Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1495
Iyad Ali
The development of hypertensive disorders is the most common medical complication during pregnancy. Preeclampsia (PE) causes multi-organ dysfunction and can lead to premature delivery, fetal death, and permanent organ damage in women. The purpose of this study is to estimate the prevalence of PE among the pregnant women who were followed at Rafidia Governmental Surgical Hospital (RGSH) in Nablus-Palestine for a year period from October 2020 to October 2021. During that period, we carried out an observational case-control study and assessed the risk factors, complications, and PE management in RGSH. The study included 170 patients with 85 preeclamptic and 85 randomly selected non-preeclamptic women from 5462 deliveries. PE group age ranged from 17 to 45 years old. PE prevalence increased with increasing gestational age (24% and 75% among women who were <37 and ≥ 37 of age, respectively), where maternal age and abortion incidents were associated with severe PE. First or multiple pregnancies were also factors linked to severe PE. Our findings support the body of evidence that PE is considered as a preventable high causative risk of fetal mortality and morbidity.
{"title":"Prevalence, Risk Factors and Complications of Preeclampsia at Rafidia Governmental Surgical Hospital in Palestine: Case-Control Study","authors":"Iyad Ali","doi":"10.35516/jjps.v16i2.1495","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1495","url":null,"abstract":"The development of hypertensive disorders is the most common medical complication during pregnancy. Preeclampsia (PE) causes multi-organ dysfunction and can lead to premature delivery, fetal death, and permanent organ damage in women. The purpose of this study is to estimate the prevalence of PE among the pregnant women who were followed at Rafidia Governmental Surgical Hospital (RGSH) in Nablus-Palestine for a year period from October 2020 to October 2021. During that period, we carried out an observational case-control study and assessed the risk factors, complications, and PE management in RGSH. The study included 170 patients with 85 preeclamptic and 85 randomly selected non-preeclamptic women from 5462 deliveries. PE group age ranged from 17 to 45 years old. PE prevalence increased with increasing gestational age (24% and 75% among women who were <37 and ≥ 37 of age, respectively), where maternal age and abortion incidents were associated with severe PE. First or multiple pregnancies were also factors linked to severe PE. Our findings support the body of evidence that PE is considered as a preventable high causative risk of fetal mortality and morbidity.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48766570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1531
Abdullah Barakat, Yahya Abu-Hameda, Salah Aljamal, Suha Al Muhaissen, Lorina Bisharat, A. Birardi, Hatim S Alkhatib
Hard gelatin capsules (HGCs) are typically used as immediate release dosage forms, however, controlled drug release can from HGCs be obtained by the application of film coating onto the capsule shells or by filling them with controlled release multi-particulates (e.g. pellets and mini-tablets). The filling of a hydrophilic gelling polymer into the capsule is an alternative approach to the time-consuming preparation and filling of multi-particulates. Carrageenan is a linear, sulfated polysaccharide that is commonly used as a thickener in pharmaceutical formulations. The release behavior of propranolol HCl – carrageenan powder mixtures filled into hard gelatin capsules was investigated as a function of drug – to – polymer ratio, the capsule fill weight, grade of carrageenan used. In addition, the effect of the drug release testing method (USP apparatus I or II), rotation speed, pH of the release medium and ionic strength of the release medium on drug release were investigated. The electrostatic interaction of propranolol HCl with carrageenan was also investigated using equilibrium dialysis method to determine the binding capacity and the stability constant of the complex formed. Viscarin GP 109 was found to provide a fast-gelling behavior with excellent controlled release properties. Drug loading and ionic strength of the medium significantly influenced drug release. Release in USP apparatus 1 was slower than that in USP apparatus 2. Propranolol HCl formed an insoluble complex with carrageenan with a high binding capacity and stability
硬明胶胶囊（HGCs）通常用作立即释放剂型，然而，可以通过在胶囊外壳上施加薄膜涂层或通过用控释多颗粒（例如丸粒和迷你片）填充来获得HGCs的药物控制释放。将亲水性胶凝聚合物填充到胶囊中是耗时制备和填充多颗粒的替代方法。卡拉胶是一种线性硫酸多糖，通常用作药物配方中的增稠剂。研究了填充在硬明胶胶囊中的盐酸普萘洛尔-卡拉胶粉末混合物的释放行为，作为药物与聚合物比例、胶囊填充重量和所用卡拉胶等级的函数。此外，还研究了药物释放测试方法（USP仪器I或II）、释放介质的转速、pH值和释放介质的离子强度对药物释放的影响。采用平衡透析法研究了盐酸普萘洛尔与卡拉胶的静电相互作用，测定了所形成复合物的结合容量和稳定常数。发现Viscarin GP 109提供了具有优异控释性能的快速胶凝行为。药物负载量和介质的离子强度显著影响药物释放。USP装置1中的释放比USP装置2中的释放慢。盐酸普萘洛尔与卡拉胶形成不溶性复合物，具有较高的结合能力和稳定性
{"title":"Formulation and evaluation of controlled-release, carrageenan-based powder formulations filled into hard gelatin capsules","authors":"Abdullah Barakat, Yahya Abu-Hameda, Salah Aljamal, Suha Al Muhaissen, Lorina Bisharat, A. Birardi, Hatim S Alkhatib","doi":"10.35516/jjps.v16i2.1531","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1531","url":null,"abstract":"Hard gelatin capsules (HGCs) are typically used as immediate release dosage forms, however, controlled drug release can from HGCs be obtained by the application of film coating onto the capsule shells or by filling them with controlled release multi-particulates (e.g. pellets and mini-tablets). \u0000The filling of a hydrophilic gelling polymer into the capsule is an alternative approach to the time-consuming preparation and filling of multi-particulates. Carrageenan is a linear, sulfated polysaccharide that is commonly used as a thickener in pharmaceutical formulations. \u0000The release behavior of propranolol HCl – carrageenan powder mixtures filled into hard gelatin capsules was investigated as a function of drug – to – polymer ratio, the capsule fill weight, grade of carrageenan used. In addition, the effect of the drug release testing method (USP apparatus I or II), rotation speed, pH of the release medium and ionic strength of the release medium on drug release were investigated. \u0000The electrostatic interaction of propranolol HCl with carrageenan was also investigated using equilibrium dialysis method to determine the binding capacity and the stability constant of the complex formed. \u0000Viscarin GP 109 was found to provide a fast-gelling behavior with excellent controlled release properties. Drug loading and ionic strength of the medium significantly influenced drug release. Release in USP apparatus 1 was slower than that in USP apparatus 2. Propranolol HCl formed an insoluble complex with carrageenan with a high binding capacity and stability","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48335512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1529
M. Alwahsh, Robert Knitsch, R. Marchan, J. Lambert, E. Tolstik, H. Raschke, Dina Mahadaly, Alexander Marx, Djeda Belharazem, R. Hergenröder
The metabolic pathogenesis of thymic carcinomas (TCs) is poorly understood and adjuvant therapy has limited success in metastatic disease and tumor recurrence. Most studies on TCs use two-dimensional (2D) cell culture models, which are not considered as physiologically relevant, and consequently translation to the in-vivo situation remains challenging. Tissue-specific architecture, based in part on interactions with the microenvironment is an essential component of tumors and may be better recapitulated in three-dimensional (3D) cell culture models. Therefore, our goal is to establish 3D thymoma models which will then be used to understand the pharmacokinetics and pharmacodynamics of anticancer drug therapy via metabolic profiling of living cells. Our novel approach using NMR allows for the measurement of small tissue-like models, which are normally not feasible with standard analytical techniques. The currently-available methods only provide a “snap-shot” of the measured time point and tend to be destructive, e.g. dissecting or optical cleaning of the specimen to gain 3D Information – a limitation we overcome with our current method using NMR spectroscopy. In addition, anticancer therapy is only partially effective, mainly due to inherent or drug-induced resistance of tumor cells to standard chemotherapeutics and radiotherapy. Therefore, novel therapeutic strategies are urgently needed.
{"title":"Novel NMR Technique for In-Vitro Toxicity Testing of a 3D Cancer Model","authors":"M. Alwahsh, Robert Knitsch, R. Marchan, J. Lambert, E. Tolstik, H. Raschke, Dina Mahadaly, Alexander Marx, Djeda Belharazem, R. Hergenröder","doi":"10.35516/jjps.v16i2.1529","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1529","url":null,"abstract":"The metabolic pathogenesis of thymic carcinomas (TCs) is poorly understood and adjuvant therapy has limited success in metastatic disease and tumor recurrence. Most studies on TCs use two-dimensional (2D) cell culture models, which are not considered as physiologically relevant, and consequently translation to the in-vivo situation remains challenging. Tissue-specific architecture, based in part on interactions with the microenvironment is an essential component of tumors and may be better recapitulated in three-dimensional (3D) cell culture models. Therefore, our goal is to establish 3D thymoma models which will then be used to understand the pharmacokinetics and pharmacodynamics of anticancer drug therapy via metabolic profiling of living cells. Our novel approach using NMR allows for the measurement of small tissue-like models, which are normally not feasible with standard analytical techniques. The currently-available methods only provide a “snap-shot” of the measured time point and tend to be destructive, e.g. dissecting or optical cleaning of the specimen to gain 3D Information – a limitation we overcome with our current method using NMR spectroscopy. In addition, anticancer therapy is only partially effective, mainly due to inherent or drug-induced resistance of tumor cells to standard chemotherapeutics and radiotherapy. Therefore, novel therapeutic strategies are urgently needed.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43531515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1462
Ibrahim Alabbadi, Abdel Karim Al-Oweidi, Amirah Daher, Ayah BaniHani, A. Awidi
Jordan is an upper-middle-income country with high expenditures on pharmaceuticals. The development of new rare disease (e.g. hemophilia) therapies has encountered significant obstacles with respect to economic the cost of the disease and treatment. The aim of this overview was to estimate current annual spending on hemophilia treatment in Jordan and estimate the financial impact of adapting a new medication (Emicizumab) recently used for treating hemophilia patients in Jordan. Methods: based on the literature review, direct medical costs were quantified, required items’ costs from the actual practice in Jordan were elicited from an expert panel, and a focus group meeting with the same was conducted one month later to determine the current estimated number of hemophilia Patients in Jordan, identify current treatment on demand quantities and their prices. All related medical costs were also identified (e.g. bleeding, the estimated number of hospital days, and/or Intensive Care Unit per bleeding episodes). Estimation of the annual consumption of current on-demand treatment quantities and cost were calculated and compared with scenarios of adding the new therapy (Emicizumab). Results: showed that the financial impact of using Emicizumab S.C. instead of Recombinant Factor VIIa I.V. on the budget of the Jordanian government will be 425,747 JOD ($601,338) annually. Conclusions: the economic advantages of a new hemophilia treatment might be very substantial for patients.
{"title":"Hemophilia in Jordan: An Economic Burden Dilemma of Rare Disease","authors":"Ibrahim Alabbadi, Abdel Karim Al-Oweidi, Amirah Daher, Ayah BaniHani, A. Awidi","doi":"10.35516/jjps.v16i2.1462","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1462","url":null,"abstract":"Jordan is an upper-middle-income country with high expenditures on pharmaceuticals. The development of new rare disease (e.g. hemophilia) therapies has encountered significant obstacles with respect to economic the cost of the disease and treatment. The aim of this overview was to estimate current annual spending on hemophilia treatment in Jordan and estimate the financial impact of adapting a new medication (Emicizumab) recently used for treating hemophilia patients in Jordan. Methods: based on the literature review, direct medical costs were quantified, required items’ costs from the actual practice in Jordan were elicited from an expert panel, and a focus group meeting with the same was conducted one month later to determine the current estimated number of hemophilia Patients in Jordan, identify current treatment on demand quantities and their prices. All related medical costs were also identified (e.g. bleeding, the estimated number of hospital days, and/or Intensive Care Unit per bleeding episodes). Estimation of the annual consumption of current on-demand treatment quantities and cost were calculated and compared with scenarios of adding the new therapy (Emicizumab). Results: showed that the financial impact of using Emicizumab S.C. instead of Recombinant Factor VIIa I.V. on the budget of the Jordanian government will be 425,747 JOD ($601,338) annually. Conclusions: the economic advantages of a new hemophilia treatment might be very substantial for patients.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44494036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1492
E. Albarahmieh, S. Tabbalat, R. Muhaisen
Starch unique physical properties and abundance makes it an ideal candidate as diluent or filler in tablets. Therefore, this work aims to produce a modified starch known as ‘pregelatinized’ with the support of renewable cellulosic wood and characterize its properties in an effort to improve its application versatility that notably appeal to the pharmaceutical industry for greener and more sustainable excipients.
{"title":"Investigations of potential pharmaceutical biofillers based on pregelatinized starch-reinforced with pine-extracted cellulose","authors":"E. Albarahmieh, S. Tabbalat, R. Muhaisen","doi":"10.35516/jjps.v16i2.1492","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1492","url":null,"abstract":"Starch unique physical properties and abundance makes it an ideal candidate as diluent or filler in tablets. Therefore, this work aims to produce a modified starch known as ‘pregelatinized’ with the support of renewable cellulosic wood and characterize its properties in an effort to improve its application versatility that notably appeal to the pharmaceutical industry for greener and more sustainable excipients.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47519111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1516
M. Dweib
Introduction: Non-prescription dispensing of antibiotics is common in the West Bank and this could contribute to the emergence of microbial resistance. Objectives: To evaluate knowledge, attitude, and practices of community pharmacists towards dispensing antibiotics without prescription (DAwP) in the West Bank, Palestine. Methods: A cross-sectional survey was conducted between April and May 2022 using a structured, validated, and pilot-tested questionnaire. Participants were community pharmacists who completed a 28-item questionnaire either in English or Arabic language based on their personal preference. The data was analyzed using descriptive and inferential analyses. Main outcome measure Knowledge, perception and practices towards dispensing antibiotics without prescription. Results: Of the 650 community pharmacists approached, 580 completed the questionnaire (response rate: 89.3%). More than half (53.5%) of the pharmacists were not aware that DAwP is illegal practice. Lack of patient willingness to consult a physician for a non-serious infection (71.2%) and an inability to afford a consultation with a physician (63.4%) were the most common reasons claimed for DAwP. A statistically significant association was found between the number of antibiotics dispensed and educating patients about the importance of adherence and completion of the full course of antibiotics (p <0.05). Conclusions: In general, community pharmacists have inadequate understanding of the regulations prohibiting the over-the-counter sale of antibiotics in the West Bank, explaining the high rate of DAwP in the region. A complicated approach consisting of educational interventions and improving the access to and affordability of healthcare facilities for the general public is required to efficiently reduce DAwP and its negative consequences on public health.
{"title":"Community Pharmacists’ Knowledge, Attitude, and Practices Towards Dispensing Antibiotics without Prescription (DAwP) in the West Bank, Palestine","authors":"M. Dweib","doi":"10.35516/jjps.v16i2.1516","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1516","url":null,"abstract":"Introduction: Non-prescription dispensing of antibiotics is common in the West Bank and this could contribute to the emergence of microbial resistance. \u0000Objectives: To evaluate knowledge, attitude, and practices of community pharmacists towards dispensing antibiotics without prescription (DAwP) in the West Bank, Palestine. \u0000Methods: A cross-sectional survey was conducted between April and May 2022 using a structured, validated, and pilot-tested questionnaire. Participants were community pharmacists who completed a 28-item questionnaire either in English or Arabic language based on their personal preference. The data was analyzed using descriptive and inferential analyses. Main outcome measure Knowledge, perception and practices towards dispensing antibiotics without prescription. \u0000Results: Of the 650 community pharmacists approached, 580 completed the questionnaire (response rate: 89.3%). More than half (53.5%) of the pharmacists were not aware that DAwP is illegal practice. Lack of patient willingness to consult a physician for a non-serious infection (71.2%) and an inability to afford a consultation with a physician (63.4%) were the most common reasons claimed for DAwP. A statistically significant association was found between the number of antibiotics dispensed and educating patients about the importance of adherence and completion of the full course of antibiotics (p <0.05). \u0000Conclusions: In general, community pharmacists have inadequate understanding of the regulations prohibiting the over-the-counter sale of antibiotics in the West Bank, explaining the high rate of DAwP in the region. A complicated approach consisting of educational interventions and improving the access to and affordability of healthcare facilities for the general public is required to efficiently reduce DAwP and its negative consequences on public health.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47760740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1505
Anas Hamdan, R. Gálvez
Neuropathic pain is defined as ‘pain arising as a direct consequence of a lesion or disease affecting the Somatosensory system, regarding the most important aspects of analgesic treatment in NP its strongly advised to make use of a confirmatory questionnaire for NP Dx, such as DN4 or LANSS, as the Screening Tools. Administer analgesic medications in accordance with the strong evidence presented in NP. Keep in mind the medications that have been given the approval for NP. Tricyclic antidepressants, selective serotonin reuptake inhibitors (SNRIs; duloxetine, venlafaxine), and gabapentinoids; pregabalin and gabapentin; alone or in combination with topical (lidocaine patch, capsaicin patch) are all indicated as first-line analgesics for patients with peripheral NP. If a medication from the first line is unsuccessful, try another medication from the same group or move on to the second line. Tramadol and oxycodone are both considered to be analgesics of the second line. Tapentadol as a replacement drug in cases of persistent pain, it may be necessary to mix medications that work via distinct mechanisms of action. Alternatively, in the event that pharmacology is unsuccessful, analgesic invasive treatments may be combined with drugs.
{"title":"Recent Advancements in the Management of Neuropathic Pain","authors":"Anas Hamdan, R. Gálvez","doi":"10.35516/jjps.v16i2.1505","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1505","url":null,"abstract":"Neuropathic pain is defined as ‘pain arising as a direct consequence of a lesion or disease affecting the Somatosensory system, regarding the most important aspects of analgesic treatment in NP its strongly advised to make use of a confirmatory questionnaire for NP Dx, such as DN4 or LANSS, as the Screening Tools. Administer analgesic medications in accordance with the strong evidence presented in NP. Keep in mind the medications that have been given the approval for NP. Tricyclic antidepressants, selective serotonin reuptake inhibitors (SNRIs; duloxetine, venlafaxine), and gabapentinoids; pregabalin and gabapentin; alone or in combination with topical (lidocaine patch, capsaicin patch) are all indicated as first-line analgesics for patients with peripheral NP. If a medication from the first line is unsuccessful, try another medication from the same group or move on to the second line. Tramadol and oxycodone are both considered to be analgesics of the second line. Tapentadol as a replacement drug in cases of persistent pain, it may be necessary to mix medications that work via distinct mechanisms of action. Alternatively, in the event that pharmacology is unsuccessful, analgesic invasive treatments may be combined with drugs.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48348135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1540
Sondos Abdaljaleel, Rima Hijazeen, M. A. Abdel Jalil, O. Awwad, G. Edwan, M. Amaireh
Background: Inappropriate surgical antimicrobial prophylaxis (SAP) practice increases patients’ morbidity, healthcare cost, and antimicrobial resistance. Several guidelines have been published to set guidance for SAP before endourological procedures. Such guidelines include the American Urological Association (AUA, 2019) and the European Association of Urology (EAU, 2020). Literature reported that compliance with the recommendations of these guidelines has been suboptimal. Aims: to investigate healthcare professionals’ (HCPs) perspectives on the barriers to international guideline adherence regarding SAP for endourological procedures and the potential strategies to optimize adherence to guidelines recommendations. Methodology: This study was a qualitative study based on face-to-face semi-structured interviews conducted with urologists in multiple medical centers across Jordan using a preformulated interview guide regarding barriers and facilitators to the adherence to international guidelines of preoperative SAP during endourological procedures. Results: Nineteen urologists were interviewed. Interviews identified many barriers influencing HCP adherence to guidelines, these included factors related to patients, HCPs, the healthcare system, or other external barriers. Also, during the interviews, HCPs suggested many strategies to enhance SAP practice which included increasing patients’ awareness about their actual need for antibiotics, providing training sessions for HCPs about appropriate SAP before endourological procedures, developing national guidelines and conducting local clinical studies, and promoting awareness of the clinical pharmacist's role. In addition to imposing national policy to control antibiotic use and prevent over-the-counter (OTC) prescriptions. Conclusion: Factors related to nonadherence to guidelines were determined. Such knowledge will constitute the backbone for planning appropriate antimicrobial stewardship programs that involve all stakeholders and address all those aspects to optimize SAP prescribing and reduce antibiotic misuse.
{"title":"Barriers and facilitators of inappropriate surgical antimicrobial prophylaxis in endourological procedures: a qualitative study from Jordan","authors":"Sondos Abdaljaleel, Rima Hijazeen, M. A. Abdel Jalil, O. Awwad, G. Edwan, M. Amaireh","doi":"10.35516/jjps.v16i2.1540","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1540","url":null,"abstract":"Background: Inappropriate surgical antimicrobial prophylaxis (SAP) practice increases patients’ morbidity, healthcare cost, and antimicrobial resistance. Several guidelines have been published to set guidance for SAP before endourological procedures. Such guidelines include the American Urological Association (AUA, 2019) and the European Association of Urology (EAU, 2020). Literature reported that compliance with the recommendations of these guidelines has been suboptimal. \u0000Aims: to investigate healthcare professionals’ (HCPs) perspectives on the barriers to international guideline adherence regarding SAP for endourological procedures and the potential strategies to optimize adherence to guidelines recommendations. \u0000Methodology: This study was a qualitative study based on face-to-face semi-structured interviews conducted with urologists in multiple medical centers across Jordan using a preformulated interview guide regarding barriers and facilitators to the adherence to international guidelines of preoperative SAP during endourological procedures. \u0000Results: Nineteen urologists were interviewed. Interviews identified many barriers influencing HCP adherence to guidelines, these included factors related to patients, HCPs, the healthcare system, or other external barriers. Also, during the interviews, HCPs suggested many strategies to enhance SAP practice which included increasing patients’ awareness about their actual need for antibiotics, providing training sessions for HCPs about appropriate SAP before endourological procedures, developing national guidelines and conducting local clinical studies, and promoting awareness of the clinical pharmacist's role. In addition to imposing national policy to control antibiotic use and prevent over-the-counter (OTC) prescriptions. \u0000Conclusion: Factors related to nonadherence to guidelines were determined. Such knowledge will constitute the backbone for planning appropriate antimicrobial stewardship programs that involve all stakeholders and address all those aspects to optimize SAP prescribing and reduce antibiotic misuse.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47192387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1483
N. Hakooz
Personalized or precision medicine has been used to describe the right drug to the right person at the right dose at the right time. One important aspect of personalized medicines is the genetic makeup of the individual. Pharmacogenetics investigates the role of individual genes in drug disposition. The use of pharmacogenetics will increase drug efficacy with minimum side effects. Several tables have been published by the FDA that list the pharmacogenetic associations with certain drugs. These tables suggest that certain subgroups of patients with certain genetic variants are likely to have “altered drug metabolism, and in certain cases, differential therapeutic effects, including differences in risks of adverse events” (https://www.fda.gov/medical-devices/precision-medicine/table-pharmacogenetic-associations#about).These tables include: Section 1: Pharmacogenetic associations for which the data support therapeutic management recommendations such as celecoxib and CYP2C9 polymorphisms. Section 2: Pharmacogenetic associations for which the data indicate a potential impact on safety or response such as codeine in CYP2D6 poor metabolizers will result in a lower concentration of the active form morphine. Section 3: Pharmacogenetic associations for which the data demonstrate a potential impact on pharmacokinetic properties only. In this list, the implications of the genotypes have not been well established for example atorvastatin and SLCO1B1 phenotypes may result in a higher systemic concentration of the drug. In the US pharmacogenetic tests are available as direct-to-consumer (DTC) tests. With DTC tests, individuals can send in a saliva sample and get results directly at their homes (Drelles et al 2021). Although the evidence on the effects of such tests and pharmacogenetic counseling is available and mounting in many clinical practices all around the world but is still to be implemented in the clinical practice in Jordan.
{"title":"Pharmacogenetics and Personalized Medicines","authors":"N. Hakooz","doi":"10.35516/jjps.v16i2.1483","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1483","url":null,"abstract":"Personalized or precision medicine has been used to describe the right drug to the right person at the right dose at the right time. One important aspect of personalized medicines is the genetic makeup of the individual. Pharmacogenetics investigates the role of individual genes in drug disposition. The use of pharmacogenetics will increase drug efficacy with minimum side effects. Several tables have been published by the FDA that list the pharmacogenetic associations with certain drugs. These tables suggest that certain subgroups of patients with certain genetic variants are likely to have “altered drug metabolism, and in certain cases, differential therapeutic effects, including differences in risks of adverse events” (https://www.fda.gov/medical-devices/precision-medicine/table-pharmacogenetic-associations#about).These tables include: Section 1: Pharmacogenetic associations for which the data support therapeutic management recommendations such as celecoxib and CYP2C9 polymorphisms. Section 2: Pharmacogenetic associations for which the data indicate a potential impact on safety or response such as codeine in CYP2D6 poor metabolizers will result in a lower concentration of the active form morphine. Section 3: Pharmacogenetic associations for which the data demonstrate a potential impact on pharmacokinetic properties only. In this list, the implications of the genotypes have not been well established for example atorvastatin and SLCO1B1 phenotypes may result in a higher systemic concentration of the drug. In the US pharmacogenetic tests are available as direct-to-consumer (DTC) tests. With DTC tests, individuals can send in a saliva sample and get results directly at their homes (Drelles et al 2021). Although the evidence on the effects of such tests and pharmacogenetic counseling is available and mounting in many clinical practices all around the world but is still to be implemented in the clinical practice in Jordan. \u0000","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48886630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-24DOI: 10.35516/jjps.v16i2.1532
Salah Aljamal, Shrouq Sotari, O. Tarawneh, Nabil N. Al-Hashimi, Saja H. Hamed, M. Al-Hussein, Hatim S Alkhatib
Electrospun zein mats are known to have poor mechanical and water uptake properties limiting their usefulness as wound dressings. In this study, the effects of the solvent system used, the incorporation of the polymeric additives; polyethylene glycol 20000 (PEG20K) and polyvinylpyrrolidone K30 (PVPK30); and the crosslinking agent Tannic Acid (TA) on the mechanical and water uptake characteristics of zein – based nanofiber mats were investigated. The incorporation of either PEG20K or PVPK30 resulted in an improvement in water vapor sorption and a reduction in water contact-angle of the nanofiber mats. In addition, the incorporation of PEG20K and PVPK30 reduced the ultimate tensile strength, and Young’s modulus while increasing the percent elongation of the nanofiber mats. The use of tannic acid as a crosslinking agent led to an increase in the water vapor sorption, ultimate tensile strength, and Young’s modulus of the nanofiber mats. Mats with smaller average fiber diameter, greater ultimate tensile strength, higher Young's modulus, and greater water vapor sorption were obtained when using 80% (v/v) aqueous ethanol as a solvent system during the preparation of the nanofiber mats when compared to those produced using 60% (v/v) aqueous ethanol. In addition, using solutions with lower zein concentration resulted in mats with lower average fiber diameter, lower ultimate tensile strength and Young’s modulus, and higher percent elongation. Selected formulations were loaded with tetracycline hydrochloride and drug release was evaluated in bulk liquid and using Franz diffusion cells. The use of Franz diffusion cells allowed the discrimination between formulation performance as a function of composition and water uptake properties. Drug release from nanofiber mats was also confirmed by observing the formation of an inhibition zone in cultures of E. coli and S. aureus using the agar diffusion assay. Improved performance of zein nanofiber mats was achieved using polymeric modifiers and crosslinking with tannic acid improving their suitability for wound dressing applications.
{"title":"Preparation and characterization of drug-loaded, electrospun nanofiber mats formulated with zein or zein-based mixtures for wound healing applications.","authors":"Salah Aljamal, Shrouq Sotari, O. Tarawneh, Nabil N. Al-Hashimi, Saja H. Hamed, M. Al-Hussein, Hatim S Alkhatib","doi":"10.35516/jjps.v16i2.1532","DOIUrl":"https://doi.org/10.35516/jjps.v16i2.1532","url":null,"abstract":"Electrospun zein mats are known to have poor mechanical and water uptake properties limiting their usefulness as wound dressings. \u0000In this study, the effects of the solvent system used, the incorporation of the polymeric additives; polyethylene glycol 20000 (PEG20K) and polyvinylpyrrolidone K30 (PVPK30); and the crosslinking agent Tannic Acid (TA) on the mechanical and water uptake characteristics of zein – based nanofiber mats were investigated. \u0000The incorporation of either PEG20K or PVPK30 resulted in an improvement in water vapor sorption and a reduction in water contact-angle of the nanofiber mats. In addition, the incorporation of PEG20K and PVPK30 reduced the ultimate tensile strength, and Young’s modulus while increasing the percent elongation of the nanofiber mats. The use of tannic acid as a crosslinking agent led to an increase in the water vapor sorption, ultimate tensile strength, and Young’s modulus of the nanofiber mats. \u0000Mats with smaller average fiber diameter, greater ultimate tensile strength, higher Young's modulus, and greater water vapor sorption were obtained when using 80% (v/v) aqueous ethanol as a solvent system during the preparation of the nanofiber mats when compared to those produced using 60% (v/v) aqueous ethanol. In addition, using solutions with lower zein concentration resulted in mats with lower average fiber diameter, lower ultimate tensile strength and Young’s modulus, and higher percent elongation. \u0000Selected formulations were loaded with tetracycline hydrochloride and drug release was evaluated in bulk liquid and using Franz diffusion cells. The use of Franz diffusion cells allowed the discrimination between formulation performance as a function of composition and water uptake properties. Drug release from nanofiber mats was also confirmed by observing the formation of an inhibition zone in cultures of E. coli and S. aureus using the agar diffusion assay. \u0000Improved performance of zein nanofiber mats was achieved using polymeric modifiers and crosslinking with tannic acid improving their suitability for wound dressing applications.","PeriodicalId":14719,"journal":{"name":"Jordan Journal of Pharmaceutical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46129566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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