Pharmacy students’ proclivity towards entrepreneurship – a sign of future innovation in pharmaceutical care service delivery

Background: Entrepreneurial inclination is linked with improved pharmaceutical care service innovations and improvements.Objective: This study examined the propensity of pharmacy students towards entrepreneurship and factors influencing this.Material and Methods: Two hundred and eighty-one pharmacy students at the University of Ibadan participated in a two-year prospective study using a self–administered validated Pharmacy Students Entrepreneurial Orientation summated scale questionnaire with five subscales in seven-points Likert scale type graded responses. Mean and percentage mean scores were determined with a high mean score indicative of entrepreneurial tendency.Results: Percentage mean score for PSEO were 88.5% and 88.8% for the first and second year of the survey, respectively. Post-graduation business ownership intentions were high (83.0%) in both years. These intentions had significantly higher mean scores on PSEO scale (p<0.001), empathic super salesperson subscale (p=0.007), innovativeness subscale (p<0.001), and risk taking subscale (p=0.024), in the first year of survey. Pharmacy students who had taken business courses had higher PSEO mean scores than those who had not taken business courses (p=0.003). Male pharmacy students were more likely to take risks more than their female counterparts in the first year of the study (p=0.035).Conclusion: Pharmacy students maintained a high level of entrepreneurial tendency in both years of the study with most students aspiring to become business owners. Male pharmacy students were more inclined to take risk and hope to be innovative in pharmaceutical care services. To further strengthen entrepreneurial inclination, pharmacy schools curricula should include entrepreneurial courses.Keywords: Entrepreneur, Pharmacy students, Pharmacy Students Entrepreneurial Orientation summated scale, Nigeri

Prevalence and clusters of modifiable cardiovascular disease risk factors among intra- city commercial motor vehicle drivers in a Nigerian metropolitan city

Background: Commercial motor vehicle drivers (CMVDs) have worst health profiles among different occupations, yet the presence of clusters of cardiovascular disease (CVD) risk factors in this group have not been described in a resource-limited setting.Objectives: The prevalence of CVD risk factors and the clusters among CMVDs was evaluated.Design: A cross-sectional descriptive study.Setting: Four motor parks in three local government areas of Ibadan city, Nigeria.Participants: Consented and conveniently sampled 152 intra-city CMVDs aged ≥ 18 years. Main outcome measures: Prevalence of CVD risk factors (hypertension, diabetes, high triglyceride, low HDLc, high waist-hip ratio, central obesity, physical inactivity, smoking, alcohol, and overweight/obesity) and their clusters were determined.Results: All participants were male from 20 – 77 years old. Most of the CMVDs were physically inactive (80, 52.6%), take alcohol (78, 51.3%), and few smokes (35, 12.4%). The prevalence of hypertension, diabetes, hypertriglyceridemia,obesity, and central obesity were 36.2%, 5.9%, 23.7%, 4.6%, and 5.3%, respectively. Four clusters of CVD risk factors in the CMVDs with the prevalence of 36.2%. 33.5%, 17.1% and 13.2% were identified with significant differences (p<0.05) in the risk factors.Conclusion: The prevalence of diabetes, obesity, central obesity, and smoking was low while the prevalence of hypertension and hypertriglyceridemia was moderate among the CMVDs, but the prevalence of alcohol intake and physical inactivity were high. Four distinct clusters of CVD risk factors were observed among the drivers.Keywords: Cardiovascular diseases, Risk factors, Motor vehicles, Commercial vehicle drivers, Nigeria.Funding: The study was self-funded

Evaluation of the extent and pattern of use of herbal bitters among students in a tertiary institution in Southwestern Nigeria

Purpose: To evaluate the extent and pattern of use of herbal bitters among students.Methods: This was a cross-sectional study where pre-tested structured questionnaires were administered to 1000 students. The questionnaire elicited information on the extent and pattern of use, self-reported indications, side effects experienced and possible drugs that were concomitantly coadministered with herbal bitters. Pearson Chi square, Fisher exact test and Relative risk ratio were used to detect association between gender and self-reported indications and side effects experienced with herbal bitters at a level of significance of p < 0.05.Results: The response rate and extent of use were 96 % and 40.9 % respectively. Herbal bitters were used for claims such as cleansers 88 (40.2 %), anti-infectives 48 (21.1 %), for rejuvenation 32 (14.0 %), and for weight loss 14 (6.1 %). Self-reported side effects included dizziness 49 (22.0 %), loss of taste 46 (20.6 %) and nausea and vomiting 22 (9.7 %). Herbal bitters were also co-administered with antimalarials 22 (6.3 %); analgesics 16 (4.5 %) and herbal supplements 13 (3.7 %). Reports of students using two different types of herbal bitter concurrently 15 (3.9 %) were also garnered. Male students experienced more side effects than females (p < 0.05).Conclusion: The co-administration of herbal bitters with allopathic medicines and the use of more than one herbal bitter at a time reported in this study can be addressed by the appropriate health authorities through proper educational programme.Keywords: Herbal bitters, Allopathic medicines, Students, Advertisement, Nigeri

The concept of adverse drug reaction reporting: awareness among pharmacy students in a Nigerian university

Adverse drug reaction (ADR) is poorly reported globally but more in developing countries with poor participation by health professionals. Currently, there is no known literature on the Nigerian pharmacy students’ knowledge on ADR reporting. Hence the purpose of this study was to find out the level of knowledge of pharmacy students on the concept of pharmacovigilance and adverse drug reaction reporting and also to evaluate their opinions on the National Pharmacovigilance Centre guidelines on adverse drug reaction reporting. A pretested 34-item semi-structured questionnaire was administered among 69 pharmacy undergraduate students in their penultimate and final years that consented to take part in the study, in one of the universities in Nigeria. The study was carried out strictly adhering to the principles outlined in the Helsinki declaration of 1964, which was revised in 1975. The questionnaire used had four sections which included a section on biographical data, a section which evaluated the students knowledge on the concept of pharmacovigilance and adverse drug reaction reporting, a section on students personal experiences of adverse drug reactions and modes of reporting them and the final section of the questionnaire evaluated the students’ opinions on the National Pharmacovigilance Centre guidelines for reporting adverse drug reactions. Descriptive statistics, Mann-Whitney U and Kruskal Wallis statistical tests were used to analyze the data obtained. None of the participants knew the sequence of reporting ADR. More than half, 40(58.0%) had heard about pharmacovigilance at symposiums, 7(10.1%) during clinical clerkship program and 18(26.1%) from media jingles. Twenty nine (42.0%) agreed that pharmacovigilance was in their curriculum, however only 16(23.2%) could define the term correctly. None of the participants had seen or used an ADR form prior to the study, but the students could easily identify and describe the type of ADR they had personally experienced in detail, however, they did not know the channel of reporting it. Only 3% reported incidences of personal experience of ADR to the physician while another 3% reported cases of such to the pharmacist. There was a significant difference comparing students’ year of study in the pharmacy program with their opinion scores on the National Pharmacovigilance Centre (NPC) guidelines on ADR reporting (p <0.05). The lack of pharmacovigilance and adverse drug reaction reporting courses in the pharmacy school curriculum result in the poor knowledge of the students on the concept of adverse drug reaction reporting, nonetheless the view and knowledge they had garnered from different sources helped the students in identifying and describing ADR but this is not enough in properly documenting cases of ADRs. Thus, the poor knowledge on ADR reporting among the students requires speedy implementation of new curriculum incorporating pharmacovigilance to enhance the involvement of pharmacists in ADR reporting in Nigeria

Safety Evaluation of Two Nigerian Polyherbal Formulations (Fidson Bitter® And Daily Living Bitter®) In Male Wistar Rats

Background: Herbal bitters are used for diverse diseases based on the manufacturers’ assertions. However, little is known about their toxicity profile.Objective: The safety profile of two commonly used herbal bitters in Nigeria (Fidson bitter® and Daily living bitter®)was evaluated in rats.Materials and Methods: Single oral dose, 2 g/kg, of each reconstituted bitter extract was administered to male and female rats in acute toxicity test. Animals were observed for 14 days for behavioral changes and mortality. In sub-acute oral toxicity experiment, 250 mg/kg and 500 mg/kg of each bitter was separately administered daily to different groups of male Wistar rats for 30 days. Safety profile of concurrent administration of these bitters was also assessed. Histopathological, hematological, and clinical chemistry indices were evaluated.Results: The LD50 was found to be &gt;2 g/kg. Daily living bitter® (DLB) had no significant effect on any of the indices evaluated (P&gt;0.05). However, Fidson bitter® caused significant reductions in white blood cells count (WBC) compared with the control. Concomitant administration of the bitters resulted in significant (P&lt;0.05) weight gain (up to 33 %), reduction in WBC and congestion of the liver without corresponding increase in liver biomarkers.Conclusion: Daily living bitter® was safe in sub-acute administration while Fidson bitter®and combination of the two bitters reduced white blood cell count. Hence, caution should be exercised in using Fidson bitter® or combination of the two bitters in humans as findings suggest possibility of immune suppression.Keywords: Toxicity profile, Polyherbal, Herbal bitters, Hematology, Wistar rats

Remedies for glucose intolerance – are traditional herbal concoctions for diabetes effective?

Background:Preventing or delaying the onset of diabetes in prediabetes has the potential to reduce the disease prevalence.Objective:The effectiveness of traditional herbal concoctions for diabetes in ameliorating glucose intolerance was investigated.Material and Methods:Oral glucose tolerance test (OGTT) was carried out by giving 500 mg/kg and 1000 mg/kg of individual plant extract and their aqueous herbal concoctions made from Musa sapientum + Allium sativum + Tetracarpidium conophorum; Gongronema latifolia + Bauhinia monandra; and Alstonia boonei + Mangifera indica to groups of rats, 30 and 60 minutes respectively prior to 3 g/kg of glucose load. Blood glucose levels were determined at 0, 10, 20, 30, 45, 60, 90, and 120 minutes post administration. Area under the curve (AUC) for OGTT and glycemic index were calculated and compared with the vehicle control and metformin (100 mg/kg). Level of significance was set at P&lt;0.05.Results:Oral glucose tolerance test AUCs of individual plants were significantly lower than that of the vehicle control (P&lt;0.05) but comparable with that of metformin (P&gt;0.05) when given 30 minutes prior to glucose load. The OGTT curve AUCs of the three herbal concoctions were significantly higher than the two controls (P&gt;0.05). Glycemic index of the concoctions were significantly higher than that of metformin (P&gt;0.05)Conclusion:The herbal concoctions were not effective in ameliorating glucose intolerance. Individual plants were more effective when administered 30 minutes prior to glucose load. The individual herbs showed potentials to delay the onset of diabetes. Further investigations should be conducted on the numerous herbal concoctions used for diabetes.Keywords: Diabetes, Herbs, Oral glucose tolerance tes

Potential inappropriate prescribing among ambulatory elderly patients in a geriatric centre in southwestern Nigeria: Beers criteria versus STOPP/START criteria

Purpose: To identify potentially inappropriate prescribing in ambulatory elderly patients and compare the appropriateness of guidelines; Beers' and Screening Tool of Older Person’s Prescription (STOPP)/Screening Tool to Alert Right Treatment (START) criteria to detect potentially&nbsp; inappropriate prescribing among the elderly.Methods: A retrospective study was conducted using case files of 335 elderly patients aged ≥ 60 years between 1st January and 31st December&nbsp; 2016, using a data extraction sheet. The 2015 American Geriatrics Society (AGS)-Beers Criteria, and version 2 of the STOPP and START were&nbsp; subsequently used to identify the Potentially Inappropriate Prescribing (PIP) and Potential Prescribing Omissions (PPOs).Results: Mean age of patients was 69 ± 0.4 years (range 60 - 85 years) and 219 (65.4 %) were females. An average of 4.2 medications per patient prescription was found. The Beers criteria identified 26.5 % PIP, while STOPP criteria identified 57.1 % PIP. START detected 29 PPOs in 15 (4.4 %) of the patient’s prescription. The most prevalent disease conditions were hypertension 235 (70.1 %) and osteoarthritis 64 (19.3 %). Polypharmacy was significantly associated with PIP in both Beers (p = 0.002) and STOPP (p = 0.001) criteria.Conclusion: The prevalence of PIP is high among elderly patients. The STOPP/START criteria identified a higher proportion of PIP among elderly patients compared with Beers criteria. The frequency of PIP should stimulate efforts to curtail potentially inappropriate prescribing and may require the need for advocating for a national criterion to be adopted by health care professionals in Nigeria. Keywords: Potential inappropriate prescribing, Beers’ criteria, STOPP/START criteria, Elderl

IN VITRO INHIBITORY ACTIVITIES OF THE EXTRACT OF HIBISCUS SABDARIFFA L. (FAMILY MALVACEAE) ON SELECTED CYTOCHROME P450 ISOFORMS.

Literature is scanty on the interaction potential of Hibiscus sabdariffa L., plant extract with other drugs and the affected targets. This study was conducted to investigate the cytochrome P450 (CYP) isoforms that are inhibited by the extract of Hibiscus sabdariffa L. in vitro. The inhibition towards the major drug metabolizing CYP isoforms by the plant extract were estimated in human liver microsomal incubations, by monitoring the CYP-specific model reactions through previously validated N-in-one assay method. The ethanolic extract of Hibiscus sabdariffa showed inhibitory activities against nine selected CYP isoforms: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4. The concentrations of the extract which produced 50% inhibition of the CYP isoforms ranged from 306 µg/ml to 1660 µg/ml, and the degree of inhibition based on the IC50 values for each CYP isoform was in the following order: CYP1A2 > CYP2C8 > CYP2D6 > CYP2B6 > CYP2E1 > CYP2C19 > CYP3A4 >> CYP2C9 >> CYP2A6. Ethanolic extract of Hibiscus sabdariffa caused inhibition of CYP isoforms in vitro. These observed inhibitions may not cause clinically significant herb-drug interactions; however, caution may need to be taken in co-administering the water extract of Hibiscus sabdariffa with other drugs until clinical studies are available to further clarify these findings

Current trends in drug metabolism and pharmacokinetics.

Pharmacokinetics (PK) is the study of the absorption, distribution, metabolism, and excretion (ADME) processes of a drug. Understanding PK properties is essential for drug development and precision medication. In this review we provided an overview of recent research on PK with focus on the following aspects: (1) an update on drug-metabolizing enzymes and transporters in the determination of PK, as well as advances in xenobiotic receptors and noncoding RNAs (ncRNAs) in the modulation of PK, providing new understanding of the transcriptional and posttranscriptional regulatory mechanisms that result in inter-individual variations in pharmacotherapy; (2) current status and trends in assessing drug-drug interactions, especially interactions between drugs and herbs, between drugs and therapeutic biologics, and microbiota-mediated interactions; (3) advances in understanding the effects of diseases on PK, particularly changes in metabolizing enzymes and transporters with disease progression; (4) trends in mathematical modeling including physiologically-based PK modeling and novel animal models such as CRISPR/Cas9-based animal models for DMPK studies; (5) emerging non-classical xenobiotic metabolic pathways and the involvement of novel metabolic enzymes, especially non-P450s. Existing challenges and perspectives on future directions are discussed, and may stimulate the development of new research models, technologies, and strategies towards the development of better drugs and improved clinical practice

Mystery patient evaluation of counseling quality offered by community pharmacists

The data presented here were collected in Ibadan metropolis, Ibadan Nigeria in 2019 using six standardized mystery patients. the data shows baseline evaluation of counseling provided by community pharmacists when visited by patients on warfarin. the educational intervention was offered in the form of an online training module on oral anticoagulant counseling. After the training, the community pharmacists were again evaluated for the quality of counseling offered to mystery patients of warfarin. These are SPSS data set