Prevalence of diabetes mellitus and antidiabetic drug utilization in the Eastern Bosnia and Herzegovina: A pilot study

There are no national estimates for the prevalence of DM in Bosnia and Herzegovina (BiH), available data is extrapolated from neighboring countries. This study aimed to determine the prevalence of DM, as well as utilization of antidiabetic drugs (ADs) and exposure rates of DM patients to ADs in the eastern region of the Republic of Srpska (RS), BiH. For external reference, data were compared to that from Serbia, Hungary and Norway. Data on the number of all adult patients with DM type 1 and 2 in the three municipalities in the eastern region of RS were obtained from medical records. The use of ADs in the RS, Serbia, Hungary and Norway for the year of 2013 was analysed by ATC/Defined Daily Dose methodology. The exposure of DM patients to ADs was expressed in percentage. The recorded DM prevalence in the three observed municipalities was 6.65%, with high proportion of type 1 compared to type 2 DM (25.32% to 74.68%). The total consumption of ADs recorded in our study was similar to those in Norway, but lower than in Serbia and Hungary. The percentage of theoretical exposure of each patient to ADs was only 78,24%, similar to that in Serbia (80.6%), whereas Norway and especially Hungary had exceptionally good exposure rates (103,8 and 126.5%). High proportion of type 1 DM patients recorded in our study indicates the insufficient detection of DM, especially type 2, whereas the low exposure rate of patients with DM to ADs indicates that even the registered patients with DM are undertreated. There is an urgent need for interventions in prevention and treatment of DM in BiH

The role of a pharmacist in pharmacovigilance system

Introduction: Although they represent an important mediator between patients and National Pharmacovigilance Centre, pharmacists still don't participate enough in system of reporting adverse drug reactions (ADR). By reporting ADR both quality of therapy and quality of patient's life are improving, and pharmaceutical industry is also encouraged to invent and produce new formulations which will be better beared and whose use will significantly improve risk-benefi t ratio. Aim: The aim of this work is that by collecting information about ADRs, based on direct contact of a pharmacist and patients, explain and improve the role of a pharmacist in pharmacovigilance system. Subjects and Methods: Information about adverse reactions were being collected in three private pharmacies in Inđija and in one private pharmacy in Sombor. In period from 20.12.2017.-10.01.2018. pharmacists collected data about adverse reactions of medicines. In period from 11.01.-01.02.2018. patients were additionally informed about unexpected and adverse drug reactions. The standard form for reporting an adverse reaction, which was taken from the site of Medicines and Medical Devices Agency of Serbia (ALIMS), was fi lled for each reported case and sent to National Pharmacovigilance Center (NPC). Suspect drugs were classified in categories according to Anatomical-Therapeutic-Chemical classification (ATC). Results: In first period, there were 19 reported reactions. After additional information given to patients, there were 33 reported adverse reactions. The most numerous adverse drug reactions were reported for the group of cardiovascular drugs (32.7%), the group of anti-infective drugs with systemic effects (15.4%) and for group of drugs which affect nervous system (13.5%). After analyzing reported reactions, according to NPC all of reactions were expected (52), but 3 of them fulfilled criteria of seriousness. Conclusions: Thanks to additional information and direct communication between a pharmacist and patients, reporting unexpected and adverse drug reactions is significantly improving

Responses to Balkanism in Emir Kusturica's Život je čudo/Life is a Miracle

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Effects of intestinal flora on pharmacokinetics and pharmacodynamics of drugs

Gut microbiota is known as unique collection of microorganisms (including bacteria, archaea, eukaryotes and viruses) that exist in a complex environment of the gut. Recently, this has become one of the most popular areas of research in medicine because this plays not only an important role in disease development, but gut microbiota also influences drug pharmacokinetics. These alterations in drug pharmacokinetic pathways and drug concentration in plasma and blood often lead to an increase in the incidence of toxicological events in patients. This review aims to present current knowledge of the most commonly used drugs in clinical practice and their dynamic interplay with the host’s gut microbiota as well as the mechanisms underlying these metabolic processes and the consequent effect on their therapeutic efficacy and safety. These new findings set a foundation for the development of personalized treatments specific to each metabolism, maximizing drugs’ therapeutic effects and minimizing the side effects because they are one of the major limiting factors in treating patients

Decade of lung cancer in Serbia: tobacco abuse and gender differences

OBJECTIVE: Lung cancer (LC) is one of the most frequently diagnosed cancers and the leading cause of cancer mortality worldwide. The aim of this study was to get a comprehensive insight into the epidemiology of LC among patients in Vojvodina, the Northern Serbian region, during the ten-year period. PATIENTS AND METHODS: This retrospective study was performed using LC hospital registry data of the Institute for Pulmonary Diseases of Vojvodina (IPBV) from 2011 to 2020. All patients reported in the registry with a place of residence in Vojvodina were included in this study. The data used in this research were: date of diagnosis, gender, age at diagnosis, place of residence, smoking habits at diagnosis, the intensity of smoking (pack/years), ECOG performance (0-5), histological cancer type, TNM classification and disease stage. RESULTS: A total of 12,055 LC patients were included, 69.6% of whom were male. The percentage of female LC patients significantly increased, from 26.9% in 2011 to 35.9% in 2020 (p<0.001). Non-small cell lung cancer (NSCLC) was diagnosed in 80.8% of patients, while 15.4% of patients had small cell lung cancer (SCLC). The most common histological type was adenocarcinoma (41.9%), followed by squamous cell carcinoma (30.0%) and SCLC (15.4%). CONCLUSIONS: The number of diagnosed LC patients in the Northern Serbian region increased over the past decade and is significantly higher in females. There was a strong correlation between smoking habits and LC in both genders. Our results also indicate the importance of introducing and promoting LC screening programs for all risk populations, particularly current and ex-smokers of younger age

The role of population pharmacokinetic analysis in rational antibiotic therapy in neonates

status: publishe

Pharmacy students’ knowledge and attitudes regarding cannabis for medical purposes

Introduction: With the growing trend for legalization of cannabis and its derivatives in Serbia, pharmacists are likely to be consulted on the safety, efficacy, and drug-drug or drug-disease interactions of medical cannabis. Thus, the aim of our study was to assess pharmacy students’ knowledge and attitude toward medical cannabis use in Serbia to determine if additional education is needed. Subjects and methods: In the study students from the final year of the study program of integrated academic studies of pharmacy at the Faculty of Medicine, University of Novi Sad were asked to complete an anonymous questionnaire regarding their knowledge and attitudes on the use of cannabis and its derivatives in medical purposes. After giving their written informed consent, they were instructed by the researchers on how to complete the questionnaire. All questionnaires were administered between August 1, 2017 and August 15, 2017. The study was approved by the Ethical Committee of the Faculty of Medicine in Novi Sad; a total of 80 questionnaires were distributed. The questionnaire consisted of 3 groups of statements on which they should mark level of their agreement related to students’ knowledge about the use of cannabis and its derivatives in therapeutical purposes, potential negative effects, dispensing in a pharmacy and legalization of cannabis and its derivatives in medical purposes. Results: Although 91.2% of the respondents agreed that cannabis and its derivatives could potentially have therapeutical effects, much lower percentage of respondents (51.3%) were familiar with possible therapeutical effects of cannabis. The same percentage of respondents learned about therapeutical effects of cannabis from sources other than school. About third (31.3%) of our respondents thought that the use of cannabis and its derivatives in therapeutical purposes could cause their abuse and the similar percentage of respondents (33.8%) thought that issuing cannabis and its derivatives in the pharmacy could expose a pharmacist to the certain dangers such as insisting on the issuing without the prescription or robbery. About 90% of the respondents agreed it is necessary to create clear guidelines for the use of cannabis and its derivatives in therapeutical purposes and 76.3% of the respondents thought that doctor’s prescription is necessary for their dispensing in a pharmacy. Most of the respondents (75%) agreed that, based on the experiences of the countries which have approved the use of cannabis and its derivatives in therapeutical purposes, its use in those purposes should be approved in Serbia. Conclusion: The majority of pharmacy students supported medical cannabis legalization but only with strict legal regulations and clear guidelines for their use implemented. Further education of the pharmacist about therapeutical effect of cannabis is necessary

Analgesic and anti-inflammatory effects of diclofenac and ketoprofen patches in two different rat models of acute inflammation

Objectives: Topical forms of Non-steroidal anti-inflammatory drugs (NSAIDs) used to treat pain, fever and inflammation ensure reduced occurrence of systemic adverse effects that are common with oral application. Compared to the systemic therapy, topical applications of NSAIDs require lower doses to achieve pain relief, and thus pose lower risk of major drug interactions. We aimed to evaluate analgesic and anti-inflammatory effects of diclofenac and ketoprofen patch in the rat model of acute inflammation. Methods: Wistar male rats, body weight 220–290 g were randomized into five groups with six rats. Two groups were treated with diclofenac patch at different doses, two with ketoprofen patch at different doses, while a placebo patch was administered to the control group. After patches removal and initial measurements of pain, gait, body temperature, paw temperature, color and paw volume, the models of acute inflammation were applied: yeast-induced hyperalgesia and carrageenan-induced edema. Measurements were repeated one, three and five hours after inflammation induction. Results: Acute inflammations induced by both used models did not affect the whole-body temperature. However, there were significant (p < 0.05) differences in pain, gait, paw temperature, color and volume between low and high dose diclofenac and ketoprofen groups compared to the control group in different time points, in both models. Conclusions: Our results confirm the analgesic and anti-inflammatory efficacy of diclofenac and ketoprofen patches when used in two well-established rat models of inflammation. These findings suggests that diclofenac patch would be a useful formulation in clinical practice as a novel treatment option. However, new prospective double blind randomized clinical trials are necessary to evaluate analgesic and anti-inflammatory effect of topically applied NSAIDs when used in specific pain and inflammation indications