SA Pharmaceutical Journal - Volume 79, Issue 5, June 2012

You might have gathered that I attend a lot of meetings. If you promise not to tell anyone, I'll let you into a secret. Sometimes, I absolutely hate going. On occasion, it's because I get bored very easily. When I was an intern, my tutor told me that I have a low threshold of boredom. He was quite right. At other times, I have better things to do, like write to you. It's very frustrating when you have to go to a meeting and you know that the work is piling up on your desk and it isn't going to go away until you sit there and do it.

As I come to the end of my three-year stint as the President of the Pharmaceutical Society of South Africa, I look back and count my many blessings for the privilege afforded me to lead such an organisation. I give thanks to God for blessing me with the privilege of being of service to my fellow colleagues. By the time you read this, we will have met at Emperor's Place, Kempton Park, to deliberate the metamorphosis of our profession. Hopefully, we will turn out to be an extraordinarily beautiful butterfly. With the dedication and hard work of so many of you and the enthusiasm of young pharmacists and students, I have no doubt that we will turn into a beautiful butterfly: the end of the beginning of a new life for pharmacy.

Welcome to the new PSSA website

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Branches and Sectors

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News and events

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PPS Confidence Index

Influenza is a common and important source of morbidity and mortality. It is a viral infection that occurs worldwide, and has no borders. The influenza virus is spread by inhaling droplets that have been coughed or sneezed by an infected person, or by having direct contact with an infected person's nasal secretions. Although definitions of influenza-like illness have been proposed, it is still not clear whether recognition of a constellation of symptoms or a syndrome is reliable enough for the clinical diagnosis of an influenza infection. Typical symptoms include malaise, rigors, fever, myalgia, a sore throat, and a runny or stuffy nose. Different non-pharmacological and pharmacological treatment options exist. Antibiotics have no place in the treatment of uncomplicated influenza. In South Africa, most cold and flu preparations contain a combination of active ingredients. Usually, they include a non-steroidal anti-inflammatory drug (NSAID). This article describes the epidemiology of influenza and the typical prodromal symptoms, from a patient and practitioner perspective. It discusses a threshold model for the diagnosis of influenza, and treatment options for uncomplicated influenza, including the use of NSAIDs.

Seasonal affective disorder (SAD) is a subtype of major depressive disorder or bipolar disorder, where depressive symptoms develop commonly during the autumn and winter months and then resolve during the spring or summer. Patients exhibit neurovegetative signs of depression such as hypersomnia, hyperphagia and psychomotor retardation, reminiscent of winter hibernatory behaviour seen in some animals. Investigations into the pathophysiology of this disorder indicate that a complex interplay of genetic and environmental phenomena predicate a subtle imbalance in chronobiology in these patients, with depression being influenced by the photoperiod, circadian phase-shifting and neurotransmitter abnormalities. While clinical trials have shown equal efficacy between antidepressant drugs and light therapy in the treatment of SAD, other non-pharmacological management options such as negative air ions, psychotherapy and exercise are being investigated. With its stimulatory effects on melatonin receptors, the antidepressant agomelatine is a new therapeutic option.

Chronic obstructive pulmonary disease (COPD) is a disease state resulting from an abnormal inflammatory response of the lungs to irritant particles and gases, with resultant progressive airflow limitation, that is partially reversible. It is associated with lung hyperinflation and systemic effects, such as chronic cough, exertional dyspnoea, expectoration, and wheezing. COPD causes physical impairment, debility, and reduced quality of life. Symptoms such as coughing or wheezing can be treated with medication. Respiratory infections should be treated with antibiotics, if appropriate. The pathological correlates are chronic bronchitis and emphysema.

Nausea and vomiting are common side-effects of anticancer treatment. Inadequately controlled emesis impairs functional activity and quality of life for patients, and may compromise adherence to treatment. Many drugs can be prescribed to prevent, lessen, or relieve nausea and vomiting associated with chemotherapy. This article provides an overview of drugs given for nausea and vomiting associated with chemotherapy.

Elderly patients often request treatment for cold and flu symptoms. Product selection may be more complicated in this patient group. The elderly are more at risk of adverse drug reactions due to an increased number of medical conditions and drugs taken, and also because of altered pharmacokinetics and pharmacodynamics, impaired renal function, reduced hepatic blood flow and liver size, increased body fat, decreased lean body mass, and changes in receptor sensitivity. This article will review the factors affecting pharmacology in the elderly, as well as the possible risks associated with some common products used in the treatment of colds and flu.

Drug info - recently asked questions

Each year, the Academy of Pharmaceutical Sciences takes great pleasure in sharing postgraduate students' success. The titles of the research projects are published to inform the profession of the range of research that is performed by pharmacists. Due to limitations with respect to space, only the main supervisor of each research project has been listed.

The Global Antibiotic Resistance Partnership (GARP) is a four-country initiative that consists of India, Vietnam, Kenya and South Africa. GARP-South Africa was launched on 8 February 2010 at a meeting attended by 40 experts (clinical, veterinary, policy, research and pharmaceutical spheres). The issues that were identified at this meeting included the establishment of a multidisciplinary GARP-South Africa national task team, and that there is an urgent need for a situational analysis to consolidate all available information pertaining to antimicrobial resistance. This should include reflections on strengths and weaknesses and the identification of gaps in the approach to the challenges posed by antimicrobial resistance. The expertise of the Centre for Disease Dynamics Economics and Policy and all GARP collaborating partners in this venture will need to be drawn upon for translation of all aspects of antimicrobial resistance into policy.

Log on! Have you surfed our SAAHIP website yet? (www.saahip. org.za). It gave me great pleasure and true pride to send out that email on the L-list, letting our members know that it had been successfully launched. In retrospect, that was probably the easy part. Now we need to ensure that it stays freshly populated. Load what your branch is doing in working towards the branch portfolio onto it. So much goes on at branch level, and not all branch members know exactly what is happening. This is a wonderful opportunity for branch chairpersons to engage in open communication with their members. This may be the perfect tool through which to develop portfolios and help Exco to achieve its objectives.

The clinic can offer different services, for example wound care, human immunodeficiency virus and acquired immune deficiency syndrome counselling, immunisations, disease and medicine review management, and a baby and diet clinic. The community's blood pressure can be measured, cholesterol and uric acid tests carried out, and sugar levels tested at a clinic. This can lead to a constant flow of feet into the pharmacy and will make pharmacists the public's first point of call.

Pharmacies for sale

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Job offers

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Pharmacist available

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Locums available

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Practice available

This month, we reflect on opportunities for the profession to promote itself, and the extent to which it is important to do so. But first, I'd like to relate a nice story.

Diabetes mellitus (DM) and hypertension are common clinical conditions that often co-exist. This combination has been called the deadly duet to emphasise the increased cardiovascular risk when the two conditions co-exist. Hypertension occurs more commonly in diabetics than in comparable non-diabetics, as the prevalence of hypertension in diabetics is about two times higher than that of hypertension as observed in the general population. In type 2 diabetes mellitus, hypertension is often present as part of a possible common underlying metabolic abnormality, such as insulin resistance. However, in type 1 diabetes mellitus, hypertension is often due to the onset of diabetic nephropathy.

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Hypertensive people are 2.5 times more likely to develop diabetes mellitus within five years. This may be due to the presence of an underlying metabolic syndrome, and made worse by the type of antihypertensive drug used, e.g. high-dose thiazides combined with high-dose beta blockers.

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The co-existence of hypertension and diabetes mellitus greatly increases the risk for macrovascular and microvascular diabetes complications. The presence of hypertension causes a 7.2-fold increase and a 37-fold increase in mortality in diabetic patients and in diabetic nephropathy respectively.

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Hypertension exacerbates all the vascular complications of diabetes, including coronary artery disease, renal disease, stroke, peripheral artery disease, leg amputations and retinopathy. Diabetes increases the risk of coronary artery disease two fold in men and four fold in women, putting women in particular, at risk.