SA Pharmaceutical Journal - Volume 83, Issue 2, 2016
Volume 83, Issue 2, 2016
Author Sarel MalanSource: SA Pharmaceutical Journal 83 (2016)More Less
Towards the end of the previous century we published a paper titled "Publish or Perish: How are pharmacy researchers coping in a changing South Africa?" in which we highlighted some similarities and differences between publications originating from South Africa, the rest of Africa, North America, Australia and Europe, specifically looking at the factors impeding research in pharmacy and the subsequent publication thereof at South African Universities.
Author Lynn LambertSource: SA Pharmaceutical Journal 83, pp 11 –13 (2016)More Less
Despite advances in options for the treatment of type 2 diabetes, optimal glycaemic control is often not achieved. Hypoglycaemia and weight gain associated with many antidiabetic medications may interfere with the implementation and long-term application of treatment strategies. Glucose homeostasis is dependent on a complex interplay of multiple hormones and gastrointestinal peptides, including glucagon-like peptide-1 (GLP-1). Abnormal regulation of these substances may contribute to the clinical presentation of diabetes. GLP-1-based therapies affect glucose control without causing hypoglycaemia through several mechanisms, including enhancement of glucose-dependent insulin secretion, slowed gastric emptying, regulation of postprandial glucagon, and reduction of food intake.
Author Lynda SteynSource: SA Pharmaceutical Journal 83, pp 14 –19 (2016)More Less
Circulating influenza ("flu") viruses are continuously undergoing change, which makes the public more vulnerable to contracting flu. While anyone can develop complications from flu, certain high-risk groups are more vulnerable to life-threatening complications. Pharmacists are in an ideal position to identify high-risk groups and to recommend an annual flu vaccination. Carefully explaining the benefits of and allaying certain misconceptions about the flu vaccination helps the number of people wishing to receive the flu vaccination annually to increase, thereby decreasing the high morbidity and mortality rate due to flu.
Source: SA Pharmaceutical Journal 83, pp 21 –24 (2016)More Less
Magnesium (Mg2+) is an essential ion for general well-being. After potassium it is the most abundant ion in the body and is responsible in enzymatic reactions especially for energy metabolism and protein synthesis. Imbalances in the overall magnesium status may lead to hypomagnesaemia or hypermagnesaemia; both of these can lead to untoward effects in cardiac, nervous or neuromuscular disorders. This article provides a brief overview on the physiological function of magnesium in the body and different indications where it may be used.
Source: SA Pharmaceutical Journal 83, pp 25 –33 (2016)More Less
The key to optimal pain management is the ability to effectively monitor the patient to ensure pain relief, whilst minimising or managing the side-effects of pain medication. This will only be possible through the collaborative work of all healthcare professionals managing the patient. This article provides an overview of the requirements for optimising pharmacotherapeutic pain management.
Source: SA Pharmaceutical Journal 83, pp 34 –43 (2016)More Less
Background: Hypothyroidism is a common clinical condition confronting all healthcare practitioners yet there remains uncertainty about the optimal medication and optimum treatment targets. In addition, many patients remain symptomatic despite using recommended medications and attaining recommended treatment targets.
Methods: All endocrinologists in South Africa who consented to be part of the guideline process were assigned various aspects of the management of patients with thyroid disease. In each section the current literature was reviewed and the level of evidence was graded. This information was then presented at a guideline meeting. Where evidence was lacking a consensus among participants was adopted.
Results: This guideline provides 11 recommendations for the management of primary hypothyroidism, secondary hypothyroidism and subclinical hypothyroidism in adults.
Conclusions: This is the first South African guideline for the management of hypothyroidism in adults and represents a comprehensive review of the current literature in an attempt to provide evidence-based guidance for all healthcare practitioners regarding the many clinical aspects encountered when managing patients with hypothyroidism.
Source: SA Pharmaceutical Journal 83, pp 44 –49 (2016)More Less
Background: A cross-sectional study was performed to determine the one-month prevalence of inappropriate antibiotic prescribing at the outpatient department of Hlatikulu Government Hospital, Swaziland. A survey was also administered to prescribers to determine their knowledge of and attitudes and perceptions towards prescribing for acute respiratory infections (ARIs).
Method: The prevalence of inappropriate antibiotic prescribing for ARIs was estimated by reviewing 410 prescriptions over one month. Ten prescribers participated in the survey conducted to assess their knowledge of and attitudes and perceptions towards prescribing for ARIs.
Results: Overall, a high prevalence of inappropriate antibiotic prescribing for ARIs was found [79%, 95% confidence interval (CI): 75-83)] with regard to doctors, (78%, 95% CI: 73-83) with regard to nurses, and (80%, 95% CI: 74-87) with respect to all age groups. Amoxicillin was the most misused antibiotic (64%). Prescribers were aware of the local treatment guidelines, although not everybody was confident applying them. Nurses in the survey listed antibiotics as their preferred drug of choice for ARIs. Most doctors displayed knowledge of prescribing for ARIs. All prescribers failed to define rational drug use. Forty per cent of the prescribers reported being influenced by patients in their prescribing practices.
Conclusion: Inappropriate antibiotic prescribing for ARIs was rampant. There is a need for strategies to impart knowledge to prescribers, and to translate their knowledge into a change in attitude in order to reduce inappropriate antibiotic prescribing for ARIs.
Source: SA Pharmaceutical Journal 83, pp 52 –54 (2016)More Less
There is a strong autarkical tendency amongst pharmacists, perhaps related to their historical origin as sole proprietors and solo practitioners. This tendency leads to a marked resistance to the imposition of detailed standards of practice, and a characterisation of such efforts as needlessly interventionist, as disregarding the professionalism that is expected of pharmacists, and as yet more evidence of an over-bearing "nanny state". This tendency is, of course, not restricted to pharmacists. Many other health professionals resist what they see as impositions from "outside", be that from medical scheme administrators, managed care firms, learned societies, guideline developers, or regulators. This article proposes a different approach and motivates for a concerted effort by SAAHIP to contribute to the strengthening of Good Pharmacy Practice standards in South Africa, specifically related to hospital pharmacy.
Author Joggie HattinghSource: SA Pharmaceutical Journal 83 (2016)More Less
Students' perception of the perceived availability and diversion of methylphenidate in a South African tertiary academic institution : cum laudeSource: SA Pharmaceutical Journal 83, pp 55 –59 (2016)More Less
Aims: To determine where residence students from a South African tertiary institution get methylphenidate for both appropriate and non-medical use, where they think they could get it and how easy they think it is to acquire.
Design: A quantitative cross-sectional study that made use of a structured questionnaire.
Setting: A South African tertiary institution.
Participants: Residence students from ten randomly selected residences (N=328; response rate=13.7%).
Measurements: Self-reports of experience and perceptions relating to sources of methylphenidate.
Findings: The mean age of the participants was 20.1 years and 56.4% of the sample was female. Although all the appropriate users have obtained methylphenidate legally at least once, they have also obtained it illegally from their friends (30.8%) and family (7 7%). The most common source for non-medical users was their friends (77.3%). Non-medical users also acquired methylphenidate using fabricated prescriptions (10.7%) and by buying it from pharmacies without a prescription (14.3%). Users and non-users had similar perceptions of where they thought they could get methylphenidate, except that users were more likely to think they can get it from friends (67.1% vs. 46 7%).
Conclusions: The current study presents novel evidence for methylphenidate diversion by university students in South Africa. Considering the abuse potential of methylphenidate, the diversion should be further explored and programmes developed to improve the legal control of methylphenidate.
Author Aleta WegeSource: SA Pharmaceutical Journal 83 (2016)More Less