Syrian pharmacovigilance system: a survey of pharmacists' knowledge, attitudes and practices

Background: The Syrian pharmacovigilance [PV] system consists of a PV unit responsible for all related activities at the national level. Pharmacists' participation in the system can play a major role in its efficiency. To date, little is known about the position or the contribution of Syrian pharmacists within the programme.

Aims: To describe Syrian pharmacists' knowledge, attitudes, practices and perceived barriers to reporting of adverse drug reactions [ADR], and to evaluate the sociodemographic effects within Damascus and rural Damascus.

Methods: We used a self-administered, cross-sectional, questionnaire-based survey conducted on a random sample of 656 registered pharmacists in 2 Syrian governorates.

Results: The response rate was 77%. Fifty-five percent of pharmacists had an acceptable level of knowledge about PV. Only 10.8% stated that they had reported an ADR at least once during their years of practice. Although 29.6% claimed they had reported ADRs to the Ministry of Health, 83.1% admitted that they did not know where or how they could get the official reporting forms.

Conclusions: Pharmacists who participated in the survey demonstrated limited knowledge towards PV and the Syrian PV system, and had relatively mixed attitudes towards reporting. Although they acknowledged the importance of ADR reporting, the current level of participation is low. The reasons for under-reporting were uncertainty of the fate of the reports, how they would be addressed, the complexity of the forms and the modest publicity of the PV programme

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

qualitative analysis of pharmacists' attitudes and practices regarding the sale of antibiotics without prescription in Syria

Antibiotic resistance poses an alarming threat in antimicrobial therapy worldwide. This practice is widely spread in Syria as in other countries. This study aims to investigate the Syrian pharmacists' attitudes and practices in regard to antibiotic dispensing without prescription. Direct interview questions and five hypothetical scenarios were presented to 350 pharmacists in 3 major Syrian cities. Interview transcripts were prepared, coded, and categorized under 5 major themes using a computer software. 147 pharmacists agreed to participate in our study. All pharmacists admit to dispense antibiotics without a prescription. Pharmacists were more likely to dispense antibiotics to their relatives, usual customers, and to patients who were prescribed the same antibiotic before. Most pharmacists did not agree that this practice posed a problem to patients welfare. The ones who agreed felt that more laws were needed and that the existing laws lacked enforcement. The results are quite alarming as our study shows that this practice will most probably continue to exist. Stricter laws and more law enforcement in addition to pharmacists and public education may constitute the most important elements to limit the spread of antibiotic dispensing without prescription in Syria

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