Pharmacists' understanding and attitudes towards pharmaceutical care in Saudi Arabia

The questionnaire was designed to determine both institutional [hospitals and healthcare centers] and community pharmacists' underst and ing, attitudes and barriers that limit provision of pharmaceutical care. Five hundred fifty institutional pharmacists and 250 community pharmacists were included in the survey. Data were collected via face-to-face encounter using piloted questionnaire. The total response numbered 375, which constitute a 71.6% response rate from community pharmacists and 35.6% from institutional pharmacists. More than 70% of the pharmacists surveyed had also favorable underst and ing of pharmaceutical care. The respondents showed positive attitudes towards pharmaceutical care. Approximately more than 89% of respondents felt the future of pharmacy would depend on the provision of professional services other than dispensing. The main barriers perceived by the pharmacist were lack of adequate training in pharmaceutical care practice, lack of work place for counseling, lack of staff, insufficient time, lack of patient dem and, lack of therapeutic knowledge, lack of support from owners. There were significant differences in responses to a number of issues recognized by male and females, age, years in practice and work setting. Pharmacists expressed general positive awareness and attitudes toward pharmaceutical care irrespective of practice settings. Several demographic factors including gender, years in experience and work setting were associated with awareness and attitudes toward pharmaceutical care. Pharmacists in Saudi Arabia indicated willingness but expressed major concern about their clinical knowledge, communication skills and pharmacy layout. This however makes implementation of pharmaceutical care logical. A joint collaboration between health authorities, colleges of pharmacy and medicine, pharmaceutical and medical societies is highly dem and ed for the promotion of pharmaceutical care in the country. Finally, training programs in pharmaceutical care practice should be available to the pharmacists

Glucagon-like peptide-1 derivatves and dipeptidyl peptidase-IV inhibitors. New hope for the treatment of type-2 dibetes

Glucagon-like peptide GLP-1 is an endogenous insulinotropic/glucagonostatic hormone that acts in a self-limiting mechanism. It is a multifunctional hormone that leads to insulin release stimulation, liver glucagon breakdown suppression, upregulation of islet cell proliferation, and neogenesis and retardation of gastric emptying. The short half-life and high renal clearance due to degradation via dipeptidyl peptidase-IV DPP-IV, and active glomerular filtration rate make this hormone ineffectual as an exogenous agent. More stable and long acting GLP-1 analogues and DPP-1 inhibitors have been developed with promising clinical value for the treatment of type-2 diabetes. The GLP-1 derivatives have the advantage of decreasing body weight while the DPP-IV inhibitors can be administered orally up to once daily. The mechanism of action as well as the tolerable side effect is astounding. This review article covers this new generation of anti-diabetics

Drug-induced pulmonary fibrosis

Pulmonary fibrosis is characterized by the accumulation of excessive connective tissue in the lungs. Its causes include chronic administration of some drugs for example bleomycin, cyclophosphamide, amiodarone, procainamide, penicillamine, gold and nitrofurantoin; exposure to certain environmental factors such as gases, asbestos and silica and bacterial or fungal infections. Some systemic diseases also predispose to the disease for example rheumatoid arthritis and systemic lupus erythematosus. The disease is associated with release of oxygen radicals and some mediators such as tumor necrosis factor-alpha TNF-alpha, transforming growth factor-beta TGF-beta, PDGF, IGF-I, ET-I and interleukins 1, 4, 8 and 13. The symptoms of the disease include dyspnea, non-productive cough, fever and damage to the lung cells. It is diagnosed with the aid of chest radiography, high resolution computed tomographic scanning and the result of pulmonary function tests. Drug-induced pulmonary fibrosis may involve release of free oxygen radicals and various cytokines for example IL-Ibeta and TNF-alpha via activation of nuclear transcription factor NF-beta as in the case of bleomycin and mitomycin or via release of TGF-beta as in case of tamoxifen or via inhibition of macrophages' and lymphocytes' phospholipases as in the case of amiodarone with the resultant accumulation of phospholipids and reduction of the immune system

Drug information centers in Saudi Arabia: evaluation of community pharmacists in Riyadh city

A survey of Riyadh community pharmacists was conducted to evaluate the available drug information resources, to highlight the role of pharmacists in providing drug information services [DIS], to determine the frequency and the type of questions received by community pharmacists, to define the need for drug information services and to reveal factors that inhibit pharmacists from providing such services. The questionnaires were distributed to representative samples of pharmacies from five different areas in Riyadh city, 90 out of 125 questionnaires were filled out. The results indicated that libraries of the community pharmacists were inadequate. The reference textbooks most frequently found were Martindale and British National Formulary [BNF]. The majority of pharmacists were actively involved in dissemination of drug information to both consumers and physicians. Many pharmacists realize their role in providing DIS. Information on pregnancy and lactation and recommended dose was rated as important needs by 92.2% and 86.7% of the pharmacists respectively. Several factors were found to inhibit pharmacists from providing DIS. The most important are lack of time, minimal support from owner and inadequate availability of references. The survey indicates the need for improvement in their reference materials to handle questions more adequately. Moreover, guidelines should be instituted to aid pharmacists in patient counseling and education. Likewise, community pharmacists should be encouraged to utilize the local drug information centers, or establish their own drug information centers