Evaluating the practice of Iranian community pharmacists regarding oral contraceptive pills using simulated patients.

Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. Objective: The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Methods: Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Results: Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists’ gender and detection of possible interaction (p value= 0.048). Conclusion: The quality of the pharmacists’ consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement

Effects of green tea on Escherichia coli as a uropathogen

Escherichia coli is the most common cause of urinary tract infections. The development of antibiotic resistance in E. coli is an important problem. Finding alternative antimicrobial agents from plant extracts has received growing interest. Camellia sinensis is a safe, nontoxic, cheap beverage that has been reported to have antimicrobial effects against various pathogenic bacteria including E. coli. Polyphenolic components of green tea ( lǜ chá) have antibacterial activity. Catechins also have synergistic effect with antibiotics such as chloramphenicol, amoxicillin, sulfamethoxazole, azithromycin, levofloxacin, gentamycin, methicillin, naldixic acid, and, especially ciprofloxacin. In this review, all experimental studies that evaluated the effect of green tea on E. coli were collected. Data from in vitro studies on the antimicrobial effects of green tea are promising, but human data are currently lacking. In vivo studies on antibacterial effects of green tea and evaluating the efficacy of its catechins in the treatment of urinary tract infection are needed

Role of pharmacists in reducing antibiotic prescribing errors in an emergency department

Background: Clinical pharmacists and clinically trained pharmacists can detect and correct prescribing errors by reviewing physicians' orders. In addition, prescribing errors related to antibiotics occur frequently in emergency departments (EDs). Aim: This study evaluated the role of pharmacists in reducing antibiotic prescribing errors in an ED. Methods: One clinically trained pharmacist spent 4 h/day in the ED for 30 days. The pharmacist attended the ward rounds and reviewed medical records to identify prescribing errors related to antibiotics, and corrected these errors in consultation with emergency physicians. The types and severity of antibiotic prescribing errors were determined. The corrected errors were also classified. Results: Antibiotics had been prescribed for 110 of 267 patients (41.20). In all, 180 antibiotic prescriptions were identified for 57 patients, of which 78 had prescribing errors. The most common types of errors were incorrect drug selection (48/78; 61.50) and wrong dose (19/78; 24.40), and the most common actual severities were Type B (30/78; 38.46) and Type C (35/78; (44.87). In addition, 41 of 78 antibiotic prescribing errors were accepted as errors by emergency physicians. The corrected prescribing errors were categorised as two (4.88) intercepted potential adverse drug events (ADEs), 35 (85.36) mitigated ADEs and four (9.76) ameliorated ADEs. Conclusion: Pharmacists have a significant role in the identification and correction of antibiotic prescribing errors. In addition, collaboration between physicians and pharmacists can lead to more appropriate antibiotic use in hospitals. © 2020 The Society of Hospital Pharmacists of Australi

Successful treatment of aluminium phosphide poisoning by dihydroxyacetone: A two-case report study

What is known and objective: Aluminium phosphide (AlP) is an agricultural fumigant which produces phosphine gas in the presence of moisture. Phosphine inhibits oxidative phosphorylation and causes cell death by inhibiting cytochrome C oxidase. Clinical manifestations of AlP poisoning are refractory hypotension, tachycardia, low oxygen saturation and severe metabolic acidosis. Case summary: Two cases received dihydroxyacetone (DHA) in addition to routine management of AlP poisoning. Administration of DHA (7 gr in 50 mL sodium bicarbonate, gavage) 2 times at a 1-hour interval improved the clinical signs. What is new and conclusion: This is the first case report to highlight the safe and successful treatment of AlP poisoning with DHA. However, more clinical studies are recommended to determine the precise mechanism of DHA action. © 2020 John Wiley & Sons Lt