Pharmacy Practice

Inflammation is a normal protective response to tissue damage mediated by Cyclooxygenase-2 (COX-2) enzyme. Cyclooxygenase enzymes are responsible for the production of prostaglandins. Increasing incidence and impact of inflammatory diseases have encouraged the search for new pharmacological strategies to face them. Pomegranate (Punica granatum L.) has been traditionally used as an anti-inflammatory and antioxidant, thus giving scope for anti-inflammatory studies. The aim of the present investigation to determine the anti-inflammatory activity and inhibitory effect on COX-2 enzyme of the ethanol extract of pomegranate rind (EEPR). The animals used in this study were male white rats which were divided into six groups, dose 20 mg/kg BW, dose 40 mg/kg BW, dose 80 mg/kg BW, positive control, negative control, and normal control. Determining of anti-inflammatory activity was carried out by inducing the soles of the rats with carrageenan and then measuring the edema volume using a plethysmometer and COX-2 inhibition is determined spectrophotometrically in a Microplate Reader. The results showed that EEPR (20 mg/kg BW and 40 mg/kg BW, and 80 mg/kg BW) had an inhibitory effect against prostaglandin synthesis by COX-2 and anti-inflammatory activity. These findings suggest that EEPR possesses promising anti-inflammatory activity, which is possibly mediated through inhibition COX-2 enzymes.

This paper comes after 10 years of the previous "Pharmacy in Jordan" review that was published in American Journal of Health System Pharmacy in 2005. The aim of this new article is to highlight the most important achievements that have been made in different sectors of Pharmacy in the Hashemite Kingdom of Jordan. This leap involved pharmaceutical industry, education, clinical pharmacy practice, technology and pharmacy others. Technology is now used on a wider scale in governmental health sectors and HAKEEM program is a living example. Many pharmacies currently specially chain pharmacies, utilize various forms of pharmacy management systems with bar-code reading to control point of sales (PoS), inventory and customer relationships. Most chain pharmacies now also keep electronic patient medication records or use software to keep patient prescription data and check drug interactions. Furthermore, chain pharmacies have expanded from just one in 2001 to a total of 56 chains in 2017, with the first drive-through pharmacy in Jordan launched in the same year. The role of the pharmacist in Jordan has shifted gradually, with approximately 24 hospitals out of 106 total hospitals in the country having some established form of clinical pharmacy services.

Resumo: O objetivo deste estudo foi avaliar o resultado do Seguimento Farmacoterapêutico realizado por meio de um Programa de Atenção Farmacêutica em parceria entre o farmacêutico de uma Farmácia Comunitária Privada e equipe de saúde de uma Unidade Básica de Saúde no controle de comorbidades cardiovasculares e na redução do risco de eventos coronarianos em pacientes com critérios da SM. Um total de 50 pacientes com critérios para síndrome metabólica (SM) foi acompanhado mensalmente, por 14 meses por farmacêutico, com realização de exames bioquímicos, aferição da pressão arterial, medidas antropométricas e cálculo do Escore de Risco de Framingham para avaliação do risco absoluto de eventos coronarianos em 10 anos. Foram realizados 10 encontros individuais na farmácia comunitária privada e quatro encontros coletivos em espaço da UBS. Os Resultados Negativos associados a Medicamentos (RNM) foram identificados e resolvidos por meio de intervenções farmacêuticas. A adesão ao programa foi 89,3% e 80,2% dos 202 RNM manifestados foram resolvidos. Houve aumento do controle da pressão arterial, melhora dos níveis de HDL, triglicerídeos e da glicemia, sendo que 84% dos pacientes tiveram controle de um ou mais critérios para SM, segundo parâmetros da NCEP-ATPIII. Houve redução do risco de eventos coronarianos em 56% dos pacientes e não foi observado aumento do risco. A implantação de um Programa de AF e Seguimento Farmacoterapêutico com interação público-privado pode determinar resultados clínicos positivos, com melhor controle das comorbidades da SM e redução do risco de eventos coronarianos. Palavras Chaves: Síndrome Metabólica, Atenção Farmacêutica, Seguimento Farmacoterapêutico, Risco de Eventos Coronarianos. Abstract: Pharmacotherapeutic Follow-up Reduces Risk of Coronary Events in Patients with Criteria for Metabolic Syndrome: Model of a Pharmaceutical Care Public-Private Partnership. The purpose of this study was to evaluate the results effects of pharmacotherapeutic follow-up, performed through a pharmaceutical care public-private partnership with interactions between the pharmacist of a private community pharmacy (PCP) and the Basic Health Unit (BHU) multidisciplinary team on the control of cardiovascular comorbidities and reduction of the risk of coronary events in patients with metabolic syndrome (MS) criteria. A total of fifty MS positive patients were followed each month for 14 months, by a pharmacist. Each patient underwent biochemical tests, blood pressure measurement, and anthropometric measurements and we calculated the Framingham Risk Score for the absolute risk assessment of coronary events in 10 years. A total of 10 individual meetings were conducted at the pharmacy and four group meetings were conducted at the BHU. The negative outcomes associated with medication (NOM) were identified and resolved through pharmaceutical interventions. Most patients (89.3%) adhered to the program, and 80.2% of 202 NOM were resolved. There was an increase control of the following comorbidities: blood pressure, HDL, triglycerides and blood glucose. In 84% of patients with one or more MS criteria, according NCEP-ATPIII, were controlled. The risk of coronary events decreased in 56% of the patients and no patients had an observed increase in risk. The implementation of this pharmaceutical care public-private partnership led to positive clinical results, with reduced risk of coronary events and better control of MS comorbidities.