Pharmacy ethics: evaluation pharmacists' ethical attitude.

Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making. Pharmacists' knowledge as well as ethical reasoning affects their clinical decision-making. Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance. The study was designed to evaluate pharmacists' attitude toward some principles of bioethics. A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010. Based on the pharmacists' attitude toward common ethical problems, 9 Likert-type scale scenarios were designed. A thousand pharmacists were surveyed and 505 questionnaires were filled. For the whole questionnaire the strongly disagree answer was the most ethical answer. On a scale from 1-5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57. For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers. The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme. The older participants (> 40 years) significantly had lower total score (P< 0.05) as well as the score of each theme (P< 0.05), except for non-maleficence. The work experience showed impact on the pharmacists' attitude toward autonomy and the participants with more than 5 years work experience significantly obtained lower score in this theme. Compiling ethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations. Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended.

The role of platelets in bone remodeling.

Platelets play a critical role in wound healing and hemostasis, as well as in repairing bone fracture. The impact of platelets on inflammation and inflammatory diseases has been appreciated. It has been demonstrated that inflammation and oxidative stress are intimately involved in the pathogenesis of osteoporosis. Degranulation of platelets, anuclear cell fragments, leads to the release of different growth factors and chemoattractants affecting bone metabolism. The net effect is, however, not fully understood. The current review is aimed to examine available studies on the impact of platelets on bone health. We searched data from Scopus, PubMed and Web of Science using keywords such as platelets, osteoblasts, osteoclasts, bone, antiplatelet drugs, bone formation, and bone resorption. As hypothesis of the review is emerging, a small number of in vivo and in vitro studies are found. Based on the available data, platelets and platelet-derived numerous immune and inflammatory agents can be viewed as targets for therapeutic and/or preventive measures in osteoporosis.

AIDS and drug rationing.

Financial shortage in resource-limited and poor countries restricts treatment in HIV-infected patients especially in poor countries. Higher HIV prevalence in poorer countries makes drug rationing a real concern. Different countries solve the problem with different methods regarding WHO guidelines, but fairness and equity should be a major consideration in drug rationing. This paper is aimed at reviewing different strategic approaches to drug rationing in AIDS treatment and then discusses pharmacists' role. In conclusion, there is no fair and equitable strategy, and in each society, cultural, ethical and socioeconomic issues along with considering a critical role for pharmacists must be taken into account.