Clinical Pharmacy Clerkship in Pakistan: A leap from paper to practice

This is the first article of its type to describe the advances taking place in clinical pharmacy education in Pakistan. The Pharmacy Council of Pakistan has developed a five-year Pharm.D program to replace the four-year B.Pharm degree. Completing clinical pharmacy clerkships is a prerequisite for receiving the Pharm.D degree. To meet this requirement, Ziauddin College of Pharmacy has developed a specialized clerkship program for its 4th and 5th year students. The College is fortunate to be linked with well developed tertiary care hospitals at three prime locations in the in the metropolitan city of Karachi, which provides opportunity for the students to gain exposure to real life situations and work with patients. The article presents an account of the efforts taken for development of the clinical pharmacy clerkship program, the problems encountered during its development, and the main outcomes of a clerkship program.   Type: Not

Enteric coating of ibuprofen tablets (200 mg) using an aqueous dispersion system

Ibuprofen is a propionic acid derivative that belongs to the class NSAIDs. Major adverse reactions associated with Ibuprofen are related to GIT and include peptic and mucosal ulcers, dyspepsia, severe gastric pain and bleeding, that results in excessive treatment failure. The goal of this study was to develop enteric coated ibuprofen tablets in order to avoid gastric mucosal irritation, diffusion of drug across mucosal lining and to let active ingredient be absorbed easily in small intestine. The formulation was developed and manufactured through the direct compression process, the simplest, easiest and most economical method of manufacturing. Enteric coating was done using an Opadry white subcoating and an aqueous coating dispersion of Acryl-Eze. Enteric coated formulation was subjected to disintegration and dissolution tests by placing in 0.1 M hydrochloric acid for 2 h and then 1 h in phosphate buffer with a pH of 6.8. About 0.04% of drug was released in the acidic phase and 99.05% in the basic medium. These results reflect that ibuprofen can be successfully enteric coated in order to prevent its release in the stomach and facilitate rapid release of the drug in the duodenum, due to the presence of superdisintegrant. Formulating this enteric coated tablets could increase patient compliance by decreasing adverse drug reactions (ADR S) associated with Ibuprofen therapy.Ibuprofeno é um derivado do ácido propiônico, que pertence à classe dos fármacos não-esteróides (AINES). As principais reações adversas associadas com o ibuprofeno se referem àquelas do trato gastrintestinal (TGI), como úlceras pépticas e da mucosa, dispepsia, dor gástrica grave e sangramento, que resultam em muitas falhas de tratamento. O objetivo do estudo foi desenvolver comprimidos revestidos de ibuprofeno que impeçam a irritação da mucosa gástrica, difusão do fármaco através da mucosa e permitam, facilmente, a absorção do princípio ativo do intestino delgado. A formulação foi desenvolvida e manufaturada por meio de processo de compressão direta, método mais simples e econômico de preparação. O revestimento entérico foi efetuado utilizando-se subrevestimento com Opadry branco e revestimento por dispersão aquosa de Acryl-Eze. A formulação de revestimento para liberação entérica foi submetida a testes de desintegração e de dissolução, em ácido clorídrico 0,1 M, por 2 h, e, então, a h, em tampão fosfato pH 6,8. Cerca de 0,04% do fármaco foi liberado na fase ácida e 99,05%, no meio básico. Estes resultados refletem o fato de que o ibuprofeno pode ser revestido com sucesso, a fim de impedir sua liberação no estômago e facilitar a rápida liberação do fármaco no duodeno, devido à presença de superdesintegrante. A formulação de tais comprimidos aumentaria a adesão do paciente pela diminuição das reações adversas (RAs), associadas à terapia com ibuprofeno

An Overview of Clinical Pharmacology of Ibuprofen

Ibuprofen was the first member of Propionic acid derivatives introduced in 1969. It is a popular domestic and over the counter analgesic and antipyretic for adults and children. Ibuprofen has been rated as the safest conventional NSAID by spontaneous adverse drug reaction reporting systems in the UK. This article summarizes the main pharmacological effects, therapeutical applications and adverse drug reactions, drug-drug interactions and food drug interactions of ibuprofen that have been reported especially during the last 10 years

Clinical Pharmacy Clerkship in Pakistan: A leap from paper to practice

This is the first article of its type to describe the advances taking place in clinical pharmacy education in Pakistan. The Pharmacy Council of Pakistan has developed a five-year Pharm.D program to replace the four-year B.Pharm degree. Completing clinical pharmacy clerkships is a prerequisite for receiving the Pharm.D degree. To meet this requirement, Ziauddin College of Pharmacy has developed a specialized clerkship program for its 4th and 5th year students. The College is fortunate to be linked with well developed tertiary care hospitals at three prime locations in the in the metropolitan city of Karachi, which provides opportunity for the students to gain exposure to real life situations and work with patients. The article presents an account of the efforts taken for development of the clinical pharmacy clerkship program, the problems encountered during its development, and the main outcomes of a clerkship program

In Vitro Susceptibility Test of Different Clinical Isolates against Ceftriaxone

Objectives: Because of the prevailing penicillin resistance in microorganisms, broad spectrum cephalosporins are used empirically specially in developing countries. The aim of this study is to determine the susceptibility pattern of different gram positive and gram negative pathogens against third generation cephalosporin-ceftriaxone to explore the existing effectiveness of this antibiotic.Methods: 180 clinical isolates of different gram positive and gram negative pathogens including P.mirabilis, S. typhi P.aeruginosa, E. coli, S. aureus and Klebsiella were collected from blood and urine samples of in-patients. 30 isolates of all species were tested against each of six brands of ceftriaxone using in vitro sensitivity tests by disc diffusion method (NCCLS criteria). The susceptibility limit was ≥21 mm zone of inhibition, while moderately susceptible was considered at 20-14 mm, and those isolates which showed >13 mm or no zone of inhibition were resistant to this antibacterial drug.Results: Ceftriaxone was found most effective against S. aureus. While 96.1% of the isolates showed susceptibility towards ceftriaxone, followed by E. coli (95%), P. aeruginosa (92.7%), K. pneumonia (89.4%) and S. typhi (87.2%). P. mirabilis showed lowest susceptibility amongst all the test organisms (83.8%).Conclusion: Ceftriaxone can be used as a drug of choice in infections caused by S. aureus, E. coli, P. aurigenosa, K. pneumonia and S. typhi. However, it should be used with other antimicrobial agents in order to increase its effectiveness against P. mirabilis

Food-Drug Interactions

The effect of drug on a person may be different than expected because that drug interacts with another drug the person is taking (drug-drug interaction), food, beverages, dietary supplements the person is consuming (drug-nutrient/food interaction) or another disease the person has (drug-disease interaction). A drug interaction is a situation in which a substance affects the activity of a drug, i.e. the effects are increased or decreased, or they produce a new effect that neither produces on its own. These interactions may occur out of accidental misuse or due to lack of knowledge about the active ingredients involved in the relevant substances. Regarding food-drug interactions physicians and pharmacists recognize that some foods and drugs, when taken simultaneously, can alter the body's ability to utilize a particular food or drug, or cause serious side effects. Clinically significant drug interactions, which pose potential harm to the patient, may result from changes in pharmaceutical, pharmacokinetic, or pharmacodynamic properties. Some may be taken advantage of, to the benefit of patients, but more commonly drug interactions result in adverse drug events. Therefore it is advisable for patients to follow the physician and doctors instructions to obtain maximum benefits with least food-drug interactions. The literature survey was conducted by extracting data from different review and original articles on general or specific drug interactions with food. This review gives information about various interactions between different foods and drugs and will help physicians and pharmacists prescribe drugs cautiously with only suitable food supplement to get maximum benefit for the patient

Community pharmacy practice in Pakistan

Objectives: This study was planned to determine the extent to which the role of a pharmacists is established in community pharmacies in Pakistan and to determine the need of qualified and experienced pharmacists in provision of healthcare at these medical stores or so called community pharmacies. Materials and Methods: A structured questionnaire was distributed to a random sample of 175 attendants at various medical stores located in different areas of Karachi with a response rate of 90.28%. Questionnaire consisted of 24 closed ended questions whose consistency and reliability were determined by Cronbach′s alpha. Statistical analysis were done using SPSS (v.16.0) Results: The result shows that the average age of pharmacy attendant lies between 21 and 30 years. Only 9.49% of attendants have professional pharmacy education. It was noted that only 22.6% check prescriber signature before dispensing prescription, which is quite a low as compared with standard practice. Interestingly 57.6% attendants think that presence of qualified pharmacy at medical stores does not make any difference in the efficacy and the business of medical stores. Conclusion: This study concludes that the current status of community pharmacy practice is below par. There is a need to involve more pharmacists at community level and develop awareness programs to counter patients′ routine drug issues and reducing the burden of disease from society