Community Pharmacy Practice

Aims: Asthma is one of the biggest health burdens on the Sri Lankan population. Achievement of treatment goals isdetermined mainlythrough pharmacological management. The main objective of this study was to evaluate the patient inhaler handling techniques and their awareness regarding their disease condition, as well as to find out how an educational intervention effects patients‘ inhaler handling techniques.


Study Design:  A Prospective cross sectional study used.


Place and Duration of Study: National Hospital for Respiratory Diseases, Welisara and Colombo South Teaching Hospital, Kalubowila between June 2017 to August 2017.


Methodology: Clinically diagnosed asthma patients were randomly divided into Control and Test groups. Control comprised 94 patients and the test comprised 93 patients. Their baseline knowledge about asthma and inhaler-using technique were assessed in 1st month by using an interviewer-administered questionnaire and checklist respectively. The test group was given both information leaflet and verbal instructions. Again, all the participants were assessed for the inhaler techniques on their next clinic day by using the same questionnaire and the checklist.


Results: After the educational intervention, there was a statistically significant improvement in the test group, in the adherence to the nine steps, including critical steps, regarding all 3 device types (PMDI, DPI, and PMDI with Spacer) in the 2nd-month visit. (at  P =.05) When considering awareness about asthma in the total population, most participants were knowledgeable regarding asthma.


Conclusion: We observed gaps in knowledge between current practice and what is expected in patients with asthma regarding their inhaler therapy. This might be due to the quality of instructions delivered by health care providers being insufficient and them lacking the time to observe patients individually for the inhaler techniques. Awareness regarding asthma and inhalation techniques can be raised by using information leaflets as well as through verbal counseling.

Keywords: Asthma dry powder inhaler pressurized metered dose inhaler spacer critical steps inhaler technique educational intervention

— This paper reports on the development of a virtual tour of a community pharmacy. The interactive walkthrough was designed to be used as an adjunct to placement training for Pharmacy students. This paper reports on the limitations and issues associated with developing a virtual tour using currently available hardware such as the GigaPan Pro and software such as the GigaPan Stitch and krpano. These tools are relatively available and claim to allow for automatic generation of virtual tours along with the addition of interactive element such as text and sounds. We found that in general producing a standard walkthrough was straightforward. We also found that with patience and some experimentation high quality outcomes could be achieved as long as only simple navigation was required. However, adding even simple interactive elements such as sound objects, pop up text and modified hotspots for more natural zooming between locations added significantly to the required IT skill set. We conclude that programming knowledge and subtle interface design skills, consistent with a trained IT professional are required if anything beyond a very basic walkthrough is to be produced.

The present investigation concerns the design and evaluation of floating tablets of Amoxicillin trihydrate, which after oral administration, are designed to prolonged the gastric residence time and to obtain site-specific drug delivery for the stomach and increased drug bioavailability. Amoxicillin is a Semisynthetic antibiotic, belonging β-lactum family, which is effective for bacterial treatment, especially for helicobacter pylori infection. The dosage form was designed by using HPMC K100M, HPMC K15M and HPMC K4M polymers as gelling agents, sodium bicarbonate as gas-generating agent and other excipients. The interaction between drug and excipients in prepared floating tablets were studied by differential scanning calorimetry (DSC) and FT-IR. Floating tablets prepared by direct compression technique. The prepared floating tablets were evaluated in terms of their pre-compression parameters, physical characteristics like hardness, friability, uniformity of weight, uniformity of drug ...

Context: Over the last ten years, many research studies concerning pharmacists’ perceptions of generic medicines have been conducted worldwide, although this issue remains underexplored in Vietnam.

Aims: To evaluate pharmacists’ views on generic medicines and to investigate the generic substitution practices in community pharmacies in the context of Vietnam.

Methods: A cross-sectional survey comprising a 24-item self-administered anonymous questionnaire was distributed to 480 pharmacists in eleven provinces in southern Vietnam between December 2016 and March 2017. The main outcome measures were pharmacists’ views on generic medicines.

Results: Of the 480 pharmacists who received the questionnaire, the effective response rate was 35.63% (n=171 pharmacists); however, 45 pharmacists chose all three correct generic names. Some 47.3% of respondents indicated that all the products that are approved as exhibiting generic equivalence can be considered therapeutically equivalent to the innovator drugs. Yet, 25.2% of respondents agreed that generic medicines are of inferior quality to branded medicines. The pharmacists who graduated from universities and those who had undergone only a short period of training differed significantly in terms of their knowledge and perceptions. About 60.2% of pharmacists recommended generics over branded products. Approximately 89% of respondents disagreed with the notion of implementing certain compulsory generic substitutions in Vietnam.

Conclusions: The pharmacists who had completed only a short training period exhibited a lack of knowledge regarding generic names. This issue should hence be addressed by both pharmacy educators and relevant government agencies in order to ensure the wider use of generic products.

Pharmacovigilance is the science and activity involved in collection, detection, assessment, monitoring, and prevention of untoward effects with pharmaceutical products. Pharmacovigilance basically boards safety of medicine. Pharmacists have key role in health systems to maintain the rational and safe use of medicine for they are drug experts who are explicitly trained in this field. The viewpoint of pharmacy students on pharmacovigilance and ADR reporting has also been discussed with an aim to focus the need to enhance content related to ADR reporting and pharmacovigilance in undergraduate pharmacy curriculum. Globally, although the role of pharmacists within national pharmacovigilance systems differs, it is very well recognized. Integration of ADR reporting concepts in education curriculum, training of pharmacists and voluntary contribution of pharmacists in ADR reporting is vital in achieving the safety goals and conservation of public health. Also, these knowledge gaps can be contented through continuous professional development programs and strengthening theoretical and practical knowledge in undergraduate pharmacy curriculums. Without sufficiently identifying and realizing training needs of pharmacists and other health care professionals, the competence of national pharmacovigilance systems is unlikely to improve which may compromise patient's safety.

Community pharmacy and general practice have traditionally worked closely together. Through the primary care home (PCH) model, the National Association of Primary Care (NAPC) aims to take joint working much further and extend the integration of services and the work of multidisciplinary teams so that community pharmacies are integral to supporting the health and care needs of their local population.

Traditionally, plants have been used as a source of medicine in India by indigenous people inhabiting various terrains for the control of different ailments afflicting human. An ethno botanical survey was undertaken in Nawarangpur District, Odisha, India. The plants and their traditional use are part of the natural and cultural heritage of the region. The study was carried out regarding the medicinal plants used by the local peoples during 2000 to 2004. Finally, the data were assessed to which extent plants are vulnerable due to collection and habitat destruction. An ethno botanical survey was undertaken in the Nawarangpur District, Odisha, India. Data were collected through field assessments from traditional healers and locals by means of personal interviews and semi-structured questionnaires. Voucher specimens were collected following standard methods, identified with the help of pertinent floras and taxonomic experts and deposited in the Herbarium, RRL-B, India for future references. A total of 69 plant species belonging to 43 families are reported during the study. The major life forms were herbs, trees, shrubs, climbers, small tree and creeper. Several medicinal plants recognized for the treatment of various diseases were collected. The root parts were widely used, followed by leaf, bark, seed and stem. This study reveals that medicinal plants still play a vital role in the primary healthcare of this local community. Traditional medicines also have the potential to form the basis of pharmaceutical drugs for the treatment of a range of diseases. Further, the information requires validation for further clinical usage.

Measurement of lung fungction is a way to determine the effectiveness of a given therapy. A monitoring asthma symptoms is to see the value of peak expiratory flow (PEF) with a peak flow meter. The measurement is objective and can be used to predict the prognosis of asthma through the monitoring of conditions of the lung. This study aims to find out information on the use of a peak flow meter explanations given to the patient's pharmacist in a pharmacy in a town in East Java. This research method is a non-experimental with cross sectional study. This study uses observation techniques in the form of a checklist, using the concept of a mysterious patient. Sampling by the proportional method, and then the data will be processed descriptively. The research sample of 80 pharmaceutical personnel consisting of 33 pharmacists and 47 non-pharmacists. In the group of non-pharmacists and pharmacists, the points most overlooked is the explanation of the recording of the results (number 6) and compared with the best value (number 8). Pharmacists still need to improve in understanding the basics and techniques in order to use a peak flow meter can help asthma patients to monitor their asthma medication. Keywords : information on how to use, peak flow meter, asthma, pharmacy

Background: Medications are powerful tools that, if used correctly, can prevent or treat disease. If used incorrectly, there is potential to cause great harm to people who take them. These unintended effects, called adverse effects, can occur from any medication. As health care teams, which include physicians, pharmacists, and other health care providers, are making decisions about using specific medications to treat an individual patient, they must weigh the potential risks against the desired benefit of each medication to minimize the chance of harm to the patient. As important members of the health care team, pharmacists work collaboratively with patients' other health care providers in all types of patient care settings ranging from community pharmacies to hospitals and long-term care facilities. Across these settings, pharmacists take specific actions that regularly contribute to improving patient safety. In addition to training on medications, pharmacist education and training includes assessing health status of patients, providing education and counseling, managing diseases, and using health care technologies. Pharmacists use this education and training to prevent medication errors, drug interactions, and other adverse medication events from reaching patients. With the expanding number and complexity of medications, pharmacists' roles and responsibilities have expanded broadly beyond medication distribution. Pharmacists are providing patient care in almost all health care settings to help people of all ages get the most from the medications that are prescribed to them. Examples of pharmacists' patient care services include providing health and wellness screenings, managing chronic diseases, assisting patients with medication management, administering immunizations, and working with hospitals and health systems to improve patient care and reduce the number of patients who are readmitted to the hospital following their hospital stay.

The purpose of the present study is to generate valuable data about overall dispensing practices available at the later settings in one of the largest town in Ethiopia; Ambo town. Descriptive cross sectional study was conducted at 15 community pharmacy settings found in the town from April to June 2014 including 255 clients. Dispensing practices were evaluated using WHO standards for dispensing. Data was analyzed using SPSS Version 20.0. Out of 18 dispensers working at these settings, only 3(17%) were pharmacists and surprisingly 5(27.8 %) were not professionally qualified (without having any college diploma or university degree). The average dispensing time obtained was 60 seconds. From the total of 225 clients visiting these settings, only 17 (7.6%) of them were found to be knowledgeable about drugs dispensed to them. Regarding adequacy of labeling, generic name, strength, dosage, and quantity of drugs were written on only 11.1%, 11.1%, 29.8% and 11.6% of the labels respectively. It was found that for more 90% of the clients, drugs were dispensed without checking patients’ identity like age. While for 6.7% wrong strength, 12% incorrect frequency and 24.4% incorrect total quantity were dispensed. Only dispensing spoon was available as dispensing aids at all settings. None of them were found to check the temperature of the refrigerator regularly & maintained with acceptable range. Generally, dispensing practices found at these pharmacy settings were mostly irrational. This could be ensured through the involvement of non-pharmacy professionals in dispensing, very short dispensing time, poor clients’ knowledge, poor labeling of medications, significant number of dispensing errors and unavailability of essential dispensing aids. So there is a need for urgent managerial and educational intervention to improve dispensing practices in the country and in the study area particularly.

Background: Medicines are an essential component of health-care services. The community pharmacies have great value in terms of providing medicinal services in developing countries. Good Pharmacy Practice (GPP) assesses whether the medicines are safe, effective, available, and accessible and are used correctly. The objective of the study is to assess the good pharmacy practice among community pharmacy of Kathmandu, Bhaktapur and Lalitpur districts. Methods: This was a cross-sectional prospective study. A quota sampling approach was adopted to sample 94 community pharmacies. Data on the premises, storage, prescription handling and dispensing, pharmacy services and rational use of drug were collected using pre-tested questionnaire. Results: The overall compliance with GPP indicators for Kathmandu, Bhaktapur and Lalitpur districts were found to be 12.81 (55.69%), 11.13 (48.39%) and 12.99 (56.48%). On structure wise study, the GPP compliance was higher in others category (Metropolitan city, Sub-metropolitan city and Municipality) i.e. 13.49 (58.65%) and 11.9 (51.74%) in VDC. The studies showed the declining involvement of pharmacists or pharmacy assistants in community pharmacy for more than eight hours a working day i.e. Lalitpur (65%), Bhaktapur (56%) and Kathmandu (59%). Antibiotic dispensing without prescription was highly practiced in Lalitpur 50% compared to Bhaktapur (44%), Kathmandu (34%). Conclusions: It was found that all districts miserably failed to comply with the standards set by GPP particularly Bhaktapur. Pharmacies seemed to have established their place in the society more as a business entity rather than healthcare establishment.

The objective of the study was  to investigate the alpha glucosidase
and  Dipeptidyl peptidase IV  (DPP-IV) inhibitory activity of aqueous
extract of Desmodium gangeticum (D. gangeticum). α-d- Glucosidase
from  Saccharomyces cerevisiae  was used as  in vitro  model to assess
α-d-Glucosidase inhibitory activity of aqueous extract of  D.
gangeticum. In-vitro inhibitory effect of aqueous extract of  D.
gangeticum  on DPP-IV enzyme was assessed by measuring the
absorbance of reaction mixture at 405  nm using a microtiter plate
reader.  Results of the study demonstrated that aqueous extract of  D.
gangeticum  exhibited good alpha glucosidase and DPP-IV inhibitory
activity with an IC
50
value of 950μg/ml and 255.5μg/ml respectively.
The results of the study provide scientific support for the use of  D.
gangeticum  in the traditional system of medicine for the treatment of
Type-II diabetes. This study should help to explain the
pharmacological mechanism of action and also help in the
development of medicinal preparation for the treatment of Type-II
diabetes.

This study had been initiated to investigate the modulatory role of
Ashwagandha root extract against gamma radiation-induced
nephrotoxicity and cardiotoxicity in male albino rats. Administration
of Ashwagandha (100 mg/kg) for 7 days prior to whole body gamma-irradiation exposure (6Gy) minimized the  hazardous effects of
radiation by decreasing the levels of serum urea, creatinine and
creatine phosphokinase (CPK) and lactate dehydrogenase (LDH)
activities. Also, ashwagandha induced significant decreases in the
levels of nitric oxide (NO) and malondialdehyde (MDA) and
significant increase in the superoxide dismutase (SOD) activity in
heart and kidney tissues compared to irradiated group. On the other
hand, administration of ashwagandha prior to whole body gamma-irradiation induced non significant change  in the levels of reduced
glutathione (GSH). Based on our data, it is proposed that
Ashwagandha extract might involve in the protection of renal and
cardiac damage induced by gamma irradiation owing to its
antioxidant capacity.

BACKGROUND:
Pharmacy support-staff (pharmacy technicians, dispensers and Medicines Counter Assistants) support the delivery of pharmaceutical and retail functions of the pharmacy. Workflow is supervised and at times dependent upon the pharmacist's presence. Policy makers and pharmacy's representative bodies are seeking to extend the community pharmacist's role including requiring the pharmacist to undertake private consultations away from the dispensary and shop floor areas. However, support-staff voices are seldom heard and little is known about the impact such policies have on them.
OBJECTIVE:
The objective of this study is to explore the impact and consequences of the English Medicine Use Review (MUR) service on pharmacy support-staff.
METHODS:
Ten weeks of ethnographic-oriented observations in two English community pharmacies and interviews with 5 pharmacists and 12 support-staff. A thematic approach was used to analyse the data.
RESULTS:
Despite viewing MURs as a worthwhile activity, interviews with support-staff revealed that some felt frustrated when they were left to explain to patients why the pharmacist was not available when carrying out an MUR. Dependency on the pharmacist to complete professional and accuracy checks on prescriptions grieved dispensing staff because dispensing workflow was disrupted and they could not get their work done. Medicines Counter Assistants were observed to have less dependency when selling medicines but some still reported concerns over of customers and patients waiting for the pharmacist. A range of tacit and ad hoc strategies were consequently found to be deployed to handle situations when the pharmacist was absent performing an MUR.
CONCLUSIONS:
Consideration should be given to support-staff and pharmacists' existing work obligations when developing new pharmacy extended roles that require private consultations with patients. Understanding organisational culture and providing adequate resourcing for new services are needed to avoid improvisations or enactments by pharmacy support-staff and to allow successful innovation and policy implementation.

What is known and objective Community pharmacists can play an important role in controlling chronic diseases. This study aimed to evaluate the effects of pharmacists' educational interventions in the community pharmacy settings on asthma control and severity, quality of life (QOL) and medication adherence. Methods Databases PubMed, Scopus and Web of Science were searched for evidence regarding asthma severity and control, QOL, and medication adherence after pharmacists’ interventions in community pharmacy settings. Twenty-one studies were eligible for qualitative and quantitative analysis. Indices and questionnaires were used in the studies, such as Asthma-related quality of life (IAQLQ), Asthma Control Test (ACT), Perceived Control of Asthma Questionnaire (PCAQ), inhaler technique (IT), Asthma Control Questionnaire (ACQ), 36-Item Short Form survey (SF-36) and peak expiratory flow rate (PEFR). The outcomes were extracted, pooled and analysed as percentages, means, standard deviations and errors, and 95% confidence intervals (CIs). Results and discussion Community pharmacists in all studies educated and followed up the asthmatic patients, addressing the outcome measures. Pharmacists underwent training courses of at least a day. Standardized mean differences for the indices were pooled as follows: IAQLQ −0.241 (95% CI, −0.362 to −0.121), ACT 0.14 (95% CI, 0.02 to 0.27), PCAQ −0.15 (95% CI, −0.28 to 0.01), IT 0.79 (95% CI, 0.05 to 1.54), ACQ −0.50 (95% CI, −0.69 to −0.30), SF-36 0.39 (95% CI, 0.16 to 0.62), PEFR 0.13 (95% CI, 0.01 to 0.26) and asthma symptoms score −0.34 (95% CI, −0.49 to −0.18). What is new and conclusion Pharmacists' educational interventions in community pharmacy settings could significantly improve asthma severity and control, QOL and medication adherence.

The purpose of this study was to investigate perception of pharmacist and prescriber regarding traditional role of community pharmacist. Questionnaire based, cross sectional study was conducted which comprised of 428 participants from Quetta, Pakistan. Majority (n=242, 56.5%) of respondents were prescribers while (n=186, 43.5%) were pharmacists with experience of 1-4 years (n=174, 40.7%). Overall the majority (n= 386, 90.2%) of the participants had positive perception regarding traditional dispensing and traditional counselling (n=314, 73.4%) role of community pharmacist. Concerning the prescribers, majority (n=200, 82.6%) had positive perception regarding traditional dispensing role and traditional counselling role (n=132, 524.5%) while concerning pharmacists, majority (n=186, 100%) had positive perception regarding the traditional dispensing role and traditional counselling (n=182, 97.8%) role of community pharmacist. This study concluded that both prescribers and pharmacists had positive perception regarding traditional role of community pharmacist, and it is recommended that further studies should be conducted regarding extended and clinical role of community pharmacist.

Background: Medications are powerful tools that, if used correctly, can prevent or treat disease. If used incorrectly, there is potential to cause great harm to people who take them. These unintended effects, called adverse effects, can occur from any medication. As health care teams, which include physicians, pharmacists, and other health care providers, are making decisions about using specific medications to treat an individual patient, they must weigh the potential risks against the desired benefit of each medication to minimize the chance of harm to the patient. As important members of the health care team, pharmacists work collaboratively with patients' other health care providers in all types of patient care settings ranging from community pharmacies to hospitals and long-term care facilities. Across these settings, pharmacists take specific actions that regularly contribute to improving patient safety. In addition to training on medications, pharmacist education and training includes assessing health status of patients, providing education and counseling, managing diseases, and using health care technologies. Pharmacists use this education and training to prevent medication errors, drug interactions, and other adverse medication events from reaching patients. With the expanding number and complexity of medications, pharmacists' roles and responsibilities have expanded broadly beyond medication distribution. Pharmacists are providing patient care in almost all health care settings to help people of all ages get the most from the medications that are prescribed to them. Examples of pharmacists' patient care services include providing health and wellness screenings, managing chronic diseases, assisting patients with medication management, administering immunizations, and working with hospitals and health systems to improve patient care and reduce the number of patients who are readmitted to the hospital following their hospital stay.

Background: Cardiovascular disease is one of the major concerns of health around the world.
Objective: To assess the feasibility and effect of a pharmacy-based cardiovascular screening in an urban referral community pharmacy in Iran.
Method: A cross sectional study was conducted in a referral community pharmacy. 287 subjects aged between 30-75 years without previously diagnosed cardiovascular disease and diabetes were screened. Measurement of all major cardiovascular risk factors, exercise habits, medical conditions and medications, and family history were performed by the investigator. Framingham risk score was calculated and high risk individuals were given a clinical summary sheet signed by a clinical pharmacist and were encouraged to follow up with their physician. Subjects were contacted one month after the recruitment and their adherence to the follow up recommendation were determined.
Result: Data from 287 participants were analyzed; 146 of the participants were referred due to at least one abnormal test: 26 individuals with cardiovascular disease risk greater than 20%, 32 with high systolic blood pressure, 22 high diastolic blood pressures, 50 high total cholesterol levels, 108 low HDL-C level, and 22 with abnormal blood glucose level. Approximately half of the individuals who received the follow up recommendation had made an appointment with their physician. Overall, 15.9% of the individuals had received medications and 15.9% received appropriate advice to modify their risk factors. Moreover, 7.5% were under work-up by the physician.
Conclusion: The screening program in community pharmacy has the potential to identify patients who might have elevated cardiovascular risk factors. However, the cost of such services might be a barrier to their widespread utilization. A plan to increase the adherence of patients for follow up recommendations is required.

Silva-Castro MM, Bermúdez-Tamayo C, García Gutiérrez JF, Jiménez Pernett J, Tuneu L, Azpilicueta I, y col. Recursos web utilizados por los farmacéuticos para realizar atención farmacéutica. Seguim Farmacoter 2004; 2(1): 19-23. 
ISSN: 1696-1137

In personalized medicine, the appropriate drugs for an individual patient are selected based on the patient’s medical history, diagnostic testing, and genetic information for the purpose of minimizing drug interactions (DIs), side effects, and adverse drug reactions (ADRs) and to obtain the maximum therapeutic benefit. The DI is one of the major problems of pharmacotherapy, which perhaps leads to adverse outcome or therapeutic failure if not properly addressed. In clinical practice, patient safety is likely to improve through the identification of frequently occurring DIs by pharmacist and notifying the other members of the health-care team. Recently, a software was introduced, which detects DIs with good precision; however, this software requires a constant update. Health-care professionals require adequate knowledge and skills on how to identify and avoid DIs to enable them complement the software assessment. Basically, DIs include drug–drug, drug–food, drug–herbal, and drug–disea...

In personalized medicine, the appropriate drugs for an individual patient are selected based on the patient’s medical history, diagnostic testing, and genetic information for the purpose of minimizing drug interactions (DIs), side effects, and adverse drug reactions (ADRs) and to obtain the maximum therapeutic benefit. The DI is one of the major problems of pharmacotherapy, which perhaps leads to adverse outcome or therapeutic failure if not properly addressed. In clinical practice, patient safety is likely to improve through the identification of frequently occurring DIs by pharmacist and notifying the other members of the health-care team. Recently, a software was introduced, which detects DIs with good precision; however, this software requires a constant update. Health-care professionals require adequate knowledge and skills on how to identify and avoid DIs to enable them complement the software assessment. Basically, DIs include drug–drug, drug–food, drug–herbal, and drug–disea...

A number of individuals in developing countries do not attend physicians for their illnesses, instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self medication is not always bad hence for the over the counter drugs it is beneficial. Most of the time drugs stored on unsafe place that may result in decrease in drug's efficacy. The objective of this paper is to assess self-medication and drug storage conditions on private pharmacy clients in Jimma town. A community based cross sectional prospective study had been conducted in Jimma town from June 28/2013_ July 14/2013 GC. The data had been collected by semistructure-questionnaire consisting questions on general demographic, socioeconomic as well as on perceived illness/ symptoms in the past one year and actions taken for it and administered to respondents of 405 systematically selected client. The collected data had been analyzed by using calculator.

||ABSTRACT In personalized medicine, the appropriate drugs for an individual patient are selected based on the patient's medical history, diagnostic testing, and genetic information for the purpose of minimizing drug interactions (DIs), side effects, and adverse drug reactions (ADRs) and to obtain the maximum therapeutic benefit. The DI is one of the major problems of pharmacotherapy, which perhaps leads to adverse outcome or therapeutic failure if not properly addressed. In clinical practice, patient safety is likely to improve through the identification of frequently occurring DIs by pharmacist and notifying the other members of the health-care team. Recently, a software was introduced, which detects DIs with good precision; however, this software requires a constant update. Health-care professionals require adequate knowledge and skills on how to identify and avoid DIs to enable them complement the software assessment. Basically, DIs include drug–drug, drug–food, drug–herbal, and drug–disease interactions. These possibilities can be identified from chemical properties, pharmacokinetics, and pharmacodynamics of the drug, patient medical history, concomitant disease, or organ failure. Focusing on DIs will help to reduce drug-related problems, advance the evidence-based medicine, and improve the level of patient satisfaction. Adequate knowledge of drug DIs will enable the health-care professionals to individualize the patient treatment in order to get maximum therapeutic benefit. This script is aimed at describing the various classes of DIs, their causes, and their implications in clinical practice and personalized medicine.

ABSTRACT
The purpose of this study was to find out if the pharmacists working in community pharmacy and outpatient pharmacy have undergone any formal education regarding drug information, and to describe the drug information resources available, utilization of Internet as drug information resource and whether the available resources are sufficient to answer the types of questions received from the patients. After a pilot study, self administered eleven-question survey, open and close-ended, was distributed by a personal visit to a total of 40 pharmacies located in Al Ain city, UAE. Only one pharmacist of each visited pharmacies was eligible to complete the survey if he/she was licensed and have at least one year of experience at the same site. About 40% of the surveyed pharmacists did not have drug information resources as a course or topic in their formal education. In the pharmacies, all had the “British National Formulary”, followed by the "Drug Information Handbook". Tertiary hospital outpatient pharmacy contained generally greater variety of drug information tertiary resources. About one third of the time spent surfing the internet was allocated for drug information. More than half of the surveyed pharmacists (55.6%) used the internet for at least 1 hour to obtain drug information. Drug safety in pregnancy and lactation was among the most frequently received questions (19.5%). The most difficult question the pharmacists received was related to the foreign drugs not available in UAE. There is a need to include a course "Drug Information Resources" in modern pharmacy program syllabi and to have online access to a reliable online database in the community pharmacy in order to allow the pharmacist to adequately provide accurate drug information.

The present study was mainly focused on investigating the influence of concentration and combination of HPMC K4M, Carbopol 934P and Chitosan on physical characterization and drug release behavior of carvedilol transdermal films prepared by the solvent evaporation technique. The physicochemical compatibility of the drug and the polymers was studied by differential scanning calorimetry and infrared spectroscopy. The results suggested no physicochemical incompatibility between the drug and the polymers. The prepared films were evaluated for physicochemical characteristics like weight variation, thickness, folding endurance, tensile strength, percentage moisture uptake, water vapor transmission rate, percentage flatness and in vitro permeation study. In vitro permeation studies were performed by using Franz diffusion cells. The drug release profiles of selected formulations were subjected to kinetic treatment using zero order, first order, Higuchi and korsmeyer's peppas kinetic models. The results followed Higuchi kinetics (r2 = 0.951−0.995) and the mechanism of release was diffusion mediated. Based on physicochemical and in vitro permeation studies, transdermal film prepared by combination of HPMC K4M and Chitosan with ratio 3:1 selected as optimized formulation shows the drug release more than 24 hours with good flexibility and stability at 250C. The developed transdermal film increases the efficacy of carvedilol for the treatment of hypertension.

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Background: Cardiovascular disease is one of the major concerns of health around the world. Objective: To assess the feasibility and effect of a pharmacy-based cardiovascular screening in an urban referral community pharmacy in Iran. Method: A cross sectional study was conducted in a referral community pharmacy. 287 subjects aged between 30-75 years without previously diagnosed cardiovascular disease and diabetes were screened. Measurement of all major cardiovascular risk factors, exercise habits, medical conditions and medications, and family history were performed by the investigator. Framingham risk score was calculated and high risk individuals were given a clinical summary sheet signed by a clinical pharmacist and were encouraged to follow up with their physician. Subjects were contacted one month after the recruitment and their adherence to the follow up recommendation were determined. Result: Data from 287 participants were analyzed; 146 of the participants were referred due ...