American Journal Of Pharmacy And Health Research

ISSN NO.: 2321-3647
September 2015 Issue 9

Relevance of Pharmacological Drug Interactions in Modern Dental Practice

Sukhwant Singh Yadav*1, Sushma Chaurasia2, Aishvarya Kaushik1, Sangeeta Talwar3

1. MDS, Senior Resident, Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, INDIA.

2. MDS, Tutor, ESIC Dental College, Rohini, New Delhi, INDIA.

3. MDS, Professor and Head, Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, INDIA.


Antibiotics, analgesics and local anaesthesia are the frequently used drugs during the treatment of dental diseases. These drugs can interact to different drug classes used in different systemic conditions. Some of these interactions are adverse and life threatening to the patients. The dental practitioner should have thorough knowledge about these interactions and methods to prevent and treat the adverse effects. This article will discuss the common possible drug interactions and their adverse effects in clinical dental practice.

Keywords: Drug interactions, antibiotics, tricyclic antidepressants, NSAIDs, vasoconstrictors.


Over the counter (OTC) drug use; Narrative Review for Ethiopian Community based Health Insurance Schemes Policy Suggestion

Seifu Hailu

Health Care Financing Specialist, USAID/HSFR/HFG Project, Abt. Associate Inc. Ethiopia, 


Over the Counter Drugs are drugs that are sold with non-prescription, which means they are sold without a prescription from health providers. They are also referred as non-prescription drugs. In Ethiopia studies reported that most illiterate, very low income people are utilizing OTC drugs commonly analgesics/antipyretics, anthelmintic, antacid and others more. According to the review of different studies, benefits of these drugs outweigh their risks, low chance of misuse or abuse. In 2012, Ethiopian Food, Medicine, Health, Administration and Control Authority (EFMHACA) revised more than 93 OTC (non-prescription) drugs which are believed to be safe enough and well-tolerated when used without prescription but specified to be dispensed by pharmacy personnel with a sufficient counseling about the condition as well as the medicament besides the maximum quantity dispensed at one time. It also considered the importance of OTC drugs in increasing access as well as the potential of the public to make a more active role for the management of minor and common illnesses in their own and authorized to be used to treat a condition that does not require the direct supervision of health providers. However, the practice of OTC drug use has neither been listed under the benefit nor the non-benefit package of community based health insurance (CBHI) schemes in Ethiopia. Hence this review wants to highlight about the issue of OTC drugs use and to provide suggestion for further research and consideration by policy makers in the CBHI schemes design or directive and in the promotion of the practices of responsible and regulated OTC drugs use in Ethiopia.

Keywords: Community based health insurance, OTC drugs


Formulation and Evaluation of a Transdermal Drug Delivery System of Antihyperlipidemic Drug Simvastatin

Masarrat Bashay*1, Sushma Singh1

1. Department of Pharmaceutics, Dr. L. H. Hiranandani College of Pharmacy, Ulhasnagar-421 003, Maharashtra, India.


The present study was aimed at developing Simvastatin loaded transdermal patch to prevent drawbacks associated with oral delivery of Simvastatin. Simvastatin is a BCS class II drug having poor aqueous solubility and good permeability. A transdermal patch of simvastatin was developed using various polymers and their combination like Eudragit RL 100, HPMC K4M, PVP K30 & Ethyl Cellulose. Polymer combination HPMC K4M & PVP K30 exhibited good film forming properties. Propylene glycol, oleic acid and glycerol were used as plasticizers to improve film-forming properties. Among these, propylene glycol exhibited excellent result but penetration was found to be less. Thus, penetration enhancers such as oleic acid, DMSO, PEG 200 were used to enhance permeability, of which DMSO was found to be excellent. A 22 factorial design was implemented using design expert software. The formulation was optimized on basis of 2 parameters percent cumulative release and percent drug content.  3D surface graph was plotted for the design. Grid survey indicated P1 batch (which contains HPMC K4M & PVP K30 as a polymer, DMSO as penetration enhancer & PEG as a plasticizer) is the optimized batch as it showed good drug content and in-vitro drug release. The drug release kinetics of transdermal patch of simvastatin was best expressed by Higuchi model of drug release.

Keywords: Transdermal patch, Simvastatin, Hydroxy propyl methylcellulose K4M, Pyrolidone (PVP) K30, Dimethylsulphoxide(DMSO).


Formulation and Evaluation of Controlled Gas Powered Systems of Captopril Tablets

N. G. Raghavendra Rao1*,G. Vijay Kumar2, Akhlaaq Ahmad3

1. Dept of Pharmaceutics, Sree Chaithanya Institute of Pharmaceutical Science, L.M.D. Colony, Karimnagar - 505527, Telangana, India.

2. Dept of Pharmaceutics, KGR Institute of Technology and Management, Rampally Village, Kesar Mandal, Ranga Reddy.

3. Dept of Pharmaceutics, Luqman College of Pharmacy, Gulbarga-585 102. Karnataka, India.


In the present investigation, an attempt has been made to increase therapeutics efficacy, reduce frequency of administration and improve patient compliance by developing sustained release gastro retentive floating tablets of Captopril using hydrocolloids like hydroxy propyl methylcellulose and Carbopol 934P by effervescent technique using direct compression method. In tablets formulations sodium bicarbonate and citric acid using gas generating agent and HPMC different grade was used to retard the drug release for 24 hrs in stomach. The prepared Gas powered tablets were subjected to post-compressional parameters. Drug compatibility with excipients was checked by DSC and FTIR studies. The stability study conducted 3 months as per the ICH guidelines. In all the formulations, hardness test indicated good mechanical strength, friability is less than 1% indicated that tablets had a good mechanical resistance. The results were revealed that as concentration of HPMC increases there is increase in floating time but release of the drug from all the formulation shows the slow release of Drug, as the concentration of sodium bicarbonate increases there is quick release of drug from all the formulation but the floating time decreases as the concentration of sodium bicarbonate increases so the optimum concentration of HPMC and Sodium bicarbonate is essential in order to achieve good result with respect to both drug release as well as floating time and floating lag time. It has been concluded that Formulation F1 and F4are the excellent formulation as they shows excellent drug release for 24 hrs with minimum floating lag time and more total floating time.

Keywords: Captopril, sodium bicarbonate, citric acid, HPMC, carbopol, controlled gas powered system.


Multiple Micronutrient Deficiencies are Related to the Nutritional Status of Children Living in North and Far North Regions of Cameroon

Ngwa Akonwi Fuh1, Ngondi Judith Laure *1, Edoun Ferdinand Lanvin1, Dibacto Kemadjou Ruth Edwige1, Julius E. Oben1

1 Laboratory of Nutrition and Nutritional Biochemistry, Department of Biochemistry, Yaoundé I University, PO Box 812


Several micronutrients are essential for adequate growth of children. However, little information is available on multiple micronutrient status of preschool children in Cameroon. The present study was designed to evaluate the relationship between multiple micronutrient levels and nutritional status among preschool school children. This was a cross-sectional study of 331 children 6-59 months in the North and Far North Regions of Cameroon. Serum concentration of magnesium, calcium, copper, and zinc were measured by inductively coupled plasma mass spectrometer. Ferritin, sTfR, RBP, CRP, AGP were measured by Sandwich ELISA. Weight-for-age, height-for-age and weight-for-height were used to estimate the children's nutritional status. The prevalence of stunting, underweight, wasting among preschool children was 42.0%, 26.0%, and 6.6%, respectively. The mean serum levels of magnesium, calcium, Body Iron Stores, copper,  and zinc were 19.9±0.1 (μg/dl), 80.7±0.3 (μg/dl), 1.02±0.25 (mg/kg), 201.5.30±33.7 (μg/dl), and 49.4±0.8 (μg/dl) respectively. The proportion of low plasma Zinc Concentration was 85.6%, Iron Deficiency anemia was 24.2% with 37.9 % of Iron deficiency associated to anemia. Height-for-age showed significant positive correlation with the levels of Zinc (r=0.093, p<0.05) and body Iron Stores (r=0.111, p < 0.01) and with the levels of magnesium (p = 0.05). 70.4% of the children presented more than one form of micronutrient deficiency. Multiple micronutrient deficiencies and Malnutrition are significantly higher for the Far North Region compared to the North Region.  The prevalence of both malnutrition and multiple micronutrient deficiency was significant. Strong Associations were observed between multiple micronutrient deficiencies and Nutritional Status.

Keywords: Preschool children, Nutritional status, Micronutrients, North region, Far North Region, Cameroon




Clinical Pharmacists’ Development and Quality Assurance of Medication Orders in a Computerized Order Entry System

Justin W. Tenney1*, Kelly Horton1

1. Clinical Pharmacist, Sidra Medical and Research Center.


This study is to evaluate the development process of medication orders in a computer system for a soon to be opened women and children’s hospital. To determine which therapeutic categories include medications that may have less defined dosing regimens. Medication orders were built into the Computerized Order Entry (COE) system and evaluated individually by pharmacists from various clinical practice backgrounds. These pre-constructed, quick entry medication orders will present common medication attributes in a drop down menu when a physician searches for a desired medication. The medication orders involved 14 components that were evaluated by the clinical pharmacists. For a medication order to be considered complete, it had to be reviewed by two consecutive pharmacists who did not see any further necessary changes to the previous pharmacist’s medication order. The number of pharmacists required to have 3 pharmacists in consecutive agreement on the medication order ranged from 3 to 9 pharmacists. The therapeutic group that required the most pharmacist evaluations to reach consensus was antimicrobials and the therapeutic category that required the least amount of pharmacist reviews was antidiabetic medications. After 6 pharmacists had reviewed the medication orders, 25.7% of the antimicrobials were without three consecutive pharmacist approvals. The most common change made after 5 reviews were completed was adjustments to age and weight filters. As there was variability in the number of pharmacist reviews required to reach completion, greater attention to detail should be considered in therapeutic areas that required more evaluations to reach a consensus.

Keywords: Pharmacist, Computerized Physician Order Entry, Therapeutic Classes.


Novel Chromatographic Methods for Simultaneous Determination of Some Anthelmintic Drugs in Bulk Powder and Pharmaceutical Formulation

Omar Abdel-Aziz1, Amira M. El kosasy1, Neven Ahmed2*

1. Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.

2. National Organization of Drug Control and Research (NODCAR), Giza, Egypt.


The present study describes the development and subsequent validation of simultaneous determination of [Levamisole HCL (І) and Closantel Sodium (П) ‘A’] and [Fenbendazole (III) and Rafoxanide (ІV) ‘B’] in two separated mixtures ‘A & B’, using isocratic RP-HPLC and TLC-densitometric techniques. In the HPLC technique; ‘agilent eclipse XDB-C8 and thermo BDS-C18 (250 x 4.6 mm) 5 µm columns’, ‘with a flow rate of 1.5 ml and 2.0 ml.min-1’, ‘acetonitrile: 0.02M potassium dihydrogen orthophosphate buffer (60:40, v/v) and acetonitrile: 0.02M ammonium formate (60:40, v/v) as a mobile phase’ and UV measurement at ‘220 and 290 nm’ were used for the studied mixtures ‘A and B’, respectively. While in TLC-densitometric technique; silica gel F254 aluminum sheets, ‘n-butyl acetate: methanol: ammonia 13.5M (10: 1: 0.1, v/v) and ethyl acetate: toluene: methanol: ammonia (4: 2.5: 2.5: 1, v/v) as developing systems’ and UV measurement at ‘240 and "292 and 284 nm"’ were used for the studied mixtures ‘A and B’, respectively. The utilized chromatographic methods were validated according to the International Conference on Harmonization (ICH) guidelines and successfully applied for determination of the studied drugs in pure form, in laboratory prepared mixtures in pharmaceutical formulations with good extraction recoveries. All the results were statistically compared with the pharmacopeial and manufacturing methods for ‘I, II and III’ and ‘IV’, respectively, where there is no significant differences were found. The developed methods were satisfactorily applied to analysis of the investigated drugs and proved to be specific and accurate for quality control of them in pharmaceutical formulations.

Keywords: Levamisole HCl, Closantel Sodium, Fenbendazole, Rafoxanide, High Performance Liquid Chromatography, TLC- densitometry.


A Rationalized Description on Study of Drug Permeability and Permeation Enhancers

Harishankar Sahu*1, Monika Keshri1, Vijendra Suryavanshi1, Chanchal Deep Kaur1

1. Shri Rawatpura Sarkar Institute of Pharmacy Kumhari, Durg (CG) INDIA.


Hydrophilic drugs are one of the most challenges in biopharmaceutical research. Hydrophilic drugs show low bioavailability following oral administration because of their poor intestinal permeation. This review sets out to discuss about anatomy and physiology of the intestinal barrier, drug absorption from intestinal tract, mechanism of intestinal drug permeability, detail information about intestinal permeation enhancers and its mechanism of action, in-vitro methods for studying drug permeability, advantages and applications of intestinal permeation enhancers.

Keywords: Intestinal Permeation Enhancers, BCS, Tight Junctions, Oral Bioavailability.


Traditional Use of Medicinal Plants for the Treatment of Diabetes Mellitus in Basra

Abdullah S. Asia1*, Kadhim N. Sheima1, Ahmed S Sabah2

1. Dept. of Pharmacology and Toxicology, Institute of Pharmacy, Basra.

2. Dept. of Medicine, Al-Mawanee Jeneral Hospital, Basra.


This study aimed to document traditional use of medicinal plants for the treatment of diabetes mellitus in Basra city, south-eastern of Iraq and to compare this information with current knowledge of plant medicine in Iraq and other Mediterranean countries, to preserve valuable information about the traditional plants used for treatment of type 2 diabetes mellitus and also to discover new treatment for diabetes. This study was conducted during the period from February to April, 2015. 199 diabetic patients aged between 20 and 80 years were included in this study, 117 patients were females and 82 were males. In addition, the relative importance of each medicinal plant species reported as use value (UV). This study reported the medicinal uses of 16 plants, species belonging to 16 families. The most commonly used plant species are Boswellia Carterii, Commiphora myrrha, Citrullus Colocynthis, Olea europaea and Trigonella foenum-graecum. Some plants are used for medicinal purposes both in Basra and in other parts of Mediterranean countries, either for the same or for different purposes. This paper helps to preserve valuable information about the traditional plants used for treatment of type 2 diabetes mellitus and also to discover new treatment for diabetes.

Keywords: Ethno botany, Boswellia Carterii, Commiphora myrrha, Citrullus Colocynthis, type 2 diabetes mellitus, Basra, Iraq.


Evaluation of Pharmacists Attitudes toward Mental Health Care, Psychiatrists and Mentally Ill Patients

S I Yakubu*1, S J Madu2, H M Abdul-Qadir3, J Muazu4

1. Department of Clinical Pharmacy and Pharmacy Administration, University of Maiduguri, P.M.B. 1069, Maiduguri, Borno State, Nigeria.

2. Department of Pharmaceutical Services, University of Maiduguri Teaching Hospital, Maiduguri, P.M.B 1414 Borno State, Nigeria.

3. Department of Pharmacy, Federal-Neuro-Psychiatric Hospital, Baga Road, Maiduguri, Nigeria.

4. Department of Pharmaceutics and Pharmaceutical Microbiology, University of Maiduguri, P.M.B. 1069, Maiduguri, Borno State, Nigeria.


Over recent years, there has been a steady increase of pharmacists interaction with psyhiatrists and mentally ill patients. Thus, this study was set out to evaluate the attitudes of pharmacists toward psychiatrists, mentally ill patients and mental health care in a neuro-psyhiatric hospital. We have adapted with modification a pretested survey instrument comprised 28 statements, which the respondents rated on a five-step Likert scale. These questionnaires were distributed to all the fifty pharmacists listed, out of which 37 (74%) respondents perceived psychiatrists, hospital for mental health care and psychiatric patients in a favourable manner. The psychiatrists were viewed as reliable professionals with established expertise, and psychiatric patients were considered to be harmless similar to normal individuals. The pharmacists attitudes toward hospital for mental health care were slightly tended in the positive direction.

Keywords: Pharmacist, Psyhiatrist, Mental health, Patient, Attitude.



Effect of Registered Medical Practitioner Treatment (RMP) on Rural Area Population-a Pharmacovigilant Approach

Kasi Jagadeesh M*1, Atchuta Pedireddy1, K J V Haneesha1, G Sumalatha1, Rajasekhar P2, B V B Balaji1

1. Department of Pharmacy Practice, Vikas Institute of Pharmaceutical Sciences, Nidigatla Road, Rajahmundry, Andhra Pradesh-533289.

2. Department of pharmacy practice, Seven Hills College of Pharmacy, Venkatramapuram, Tanapalli, Tirupati, Andhra Pradesh-517561, India.


In developing countries like India, majority of healthcare is borne to private sector, resulting that most of the people levy on local /available unrecognized medical practitioners. The RMP’s are very popular in the rural areas and urban slums because they are the primary contact in the medical emergencies that leads to some drug related errors, adverse effects and interactions. The quality of life in developing countries can be improved by enhancing the standards of medical treatment at all levels of the health care delivery system. This can be achieved through interventions, continuous medical education programs, effective implementation of therapeutic strategies. Our investigation is to study about the impact of RMP’s treatment and to ensure the drug safety by clinical pharmacy services in rural India.

Keywords: RMP’s, Health Care, Therapeutic Strategies, Rural Area Population.


A Study on Evaluation, Assessment and Awareness of Possible Risk factors and its appropriate treatment of Stroke Patients using NIHSS scale

CH. Pragathi*1,

1. SVS hospital, Osmania University 


There are chiefly two types of strokes –Ischemic and Hemorrhagic. Apart from these two TIA and subarachnoid forms are taken into consideration in our study. This is a prospective, observational, and interventional study which being focussed on stoke patients. Using standard NIHSS scale a prospective study is being carried out to determine the risk factors in both in-patients and out-patients and using counselling sessions and community services they were interviewed by telephone then visited for noting the therapeutic outcome. A total of 97 cases of stroke were collected of which 66were males and 31 females, average stroke cases are found more in age group of 50yrs and above. Ischemic stroke was reported more in smokers (16), tobacco chewers (7), alcoholics (27), HTN (23), DM (6), and Dyslipidemia (42) patients followed by other types. According to NIHSS severity of score 3% (3)falls into >20 severe category with 3males followed by 21.6%(21) are moderate to severe(16-20) with 12males and 9 females, about 57.7%(56cases) were moderate(5-15) scoring with 40males and15 females, followed by 17.5%(17 cases) of <5minor stoke with 11males and 6females were found. A total of ischemic (59cases)stroke was reported high followed by TIA (14cases)followed by hemorrhagic equals subarachnoid(12cases) with a high frequency of moderate (5-15)stroke(56cases) followed by moderate to severe(16-20) stroke (21cases), followed by minor(<5) stroke(17cases) and severe(>20) stroke(3cases). There is a significant improvement in patient condition from moderate to severe ranking to moderate ranking. The study concludes that the proper awareness on stroke reoccurrence and a detailed knowledge on stroke can decrease the incidence of recurrent attack.

Key words: Stroke, NIHSS ranking, Smokers, Alcoholics, HTN, DM, Dyslipidemics.