ResearchPad - Pharmacy Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Assessment of Potentially Inappropriate Prescribing of Opioid Analgesics Requiring Prior Opioid Tolerance]]>

Key Points


What proportion of patients are opioid-tolerant when starting opioids that require prior tolerance for safe use?


In this cohort study including 153 385 use episodes of opioid analgesics labeled only for use in people who are opioid-tolerant, more than half of patients who received these medications showed no evidence of prior opioid tolerance in health insurance claims or electronic health records.


These findings suggest that many patients may be at risk of potentially serious adverse events owing to widespread use of certain extended-release opioids without prior opioid tolerance.

<![CDATA[Primary health care policy and vision for community pharmacy and pharmacists in England]]>

The United Kingdom health and care system is changing dramatically to meet the health challenges of the 21st century. People will increasingly have multiple morbidities. The focus of service delivery is changing from hospital to community, patient to population and curative to preventive. This paper describes the NHS and primary care and community pharmacy in England at the start of 2020, a time of great change. The 10-year vison for the NHS is that everyone gets the best start in life, world class care for major health problems supporting people to age well. It has over 40 mentions of pharmacists and pharmacy. The key aims of the plan are to improve ‘out-of-hospital’ care, and finally dissolve the historic divide between primary and community health service in England. All of England is covered by integrated care systems and the newly formed primary care networks which will form the foundation of these new systems. Pharmacy is involved at multiple levels. There are 11,569 community pharmacies and most of their total income comes from the NHS (range 68-85%). Around 60% pharmacies are part of multiple chains, with the remaining 40% independents or small chains of less than six outlets. The new five-year community pharmacy contract provides an opportunity to develop community pharmacy and move towards service delivery away from dispensing volume. The new services are described under medicines optimisation, prevention and urgent care. The pharmacy quality scheme is also described. The new deal will help many community pharmacies to plan their future, particularly for those pharmacies who are ready and able to change and work closely with pharmacists and other health professionals in collaboration with Primary Care Networks. There will be specific challenges around: dispensing efficiencies, freeing up pharmacists’ time, wider use of clinical skills of community pharmacists, community pharmacy viability and consolidations.

<![CDATA[Alexander von Humboldt’s contribution to the biomedical sciences and scientific illustration. In honor of his 250th anniversary]]>

Alexander von Humboldt (1769–1859) is one of the most prominent Germans. His multidisciplinary activity set standards to science at the beginning of modern era. His personality is celebrated worldwide. The Alexander von Humboldt Foundation in Bonn is still preserving his memory and endorsing research in all the fields. This paper is a historical sketch presenting his contributions to the development of medical sciences and also to the progress of scientific illustrations. We also introduce personalities of the Cluj-Napoca medical school who were fellows of the Alexander von Humboldt Foundation.

<![CDATA[Canagliflozin in Type 1 Diabetes: A Case Series of Patient Outcomes in a Diabetes Clinic]]> ]]> <![CDATA[Propofol Attenuates Hypoxia/Reoxygenation-Induced Apoptosis and Autophagy in HK-2 Cells by Inhibiting JNK Activation]]>


The aim of this study was to investigate whether propofol could attenuate hypoxia/reoxygenation-induced apoptosis and autophagy in human renal proximal tubular cells (HK-2) by inhibiting JNK activation.

Materials and Methods

HK-2 cells were treated with or without propofol or JNK inhibitor SP600125 for 1 hour and then subjected to 15 hours of hypoxia and 2 hours of reoxygenation (H/R). Cell viability and LDH release were measured with commercial kits. Cell apoptosis was evaluated by flow cytometry. The expressions of p-JNK, cleaved-caspase-3, Bcl-2, and autophagy markers LC3 and p62 were measured by Western blot or immunofluorescence.


HK-2 cells exposed to H/R insult showed higher cell injury (detected by increased LDH release and decreased cell viability), increased cell apoptosis index and expression of cleaved-caspase-3, a decrease in the expression of Bcl-2 accompanied by increased expression of p-JNK and LC3II, and a decrease in expression of p62. All of these alterations were attenuated by propofol treatment. Similar effects were provoked upon treatment with the JNK inhibitor SP600125. Moreover, the protective effects were more obvious with the combination of propofol and SP600125.


These results suggest that propofol could attenuate hypoxia/reoxygenation induced apoptosis and autophagy in HK-2 cells, probably through inhibiting JNK activation.

<![CDATA[Consequences of Undocumented Medication Use]]> ]]> <![CDATA[Simultaneous prescribing of atypical antipsychotics, conventional antipsychotics and anticholinergics—a European study]]>


The aim of this study was to investigate to what extent atypical antipsychotics, conventional antipsychotics and anticholinergics are prescribed simultaneously in daily clinical practice in Europe.


A pharmaco-epidemiological study was carried out in which hospital pharmacists from 45 hospitals in Belgium, Denmark, France, Germany, The Netherlands and Scotland participated. Prescription data for 2,725 patients (mainly inpatients) who had been using an atypical antipsychotic for more than 6 weeks were analysed.

Main outcome measure

The frequencies of simultaneous prescription of atypical antipsychotics with other antipsychotics and/or anticholinergics.


In this sample of patients with an atypical antipsychotic 42.1% was prescribed another antipsychotic (24.1% if low-potent antipsychotics were not included in the analysis) and 30.1% was prescribed an anticholinergic. In total 47.1% of patients were prescribed an atypical antipsychotic without any other antipsychotic or anticholinergic.


It is common practice to prescribe a combination of atypical antipsychotics and conventional antipsychotics and/or anticholinergics. This suggests that monotherapy involving an atypical antipsychotic is not considered to be an adequate treatment for a substantial number of patients in clinical practice.

<![CDATA[Determinants of potential drug–drug interaction associated dispensing in community pharmacies in the Netherlands]]>


There are many drug–drug interactions (D–DI) of which some may cause severe adverse patient outcomes. Dispensing interacting drug combinations should be avoided when the risks are higher than the benefits. The objective of this study was to identify determinants of dispensing undesirable interacting drug combinations by community pharmacies in the Netherlands.


A total of 256 Dutch community pharmacies were selected, based on the dispensing of 11 undesirable interacting drug combinations between January 1st, 2001 and October 31st, 2002. These pharmacies were sent a questionnaire by the Inspectorate for Health Care (IHC) concerning their process and structure characteristics.

Main outcome measure:

The number of times the 11 undesirable interacting drug combinations were dispensed.


Two hundred and forty-six questionnaires (response rate 96.1%) were completed. Dispensing determinants were only found for the D–DI between macrolide antibiotics and digoxin but not for the other 10 D–DIs. Pharmacies using different medication surveillance systems differed in the dispensing of this interacting drug combination, and pharmacies, which were part of a health care centre dispensed this interacting drug combination more often.


Medication surveillance in Dutch community pharmacies seems to be effective. Although for most D–DIs no determinants were found, process and structure characteristics may have consequences for the dispensing of undesirable interacting drug combinations.