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Pharmacy Newsletter : August 2016, Pharmacy Department

Pharmacy Newsletter

Content:

• Pharmacy Help Desk Service.
• New Guidelines for the Management of Aspergillosis
• Overview of New CHEST Antithrombotic Guideline for Treatment of VTE (10th Edition)
• Immunization against Pneumococcal
• FDA Warnings 2016

Pharmacy Newsletter : April 2016, Pharmacy Department

Pharmacy Newsletter

Content:

• Medication Management in Geriatrics | Overview of Beers Criteria 2015
• Zika Virus Disease (ZVD) – An Emerging Culprit
• Emerging Avenues for Botulinium Toxin Therapy
• Novel Treatment Approach of Pancreatic Cancer
• FDA Podcast 2015
• Extra Care is Needed Because Warfarin is High - Alert Medicine
• Reporting of ADR
• ADR Trends of 2015 at AKUH

Almond Supplementation Reduces Serum Uric Acid In Coronary Artery Disease Patients: A Randomized Controlled Trial., Humaira Jamshed, Anwar Gilani, Fateh Ali Tipoo Sultan, Faridah Amin, Jamshed Arslan Arslan, Sumaira Ghani, Madiha Masroor

Department of Biological & Biomedical Sciences

Objective

Elevated serum uric acid (UA), a biomarker of renal insufficiency, is also an independent prognostic marker for morbidity in coronary artery disease (CAD) and poses serious health risks. This study reports the effect of almond consumption on UA in CAD patients.

Study design

A randomized controlled clinical trial was conducted with three groups: no-intervention (NI), Pakistani almonds (PA) or American almonds (AA). Patients were recruited from the Cardiology Clinics, Aga Khan University Hospital. Two follow-ups were scheduled at week-6 and week-12. 150 patients were randomly divided in three groups (50 per group). NI was not given almonds, whereas the …

Pharmacy Newsletter : September 2015, Pharmacy Department

Pharmacy Newsletter

Content

• Advancement in Pharmacotherapy
• Auxiliary Labels
• How to Take Oral Diabetic Medications with Food, Nutrient/Herb and other Medications?
• Proud to Report

Pharmacy Newsletter : April 2015, Pharmacy Department

Pharmacy Newsletter

Content:

• Medication Safety Alert
• FDA Drug Safety Podcast of the Year 2014
• Operational Quality and Patient Safety Indicators – 2014
• Pharmacy Staff Appreciation Evening

Pharmacy Newsletter : December 2014, Pharmacy Department

Pharmacy Newsletter

Content:

• New WHO Guide to Prevent and Control Cervical Cancer
• Analgesic use in Adult Patients with Advanced Chronic Liver Disease or Cirrhosis
• The Novel Treatment of Clostridium Diffi cile Associated Diarrhea (CDAD)
• 25th September, World Pharmacist Day-Celebration

Pharmacy Newsletter : September 2014, Pharmacy Department

Pharmacy Newsletter

Content:

• Pharmacy managed Polio immunization services
• FDA Pharmacy News Flash
• New weapons against MRSA
• Pencillin allergy and cross reactivity among beta lactams
• Inhales at Aga Khan University Hospital pharmacy services
• Proud to report

Pharmacy Newsletter : April 2014, Pharmacy Department

Pharmacy Newsletter

Content:

• Investiture of Clean Room Pharmacy, Epitomize USP Chapter
• 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
• Anticoagulation Clinic - Enhancing Patient Care
• Clinical Quality and Patient Safety Indicators

Pharmacy Newsletter : September 2013, Pharmacy Department

Pharmacy Newsletter

Content:

• Pharmacist-Run One Window Immunization
• Pharmacy Take Away Service
• Insulin
• Pencillin Test Dose Dilution
• Pharmacist Interventions

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Pharmacy Newsletter : May 2013, Pharmacy Department

Pharmacy Newsletter

Content:

• Patient Information Brochure
• “Beers Criteria”– Medication Safety in Elderly Patients
• Adverse Drug Reactions – Summary 2012

Polypharmacy In Elderly: A Cautious Trail To Tread, Saniya Raghib Sabzwari, Waris Qidwai, Seema Bhanji

Department of Family Medicine

Polypharmacy has now increasingly come into focus as the recipient of healthcare in old age worldwide. In elderly it is associated with frequent adverse drug reactions (ADRs) and drug-drug interactions resulting in significant morbidity. Geriatrics is still an emerging specialty in South Asia, especially in Pakistan, where multiple reasons for polypharmacy exist. An extensive literature review of articles using key words like \'polypharmacy,\' \'elderly\' was conducted. The recently updated Beers Criteria of classification of inappropriate drugs in the elderly was reviewed in detail. Articles of relevance to polypharmacy and evaluation of guidelines for appropriate interventions to minimise inappropriate drug prescribing …

Access To Essential Medicines In Pakistan: Policy And Health Systems Research Concerns., Shehla Zaidi, Maryam Bigdeli, Noureen Aleem, Arash Rashidian

Community Health Sciences

NTRODUCTION:

Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns.

METHODS:

An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. …

Pharmacy Newsletter : October 2012, Pharmacy Department

Pharmacy Newsletter

Content:

• Quick review of important standards of medication management and use
• Food Grade vitamin D supplements - are our patients safe?
• Cross sensitivity (cross allergy) between drugs
• Drug safety updates

Water Pipe Smoking Amongst The University And College Students Of Karachi, Pakistan, Shehla Batool Jaffri, Aisha Yousuf, Waris Qidwai

Department of Family Medicine

Background:

An extensive literature search revealed that water pipe smoking is an emerging health risk and deserves the attention of health professionals. This study was therefore undertaken to determine the frequency of water pipe smoking among students in college and universities of Pakistan and to assess the practices, knowledge and attitude towards water pipe smoking among them.

Method:

A cross sectional survey was conducted in the College and Universities of Karachi, Pakistan from April 2009 to October 2009. Students were selected through non probability sampling and given self administered questionnaire after the informed consent.

Result:

A total …

Antioxidant, Antimicrobial Properties And Phenolics Of Different Solvent Extracts From Bark, Leaves And Seeds Of Pongamia Pinnata (L.) Pierre, Zahid Iqbal Sajid, Farooq Anwar, Ghulam Shabir, Ghulam Rasul, Khalid M. Alkharfy, Anwarul Hassan Gilani

Department of Biological & Biomedical Sciences

This study appraises the antioxidant and antimicrobial attributes of various solvent extracts (absolute methanol, aqueous methanol, absolute ethanol, aqueous ethanol, absolute acetone, aqueous acetone, and deionized water) from bark, leaves and seeds of Pongamia pinnata (L.) Pierre. Maximum extraction yield of antioxidant components from bark (16.31%), leaves (11.42%) and seeds (21.51%) of P. pinnata was obtained using aqueous methanol (20:80). Of the extracts tested, the bark extract, obtained with aqueous methanol, exhibited greater levels of total phenolics [6.94 g GAE/100 g dry weight (DW)], total flavonoids (3.44 g CE/100 g DW), inhibition of linoleic acid peroxidation (69.23%) and DPPH radical …

Species And Tissue-Specificity Of Prokinetic, Laxative And Spasmodic Effects Of Fumaria Parviflora, Najeeb-Ur-Rehman, Malik Hassan Mehmood, Adnan J. Al-Rehaily, Ramzi A. A. Mothana, Anwar H. Gilani

Department of Biological & Biomedical Sciences

Background: Fumaria parviflora Linn. (Fumariaceae), is a small branched annual herb found in many parts of the world including Saudi Arabia and Pakistan. This study was designed to provide pharmacological basis for the medicinal use of Fumaria parviflora in gut motility disorders. Methods: The in-vivo prokinetic and laxative assays were conducted in mice. Isolated intestinal preparations (ileum and jejunum) from different animal species (mouse, guinea-pig and rabbit) were separately suspended in tissue baths containing Tyrode's solution bubbled with carbogen and maintained at 37 degrees C. The spasmogenic responses were recorded using isotonic transducers coupled with PowerLab data acquisition system. Results: …

Pharmacy Newsletter : March 2012, Pharmacy Department

Pharmacy Newsletter

Content:

• ‘Warfarin’ – High Alert Medication Policy Update
• Rational use of Antibiotics 2011 – a Snapshot
• Pharmacist Interventions – Curbing Potential Prescribing Errors
• Reporting Adverse Drug Reactions - An Important Tool for Patient Safety!
• Drug Safety Updates

Aqueous-Methanolic Extract Of Sweet Flag (Acorus Calamus) Possesses Cardiac Depressant And Endothelial-Derived Hyperpolarizing Factor-Mediated Coronary Vasodilator Effects., Abdul Jabbar Shah, Anwar Gilani

Department of Biological & Biomedical Sciences

This investigation was aimed to probe the pharmacological base of medicinal use of Acorus calamus in ischemic heart diseases. Effect on heart parameters was studied in isolated rabbit heart while coronary vasodilator effect was studied in isolated bovine coronary arterial rings, suspended in tissue baths filled with Krebs solution, maintained at 37degreesC, aerated with carbogen and responses were measured on PowerLab data acquisition system. In Langendorrf's perfused rabbit heart, the crude extract of Acorus calamus (Ac.Cr) at 0.01-10 mg/mL partially suppressed force of ventricular contractions (FVC), heart rate (HR) and coronary flow (CF). The ethylacetate fraction completely suppressed FVC, partially …

Antiurolithic Activity Of Origanum Vulgare Is Mediated Through Multiple Pathways, Aslam Khan, Samra Bashir, Saeed R. Khan, Anwar H. Gilani

Department of Biological & Biomedical Sciences

Background: Origanum vulgare Linn has traditionally been used in the treatment of urolithiasis. Therefore, we investigated the crude extract of Origanum vulgare for possible antiurolithic effect, to rationalize its medicinal use. Methods: The crude aqueous-methanolic extract of Origanum vulgare (Ov.Cr) was studied using the in vitro and in vivo methods. In the in vitro experiments, supersaturated solution of calcium and oxalate, kidney epithelial cell lines (MDCK) and urinary bladder of rabbits were used, whereas, in the in vivo studies, rat model of urolithiasis was used for the study of preventive and curative effect. Results: In the in vitro experiments, Ov.Cr …

Access To Essential Medicines: In Pakistan Identifying Policy Research And Concerns, Shehla Zaidi, Noureen Nishtar

Community Health Sciences

The fundamental importance of ensuring access to medicines, particularly for the poor, is reflected in MDG 8 however remains poor in many low and middle income countries (LMICs). Country specific evidence on access to medicines is weak in LMICs and research has rarely been from an integrated health systems perspective. This study used an evidence based approach to identify key priority concerns and emerging research questions related to access to medicines in Pakistan. WHO’s Access to Medicine Framework was used as the conceptual basis for data collection on rational usage, affordability, financing and health systems. Methods involved a systematic desk …

Pharmacy Newsletter : July 2011, Pharmacy Department

Pharmacy Newsletter

Content:

• E-Call logging system at Drug and Poison Information Centre
• Computerised Physician Order Entery System (CPOE) featured with more robust allergies information
• Initiation of Point of Care Clinical Pharmacy in Paeds Oncology
• Sulfa Allergy: Myths and Realities
• Drug Safety Updates

Effect Of Preventive Zinc Supplementation On Linear Growth In Children Under 5 Years Of Age In Developing Countries: A Meta-Analysis Of Studies For Input To The Lives Saved Tool, Aamer Imdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction:Zinc plays an important role in cellular growth, cellular differentiation and metabolism. The results of previous meta-analyses evaluating effect of zinc supplementation on linear growth are inconsistent. We have updated and evaluated the available evidence according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and tried to explain the difference in results of the previous reviews.

Methods:

A literature search was done on PubMed, Cochrane Library, IZiNCG database and WHO regional data bases using different terms for zinc and linear growth (height). Data were abstracted in a standardized form. Data were analyzed in two ways i.e. weighted …

Antispasmodic And Ca++ Antagonist Potential Of Marrubiin, A Labdane Type Diterpene From Phlomis Bracteosa, Javid Hussain, Riaz Ullah, Arif-Ullah Khan, Fazal Mabood, Mohammad Raza Shah, Ahmed Al-Harrasi, Anwar Gilani

Department of Biological & Biomedical Sciences

A tricyclic labdane type diterpene was isolated for the first time from ethyl acetate soluble part of Phlomis bracteosa. Its structure was confirmed by x-ray which was found to be marrubiin. When studied in isolated rabbit jejunum, marrubiin caused concentration-dependent relaxation of spontaneous and high K+ (80 mM)-induced contractions, like that caused by verapamil, indicating that marrubiin exhibits spasmolytic activity, possibly mediated through Ca++ channel blocking action.

Pharmacy Newsletter : December 2010, Pharmacy Department

Pharmacy Newsletter

Content:

• Vancomycin adverse drug reaction
• Recent FDA drug safety updates
• High risk diagnosis
• Top 10 reason for not reporting adverse drug reactions (ADRs)

Studies On Antidyslipidemic Effects Of Morinda Citrifolia (Noni) Fruit, Leaves And Root Extracts., Saf-Ur Rehman Mandukhail, Nauman Aziz, Anwar Gilani

Department of Biological & Biomedical Sciences

Background: The objective of present study was to provide the pharmacological basis for the medicinal use of Morinda citrifolia Linn in dyslipidemia using the aqueous-ethanolic extracts of its fruits (Mc.Cr.F), leaves (Mc.Cr.L) and roots (Mc.Cr.R). Results: Mc.Cr.F, Mc.Cr.L and Mc.Cr.R showed antidyslipidemic effects in both triton (WR-1339) and high fat diet-induced dyslipidemic rat models to variable extents. All three extracts caused reduction in total cholesterol and triglyceride levels in triton-induced dyslipidemia. In high fat diet-induced dyslipidemia all these extracts caused significant reduction in total cholesterol, triglyceride, low density lipoprotein-cholesterol (LDL-C), atherogenic index and TC/HDL ratio. Mc.Cr.R extract also caused increase …

Antispasmodic, Bronchodilator And Blood Pressure Lowering Properties Of Hypericum Oblongifolium - Possible Mechanism Of Action, Arif-Ullah Khan, Munasib Khan, Fazal Subhan, Anwar Gilani

Department of Biological & Biomedical Sciences

The crude extract of Hypericum oblongifolium (Ho.Cr), which tested positive for flavonoids, saponins and tannins caused concentration-dependent (0.1-1.0 mg/mL) relaxation of spontaneous and high K(+) (80 mM)-induced contractions in isolated rabbit jejunum preparations, suggesting a Ca(++) antagonistic effect, which was confirmed when pretreatment of the tissue with Ho.Cr produced a rightward shift in the Ca(++) concentration-response curves, like that caused by verapamil. Ho.Cr relaxed carbachol (1 mu M) and high K(+)-induced contractions in guinea pig tracheal preparations. It caused a dose-dependent (3-100 mg/kg) fall in arterial blood pressure of rats under anesthesia. In isolated guinea pig atria, Ho.Cr caused inhibition …

Antispasmodic And Vasodilator Activities Of Morinda Citrifolia Root Extract Are Mediated Through Blockade Of Voltage Dependent Calcium Channels, Anwarul Hassan Gilani, Saf-Ur-Rehman Mandukhail, Javeid Iqbal, Masoom Yasinzai, Nauman Aziz, Aslam Khan, Najeeb-Ur-Rehman

Department of Biological & Biomedical Sciences

Background: Morinda citrifolia (Noni) is an edible plant with wide range of medicinal uses. It occurs exclusively in tropical climate zone from India through Southeast Asia and Australia to Eastern Polynesia and Hawaii. The objective of this study was to explore the possible mode(s) of action for its antispasmodic, vasodilator and cardio-suppressant effects to rationalize its medicinal use in gut and cardiovascular disorders. Methods: Isolated tissue preparations such as, rabbit jejunum, rat and rabbit aorta and guinea pig atria were used to test the antispasmodic and cardiovascular relaxant effects and the possible mode of action(s) of the 70% aqueous-ethanolic extract …

Essential Medicines Management During Emergencies In Pakistan, S. K. S. Bukhari, J.A.R. H. Qureshi, Rashid Jooma, K.M. Bile, G. N. Kazi, W. A. Zaibi, A. Zafar

Section of Neurosurgery

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan's 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level …

Pharmacy Newsletter : November 2009, Pharmacy Department

Pharmacy Newsletter

Content:

• Pharmacy News
• FDA Alerts
• Drug Safety Updates
• Swine Flu Update
• European Migraine Guidelines Update