ABSTRACT
Prescriptions comprising multi-drug therapy mostly illustrate the prescribing error. The phenomenon of error is bonded with human inaccuracy. The erroneous practice is observed in under developed countries like Pakistan, Bangladesh and also in developed ones. Consequently drug-drug interaction is one of the most common error associated with potentially serious adverse response even death. Accordingly the present study was conducted to assess the prevalence of prescribing errors and drug-drug interactions in out-patients receiving angiotensin receptor blockers. The study was done with population size one hundred fifty prescriptions obtained from different out-patient settings in Karachi. The prescriptions were screened for prescribing errors and risk factors for drug-drug interactions. Drug-drug interactions were recognized by Micromedex.2.0.Drug-Reax®database. The most common type of error was omission error. These errors were patient's age, weight and diagnosis found in 51.3%, 97.3% and 74% of prescriptions, respectively. The prevalence of drug-drug interaction was 38%. A total of 746 drugs were prescribed with an average of 5 drugs per prescription and 450 medication errors were detected. Majority of the interaction were moderate [19.33%], others were minor [14%] and major [6%] in severity. Patients who prescribed many drugs [more than 5 drugs in a while] had a higher risk of developing drug-drug interactions [OR=4.76; 95% CI=2.30-9.64; p=0.0001*].The study data reports the occurrence of prescribing errors in Karachi and also necessitate the need of clinical pharmacist's services in health care system. The step will help to minimize the risk factors by having the drug prescriptions reviewed by the pharmacists
ABSTRACT
A precise, sensitive and quick High Performance Liquid Chromatographic [HPLC] method for the determination of rosuvastatin calcium in bulk and tablet dosage forms has been validated. The chromatographic scheme involved: Sil-20A auto sampler, LC-20A pump, SPD-20A UV/visible detector with separation attained by C18 column at 40oC temperature through a mobile phase of acetonitrile and buffer [50:50] at a flow rate of 1.0ml/min. The method is precise [%RSD for intra-day and inter-day extended between 1.06-1.54% and 0.103-1.78%] and linear [r[2]=0.9997]. Limit of detection and quantification [LOD and LOQ] of the adopted method were 0.78 and 1.56Mug/ml. The proposed HPLC method was established to be sensitive, precise and swift that can be proficiently adopted in quality control/quality assurance laboratories for predictable investigation of the bulk and oral solid dosage forms of rosuvastatin calcium
ABSTRACT
The current study was aimed to judge bioequivalence between two formulations of cefadroxil capsules as guided by FDA guidelines. Another objective was to conduct pharmacokinetic evaluation in Pakistani population. A single-dose, randomized, cross-over pharmacokinetic study was conducted during the month of May'2013 to August'2013. Washout period was one week. Fourteen healthy male adult volunteers were enrolled in the study, however twelve completed the study. Cefadroxil plasma concentration was analyzed by using validated HPLC method. Protein precipitation was achieved by the addition of 6% tri chloro acetic acid in 1:1 ratio and detection was done at 260 nm. Retention time was 7.792 min and correlation coefficient [R[2]] was 0.9953 showing linearity of the method. Blood sampling was carried out at different time intervals after administration of either test [TEST 500 mg] or reference [REF[registered] 500mg] formulation. Pharmacokinetic parameters [AUC[0-infinity], AUC[0-t], C[max], T[max], t[1/2] and k[el]] were calculated using Kinetica[register] PK/PD software. The geometric mean ratios and 90% confidence interval [CI] of these pharmacokinetic parameters for cefadroxil [test and reference] formulations were 0.986 [90.83-106.98%] for AUC[1-t]; 0.967 [89.13-104.92%] for AUC[0-infinity] and 0.999 [91.06-109.69%] for C[max]. The differences between T[max] of both formulations were not found to be statistically significant [p-value was more than 0.05]. The 90% CI of the test/reference AUC and C[max] ratio of cefadroxil were within the FDA recommended range for bioequivalence. Maximum plasma concentration C[max] was 12.5 micro g/ml for test and 12.47 micro g/ml for reference formulations. Average time to reach C[max] for test and reference formulation was 1.54 and 1.5 hrs. The two formulations of cefadroxil studied during the above study were verified bioequivalent. Maximum plasma concentration of cefadroxil was lower than those mentioned in some previous studies, while T[max] and half-life were near to values reported in literature
Subject(s)
Humans , Male , Adult , Biological Availability , Pharmacokinetics , Capsules , VolunteersABSTRACT
An innovative, selective and rapid reversed phase High Performance Liquid Chromatographic [RP-HPLC] method for the analysis of cefadroxil in bulk material and oral solid dosage forms has been developed and validated. The Chromatographic system consisted of Sil-20A auto sampler, LC-20A pump and SPD-20A Uv/visible detector. The separation was achieved by C[18] column at ambient temperature with a mobile phase consisting of methanol: Phosphate buffer [10: 90] at a flow rate of 1.5 ml/min. The method is reproducible, repeatable [%RSD for intra-day and inter-day ranged between 1.75-5.33% and 0.58-2.69%] and linear [R[2]=0.9935]. The LOD and LOq of the method were 0.5 and 1.0 microg/ml, respectively. The present RP-HPLC method was found to be sensitive, accurate, precise, rapid and cost effective that can be efficiently used in QC/QA laboratories for routine analysis of the raw materials as well as oral dosage formulations of cefadroxil
ABSTRACT
Medication errors [ME] are human errors, which are very frequent in cardiovascular patients and result in patient morbidity and mortality. This study was focused to evaluate the quality of prescriptions and to emphasize the placement of clinical pharmacist in health care team. This study was carried out in different outpatient settings of [in] Karachi, Pakistan. The study period was June'2011 till June'2012. Retrospective data was analyzed for the outpatients' prescription of beta blocker drugs. During the study, prescriptions [n=450] were collected from different outpatient settings of [in] Karachi, Pakistan. Prescription containing beta-blockers were analyzed for the essential elements to be mentioned in prescription. Drug-drug interactions were identified by the Micromedex.2.0 Drug-Reax database and severity of medication error was determined by NCCMERP Index. A total of 1627 medication errors were identified in 450 prescriptions. The most frequent error was not mentioning the patient's weight [95%], followed by missing diagnosis [79.4%] and drug-drug interactions [69.5%]. Twenty-two prescriptions were placed in the most severe category I [4.88%]. Average number of drugs per prescription was 4.76. Significant difference was observed [x[2]=52.418, p<0.05] using SPSS 19 for those prescription orders having more than 5 drugs with Beta-blockers. This indicates that the errors in prescription such as drug-drug interactions, wrong dose etc. was significantly increased with the number of drugs per prescription. Results showed that medication errors are very frequent in prescription written in outpatient setting of various hospitals and clinics in Karachi. This shows that the irrational prescribing is a common practice in developing countries. Placement of skilled pharmacist in the health care system is the only solution for avoidance of these medication related problems.
Subject(s)
Drug Prescriptions , Adrenergic beta-Antagonists , Pharmacists , Delivery of Health Care , Outpatients , IncidenceABSTRACT
Fast Disintegrating Tablets [FDTs] is a rapidly growing dosage form preferred for special population (pediatric, geriatric and psychotic patients]
It is also developed with the aim of improving bioavailability and patient compliance
During the present study, cefadroxil fast disintegrating tablets formulations [n=9] were designed and optimized by central composite design with two independent variables [croscarmellose and crospovidone] using design expert® software
The effects of independent variables on formulation properties such as friability, hardness, in vitro dispersion and disintegration were assessed by drawing response surface graphs with design expert® software. Tablets were assessed for pharmacopeial and non-pharmacopeial parameters to ensure the quality of compressed tablets
Among all formulations, F3, F8 and F9 have shown better results. The formulation F9 containing 15mg croscarmellose and !l075mg crospovidone showed good pharmacotechnical attributes as well as shelf life. F 9 showed improved dissolution with t90o/0 of> 2 min and will lead to better bioavailability
ABSTRACT
Fluoroquinolones are broad-spectrum antibiotics that are considered as first line drugs to treat infectious diseases. In order to find out useful fluoroquinolones, the antibiotic resistance of fluoroquinolones, namely, ofloxacin [OFL], ciprofloxacin [CIP], norfloxacin [NRF], enoxacin [ENX], pefloxacin [PFL] and levofloxacin [LVF] was investigated against ninety five clinical isolates that includes Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Proteus mirabilis. In vitro activity of these isolates was carried out by agar dilution method. All Staphylococcus aureus were sensitive to OFL at 2 microg/ml. About 6% isolates of Klebsiella pneumoniae were found to be resistance to LVF and ENX, 6% to CIP, OFL and PFL and none of the isolates were resistant to LVF and ENX. Percentage resistance of P. aeruginosa was found to be 4.35% to CIP, 7% to OFL and 2.2% to NRF, whereas 8.69% to ENX, 0% to PFL and 17.4% to LVF, respectively. The present study provides the data about the emergence of resistance to fluoroquinolones among gram positive and gram negative bacteria and strongly recommends the rational and appropriate use of these antibiotics