Migraine Management Using Feverfew, Butterbur, Peppermint, and Ginger: Perspectives of Pharmacy Students

A literature search and a survey of pharmacy students were conducted regarding some common herbs used for the treatment of migraine. The literature search shows that feverfew, traditionally used for migraines, had mixed evidence of effectiveness, while butterbur received a strong recommendation for prevention. Peppermint showed promise in reducing headache intensity, particularly when given intranasally, but ginger's efficacy remains unclear. Further research is needed to confirm ginger's role in migraine treatment. The survey, which was conducted among 39 pharmacy students on five knowledge-based and five opinion-based questions regarding the use of herbal remedies revealed a varied comprehension level, with an overall 69% accuracy in knowledge-based responses regarding migraines. For the most part, respondents demonstrated awareness of lifestyle measures in preventing migraines, but many respondents lacked clarity on self-medicating with herbal remedies and over the counter products. Opinion-based inquiries indicated a positive inclination towards herbal remedies, with more than 80% agreeing on their viability as alternatives to conventional medications. The survey showed a 69% average correctness rate for knowledge-based questions about migraines. Maintaining a regular sleep schedule received the highest accuracy at 94.1%, while stress as a trigger for migraines received a 71.4% correct response rate. Over 70% believed that those using herbal remedies for migraines were generally more satisfied with their treatment outcomes. While there is a need for improved education on migraine-related topics, there is a prevailing positive attitude toward the potential benefits of herbal remedies in managing migraines. Diverse opinions existed on satisfaction levels and the comparative effectiveness of lifestyle changes versus herbal interventions. Despite limitations in the sample size and focus on pharmacy students, the study underscores the need for enhanced education on migraines while highlighting growing interest in alternative healthcare among healthcare professionals.&nbsp

Non-Approved Uses of Celecoxib and Indomethacin: Pharmacy Students’ Knowledge and Opinions

A survey was conducted among first-year pharmacy students at Howard University College of Pharmacy to measure their level of knowledge and gauge their opinion regarding the off-label uses of two non-steroidal anti-inflammatory drugs (NSAIDs), indomethacin and celecoxib. The average level of knowledge on indomethacin and celecoxib was 36.2% and 31.2%, respectively. Among the five knowledge-based questions on each of these drugs, the highest correct response rate was obtained on indomethacin dosing at 72.9%, and 64.7% on the class of drugs celecoxib belongs to. In the responses to questions on indomethacin, the highest correct response of 72.9% was significantly higher (p<0.05) than responses to other knowledge-based questions, except for the knowledge level on the class of drugs (59.5%; p=0.3257). In the same manner, the correct response rate of 64.7% for the class of drugs that celecoxib belongs to was significantly higher than the response rates for the other questions (p<0.05), except when compared to the response to the question whether hyperplastic polyps and serrated polyps can develop into cancer (41.2%, p=0.0883). The opinions of the students varied, with a majority (55.9%) agreeing that serious diseases should be treated with non-approved medications. In the case of indomethacin, 35.5% of the respondents believed that because of toxicity issues, it should not be used outside the approved indications, while 27.8% believed that the safety has been established and can be used outside the approved use. Most respondents (55.9%) on celecoxib thought colorectal cancer is a serious disease and can be treated with non-approved drugs

Pharmacist-led smoking cessation services in Ethiopia: Knowledge and skills gap analysis

Introduction The present study’s objectives were: 1) assess the knowledge and attitude of pharmacists and pharmacy students regarding smoking/smoking cessation, and 2) document the extent of community pharmacists’ involvement in the provision of smoking cessation services in Ethiopia. Methods This study used cross-sectional and direct observation methods. A series of questionnaires were administered to final-year pharmacy students and practising pharmacists. Two scenarios simulating tobacco use in pregnancy and cardiovascular patients were selected and played by two well-trained simulated patients (SPs). Findings were analysed and presented using mean total scores, analysis of variances and independent sample t-test. Results A total of 410 participants (213 out of 238 pharmacy students, response rate 89.5%; 197 out of 361 pharmacists, response rate 54.6%) completed the survey. Both pharmacy students and practising pharmacists had positive attitudes towards smoking cessation, and both groups had similar mean knowledge scores. A total of 80 simulated visits were conducted. Recipients of training on smoking cessation had significantly higher mean knowledge and attitude scores compared with those who did not receive such training. The majority of the pharmacists demonstrated poor in history-taking practice, and seldom assessed the patients’ nicotine dependence level. Nicotine replacement therapies (NRTs) were supplied in only 10 of the visits and suggested, but not dispensed, in 35 of the visits. On the other hand, pharmacists in 59 visits counselled patients to visit addiction specialists and physicians. Conclusions The present study revealed the presence of significant clinical knowledge gaps and inadequate skills among pharmacists regarding smoking cessation services. Educating pharmacists about smoking cessation support as part of their continuous professional development and providing a hands-on customised educational intervention, such as practice guidelines in the form of an Ask-Advise-Refer approach, about smoking cessation will be useful

Clinical Implications and Limitations of JNC7 in HTN Management and Recommendations for JNC8

Hypertension (HTN) is the persistent elevation of arterialblood pressure, and if untreated, it leads to coronary heartdisease (CHD) and target organ disease (TOD). 5 HTN is themost common primary diagnosis in the United States, affectingover 52 million Americans.6 The prevalence of HTN increaseswith age, is more common among African Americans, and ismore common among men. Since 2003, the current practiceguidelines for the evaluation and management of HTN in theUnited States have been made available by the National Heart,Lung, and Blood Institute. The Seventh Report of the JointNational Committee on Prevention, Detection, Evaluation, andTreatment of High Blood Pressure, or JNC 7, revised previousrecommendations. The practice guidelines were necessitatedby the findings of many observational studies and clinical trialsdealing with HTN; the need for useful, clear and concise clinicalguidelines; the JNC’s consensus that a simplified classificationof blood pressure (BP) was necessary; and a realization thatclinicians were not using previous guidelines very much.1–