SA Pharmaceutical Journal - Volume 78, Issue 3, 2011
Volume 78, Issue 3, 2011
Source: SA Pharmaceutical Journal 78, pp 8 –10 (2011)More Less
The Consumer Protection Act : how does it affect pharmacy?
The PSSA / Alpha Pharm Distance Learning Programme 2011 for pharmacists
The PSSA / Alpha Pharm clinical education programme 2011 for pharmacy staff
Guidelines to complaint handling, correcting mistakes and apologising
Pharmacotherapy during pregnancy, childbirth and lactation : principles to consider : evidence-based pharmacy practiceSource: SA Pharmaceutical Journal 78, pp 12 –17 (2011)More Less
Pregnancy, childbirth and lactation pose unique challenges in terms of drug therapy. The pregnant mother and her unborn child are exceptionally vulnerable from a physiological, clinical and ethical point of view. This warrants careful consideration of a number of important aspects, which could firstly influence the decision to opt for drug therapy, and secondly the specific agent that is selected for each indication. In this article, an overview is given of these important aspects.
Author L. JohnstonSource: SA Pharmaceutical Journal 78, pp 18 –21 (2011)More Less
Deep vein thrombosis (DVT) is a significant, potentially fatal complication following surgery. Certain orthopaedic procedures, such as hip or knee arthroplasty, present a greater risk of venous thromboembolism (VTE) than others. These surgical risks are further compounded by individual patient risk factors. In the event of a DVT, treatment with low-molecular-weight heparin (LMWH) should be initiated on diagnosis, followed by initiation of oral anticoagulant therapy. Once the LMWH is discontinued, anticoagulation with warfarin should be continued for a period of time, to be determined by assessing the individual's risk of VTE recurrence.
Author I. TruterSource: SA Pharmaceutical Journal 78, pp 22 –26 (2011)More Less
Medicines that affect the renin-angiotensin-aldosterone system are effective in several diseases. Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to angiotensin II, while angiotensin-receptor blockers (ARBs) selectively inhibit angiotensin II from activating the angiotensin-specific receptor (AT1). Studies found that the two drug classes are equally safe and effective at managing hypertension, and have similar effects on other risk factors and clinical outcomes in patients with essential hypertension. It has also been confirmed that ARBs are less likely to cause coughing, but it has been suggested that this side-effect might be less common with ACE inhibitors than randomised trials indicate. Therefore, two important questions arise: which drug class is more effective, and what would the effect be if the two classes were used together? A recent study reported that restricting the prescribing of ARBs, so that they are given only to patients who are intolerant to ACE inhibitors, could save millions of dollars in health care costs, without any adverse effects on cardiovascular health. Despite the fact that both ACE inhibitors and ARBs are important in the treatment of essential hypertension, there is a lack of comparative evidence of the long-term benefits and harms of these two classes of agents. Only a few studies have compared ACE inhibitors and ARBs for periods longer than one year, and there is a lack of research on the pharmacoeconomic aspects of these two drug classes. More studies are needed.
Author V. ThunstromSource: SA Pharmaceutical Journal 78, pp 28 –32 (2011)More Less
This article outlines the clinical features and management of basic eye conditions that every pharmacist should know about. These include ocular and adnexal conditions such as stye, conjunctivitis, blepharitis and preseptal cellulitis. The more severe conditions, such as dacryocystitis, corneal ulcer and orbital cellulites, also are presented, along with the criteria for referral.
Author C. WhittakerSource: SA Pharmaceutical Journal 78, pp 34 –36 (2011)More Less
Iron deficiency, with resultant anaemia, is probably the most widespread nutritional deficiency in the world. It is associated with a substantial health and economic burden, particularly in developing countries. This article reviews the common causes, symptoms and diagnosis of iron deficiency, with particular attention being paid to the appropriate selection and use of iron supplements.
Author S. MochSource: SA Pharmaceutical Journal 78, pp 38 –43 (2011)More Less
Dysthymia is an under-diagnosed mood spectrum disorder that is almost as common as major depression and, if left untreated, has a chronic course which can impact negatively on a patient's quality of life. Whilst symptoms are not as numerous or severe as in major depressive disorder (MDD), morbidity associated with dysthymia can be serious owing to the long duration of the distressing syndrome. Consistently depressed mood can lead to impairment in workplace functioning, as well as compromised management of interpersonal, marital and familial relationships. Optimal management involves a combination of pharmacological treatment with antidepressant medications (e.g. selective serotonin reuptake inhibitors) and various forms of psychotherapy.
Microemulsion drug delivery system : design and development for oral bioavailability enhancement of lovastatin : original researchAuthor S. MandalSource: SA Pharmaceutical Journal 78, pp 44 –50 (2011)More Less
Background: Lovastatin lowers cholesterol levels through reversible and competitive inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), an enzyme involved in the biosynthesis of cholesterol. Oral bioavailability of lovastatin is < 5% because of rapid metabolism in the gut and liver. The main purpose of this research work was to develop a novel delivery system i.e. microemulsion (ME), and to study whether the oral bioavailability of lovastatin could be improved through this delivery system.
Method: A Capmul® MCM-based ME formulation with Cremophor® EL as surfactant, and Transcutol® P as co-surfactant, was developed for oral delivery of lovastatin. Pseudoternary phase diagram was constructed to determine the ME existing zone. Optimised ME was evaluated for its transparency, droplet size, zeta potential, viscosity, conductivity, percentage assay, and phase separation study. Solubilisation capacity of the ME system was also determined. An accelerated stability study of optimised ME was carried out to check the stability of the formulation. The prepared ME was compared with the pure drug solution and commercially available lovastatin tablet for in vitro drug release. Comparative oral absorption of lovastatin from the ME and suspension of the commercially available lovastatin was investigated through an in vivo study in a rat model.
Results: The optimised ME formulation containing lovastatin (20 mg), Capmul® MCM (7%), Cremophor® EL (24%), Transcutol®P (8%), and distilled water, had a droplet size (10 times diluted) and zeta potential (10 times diluted) of 27.9 nm and -3.11 mV respectively. The optimised ME was found to be stable for six months. ME showed higher in vitro drug release, as compared to plain drug suspension and the commercially available lovastatin. The in vivo studies revealed an increase of bioavailability (4.7 times) after oral administration of the ME formulation as compared with the commercially available lovastatin.
Conclusion: These results demonstrate the potential use of ME for improving the bioavailability of hydrophobic compounds, such as lovastatin by oral route.
Source: SA Pharmaceutical Journal 78, pp 51 –52 (2011)More Less
Galvus® (vildagliptin) is a new oral antidiabetic agent indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus. Vildagliptin is approved for use as add-on therapy in patients taking metformin, a sulphonylurea or insulin.
Author Kruger JohanSource: SA Pharmaceutical Journal 78 (2011)More Less
Do we live up to the expectations that patients, medical aids, statutory bodies, the institutions that trained us and our peers have of us?
When we receive a prescription with an obvious error in it, what happens? Do we just ignore it and argue that that is what the prescriber wanted, and he / she will have to accept ultimate responsibility for it? Or do we phone them and hesitantly ask if that is what they wanted? Or do we professionally express our opinion on the suggested dosage, interaction possibilities, and offer alternatives to the prescribed item?
Professor Isadore Kanfer elected as a Fellow of the American Association of Pharmaceutical Scientists : cum laudeSource: SA Pharmaceutical Journal 78 (2011)More Less
At the recent American Association of Pharmaceutical Scientists (AAPS) annual meeting, held in New Orleans, USA, Emeritus Professor Isadore Kanfer, PhD, of the Rhodes University Pharmacy Department, was made a Fellow of the AAPS. He was also elected as chairman of the bioequivalence focus group.
Author Sarel MalanSource: SA Pharmaceutical Journal 78 (2011)More Less
Best practice vs. actual practice
In the last few months, I have heard from more than one intern and student that what is being taught at university is "far from reality" or, "it doesn't work that way in practice". What can be the reason for that? Have academics lost track of what is really happening out there at the coal face? Are we teaching certain aspects of the practice of pharmacy, knowing full well that it doesn't work that way in real life? A word of caution here: remember that in South Africa, we are still in the lucky situation in which the majority of our pharmacy academics are actually pharmacists, and most of them still work in pharmacies.
Author Gary BlackSource: SA Pharmaceutical Journal 78, pp 57 –59 (2011)More Less
I am often approached by both doctors and pharmacists for assistance on what to do about fraudulent prescriptions. In this article, I outline the problem as it presents itself in practice, consider some legal aspects and ethical obligations, offer some practical suggestions, and explain the process followed by our office in trying to alert pharmacists about fraudulent prescriptions.
Source: SA Pharmaceutical Journal 78, pp 60 –68 (2011)More Less
All medicines have specific properties because of their molecular structure. The atoms represent the different aspects of pharmacy - people, vision, industry, hospital, community, academia. The bonds bind us together to create a unique structure with unique properties - our profession. It is up to us to stabilise and re-stabilise the molecule to adapt it to function optimally in the changing environment. The possibilities and the new innovations of designing and redesigning this molecule - and our profession - are unlimited!
The 25th SAAHIP conference provided an opportunity for pharmacists to review their vision and commitment by strive by sharing their experiences and benefiting from the responses of their peers.
Source: SA Pharmaceutical Journal 78 (2011)More Less
Braam Malherbe is described as an extreme adventurer, conservationist, youth developer and motivational speaker. Since 2006, most people recognise him and his friend, David Grier, as the men who ran 4 200 km along the length of the Great Wall of China.
The Great Wall of China has been likened to a sleeping dragon. In telling of his experiences, it was appropriate that the SAAHIP Conference was held in the Drakensberg - Braam spoke of awakening the sleeping dragon that needs to be awakened in each person. He shared his thoughts on living out one's dreams.
Author Thanushya PillayeSource: SA Pharmaceutical Journal 78 (2011)More Less
As pharmacists and as members of the South African Association of Hospital and Institutional Pharmacists, we:
- Acknowledge the history of our country and that of our profession, and the need for the profession to strive for unity and avoid the crippling effects of fragmentation;
- Honour those who have worked and suffered for the development of our profession;
- Recognise the broad transformation process taking place in South African society at this time in our history;
- Believe that we are united and strengthened by the diversity and challenges of our profession;
- Adopt this constitution as the ultimate authority governing our association and its members.
Source: SA Pharmaceutical Journal 78 (2011)More Less
You may receive an application to place the following advert in the South African Pharmaceutical Journal (SAPJ): "Nominations are invited by the Coalition of Counterfeit Medicine Manufacturers for suitable candidates considered to be worthy of the prestigious Health Professions Masquerader of the Year Award.