Volume 7 - Issue 1

S.NO Title & Authors Name page
Use of the patient’s medication experience in pharmacists’ decision making process
Isabela Viana Oliveira, Erika Lourenço de Freitas, Kirla Barbosa Detoni, Djenane Ramalho-de-Oliveira
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When providing comprehensive medication management (CMM) services, pharmacists must recognize patients’ medication experiences to make patient-centered decisions. The aim of this study was to understand how patients’ medication experiences are applied in pharmacists’ decision-making process during the provision of CMM services. Using grounded theory, we devised a theoretical proposition, which derived from narratives of 11 pharmacists, observations of CMM consultations and clinical case discussions.  The results suggested that understanding the patient’s medication experiences can guide the professional to identify and resolve drug therapy problems. According to the participants, the medication experience can lead the practitioner to two courses of action: to improve health literacy, helping the patient overcome barriers to medication use; or to adapt the intervention, matching the pharmacotherapy to the patient’s routine. This knowledge can be used as a guide to teach pharmacy students and novice pharmacists how to incorporate patients’ medication experiences into clinical decision-making.

Study on complexation of ascorbic acid derivatives with γ-cyclodextrin
Yutaka Inoue, Misa Horage, Rina Suzuki, Daichi Niiyama, Ryota Urano, Shigeru Ando, Junko Kikuchi, Isamu Murata, Ikuo Kanamoto
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The aim of this study was to assess the physicochemical properties of a solid dispersion of L-ascorbyl 6-palmitate (ASCP) as poorly water soluble and ?-cyclodextrin (?CD) prepared by co-precipitation or co-grinding by using powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), nuclear magnetic resonance (solution state 1H-NMR and solid state 13C-NMR), and solubility test. Physical assessments and measurements indicated that a co-precipitate of ASCP and ?CD resulted in inclusion complex formation at a molar ratio of 1:3 and that a ground mixture of ASCP and ?CD resulted in inclusion complex formation at a molar ratio of 1:2. A solubility test revealed that the co-precipitate and ground mixture had improved solubility compared to ASCP alone. The co-precipitate had greater solubility than the ground mixture. This result is presumably due to molecular interaction occurring as result of the differences in the molar ratios and differences in the structure of complexes for ASCP and ?CD in a solid state.

In vitro susceptibility of clinical uropathogens to levofloxacin at the Ghana police hospital
Daniel Kwame Afriyie, Martha Gyansa-Lutterodt, George Asare, Kwabena Agyekum, Edem Wormenor and Seth Kwabena Amponsah
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Background: Quinolones are among drugs used in the treatment of urinary tract infections (UTIs). However, there has been an increase in quinolone-resistant uropathogens over the last decade. The aim of this study was to assess the sensitivity pattern of isolated uropathogens to levofloxacin. Methods: Urine samples (n = 519) from suspected UTI patients were collected from July 2014 to September 2014. Microorganisms with significant growth were identified after initial culturing at 37°C for 24 hours. Susceptibility of isolated uropathogens to levofloxacin at a break point of 5 µg was done by the Kirby-Bauer disc diffusion method. Results: The prevalence of UTI among sampled patients was 18.3%. Predominant microbial isolates were: Escherichia coli (56.8%), Coliform spp. (24.2%) and Staphylococcus aureus (9.5%). Overall resistance of isolated uropathogens to levofloxacin was 51.6%. Levofloxacin resistance by predominant uropathogens was 63% for E. coli, 34.8% for Coliform spp. and 22.2% for S. aureus. Conclusions: High resistance of some isolated uropathogens to levofloxacin, especially with E. coli was observed in this study. Thus, the need for coordinated susceptibility monitoring of clinical isolates to levofloxacin.

Effects of Vernonia Amygdalina Leaf Extract on Total Antioxidant Capacity and Malondialdehyde Levels in Acetaminophen-Induced Toxicity in Mice
Mweenda Sitanimezi, Ezeala Christian Chinyere, Prashar Lavina
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Background: Many plants have been shown to possess antioxidant properties. Aim: To determine the effects of V. amygdalina on Total antioxidant status and malondialdehyde levels in mice treated with acetaminophen overdose. Methodology: Mice were separated into 5 groups of 6 mice each. 300mg/kg of acetaminophen was administered to all groups except group 1. Then V. amygdalina extract was administered to groups 1 and 3 at 50mg/kg and group 4 at 100mg/kg, and group 5 received Vitamin C at 500mg/kg, all treatments were given orally. 8 hours later blood samples were collected by cardiac puncture, livers were excised, homogenised and used for biochemical analysis.  Results: Acetaminophen produced a significant reduction in TAOC and a marked increase in MDA levels of mice in groups 2, 3, 4 and 5. These effects were significantly attenuated by V. amygdalina administration, in a dose dependent manner. These effects were comparable with those of Vitamin C. Conclusion: Results suggests that Vernonia amygdalina possesses significant antioxidant effects.

Dissolution incompatibility of Paracetamol as a silent dissolution retardent of concomitantly administered drugs
Kithmini Yasarathna, Chamodi Wijesinghe, Banukie Jayasuriya, Walisinghe Pathirana.
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High strength tablets containing 500 mg or more active ingredients could affect the dissolution of concomitantly administered drugs. Dissolution of ten generic solid dosage forms was determined in the presence of sodium bicarbonate and paracetamol, 500 – 2250 mg. In a total of 111 dissolution tests 41 failed (37%) to meet the criteria. Where paracetamol was present 36 out of 50 end points failed (72%) with an extreme case in diltiazem tablets with 0% dissolution. Since longest test end points with failures mostly range from 60 – 90 minutes it is advisable to administer paracetamol 1.5 hours after other drugs in order to avoid potential pharmacokinetic disturbances.a

Stability and sterility of single dose infusion vial of acetaminophen for multiple dosing
Azfar Athar Ishaqui, Syed Baqir Shyum Naqvi, Iyad Naeem Muhammad, Sheikh Abdul Khaliq, Syed Hameez Jawed, Adnan Iqbal.
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Single dose vials are considered to be used for single dose and single patient only. Many infection outbreaks reported previously by using single dose vials for multiple dosing were mainly due to improper handling by health care workers. However, under certain circumstances it is permissible to use single dose vial for multiple dosing. In present study, sterility and stability of 50 acetaminophen single dose vials were analyzed for 24 hours by withdrawing samples at different time intervals after the initial first spiking of vial by using basic aseptic techniques. The sterility was examined by inoculating samples on thioglycolate broth, nutrient agar and Sabouraud’s Dextrose agar but none of the samples found contaminated. The stability was evaluated by UV-visible spectrophotometric method. One way analysis (P-value=0.152) reject the null hypothesis and did not reveal any significant differences among samples at different time intervals. The study concludes the use of the SDV for multidosing provided the prevention of contamination in the system.

A Study on Evaluating Prescriptions in Emergency Unit of Tertiary Care Teaching Hospital Based on Who Prescribing Indicator
M Kumaraswamy, Laxman Wagle, Jeet Bahabhur Moktan, Niraj Shrestha, Treesa Augustine
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Aim of this study was to evaluate the prescribing habits of physician in emergency unit of tertiary care teaching hospital based on World Health Organization prescribing indicators. A prospective observational study for a period of 6 months was conducted after ethical research committee approval. All the patients visiting at emergency unit were enrolled. Data were measured in frequency, mean and percentage using Microsoft excel. Among 600 patients, we found males (68.66%) were more than females (31.33%) and majority (35.83%) under the age group of 21-40 years. Average number of drugs per prescriptions were 4.01±1.68 where 22.28% of drugs were generics, 16.33% of drugs were antibiotics, 83% of drugs were injections, 89.98% of drugs were from Indian essential drug list and 62.30% of drugs were from WHO essential drug list. Based on these results it was possible to promote rational use of drugs by improving physician prescribing habits.

Spectrophotometric method for simultaneous estimation of Epalrestat and Methylcobalamin in pharmaceutical dosage form
Madhuri A. Hinge, Niraj K.Patel, Rajvi J. Mahida
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A simple, accurate, and reproducible UV-spectrophotometric method has been developed for simultaneous estimation of Epalrestat and Methylcobalamin in tablet dosage form.  In Absorbance ratio method  ,two wavelengths 238 nm and 257.80 nm were used  over the concentration range of 50 - 250 µg/ml and 0.5 - 2.5 µg/ml for Epalrestat and Methylcobalamine respectively. Correlation coefficient found to be 0.9995.Accuracy for both the drugs were in the range of 98-101 %. The method was validated as per the International Conference on Harmonization (ICH) guidelines.

Validated Spectrophotometric method for estimation of Paclitaxel in Bulk and Pharmaceutical Formulation
Indrayani D. Raut, Rajendra C. Doijad , Shrinivas K.Mohite
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A simple, precise, rapid UV method has been developed for the determination of Paclitaxel in bulk and its pharmaceutical dosage form. Paclitaxel is a mitotic inhibitor used in cancer chemotherapy. Paclitaxel is used to treat patients with lung, ovarian, breast, head and neck cancer, and advanced forms of Kaposi's sarcoma.  Various methods for analysis of same are available but are time consuming and expensive. Here we have developed new, precise, simple spectrophotometric method for estimation of Paclitaxel from bulk. Medium prepared were selected phosphate buffer PH 10. It showed absorption maxima at 230 nm.This method were validated according to ICH guidelines. The drug obeyed Beers law and showed good correlation. The linearity was observed between 5-55 µg/mL . There was no significant difference in the intraday and interday analysis of Paclitaxel determined. The results of analysis were validated with respect to recovery, linearity; Limit of detection and limit of quantitation were found to be satisfactory.

Pathophysiology and Pharmacotherapy of Persistent Post- Infectious Cough: A Review of Literature
Lavina Prashar and Christian C Ezeala
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Persistent post-infectious cough (PPC) is a subacute cough lasting less than 8 weeks.  This article aims to review recent advances in the pathophysiology and pharmacotherapy of PPC secondary to upper respiratory tract infection.  Between April and August, 2016, relevant databases were searched using the search words “subacute cough,” “persistent post-infectious cough,” “post-viral cough,” “causes,” pathogenesis,” and “management.” Inflammatory mechanisms play a reported role in the pathophysiology of PPC. Interplay of mediators such as neuropeptides, cysteinyl leukotrienes, Th1-like and Th2-like cytokines and gamma interferon, has been suggested. Combination of ‘Honey and ‘Coffee’ and Suhuang Zhing, a traditional Chinese medicine is reported to demonstrate clinical efficacy in clinical trials. Natural products and herbal medicines appear to be superior to conventional treatments.

A Comparative Study between Market products and Immediate Release Loratadine Tablets Formulation using different Superdisintegrants
Samira Karim, Saimum Islam, Khurshid Jahan, Md.HaiderAli, Kanij Nahar Deepa and Mohammad Shahriar
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Aim of the present study was to develop immediate release tablets of loratadine. Loratadine immediate release tablets were formulated by using different ratios of different superdisintegrants like sodium starch glycolate and kollidon CL with direct compression method. Tablets were prepared and evaluated for different quality parameters. A comparison of commercial loratadine tablets has also been evaluated. The percent releases of the all formulations (total six) were from 91.47%- 98.70% after 1 hr dissolution studies. Best formulation was F3 because of lesser disintegration time and highest percentage drug release at the end of 1 hr. On the other hand, sample-A released 99.83% of drug while sample-B released 99.04% of drug within 1 hr from release pattern of commercial product of loratadine tablets. The study reveals that the superdisintegrants of the study have the capacity to speed up the release of the drug from the immediate release tablets and the more is the amount of the superdisintegrants in the formulation the more is the release of drug showing more immediate action of drug release.

Toxicological Studies of an Ayurvedic Medicine \"Swalpo Chandrodoy Makardhwaj\" Used as Geriatric Rejuvenator
Massnoon Ali, Md. Mamun Sikder, Uday Krishna Mondal, Konica Arju Leeza, Manoth Kumer Biswas, Md. Rakib Hasan, Runa Masuma, and M. S. K. Choudhuri
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Swalpo Chandrodoy Makardhwaj (SCM) is an Ayurvedic geriatric rejuvenator used as a traditional medicine in the rural area of Bangladesh. To find out the toxicological characteristic of SCM, it was administered chronically to the male Sprague-Dawley rats at a dose of 100 mg/kg for 32 days and the following toxicological changes were noted. All throughout the experimental period the SCM treated animals were always maintaining negligible changes in body weight. There is a statistically significant (p=0.012) decrease in the organ water content of the male rat lungs whereas a statistically significant (p=0.044) increase was noted in case of organ water content of liver. There is a statistically significant increase in relative percent weight of rat kidney (p=0.028) and absolute weight of rat spleen (p=0.024). There is also a statistically significant (p=0.034) increase in the relative percent weight of the male rat spleen.

Phytochemical and pharmacological study on argemone mexicana linn (papaveraceae)
Sunita Verma
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Argemone mexicana L. belong to family Papaveraceae, commonly known as “Prickly Poppy” and “Satyanashi”. It grow as weed in almost all part of India. The plant have many alkaloid, terpenoids, glycosides and flavanoids which are responsible for many pharmacological activities. This review aims at describing the botanical description, classification, phytochemical profiles of various parts of Argemone mexicana.

Formulation and evaluation of Bosentan nanosuspensions by nanoprecipitation method
Nagendra reddy JVV, Jagan mohan reddy NVV, Prasanna ML, Narendra D
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In the present study, an attempt was made to formulate and evaluate Bosentan Nanosuspension by Nanoprecipitation method and to reduce symptoms in patients suffering with pulmonary arterial hypertension. Nanosuspension containing the drug were prepared by Nanoprecipitation method using combinations of polymers such as Sodium lauryl sulphate (SLS), TWEEN-80, Poloxamer 188, Urea and methanol. Estimation of Bosentan was carried out spectrophotometrically at 274nm. The Oral Nanosuspension were evaluated for drug content uniformity, particle size analysis, zeta potential, in-vitro drug release, short-term stability, drug- excipient interactions (FTIR). IR spectroscopic studies indicated that there are no drug-excipient interactions. Of all the formulations (PF1 – PF6) PF3 formulation containing SLS 1.25%, Tween-80 0.2% and Poloxamer 1% were found to be promising which showed 99.55±0.84% release at the end of 30min & it follows first order drug release kinetics. For optimized formulation (PF3) particle size, polydispersible index & zeta potential was found to be 38.1nm, 2.88 & -4.49mV respectively. The optimized formulation was stable at 400C/75 % RH for 3 months.
Prevalence of gastroesophageal reflux disease and comparing the efficacy of different proton pump inhibitors for symptomatic relief based on endoscopic findings in a tertiary care hospital
Dr. G. Ramya Bala Prabha, M. Prasamse, S. Mounika, P. Anunay Joseph, B. Chaitanya, Dr. T. Rammohan Reddy, Dr.P. Shravan Kumar
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Gastro Esophageal Reflux Disease (GERD) is a condition that occurs when the refluxed stomach contents lead to troublesome symptoms and complications. Prevalence of GERD differs in various geographical regions. Factors such as smoking, alcohol consumption, certain medications and foods have a significant effect on the aggravation of the diseaseA prospective observational study was conducted between August 2015 & January 2016 in department of Gastroenterology, Gandhi hospital, Secunderabad after approval from Institutional Ethical Committee, CMRCP. Cases included according to study criteria. A total of 2460 subjects participated, out of which 130 subjects were found to be affected with GERD. Data obtained from cases were analyzed to obtain final outcome by statistical analysis using ANOVA. The prevalence of GERD in males was 58.46%. 70.77% of the patients belonged to the age group of below 50 years. Alcoholism 36.93%, smoking 42.31%, tea consumption twice daily (47.69%), meat consumption 72.31% are the factors that aggravate disease. 99 patients who presented for second endoscopy were compared to know the efficacy of each proton pump inhibitors (Pantoprazole, Rabeprazole and Esomeprazole) considered in this study. Rabeprazole showing 37.81% symptomatic relief followed by esomeprazole 35.37% and pantoprazole 26.82%. several factors such as change in the diet, lifestyle, smoking and alcohol consumption can affect the prevalence of GERD in this rapidly progressing society. The prescribed proton pump inhibitors are well tolerated with Rabeprazole showing better efficacy than Esomeprazole and Pantoprazole for the relief of esophageal lesions and GERD related symptoms.
Effect of nigella sativa in experimentally induced inflammatory bowel disease in rats
Tazneem. B , Abdullah khan
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Inflammatory bowel disease (IBD) (ulcerative colitis and Crohn’s disease) is an idiopathic, chronic inflammatory condition, which affects the gastrointestinal tract.The present study was carried out to evaluate the effect of ethanolic extract of Nigella sativa in experimentally induced inflammatory bowel disease (IBD) in rats. Colitis was induced by a single intra-colonic application of 20 mg 2,4,6-trinitrobenzene sulfonic acid (TNBS) dissolved in 35% ethanol into the descending colon. Rats were divided into six groups. Animals were treated with vehicle (ethanol), TNBS dissolved in 35% ethanol, Ethanolic extract of Nigella sativa seeds (ENS) 100, 200 and 400 mg/kg body weight p.o. and sulfasalazine(SSZ) 360 mg/kg body weight p.o. for 14 days. After completion of 14 days of treatment, animals were sacrificed and the following parameters were assessed morphological score, histopathology and biochemical parameters like myeloperoxidase (MPO), malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) activity and serum nitrate levels. Nigella sativa provided protection against TNBS-induced colonic damage. There was significant protection with ENS 200 and 400 mg/kg body weight compared to control (P <0.001). Morphological and histological score were significantly reduced in all the treated groups (P<0.001). All parameters were altered in ulcerated rats, and improved in animals receiving ENS, an effect that was comparable to that of the standard sulfasalazine, especially at the highest dose level. Results indicate efficacy of ENS against TNBS induced experimental colitis in rats.
K. Pavan Kumar, Balisa Mosisa Ejeta, Biniam Paulos Bura, Madhusudhana Reddy Induri
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The research work was carried on the evaluation of antibacterial, antifungal and anthelminthic activities of the methanolic, petroleum ether and aqueous extracts of Madhuca indica bark belonging to family Sapotaceae. Disc diffusion technique was used for in-vitro antibacterial and antifungal activities using ciprofloxacin (5µg/disc) and clotrimazole (10µg/disc), zone of inhibition was observed against two gram positive bacteria (Staphylococcus aureus, Bacillus subtilis), two gram negative bacteria (Escherichia coli, Pseudomonas aeruginosa), two fungal species (Aspergillus Niger, Candida albicans) at concentration of 50, 100, 150, 200µg/mL). Anthelminthic activity was investigated in pheretima posthuma (Indian Earth Worm) at concentration 10, 20, 50mg/mL against standard drug piperazine citrate (10mg/mL). For antibacterial and antifungal activity of all the extracts has shown moderate to good activity against standard drugs. Among all the extracts aqueous extract and methanolic extract have shown good activity when compared to petroleum ether extract which showed moderate activity against standard drugs. For anthelminthic activity of petroleum ether extract has shown good activity against the other extracts.

Determination of Oseltamivir Phosphate in Capsules by Visible Spectrophotometry
Prasad B, T. Meeravali, N. Durga Bhavani, Y. Rajesh, Sunkara Bhawani
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A simple, sensitive, accurate and precise spectrophotometric method was described for the determination of Oseltamivir Phosphate in bulk dosage forms. The method is based on the formation of ion-pair of the drug with anionic dye such as bromophenol blue (BPB) which is extracted into chloroform having absorption maxima at 420 nm Regression analysis of the Beer's plots showed good correlation in the concentration ranges 10-100 µg/ml. The proposed method was successfully applied to the dosage forms containing the Oseltamivir Phosphate.   No interference from common excipients was observed.

Determination of Oseltamivir Phosphate in Capsules by Visible Spectrophotometry
Prasad B, T. Meeravali, N. Durga Bhavani, Y. Rajesh, Sunkara Bhawani
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A simple, sensitive, accurate and precise spectrophotometric method was described for the determination of Oseltamivir Phosphate in bulk dosage forms. The method is based on the formation of ion-pair of the drug with anionic dye such as bromophenol blue (BPB) which is extracted into chloroform having absorption maxima at 420 nm Regression analysis of the Beer's plots showed good correlation in the concentration ranges 10-100 µg/ml. The proposed method was successfully applied to the dosage forms containing the Oseltamivir Phosphate.   No interference from common excipients was observed.