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.

<![CDATA[Piperacillin/tazobactam-induced bone marrow suppression during pregnancy: A case report]]> ]]> <![CDATA[Development of enoxaparin sodium polymeric microparticles for colon-specific delivery]]>

Background and aims

Recent studies have shown that low molecular weight heparins are effective in the treatment of inflammatory bowel disease. Therefore, there is considerable interest in the development of an oral colonic delivery pharmaceutical system allowing targeted release of heparin in the inflamed tissue. The objective of this study was to prepare microparticles for the oral administration and colonic release of enoxaparin and to evaluate the influence of certain formulation factors on their characteristics.


Microparticles were prepared by water/oil/water double emulsion technique followed by solvent evaporation. The influence of several formulation factors on the characteristics of microparticles were evaluated. The formulation factors were alginate concentration in the inner aqueous phase, polymer (Eudragit® FS 30D and Eudragit® RS PO) concentration in the organic phase and ratios between the two polymers. The microparticles were characterized in terms of morphology, size, entrapment efficiency and enoxaparin release.


The results showed that increasing sodium alginate percentage reduced the encapsulation efficiency of enoxaparin and accelerated enoxaparin release. Regarding the influence of the two polymers, reducing polymer concentration in the organic phase led to a smaller size of microparticles, a lower entrapment efficiency and an important retardation of enoxaparin release. The formulation prepared with Eudragit® FS 30D limited the release to a maximum of 3% in gastric simulated environment, a specific characteristic of oral systems for colonic delivery, and fulfilled our objective to delay the release.


Microparticles prepared with Eudragit® FS 30D represent a suitable and potential oral system for the colonic delivery of enoxaparin.

<![CDATA[Assessment of quality control parameters and in vitro bioequivalence/interchangeability of multisourced marketed metformin hydrochloride tablets]]> ]]> <![CDATA[A Review of the Efficacy and Safety of Sodium–Glucose Cotransporter 2 Inhibitors: A Focus on Diabetic Ketoacidosis]]> ]]> <![CDATA[Theodor I. Preda Hospital from Craiova Between the Years 1870–1910]]>

One of the most important hospitals in Craiova, hospital Theodor I. Preda, was the result of private initiatives in health care. It was founded in 1870 by the Municipality of Craiova, according to the request expressed by Theodore I. Preda in his will. Until 1910 it functioned in the homes of the donor and the money necessary for the activity came from leasing out the Stârcoviţa and Cearângul estates that belonged to Theodor I. Preda and were donated to the town hall in order to maintain the hospital that would bear his name. Thanks to the efforts of the city hall but also of accrued income, it was possible to put up another building. The new premises of the hospital, which was opened in 1910, improved work and turned it into a modern hospital.

<![CDATA[Characteristics and quality of adverse drug reaction reporting among healthcare providers at Rumailah Hospital in Qatar]]> ]]> <![CDATA[Incidence, nature and causes of medication errors in hospitalised patients in Middle Eastern countries: A systematic review]]> ]]> <![CDATA[Medication and Exercise Interactions: Considering and Managing Hypoglycemia Risk]]> ]]> <![CDATA[Reducing antimicrobial prescribing errors, in the neonatal intensive care unit, Women's Hospital, Hamad Medical Corporation]]> ]]> <![CDATA[Counseling provided by the pharmacist in Romanian community pharmacies: the patients’ perspective]]>

Background and aims

Patient education is a critical task that may be carried out by the pharmacists, especially in the context of contemporary pharmacists’ roles, which tend to be closer to patients and their needs. This study aimed to evaluate the counseling provided by the pharmacist in the community pharmacy, from the patient’s perspective.

Patients and methods

We conducted a prospective, non-interventional study in 520 pharmacies from 10 Romanian counties across the country. The first 10 visitors of the pharmacy on a given day were asked to complete a questionnaire regarding the counseling provided by the pharmacist during the visit.


More than 90% of patients received advice from the pharmacist on the route of administration, use in relation to meals, dosage and length of treatment. More than 80% of the patients were counseled on the medicine contraindications and precautions, interactions with other medicines and food, side effects, additional changes in lifestyle and diet appropriate to the condition and the necessity to immediately consult a doctor/pharmacist in case of adverse drug reactions. Lower percentages were registered for advising the patient on the obligation to return to pharmacy the unused psychotropic drugs (38.04%) and the ability of the drug to modify the laboratory results (47.66).


The results of the present study showed that the counseling activity in the community pharmacy is carried out by the pharmacists in a high proportion, according to the patients’ feedback.

<![CDATA[Metformin in Gestational Diabetes Mellitus]]> ]]> <![CDATA[Aspect on Health Sociology and Social Medicine Reflected in the Studies of Constantin Stanca (1889–1969)]]>

Constantin Stanca (1889–1969) was the first director of the Institute for the Study and Prevention of Cancer from Cluj between 1929 and 1940 and the founder of the Gynecologic Oncology Surgery Department of this Institute. During his important career in gynecology and surgical oncology, which took place in Cluj and in Bucharest, he was also interested in medical sociology and in social medicine. Our paper presents some of Stanca’s objectives in these domains: to increase the health status of women, to prevent gynecological diseases and to improve women’s working conditions, especially in factories.