Open Access Short Communication

Optimization of the Extraction Procedure of Apixaban from Dried Rat Plasma Spots

L. V. Aksenova, V. V. Koval, A. A. Chernonosov

Journal of Pharmaceutical Research International, Page 6-14
DOI: 10.9734/jpri/2020/v32i530430

Aims: Apixaban is an anticoagulant used to treat and prevent blood clots, as well as to prevent stroke in people with atrial fibrillation. The dried spot analyses, including dried blood spots and dried plasma spots, are used to simplify techniques for determining drug concentrations in blood and plasma. In this case, equipment with highly sensitive detector is required, for example, mass spectrometer, as well as a high level of drug extraction from the dried spot. In this work, apixaban extraction from dried plasma spots (DPS) was studied in order to determine the optimal parameters of the extraction method.

Study Design: Short Research Articles.

Place and Duration of Study: Core Facility of Mass Spectrometric Analysis, Institute of Chemical Biology and Fundamental Medicine SB RAS, between September 2019 and February 2020.

Methodology: The organic extraction method was chosen for evaluation as the most suitable for LC-MS assay. Several parameters: percentage of organic solvent, presence or absence of 0.1% formic acid (FA), time, volume and temperature of extraction were investigated to find the best combination for recovery of apixaban from DPS for further LC-MS analysis.

Results: The results showed that the main influence on the extraction is the composition of the solvent, volume of solvent, as well as temperature and time of extraction. Pure acetonitrile is the worst solvent for extracting apixaban from DPS. Solvents: MeOH:H2O (100:0, v: v), MeOH: 0.1% FA in H2O (80:20, v:v), ACN: 0.1% FA in H2O (90:10, v:v) or ACN:MeOH (90:10, v:v) provide better recovery of apixaban. The optimum extraction parameters were as follows: 90% acetonitrile concentration, extraction temperature of 40°C, extraction time of 15 min, and solvent volume of 100

Open Access Original Research Article

Trends in the Outpatient Prescribing of Clopidogrel

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2020/v32i530429

Aim: This study aims to evaluate the trends in outpatient prescribing of clopidogrel in order to guide the physicians to appropriate clopidogrel prescribing practice in Alkharj.

Methodology: This is a retrospective study that was conducted in a public hospital in Alkharj city. The outpatient prescriptions were reviewed to evaluate the prescription patterns of clopidogrel in the period between 01-01- 2018 and 31-12-2018. The data were collected and analyzed using Excel software; the descriptive data were represented by frequencies and percentages.

Results: The majority of the patients who received clopidogrel were in the ages between 50 to 69. The majority of the prescribing physicians were residents followed by specialists. Cardiology (50.00%) followed by Internal Medicine (23.71%) were the departments that prescribed the majority of Clopidogrel.

Conclusion: Clopidogrel was used frequently and mainly alone without combination. It is prescribed primarily by resident prescribers who are usually with less experience than specialists and consultants. It is important to prescribe it appropriately and it is the responsibility of pharmacists to check for the appropriateness of its dispensing and to check for drug-drug interactions before dispensing it.

Open Access Original Research Article

Prescribing Trends of Amlodipine in Outpatient Setting

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 15-19
DOI: 10.9734/jpri/2020/v32i530431

Aim: This study aims to illustrate the Prescribing Trends of Amlodipine in Outpatient Setting in Al-Kharj city.

Methodology: This is a retrospective study that was conducted in a public hospital in Alkharj city. The outpatient prescriptions were reviewed to evaluate the prescription patterns of Amlodipine. The data were collected and analyzed using Excel software, the descriptive data were represented by frequencies and percentages.

Results: The majority of amlodipine prescriptions were for patients more than 40 years old. The most prescribed departments were internal medicine followed by emergency and cardiology department. Amlodipine was mainly prescribed by resident physicians.

Conclusion: Amlodipine is one of the most prescribed antihypertensive drugs. It is prescribed mainly by residents, many of them without sufficient experiences. This may lead to inappropriate prescribing patterns, as a result more efforts needed to increase the knowledge of prescribers regarding the appropriate use of cardiovascular medicines including amlodipine.

Open Access Original Research Article

Management, Medication Use and Economic Burden of Asthma among Hajj and Umrah Pilgrims

Abdul Haseeb, Arwa Saleh Alzahrani, Nisrin Nasseraldeen Bifari, Samah Mohammed Bugis, Shaza Eid O. Alharbi, Dina Jameel Ridnah, Weam Waiel Kutob, Eman Abdullah Alzhrani, Ghadair Al-Nass, Mohamed Fadaq, Turki Mohammad Noor Al-Sulaimani, Muhammad Shahid Iqbal

Journal of Pharmaceutical Research International, Page 20-27
DOI: 10.9734/jpri/2020/v32i530432

Introduction: During Hajj and Umrah season, asthma-related acute admissions produce the enormous burden on healthcare facilities and causes delay in admissions for more severe cases, e.g. myocardial infarction, cardiac failure and severe trauma cases. Therefore, the snapshot of asthma-related admissions during the Hajj and Umrah season was determined by asthma-related admissions and medication use and economic burden during Hajj and Umrah pilgrimage season.

Methodology: All asthma-related admissions during the month of Ramadan (fasting month) and Hajj pilgrimage were assessed from patients’ data retrospectively. The convenience sampling strategy was used to retrieve study variables. Statistical Package for Social Science (SPSS) Version 22.0 was used to analyze the data.

Results: A total of 271 patients were selected as per inclusion criteria, the majority of them were males 153 (56.5%), while most of them were Saudi 70 (35.8%) and Egyptians 86 (31.7%). During hospitalization, the common treatment for acute exacerbations was inhaled corticosteroids 224 (86.3%), IV corticosteroids 129 (47.6%), Inhaled short-acting beta-agonists 244 (90%) and inhaled bronchodilators (ipratropium bromide) 237(87.5 5%).

Conclusion: This periodic mapping of asthma-related admissions and its management during these massive gathering events is indeed a significant effort to explore issues of acute asthma exacerbations management and to provide information to plan for future interventions and policies.

Open Access Original Research Article

The Adverse Effects Reporting of Antibiotic Induced Diarrhea

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 28-32
DOI: 10.9734/jpri/2020/v32i530433

Introduction: In Saudi Food and Drug Authority, there is a center called National Pharmacovigilance and Drug Safety Center responsible for adverse events reporting. This study aims to demonstrate the antibiotic induced diarrhea reporting by National Pharmacovigilance and Drug Safety Center in Saudi Arabia.

Methodology: This is a retrospective study about the reporting of diarrhea adverse effects caused by antibiotics. The data were collected from the adverse effects reports that were submitted to Saudi Food and Drug Authority in 2017 and 2018.

Results: Gastrointestinal adverse effects reports were mainly for penicillin antibiotics. The major gastrointestinal adverse effect of penicillin was diarrhea (100 reports out of 147 reports for penicillin include diarrhea). Most of the diarrhea reports were caused by Amoxicillin/Clavulanate followed by Amoxicillin.

Conclusion: One of the major adverse effects for antibiotics is diarrhea that is mainly occurred by penicillin antibiotics. The majority of cases of antibiotics-associated diarrhea are not serious, but still affect the patients’ quality of life. Therefore, it is important to increase the awareness regarding medications adverse effects and their reporting.

Open Access Original Research Article

Career Satisfaction among Community Pharmacists

Muhammad Shahid Iqbal, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 33-41
DOI: 10.9734/jpri/2020/v32i530434

Objective: This study's objective was to determine the level of career satisfaction among practicing Community Pharmacists (CPs) and the impact of various factors on career satisfaction.

Methods: This cross-sectional study used a self-administered instrument to access the current level of career satisfaction among CPs. The survey instrument questions were adopted from previous studies and were contextualized to suit study objectives and revalidated using face and content validation. The study instrument was distributed and collected. 

Results: A total of 172 responses from CPs were received, 112 (65.1%) from males and 60 (34.9%) from females. The difference in age categories was significantly profound in the less than 34 years old group being 113 (65.7%) compared with the more than 34 years old being 59 (34.3%). Around 98 (57%) were working in chain pharmacies and 74 (43%) in independent pharmacy stores. The study result showed126 (73.3%) were unsatisfied in their careers and 46 (26.7%) were satisfied.

Conclusion: Age and working experience are both major contributing factors to career satisfaction levels. Only 36.5% reported having higher career satisfaction levels among total participated CPs.

Open Access Original Research Article

Out-of-pocket Healthcare Costs of COPD Exacerbation Episodes: A Hidden Cost and Growing Strain on Family Budgets

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 42-48
DOI: 10.9734/jpri/2020/v32i530435

Introduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) appears to be the main reason for hospitalization among chronic obstructive pulmonary disease (COPD) patients. This study aimed to evaluate the substantial economic burden of COPD in terms of out-of-pocket costs (OOPCs) among COPD patients.

Methods: This study consisted of 67 consenting patients with AECOPD. A cross-sectional study was performed via convenience sampling. Data were gathered based on per episode of exacerbation and the calculation of OOPCs was done based on direct and indirect costs.

Results: This study showed that the mean length of hospital stay for four severity levels (according to GOLD guidelines) was 3.4, 7.2, 10.3 and 14.1 days, respectively. The mean OOPCs per episode of exacerbation according to the severity level were 139.1, 153.3, 171.4 and 365.8 USD, respectively.

Conclusion: Impacts of OOPCs regarding AECOPD episodes on healthcare resources are worthy of attention. Cost estimation from patients’ perspective especially OOPCs estimation is important in decision and policy-making to improve healthcare states of a population. 

Open Access Original Research Article

Health-Related Quality of Life among University Healthcare Academics

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 49-59
DOI: 10.9734/jpri/2020/v32i530436

Introduction: Having a good health-related quality of life (HRQoL) is important to ensure good job performance. However, it is subjective and it cannot be measured easily. This study aimed  to evaluate HRQoL among universityhealthcare academics in public andprivate  universities.

Method: In this study,a stratified random sampling approach was employed. The strata were created based on departments in the universities. A random sample from each stratum was taken in a number proportional to the stratum's size when compared to the overall target population. A validated questionnaire comprising two sections was administered online to collect the data. Descriptive and inferential statistical analysis (Mann-Whitney U test and Kruskal Wallis H test) were applied using SPSS version 22.

Results: Out of all the total 130 respondents, 57 (43.8%) were from a private university and the other 73 (56.2%) were from a public university. There were 61 (46.9%) male respondents and 69 (53.1%) female respondents. HRQoL according to the studied domains of the DUKE health profile was associated with various demographic and socioeconomic variables such as type of institution, department/faculty, age, gender, number of children, and years of experience.

Conclusion:The demographic and socioeconomic variables were strongly associated with the HRQoL among university healthcare academics.

Open Access Original Research Article

Antimicrobial Effect of Essential Oil of Thymus capitatus from Northern Cyprus and Its Gargle Preformulation

Dudu Özkum Yavuz, Yıldız Özalp, Banu Tuncay, Nurten Altanlar, Duygu Şimşek

Journal of Pharmaceutical Research International, Page 60-66
DOI: 10.9734/jpri/2020/v32i530437

Aims: The aim of this study is to prepare herbal gargle preformulations making use of essential oil of aerial parts of Thymus capitatus growing wild in Northern Cyprus and comparing antimicrobial efficacy between these formulations with pure essential oil.

Place and Duration of Study: Department of Pharmaceutical Technology, Faculty of Pharmacy, Near East University, Nicosia, TRNC and Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Ankara University, Ankara, Turkey, between January 2017 and June 2017.

Methodology: Preformulations with three different concentrations of Thymus capitatus essential oil were prepared by using simple preparation method. Preformulation studies were done in lab with less than 500 ml. There is not specific process parameters. Manufacturing process and process parameters will be clarified with further studies. These compositions and the essential oil were tested in-vitro for antimicrobial activity studies by using broth microdilution method. Staphylococcus aureus ATCC 43300, Staphylococcus aureus ATCC 25923, Staphylococcus epidermidis ATCC 12228, Bacillus subtilis ATCC 6633, Escherichia coli ATCC 25922, Enterococcus faecalis ATCC 29212, Klebsiella pneumoniae RSKK 574, Salmonella paratyphi C, Pseudomonas aeruginosa ATCC 9027, Pseudomonas aeruginosa ATCC 27853 as bacteria and Candida albicans ATCC 10231, Candida parapsilosis ATCC 22019 as yeasts were used for antimicrobial activity tests.

Results: All trials were found to be more effective than EO, and a significant effect was observed when compared to the values ​​of standard antimicrobial agents.

Conclusion: TheThymus capitatus growing in Northern Cyprus could be used as a herbal raw material, essential oil source in developing herbal gargle preformulations to reduce fungal and bacterial infections in mouth.

Open Access Original Research Article

A Cross-sectional Assessment of Quality of Life among Pharmacy Academics

Muhammad Shahid Iqbal, Fahad I. Al-Saikhan, Muhammad Zahid Iqbal

Journal of Pharmaceutical Research International, Page 67-75
DOI: 10.9734/jpri/2020/v32i530438

Introduction:  These days, living a good quality life has become a luxury rather than a necessity and investigating the quality of life (QoL) across teaching professionals seems to be beneficial. This study aimed to determine the association between demographic and socioeconomic variables and the QoL among pharmacy academics.

Methods: Stratified random sampling was applied to collect data using a pre-validated and self-administered questionnaire the Duke Health Profile (DHP). Statistical Package for Social Science (SPSS) ver. 22.0 was used to analyze the descriptive and inferential data.

Results: One hundred and fifty-five pharmacy academics were included in this study where majority 98 (63.2%) were males and 57 (36.8%) were females. The majority 74.2% weremarried and 68.4% were having more than 5 years of teaching experience. A total of 123 ofthe pharmacy academics were more than 35 years old which accounted for 79.4% of the respondents. Various determinants like age, residence, gender, administrative position, marital status,             monthly income, and teaching experience are the main factors affecting QoL among pharmacy academics.

Conclusion: From the present study it could be concluded that QoL among pharmacy academics was significantly influenced by numerous socio-economic and demographic determinants.

Open Access Original Research Article

Determinants of Oral Health-Related Quality of Life among Patients on Root Canal Treatment

Muhammad Zahid Iqbal, Sawri Rajan, Muhammad Shahid Iqbal

Journal of Pharmaceutical Research International, Page 76-82
DOI: 10.9734/jpri/2020/v32i530439

Introduction: Several determinants directly affect the Oral Health-related Quality of Life (OHRQoL) of root canal treatment (RCT) patients like knowledge, attitude, perceptions, age, gender, marital status, smoking and pre-exposure history of RCT. This study determined the sociodemographic determinants of OHRQoLamong patients underwent RCT.

Methods: This cross-sectional study determiningthe OHRQoL of patients on RCTwas conducted among patients visiting various dental clinics. A self-administered and validated questionnaire comprising of four OHRQoL themes was used to collect the data. Statistical Package for Social Science (SPSS) ver. 22.0 was used to analyze the data.One-way ANOVA and independent t-test were used to determine the p-value.

Results: For each theme of the OHRQoL research tool, its association was statistically significant with at least one demographic determinant of the RCT patients. A total of 26.3% of the participantswere males and 73.7% were females.Among the RCT patients, 38.5% were single whereas 61.5% were married.

Conclusion: In conclusion, a moderately-good level of OHRQoL was observed among the patients on RCT.