Clinical Pharmacology articles list

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

The rate of aging is rapidly increasing and the term of geriatric refers to offer a medical care to elderly people. Drug consumption study on geriatric population is a vital issue since this group is totally neglected in Libya. The aim of this study was to assess drug utilization pattern among elderly patients in terms of world health organization core prescribing indicators and to evaluate the treatment cost. A total of 106 prescriptions were randomly collected from different community pharmacies located in Tripoli during the summer 2019, and were evaluated (total number of prescribed drugs is 359) for their clinical efficacy and safety. The findings revealed that 60 drugs acting on GIT (16.7%), 50 antimicrobial drugs (13.9%), 31 antihypertensive drugs (8.6%) and 30 drugs for respiratory diseases (8.4%) were prescribed to patients who are 65 years old or more. With regard to disease pattern in the elderly Libyan patients, 27 drugs were prescribed for diabetes mellitus (7.5%), 24 drugs for cardiovascular drugs (6.7%) and 14 drugs for anti-hyperlipidemia (3.9%). According to the WHO core drug use indicator pattern, the average number of drugs prescribed per encounter was 3.3. Prescription by generic name was low (41.5%). Antibiotics were 36.8% while injections were 26.6%. Thus, this study suggest that geriatric medicine and rational drug use should strongly be implanted in medical schools and teaching hospitals. Besides, a drug pattern use of the Libyan community is urgently required to avoid drug prescribing errors.

Fathi M. Sherif

A medication error is any preventable event that may cause or lead to inappropriate use of drugs or patient harm if it is not under the control of the health care professional. Despite the fact that healthcare professionals take the responsibility very seriously, it has been estimated that 250 000 Americans die annually due to medication errors. Although, estimates show that one in ten patients worldwide is affected by medication errors while receiving hospital care, the harm can be caused by a range of incidents or adverse events. The exact incidence of medication errors in the neonatal intensive care unit (NICU) is unknown. In neonates especially premature infants, the immaturity of developing body systems affects the absorption, distribution, metabolism and excretion of drugs and therefore an exponential risk for medication errors is present. The risk of medication errors in children are much greater than adults.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypertension is a public health issue that significantly increases the risk of health problems and decreases health quality of life of the patients. Angiotensin converting enzyme inhibitors are used to control hypertension by preventing production of angiotensin II in turn decrease blood pressure, thus it may enhance the quality of life. This study aims to assess the effect of angiotensin converting enzyme inhibitors on the quality of life of patients with hypertensive aging 40 years or older in Benghazi city in comparison with other classes of hypertension medications. A case control observational study was conducted, adopting the structured face-to-face interviewing survey technique. Over 150 patients who visited Benghazi medical center during the study period (November, 2019 to March, 2020), to follow up their chronic disease. The investigators used a pre-validated, pre-piloted questionnaire that has been adopted from SF 36 and modified according to the updated literature review; responses to each question were coded and analyzed. The results display that antihypertensive medications were found to be significantly related to the limitation on the physical activity domain and found that medications decrease the limitation on the activity with about 20% of the patients who taking angiotensin receptor blockers (20%) and 30% of the patients taking angiotensin converting enzyme inhibitors, 40% of the patients had no limitations on bending kneeling and stooping. Moreover, on the limitations on walking more than one kilometre, the results were about 15% of the patients taking angiotensin receptor blockers and 30% of the patients taking angiotensin converting enzyme inhibitors had a slightly or no limitation on walking more than a kilometre. Thus, the findings indicate that antihypertensive medications have a positive effect on quality of life of the patient in limitation on activity domain but no conclusive difference was found between angiotensin converting enzyme inhibitors and angiotensin receptor blockers medications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Introduction: Psilocybin mushroom use is well documented in spiritual and religious ceremonies globally. This drug is now the most popular in Europe and the USA. Objective: The objective of this study is to explore the experiences and effects of psilocybin on patients with depression and anxiety. Method: A qualitative study was conducted interviewing ten participants currently taking psilocybin while experiencing depression and/or anxiety. Ethical approval was obtained from the University ethics committee. Participants were recruited via social media and groups are known to have used psilocybin for the treatment of anxiety and/or depression. Participants were informed of study aims and consent was obtained before interviews commenced. Confidentiality was maintained throughout this study. Interviews began with informing participants that psilocybin may be effective in the management of depression. Initially, information around the way treatment with psilocybin was obtained was sought. This was followed by queries around the effects of the drug in terms of experiences both during and after treatment. Finally, participants were asked to outline the positive effects of psilocybin on their lives. Results: The data were thematically coded using Grounded Theory as an underpinning philosophical paradigm. Emerging themes included enhancement of smell, vision, hearing, and taste sensations. Another theme emerging was the experience of being ‘connected with the universe’ while on the drug. Additionally, participants reported a stabilization of mood, an increase in optimism and emotional control, and a healthier emotional connection with others. Most also felt an increase in comfort, peace and calmness. Another theme that emerged centered on the mechanism of action of psilocybin. Participants stated that this substance seemed to ‘make new connections in their brain,’ resulting in new perspectives. Some participants felt this resulted in a calming influence on the mind and body. This aligns with research showing that psilocybin works by changing the thinking and improving information processing. Conclusion: Psilocybin has promising effects on the patients with depression/anxiety even after a single dose. Psilocybin is safe but the administration should be guided by a health professional to yield safe and positive outcomes.

Gwen Erlam

This study's objective was to determine the distribution of allele frequencies of CYP2C9 and CYP2C19 gene polymorphisms among the Papuan population, known as the second-largest ethnic group in Indonesia. According to recent research, there is a decrease in CYP2C9 and CYP2C19 produced by humans globally, including in Indonesia. These gene polymorphisms aid in the transmission of various endogenous and exogenous drugs in the human body. Material and Methods: A sum of 99 subjects, comprising 73 male and 26 female subjects aged 20-30 years, were used for this research. PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis using AvaII, NsiI, and SfaNI enzymes tested for the genotypes CYP2C9 and CYP2C19 administered. The distribution of genotypes was calculated in the population (P<0.05) using the Hardy-Weinberg equilibrium. The Faculty of Medicine Gadjah Mada University's Medical and Health Research Ethics Committee (MHREC) accepted this research with written consent. The results revealed that in Papua subjects, CYP2C9*2 (rs1799853) and CYP2C19*17 (rs12248560) alleles were absent while in 17 percent of the population CYP2C9*3 (rs1057910) allele frequency was. In conclusion, CYP2C9*3 has the highest polymorphism rate in Indonesia, with the absence of CYP2C9*2 and CYP2C19*17. Therefore, genetic drift can occur within this ethnic group.

Syahrul Tuba

Cardiovascular drugs constitute one of the largest and most widely used among other diseases and cardiovascular drug market has largely been exploded . Although these drugs have the potential to significantly improve the treatment of various cardiac diseases. They are potent agents with potential for serious adverse effects, toxicity and drug interactions. Newer agents are considerably costly than older drugs and, therefore, cost-effective strategies must be developed. Thrombolytics are pharmacological agents come from bacterial origin as streptokinase and staphylokinase or from human origin as urokinase or t-PA. Thrombolytics are used to restore blood flow to infracted artery quickly. Only streptokinase, alteplase, reteplase and tenecteplase are approved by US-FDA for treatment of ST-elevation myocardial infraction (ST-EMI) [3]. This reopens blood vessels after their occlusion and prevents tissue necrosis. Although, the safe and effective use of each of these drugs requires a thorough understanding of appropriate patient selection, drug timing, dosing regimens and monitoring parameters. The greatest benefit to risk ratio for specific drugs is seen in certain subsets of patients the complexities of cardiovascular drug therapy illustrate the need for an in depth current knowledge of clinical trial evidence.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Self-medication with antibiotics is becoming a trend that threats the health systems worldwide through developing bacterial resistance which is associated with high health care costs and increased rate of morbidity and mortality. The main objective of this study is to assess antibiotic self-medication practice among Libyan university pharmacy students. This is a cross-sectional study conducted among pharmacy students at Sabratha University in the western region of Libya. A validated questionnaire was used to collect relevant data which were statistically analyzed. A total of 170 undergraduate Pharmacy students participated in the study during spring 2021. About 80% of the participants reported the use of antibiotics without consulting a physician. The major reason for using antibiotics was to get a quick relief of emergency conditions which was reported by 35% of the students. About 25% of the students used antibiotics to relieve their pains and aches. The most commonly used antibiotic was amoxicillin (55%). Most antibiotics were obtained over the counter from community pharmacies (85%). Half of the participants were not sure if they can advise patients to use antibiotics without a prescription, although 60% of them believed that it was good practice. In conclusion, prevalence of antibiotic self-medication among university pharmacy undergraduate students is high. Thus, serious interventions are required to ensure safe and effective use of antibiotics among the population in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Streptococcus bovis/gallolyticus was considered as lower grade pathogen involved in endocarditis. Recent accumulating evidence has suggested that Streptococcus bovis/gallolyticus plays an important role in the initiation and development of colorectal cancer. This study was aimed to address the association between Streptococcus bovis/gallolyticus and colorectal cancer among Libyan patients, to determine the dominant biotype of Streptococcus bovis/gallolyticus associated with colorectal cancer patients and to evaluate the antibiotic susceptibly patterns of isolated strains. The study involved 20 colorectal cancer patients, 20 patients with large adenomas polyp and 20 people with healthy colonic mucosa as a control group. All the candidates were subjected to colonoscopy and histopathological examinations and conformation. The suspected and normal cases were then diagnosed according to the protocol used by the medicine specialist and grouped in accord with the study aim. All biopsies were handled and treated to isolate the suspected positive colonies of Streptococcus bovis/gallolyticus. Of the 20 colorectal cancer patients, seven patients (35%) were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 1.22 - 1.72, p < 0.05). Nine patients (45%) were diagnosed colorectal cancer positive at age above 60 years old, eight patients (40%) at age 40 - 60 years old and three patients (15%) at age bellow 40 years old. Also, nine out of 20 patients (45%) with large adenomas polyp were found to be Streptococcus bovis/gallolyticus carriers, (95% CI 2.16 - 2.71, p < 0.05). Of the 20 healthy people with colonic mucosa, Streptococcus bovis/gallolyticus never been isolated. Streptococcus. bovis biotype II/I and Streptococcus. equinis were both susceptible to the above mentioned antibiotic classes, although Streptococcus bovis biotype I was highly resistance to most clinically used antibiotics. However, there was strong relationship between Streptococcus bovis/gallolyticus and colorectal cancer or large polyp formation. However, it is not well understood whether the bacterium has a pathogenic role in the initiation and progression of neoplasia or just an epiphenomenon of colorectal neoplasms.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Community pharmacies not only act as sites of drug purchase but also as healthcare setting. The aim of this study is to examine the extent of public’s use of community pharmacy and their reasons of visiting to Sabha, South part of Libya. Thus, a descriptive, cross-sectional survey with self-administered questionnaire was developed and validated. Data was collected during 2019 by registered pharmacists using the self-designed prepared questionnaire for community pharmacies in Sebha. Of all 600 questionnaires were handed during 2020, 462 forms were returned (77%, response rate). The majority of the respondents reported they had visited the community pharmacies at least once in a month (n = 343, 74%). The highest reason of visiting reported by the respondents was dispensing their prescription medications (n = 304, 65%) while purchasing medication without prescriptions was accounted with n = 162, (35%). The highest rate of the respondents was given advice about antibiotic use (n = 224, 48%) followed by physical exercises (n = 178, 39%) and healthy eating (n = 173, 37%). The majority of the respondents preferred to visit community pharmacy over other healthcare centers because of minor health problems (n = 358, 77%). The major factors influence the consumers choose any particular pharmacy were the professionalism of pharmacy staff (n = 254, 55%) and the availability of the medical products (n = 221, 48%). The respondents incline to choose community pharmacy as a primary health center when they faced drug related problem (n = 248, 54%). In conclusion, the current study revealed that the majority of Libyan people are regular users of community pharmacies and various services and topics of advice have been given by their staff. However, shortage of professional pharmacists in community pharmacies can undermine the opportunity of given reliable pharmaceutical care from these communications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypoglycemia is a common complication of intensive diabetes mellitus therapy. This study was aimed to review the profile of admitted Libyan cases of non-pregnant adults and adolescents. A retrospective study for patients admitted to Tripoli Diabetes Hospital, Tripoli, Libya. Data were collected from medical files of diabetic patients with hypoglycemia from January 2017 to July 2018. Thus, during this period, a total of 29 cases with hypoglycemia were admitted to the hospital. Their age was ranged from 18 to 86 years in which 76.0% were female, 25.0% were non-smokers, 59.0% were married and 55.0% were non-employers. Patients with diabetes mellitus (86%) showed hypoglycemia attack per month of 3.90 ± 2.25. From the 25 cases with diabetes mellitus, 7.0% were newly diagnosed (> one year), 45.0% their duration of diabetes mellitus were more than 9 years and 35.0% were less than nine years. Their Hemoglobin A1C was on target (6.5–7.0%) in 21.0% of the cases, in which 17.0% were on below target range (< 6> 7.0%). 14.0% were on glibenclamide, 3.0% on glimepiride and 69.0% on insulin. Patients on insulin therapy twice daily in 28.0%, triple in 17.0% and basal bolus regime in 24.0%. Hypoglycemia unawareness was presented in 17.0%, hypoglycemia was major in 45.0% of the cases, and in 38.0% were in daytime. Insulin induced hypoglycemia were in 66.0%, and suicidal attempt were in 10.0%. Exercise induced hypoglycemia 10.0% and 3.0% of cases with malignancy induced hypoglycemia. Co-exist systemic illness was mainly absent in 69.0% but cardiovascular diseases in 14.0% and renal diseases in 7.0%. Majority of cases were discharged in good condition (86.0%) and 14.0% discharged against medical advice. Hypoglycemia mostly occurs in patients with diabetes mellitus treated with insulin and in most the cases were reversible and saved with good management. Thus, patient education is a fundamental issue in prevention and reducing complications of hypoglycemia in patients with diabetes mellitus.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Tuberculosis is communicable disease which is common and often deadly infectious disease caused by mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem in the world. The aim of this study is to assess prevalence and associated risk factors of pulmonary tuberculosis. Treatment and development of multidrug-resistant tuberculosis were also considered. Drugs for Pulmonary tuberculosis confirmed cases used in calculating tuberculosis prevalence in Libya which is obtained from archive department of Abu Seta Hospital. Data obtained from 427 files during 2019 determine the incidence and epidemiology of tuberculosis in Libya. For a total of 427 confirmed cases of pulmonary tuberculosis, about 75.0% of the cases were male and most of the patients (55.0%) were within the age group of 20 - 40 years old. Of the study patients, 114 patients (26.7%) were viral infected and most of the viral infected cases were in the age group of 20 - 40 years and the majority of this age group patients (n = 41, 53.2%) were infected with HIV/HCV, while the least percentage in this group age were infected with HIV/HBsAg (01.3%). Among 427 cases, 73 cases (17.1%) were comorbid with other chronic diseases. Of the 73 cases, 54 cases (74.0%) were diabetes mellitus whereas only 1.4% of them had bronchial asthma, Parkinsonism and renal failure. The drug therapy of active tuberculosis disease needs combination chemotherapy to escape the selection of naturally occurring drug-resistant mutants. Amongst current anti tuberculosis drugs, the rifamycins hold the highest potential for shortening treatment and improving effects. Prevalence of smear positive tuberculosis and bacteriologically confirmed that a high rate of tuberculosis among unemployed population. This study reported that the highest incidence rate is found in people who are smokers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer’s disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID-19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center’s protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines’ List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines’ list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Metamizole or Novalgin® is a widely used well tolerated analgesic drug which is however compromised by agranulocytosis as adverse effect. Subsequent to nonenzymatic hydrolysis, the primary metabolic step is N-demethylation of 4-methylaminoantipyrine (4-MAA) to 4-aminoantipyrine (4-AA). The aim of the present study was to identify the human cytochrome P-450 enzyme (CYP) mediating this reaction. This study identified the relevant CYP using virus expressed isolated human CYP, human liver microsomes and rat liver microsomes with chemical inhibition studies. The substrate of 4-methylaminantipyrine was employed at six different concentrations (25, 50, 100, 400, 800 and 1200 µmol per l) with varying concentrations of selective inhibitors of CYP1A2 (furafylline, fluvoxamine), CYP3A4 (ketoconazole), CYP2A6 (coumarin), CYP2D6 (quinidine), CYP2C19 (omeprazole, fluvoxamine, tranylcypromine), CYP2C9 (sulphaphenazole) and CYP1A1 (alpha-naphthoflavone). 4-MAA and 4-AA were analyzed by HPLC and enzyme kinetic parameters (Km and Vmax) were determined by regression (Sigma plot 9.0). The N-demethylation of 4-MAA by microsomes prepared from baculovirus expressing human CYP was pronounced with CYP2C19. Intrinsic clearance of the most active enzymes were 0.092, 0.027 and 0.026 for the CYP enzymes 2C19, 2D6 and 1A2, respectively. Metabolism by human liver microsomes was strongly inhibited by fluvoxamin, omeprazole and tranylcypromine (IC50 of 0.07, 0.07 and 0.18, respectively) but with coumarin, sulphaphenazole, ketoconazole, moclobemid, quinidine alpha-naphthoflavone and furafylline were 0.79, 1.20, 1.36, 1.44, 3.46, 4.68 and 8.41, respectively. The enzyme CYP2C19 apparently has an important role in N-demethylation of 4-methylaminoantipyrine which should be further analyzed in clinical studies and which may also be interesting concerning the agranulocytosis.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

In childhood, epilepsy is the most common globally widespread neurological problem, usually with serious consequences for this most critical period of development. Dravet and Lennox Gastaut syndromes are two forms of rare and severe treatment resistant epilepsies that occur early in the life. These resistant epilepsies recognised by continuous unrelenting seizures of many types including the occurrence of status epilepticus. In addition, it is associated with the development of behavioural, neurological, cognitive deficits and the sequelae of increased risk of mortality rate. Historically, cannabis was found to possess several medical benefits including its use for epilepsy. In this review, information and data were extracted from 99 references using PubMed and Google Scholar (November, 2021). Data with clinical evidence on cannabidiol regarding its efficacy on Dravet syndrome and Lennox Gastaut syndrome, mechanism of action, safety, pharmacokinetic properties and interactions with anti-epileptic medications were all reviewed and discussed. Highly purified cannabidiol is a cannabis derived compound that is suggested in recent research as an add-on therapy to the existing treatment of both resistant epileptic types; since it is able to reduce the duration, frequency and severity of seizure disorders. It is also characterised with multiple signalling transduction mechanisms, primarily via inhibition of excitatory and potentiation of inhibitory pathways.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Schizophrenia is treated with antipsychotic drugs and is a chronic neuropsychiatric disorders. The influence of antipsychotics on the cytokine systems may be responsible for their clinical efficacy in schizophrenia. Granulocytopenia and agranulocytosis are severe side effects of antipsychotic therapy. The objective of this study was to estimate incidence of drug-associated agranulocytosis in newly diagnosed schizophrenic patients in and to evaluate the risk factors and outcomes. Seven participants groups were designed. Healthy persons as control. Schizophrenic patients before treatment. Schizophrenic patients after one-month of treatment. Schizophrenic patients after two - month of treatment. Schizophrenic patients after three - month of treatment. Schizophrenic patients after chronic treatments. Schizophrenic patients one month after chronic treatment. This study included screening for the expression and function of circulating leukocyte granulocyte-macrophage colony-stimulating factor receptor, screening of patient's biochemistry and haematology picture. Granulocyte-macrophage colony-stimulating factor expression was decreased after antipsychotic treatment for one month and continued to decrease after two months' treatment. Granulocyte-macrophage colony-stimulating factor expression starts to increase after the two-month treatment and continues increasing to controls or newly diagnosed schizophrenics or after chronic treatment. Complete blood counts were not changed compared. Liver function showed a transient increase in serum alkaline phosphatase after one and two month of treatment. All other parameters were not changed. Kidney function showed that urea and creatinine levels were within the normal range during the different treatments. Concerning lipid profile, low density lipoproteins levels were increased after one month, two months of treatment and after chronic administration of the antipsychotic drugs. It is concluded that antipsychotic treatment produces a decrease in granulocyte-macrophage colony-stimulating factor expression; the decrease reach the maximum effect after two months, then starts to increase back to normal levels. A transient increase in serum alkaline phosphatase in the first two months' treatment. Urea and creatinine levels and lipid profile were within normal range, except low density lipoproteins levels were increased during the two months treatment and after chronic administration of the antipsychotic drugs.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Prevalence of hypovitaminosis D is not restricted to the elderly and hospitalized population. Worldwide, the rate of prevalence of vitamin D deficiency has grown up rapidly in adults over the past decades. Among Libyan population including young students may has a high risk of vitamin D deficiency. The aims of this study were to examine vitamin D status among pharmacy students of Sebha University and to study the hematological profile as well as correlation of vitamin D deficiency with incidence of anemia among the students. This study was carried out on Pharmacy students from 13th January to 12th March, 2020. This is a cross-sectional study designed to determine vitamin D status among healthy young pharmacy students studying at the Sebha University. The blood samples were collected randomly from 62 pharmacy students to analysis complete blood count and 25-hydroxyvitamin D. The concentration of hemoglobin on total student was 12.5 ± 1.9 g/dl which was normal according to the WHO level (12.0 g/dl). Out of total, 36 students (59.1%) were found to have normal hemoglobin concentration (13.7 ± 1.4 g/dl) and 26 students (40.9 %) were found to have low hemoglobin concentration (10.8 ± 1.1 g/dl). Other blood profile as HCT, MCV, MHC and MCHC where statistically significant lower but the counts of RBCs, WBC and platelets were not on anemic group comparing to normal group. The present study reported that majority of pharmacy students in male and female blood donors have low vitamin D levels which represent (87.0%). Out of the total participants (n = 54) who have low vitamin D (n = 49, 79.0%) were classified under vitamin D deficiency category while (n = 05, 08.0%) of students had vitamin D insufficiency. In conclusion, prevalence of hypovitaminosis D (low 25-hydroxyvitamin D) among the pharmacy students at Sebha University was highly occurrence with concomitant a high rate of prevalence of anemia. Thus, vitamin D deficiency at this age represents a public health problem that should be addressed.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The application of clinical pharmacokinetic is the responsibility of all pharmacists providing pharmaceutical care. An appropriately applied clinical pharmacokinetic is expected to result in improved patient outcomes: decreased mortality, reduced length of treatment, reduced length of hospital stays and cost-savings. Data on the extend of pharmacokinetic application in Libyan hospitals remain scarce but available subjective evidence suggests that services related to clinical pharmacokinetic are mostly provided and performed by professionals other than clinical pharmacists. To explore the training background and perceptions of pharmacists on the pharmacokinetic course contents they received during their undergraduate pharmacy programs. Also, to determine the attitudes and barriers experienced by the pharmacists when applying pharmacokinetic principles in their current practice. This is a cross-sectional, descriptive study that was conducted between July 2018 and November 2019 using a self-administered survey. The study targeted hospital pharmacists practicing in different hospitals in Libya. A total of 104 pharmacists completed the questionnaire and submitted it back. The majority of participants learned pharmacokinetic courses as a mandatory course during undergraduate courses 81.0% with 37.0% selecting that course was taught as a separate course or courses. Around 80.0% of the participants agreed or strongly agreed that pharmacokinetic courses received in undergraduate studies are useful in pharmacy practice with over 75.0% of the participants agreeing or strongly agreeing on relevance of those course to their current clinical practice. About 40.0% of the participants described their current skills in allowing optimal patient care as can be better. Different barriers were highlighted by the participants to allow sufficient clinical pharmacokinetic practice including lack of sufficient information, lack of awareness of pharmacists’ role and skills in applying clinical pharmacokinetic by other pharmacists and by other health care providers. Thus, this study shows that most practicing pharmacists showed a positive attitude of current pharmacokinetic practice and to the impact of their undergraduate studies on their successful practice. However, they have clearly addressed the room for improvement.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences