Abuse of sulfonylureas: Is factitious hypoglycemia a cause for concern?

Several prescription and nonprescription drugs are liable for abuse. However, oral hypoglycemic agents are among the most benign and low-risk drugs in terms of abuse liability. This commentary intends to raise awareness regarding the abuse of a particular type of oral hypoglycemic agent, namely sulfonylurea drugs, used to experience mental-altering effects for its euphoric “hypoglycemic rush.” Information is available on discussion fora online where people exchange their experiences. Moreover, several case reports have been published and described the liability for abuse of sulfonylurea drugs. This article intends to shed the light on this phenomenon in light of the available literature, attempting to explain the possible scientific basis for it. In addition, it highlights the need for health professional awareness and vigilance for this form of drug diversion. © 2019, Springer Nature Switzerland AG

Knowledge, attitude and opinion of drug misuse and abuse by pharmacy students: a cross-sectional study in Jordan

Purpose: To assess the knowledge, attitude and opinion of final-year undergraduate and postgraduate pharmacy students regarding inappropriate drug use in a university campus, Amman, Jordan.Methods: A cross-sectional survey using a self-completed validated anonymous questionnaire that consisted of two parts was adopted. The first part of the questionnaire pertained to respondents’ demographic details, education level and any experience they might have had with drug misuse or abuse. The second part described students' knowledge, attitude and practice regarding the identification, prevention and management of drug misuse and abuse.Results: A total number of 198 pharmacy students filled the questionnaire (N = 131 undergraduate, and N = 67 postgraduate students). A majority of the students strongly agreed/agreed that all pharmacy staff must be trained on recognizing drug abusers (92.0 %), informed of the kinds of drugs abused in the local area of the pharmacy (93.4 %) and trained on methods of dealing with drug abusers (92.6 %).Conclusion: There is a need to implement a well-structured training on the identification, prevention and management of prescription and OTC drug misuse and abuse in undergraduate pharmacy curricula in Jordan. Modules should be updated regularly and tailored to meet the needs of pharmacy practice

Pregabalin Misuse and Abuse: A Scoping Review of Extant Literature

Prescribing of pregabalin is increasing worldwide with public health concerns centering on misuse and abuse of prescribed and diverted pregabalin. To describe and map what is known about misuse and abuse of pregabalin, a scoping review of available published literature was undertaken. A scoping review methodology was used to identify and map available literature on misuse and abuse of prescribed and diverted pregabalin. Four themes emerged on the misuse and abuse of pregabalin: (a) abuse potential, (b) prevalence of abuse, (c) risk and predisposition, and (d) consequences of abuse. Fifty-four records were reviewed and charted. Of note was the dearth of research on the topic prior to 2005, with increased interest in pregabalin abuse potential from 2010 onward. Available literature supports concern around abuse potential of pregabalin, especially among patients with a history of substance abuse. Prescribers should adopt more rational prescribing. © 2018, The Author(s) 2018

Anabolic-Androgenic Steroid Use in the Eastern Mediterranean Region: a Scoping Review of Extant Empirical Literature

The use of image- and performance-enhancing drugs particularly anabolic-androgenic steroids (AAS) is not a new phenomenon. AAS use is not limited to athletes, with mainstream populations using these drugs for aesthetic purposes. Prevalence has been predominantly in Western countries, with some recent studies indicating a rise in popularity in the Eastern Mediterranean region. A scoping review of extant empirical literature from the Eastern Mediterranean region described and mapped what is known about the extent of AAS in the region. Four themes emerged from the review: (1) profile of AAS users; (2) AAS within gymnasium practice; (3) AAS regimes of use; and (4) knowledge and understanding of the AAS concept and related adverse effects. The review highlights a relatively new phenomenon of AAS use in the Eastern Mediterranean. The review underscores the need to carry out further research, particularly qualitative and quantitative studies with both genders, and cognisant of the complexities of culture and religiosity

Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study

AbstractFactors associated with antibiotic use, resistance and safety have been well recognized worldwide in the literature. Nevertheless, only few studies have been conducted in Jordan in this area. The aim of this study was to assess knowledge, behavior and attitude toward antibiotics use among adult Jordanians. The study represents a cross sectional survey using an interviewer administered questionnaire. Data collected from a random sample of 1141 adult Jordanians, recruited at different settings, regarding their knowledge about the effectiveness of, resistance toward, and self medications with antibiotics against bacterial, viral and parasitic diseases. 67.1% believed that antibiotics treat common cold and cough. 28.1% misused antibiotics as analgesics. 11.9% of females showed inadequate knowledge about the safe use of antibiotics during pregnancy and nursing. 28.5% kept antibiotics at home for emergency use and 55.6% use them as prophylaxis against infections. 49.0% use left-over antibiotics without physicians’ consultation while 51.8% use antibiotics based on a relative advice. 22.9% of physicians prescribe antibiotics over the phone and >50.0% routinely prescribe antibiotics to treat common cold symptoms.Our findings indicated that young adults showed unsatisfactory knowledge of proper antibiotic use. Therefore, there is an urge for educational programs using all media means

Opthalmic drug abuse and misuse in Jordan: An Observational Study from Community Pharmacies in Amman.

Background: There has been a trend in the past five years in Jordan for ophthalmic anticholinergic preparations to be misused or abused. This is done mainly to experience mental altering effects such as mood changes, euphoria or hallucinations. Such products are mostly obtained from community pharmacies without a prescription. Objectives: This study aimed to observe the requests of ophthalmic preparations in community pharmacies in Amman, Jordan, and evaluating the most popular and frequently requested ophthalmic drops suspected of abuse. Also, it aimed to describe the current methods that Jordanian community pharmacists use to manage such requests. Methods: A prospective cross-sectional observational study was conducted between November 2016 and January 2017 at sixteen different community pharmacies in Amman. All ophthalmic products requested were observed during this period. Results: A total of 140 ophthalmic product requests for 130 customers were observed. Dry eye was the most common complaint for which the customer requested the medication (n = 30, 23.1%) and direct self-medication (ie-requesting the product by name), was the most frequent method of purchase (n = 63, 48.5%). In 19 cases (14.6%), product requests were suspected to be for non-medical (ie-abuse) purposes. Most of the suspected cases were for Pentolate® (n = 11, 57.9%), whereas 7 were for Prisoline® (36.8%) and 1 for Naphcon-A® (5.3%). The majority of observed cases were for products requested without a prescription (n = 16, 84.2%), and in 12 cases out of which, sale was refused (63.2%). Conclusion: More effort and enforcement of pharmacy regulation for safe dispensing is needed to reduce the abuse of ophthalmic products. Educating pharmacists and ophthalmologists would help raise awareness and control the type of drug abuse

Palestinian children's experiences of drug abuse in the home in the Occupied Territories of Palestine: A scoping review of extant literature

The Occupied Territories of Palestine (OtP) consists of the non-contiguous West Bank including East Jerusalem, and the Gaza Strip. Its dense population with political and economic tensions is affected by a rise in drug trafficking, abuse and addiction. A scoping review mapped what is known about Palestinian children's experiences of drug abuse in the home. Following application of exclusion measures, six records remained. Charting and analysis resulted in three themes; The consequences of being a child with a drug using parent; Causal factors of drug use in Palestinian families; and Prevalence rates of parental drug use are unknown. The review paints a concerning picture of stigma, family dysfunction, school drop-out, child and family isolation and maladaptive child development. Exposure to drugs, trauma and abuse contributes to strong potential for Palestinian child drug use, sexual exploitation, overdose, psychiatric illness, and infectious diseases acquisition. The review will inform the urgent strategic response

The Misuse and Abuse of Ophthalmic Preparations:a Scoping Review of Clinical Case Presentations and Extant Literature

The emergent trend of misuse and abuse of ophthalmic drugs is a public health concern. Common ophthalmic preparations contain anticholinergics, antihistamines, decongestants, anesthetics, and vasoconstrictive and topically applied nonsteroidal anti-inflammatory drugs. Misuse and abuse relates to their effect in causing euphoria, relaxation, hallucination, and reduction of depression symptoms. A scoping review of literature was conducted using Arskey and O’Malley (International Journal of Social Research Methodology 8(1):9–32, 2005) framework for mapping extant literature on the current knowledge of the issue. Four themes emerged: abuse of cycloplegics and mydriatics, misuse and abuse of topical ophthalmic anesthetics, misuse of topical ophthalmic vasoconstrictive and topically applied nonsteroidal anti-inflammatory drugs (NSAIDs), and public and pharmacist views on ophthalmic drug abuse/misuse. The review underscores the complex motives for misuse and abuse, availability of ophthalmic products, self-medication practices, presence of co-morbidities, and low public awareness which harms the important role of health professionals regarding suspected misuse of these common products

Pharmacy education and practice in 13 middle eastern countries

The Arab world has influenced the art and science of pharmacy for centuries. Pharmacy education and practice is continuing to evolve in the Arabic-speaking traditional Middle East countries, although relatively little information has been published in the English press. Our goal was to providea high-level synopsis of conditions in this region. We selected 13 countries for review. Information was obtained by reviewing the available published literature and individual university and program web sites, as well as contacting with program or country representatives. Seventy-eight active pharmacy schools in 12 countries were identified. At least 14,000 students (over 75% from Egypt) are admitted into baccalaureate degree programs every year. The 5-year baccalaureate degree remains the first professional degree to practice. While changes in pharmacy education have been relatively rapid over the past decade, the advancement of pharmacy practice, particularly in the private sector, appears to be slower. Hospital pharmacists often possess an advanced degree and tend to have a higher level of practice compared to that of community pharmacists. Despite the adversities that face academics and practitioners alike, there is a strong desire to advance the science and practice of pharmacy in the Middle East

Community Pharmacists Experience of Pregabalin Abuse and Misuse: A Quantitative Study from Jordan

Pregabalin is an anticonvulsant that has an abuse potential. The aim of this study was to investigate abuse/misuse of pregabalin in Jordan from the perspective of community pharmacists. A cross-sectional survey using a structured questionnaire was delivered to a sample of community pharmacies. Self-reported method was used to fill the surveys. A total of 151/205 questionnaires were completed (response rate = 74.1%). A total of 132 respondents (87.4%) reported cases of pregabalin abuse in their pharmacies. Less than half of the respondents (n = 69; 45.7%) indicated that pregabalin requests were, in most of the cases, not accompanied by prescriptions. More than half of the sample (55.8%) noticed an increased pattern of pregabalin abuse/misuse during the last six months. The study underscored the need for regulatory efforts and pharmacovigilance to manage pregabalin abuse, along with a pharmacist and patient education at a community pharmacy level