pharmacists, in practice do not consider themselves very obliged to observe health principles.

Effectiveness of Patient Medication Counseling in a Tertiary Care Hospital: A Cross-Sectional Study

Prashant Mishra — 2024-10-02

Background: Medicine is prescribed to help the patient. But it can cause unwanted effects in the patient if one take too much or multiple medicines that don’t go together. Many patients have problems each year, some serious, because of taking the wrong medicine or not taking the right medicines correctly. This cross-sectional study was done to assess the effectiveness of patient medication counseling in a tertiary care hospital.
Methods: This cross-sectional questionnaire-guided study was carried out in the dispensary of a tertiary care hospital, from January to April 2024. convenient sampling technique was employed to select study participants.
Results: A total of 540 respondents were included in this study. Only 50.3% of the participants knew the correct frequency and dose of the prescribed medications. Majority of the patients did not knew the indications of the medication they were taking.
Conclusion: There is a need to strengthen the patient medication counselling process so that patients understand & remember what have been advised during counselling. As a healthcare provider, it is our responsibility to educate the patient about the prescribed medicines to obtain the positive healthcare and ensure safe use of medicines.

Molecular Targets for the Novel Therapies of Inflammation and Wound Care

Palak Agrawal — 2024-10-02

Anti-inflammatory drugs, particularly steroidal and non-steroidal, are already the sole treatment options for inflammatory illnesses. Chronic use of these medicines has been linked to gastrointestinal, cardiovascular, as well as other serious side effects. New anti-inflammatory and wound healing drugs with selective effect and lower toxicity are desperately needed. Novel therapies acting on different molecular targets have shown promising resultsRelevant studies (2003-2024) were identified through electronic searches of PubMed and Google scholar. The search used the keywords, including the following inflammation, wound care, signalling pathways, molecular targets of inflammation. Neutrophils and macrophages play a significant role in the release of mediators and phagocytosis at the site, Nf-kB signaling pathway and the JAK/Stat signaling pathway stimulate the production of mediators including IL-6, IL-1, and TNF-α, although their overproduction can have a variety of consequences. Cell therapy, MicroRNA, plasma protein therapy, COX-2 inhibitor with stem cells, combination of AMD3100 and Tacrolimus and combination of siRNAs with Plurogel for increasing wound healing time are among the approved and continuing clinical trial novel therapies mentioned. This study shows that these new therapeutics can interact with numerous targets and modify the dysregulated inflammatory pathways and mediators associated with normal and chronic wounds more effectively than standard anti-inflammatory medication treatments.

Comprehensive Review of the Potential Anti-Breast Cancer Properties of Various Medicinal Plants

Harshada A. Kusane — 2024-10-02

Breast cancer is the most frequent cancer in women throughout the globe, and its management can be difficult due to its complex etiology. Treatment with chemotherapy, surgical procedures, radiation treatment, and hormone therapy are among the most frequently utilized treatments. However, complications and resistance to multiple drugs can cause challenges. This overview addresses how organic medicinal products obtained from edibles and plants can assist with treatment of Breast cancer. The article scrutinizes the ways by which natural substances may exert beneficial impact in the prevention and management of breast carcinoma as well as offers knowledge regarding the therapeutic plant, including its family, part used, kind of extraction, and molecular mechanisms in breast carcinoma. Following an exhaustive analysis of the various plants, we discovered that Peganum normata, Ammi visnaga, Camellia sinensis, Curcuma longa, and Allium sativam L. had potential anti-breast cancer activities. These data were gathered from PubMed, Scopus, and Google Scholar.

IV Ciprofloxacin-Induced Phlebitis: Investigating the Impact of Pharmaceutical and Process-Related Factors on Patient Safety

Sareh Hosseini — 2024-10-02

Transient phlebitis is a rare but notable adverse reaction that can occur following intravenous administration of various medications, including ciprofloxacin, an antibiotic recognized for its broad-spectrum activity. This case report discusses a 48-year-old male patient with poorly controlled type 2 diabetes who developed phlebitis after receiving undiluted ciprofloxacin via a peripheral intravenous line. Symptoms emerged within 24 hours, characterized by swelling and redness at the injection site, prompting the discontinuation of the medication. Analysis revealed that improper dilution and rapid infusion rate were major factors contributing to the development of phlebitis. This underscores the importance of adhering to guidelines provided in product information leaflets for intravenous drug preparation and administration. The case emphasizes the critical need for healthcare professionals to follow recommended protocols to reduce the risk of infusion-related complications, especially in patients with underlying comorbidities.

Standard dose Cytarabine-Induced Encephalopathy in an Acute Myeloid Leukemia Patient: A Case Report

Mehrshad Ebrahimpour — 2024-10-02

The mainstay of treatment for acute myeloid leukemia (AML), cytarabine, is known to induce encephalopathy, usually at high doses. During induction chemotherapy, a 38-year-old woman with non-M3 AML experienced encephalopathy following the administration of standard-dose cytarabine. The patient's mental state deteriorated, and she exhibited symptoms of physical weakness, confusion, and lethargy. There were no abnormalities in the brain parenchyma discovered by a CT scan. After a diagnosis of cytarabine-induced encephalopathy, cytarabine treatment was abruptly discontinued. Levetiracetam was used for managing seizures, intravenous hydration, and medication management, all of which were put into place as supportive measures. Over the next few days, the patient's mental state got better, and ten days later, she was fully conscious again. The encephalopathy and cytarabine were likely related, according to the Naranjo scale. Cytarabine was not reintroduced due to the patient's recovery and to prevent any potential problems. Rather, an alternate treatment regimen consisting of etoposide and mitoxantrone was initiated. This case emphasizes how crucial it is to take cytarabine-induced encephalopathy into account as a possible side effect when treating AML, even at lower doses of the medication. to minimize patient morbidity and ensure a successful treatment course, healthcare practitioners need to be on alert for signs and symptoms of this condition. Early detection and rapid cessation of cytarabine medication are critical steps in this regard.