hypotensive and uricosuric effect of valsartan compared to losartan in gout patients

Objective: Our objective was to investigate the possible relationship between previous or concurrent use of losartan or valsartan and gout in newly diagnosed patients

Materials and Methods: Thirty-two newly-diagnosed gout patients, whose blood pressure was controlled using losartan for at least 3 months were included. The study was divided into 3 stages; stage I where patients were controlled for 3 months using losartan [50 mg/day], stage II - where patients were switched from losartan to valsartan [80 mg/day] with their blood pressure controlled and maintained for another 3 months using valsartan instead of losartan and stage III - where patients were switched back to losartan [50 mg/day]. All changes in clinical and biochemical parameters were reported

Results: There were no significant changes in biochemical parameters such as liver enzymes, serum levels of creatinine, sodium and bicarbonate. Serum levels of potassium and uric acid were elevated. Valsartan significantly increased potassium and uric acid levels at the end of stage II [P = 0.024]. Since these adverse effects did not disappear after changing back to losartan at the end of stage III, we performed an additional 3-month follow-up stage. The subjects required a period of 6 months to return to levels seen at the end of stage I

Conclusion: Losartan showed a slightly higher hypotensive effect than valsartan in patients newly diagnosed with gout. It also resulted in lower uric acid levels

Antibiotic dispensing without prescription in Jordanian community pharmacies: a pharmacist's perspective

The sale of antibiotics without medical prescriptions has been recognized as a major source of drug misuse and medication risk in Jordan. This practice constitutes one of the major causes of the on going problem of antibiotic resistance. This study provides a pharmacist perspective on the problem through presenting the most common antibiotics dispensed, the related indications, and pharmacists proposed solutions to this problem in the city of Amman, Jordan. This was achieved by means of a structured questionnaire prepared by the investigators and completed by the pharmacists themselves. It was suggested that the problem at hand can be overcome through the enforcement of laws to control such practice. Also, increasing awareness among patients and pharmacists, and empowering pharmacists to play more active role in patients care are important steps that will contribute in minimizing this practice