International Journal of Hospital Pharmacy

  • PASS Protocol Fever as basis of COVID-19 testing in Patient- A Union Therapy Initiative

    Fever is the sole symptomatic measurement modality for Covid-19 screening which could be implemented easily all over the globe in with optimal utilization of resources. Being easy economical and easily reproducible, this has a potential to be a gold standard as well as simplicity of the procedure could help in its monitoring by patients itself and would operate an important element of patient involvement in treatment and would help in adherence in countries where health care staff are short and patient burden is high. This protocol will extend helping hands to health care worker and will involve patient participation in the treatment also.

  • Guidelines for Safe and Effective Use of Hydroxychloroquine in COVID-19 Patients

    The emergent need to treat COVID-19 patient must be tempered with safe use of drugs. The guideline set forth provides parameters for dosing and monitoring hydroxychloroquine in this population, reducing the occurrence of adverse effects and improving overall pharmacotherapy.

  • RETRACING RATIONALITY FOR COVID -19 – A UNION THERAPY INITIATIVE

    Rationality is not a phenomena restricted to drugs It is also included in behavioral, psychological mythological spiritual and religious elements. Every aspect of health as per WHO health definition affects the treatment process of illness to restore health. This review is based on rationality as per the union therapy concept/ Sayojyachikitsa which aims to integrate various aspects of rationality and aims to integrate supernatural mythological and scientific aspects of rationality and devised 15 R to make treatment comprehensively holistic. This would make therapy accessible acceptable on global scale. This would help to use drugs in COVID -19 threat where in addition to clinical elements behavioral, psychological mythological spiritual and religious elements of rational drug use can play a vital role.

  • PHARMACEUTICAL PROFESSIONAL PERFORMANCE IN PRIMARY HEALTH CARE

    Introduction: The pharmacist’s role in pharmaceutical care occurs especially in two axes: medication management and pharmaceutical care. Direct patient care is a challenge for the Brazilian health system, as this context provokes the construction of a new professional identity of the pharmacist: the clinic. Objective: To analyze a current panorama of the role of pharmaceutical professionals in primary health care. Methodology: This was a descriptive and exploratory literature review study with a qualitative approach. The descriptors “primary care”, “pharmacist” and “pharmaceutical care” were used, searched in an integrated way in the Scielo and Medline database. Results: The pharmacist still has a relevant role in management, but increasingly the system encourages the pharmacist to a more inclusive approach to patient care. There is consensus among the authors that the low number of pharmacists in primary care, coupled with the lack of perception of these professionals as part of the team and the lack of clarity about their attributions, contribute to the lack of recognition of this professional in the field of clinical practice. Conclusion: The incorporation of pharmaceutical clinical services has been shown to be an important strategy for resignification of the pharmacist in primary care. Actions involving clinical services need to be developed more frequently, so that the patient care bias is as explicit as the bureaucratic bias of pharmaceutical care.

  • Nimesulide-induced Fixed Drug Eruption

    Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. Nimesulide is a nonsteroidal anti-inflammatory agent with antipyretic and analgesic properties. It is being commonly prescribed in India.[1] Some of the side effects reported with its use are Pruritus, urticaria, purpura, maculopapular rash and localized toxic pustuloderma.[2],[3] Due to severe hepatotoxicity and hemolytic anemia associated with its use, Nimesulide is likely to be withdrawn from the market in many countries. Case report: The authors report a case of a patient with a history of antihistamine hypersensitivity that developed a bullous form of pigmented fixed drug eruption after Nimesulide. Patch tests performed on residual skin lesion were positive to Nimesulide, confirming that this was the culprit drug.

  • A Comprehensive Review of Clinical Pharmacists in Chronic Care Management

    Pharmacy practice has changed substantially in recent years. The professionals have the opportunity to contribute directly to patient care in order to reduce morbimortality related to medication use, promoting health and preventing diseases. Healthcare organizations worldwide are under substantial pressure from increasing patient demand. Unfortunately, a cure is not always possible particularly in this era of chronic diseases, and the role of physicians has become limited to controlling and palliating symptoms. The increasing population of patients with long-term conditions are associated with high levels of morbidity, healthcare costs and GP workloads. Clinical pharmacy took over an aspect of medical care that had been partially abandoned by physicians. Overburdened by patient loads and the explosion of new drugs, physicians turned to pharmacists more and more for drug information, especially within institutional settings. Once relegated to counting and pouring, pharmacists headed institutional reviews of drug utilization and served as consultants to all types of health-care facilities. In addition, when clinical pharmacists are active members of the care team, they enhance efficiency by: Providing critical input on medication use and dosing. Working with patients to solve problems with their medications and improve adherence.

  • Union Therapy- a Weapon Against Covid 19

    Illness and diseases has inflicted humans since ancient times through the course of development1.They emerged in Africa and initially were hunters and gatherers who learned many things from nature in terms of food shelter medicine and living. The nomadic life led to higher mortalities to them hence as a fact they started worshiping the forces of nature like sun water etc.2-4. With advancement of time and through wisdom acquired from the observations and knowledge through peer’s ancestors they stared farming and as a fact started to live in settled communities near river banks or water source. The role of their ancestors in shaping their customs and beliefs led to allot them the space of deities or as a connection link between deities. This settlement led the foundation of religions and development of civilizations. The civilizations holds their customs and beliefs which were centered over the idea of a supreme deity or supernatural power which governs all and prayers were offered to them for solutions of issues which were regarded as wrath of the God. Even sacrifices included with norms were also conducted in different cultures. In some instances body organ images were dedicated to Gods for treatment. and different deities were worship for safeguarding health. Traditional knowledge of medicines in different cultures also witnessed a transition from oral transmission to documented texts to development and integration with modern science. During course of time there has been many instances of integration which correlates with similarities irrespective of their individual inherent uniqueness in the various medical systems followed like links between Ayurveda and Sidhha, Ayurveda and TCM, TCM and Korean medicine, Buddhist medicine and Ayurveda Unani and other contemporary medicines were found. 5-10. But still in spite of similarities they are being practiced as separate entities as a result many diseases are…

  • Healthcare professionals’ awareness towards drug-drug interaction in Ayder comprehensive specialized hospital Mekelle, Ethiopia

    Background: Healthcare professionals are the most responsible body to identify potential interaction of drugs that are prescribed as well as those that the patient may be self-administering. However, awareness of healthcare professionals towards drug-drug interaction is poor. So to improve patient medication safety, it is important to assess healthcare professionals’ knowledge pertaining to drug-drug interactions and common drug-drug interactions information sources. Method: Cross-sectional study design was employed. Self-administered questionnaire was prepared to assess healthcare professionals’ knowledge of drug-drug interactions and usual sources of drug-drug interaction information. Participants were asked to classify 10 drug pairs as ‘contraindicated’, ‘can be used with monitoring’, ‘no interaction’ and ‘not sure’. Study was conducted from November 2017 to June 2018. Participants were selected using simple random sampling method. Data were analyzed using statistical software, SPSS for windows version 20. The relationship between knowledge and independent variables (age, sex, profession, work experience, training, familiarity with standard treatment guideline perception and source of information) was assessed using binary logistic regression analysis (Crude and adjusted Odds ratio, 95% confidence interval). Result: The study was done by enrolling 293 healthcare professionals among whom 46 were Physician, 31 Pharmacist, and 216 Nurses. Over all, healthcare professionals in Ayder Comprehensive Specialized Hospital had low score (24.29%) knowledge of drug-drug interactions. However, among the healthcare professionals pharmacists had good drug-drug interactions knowledge than physicians and nurses with an average score of 32.87%, 21.06% and 18.96% respectively. Drug reference books were the most cited drug-drug interaction information source used by 97 (33.10%) participants. Familiarity to the standard treatment guideline, profession and drug-drug interaction information sources were found to be associated with healthcare professionals’ knowledge of drug-drug interactions (p value

  • An observation cross sectional study to assess the prevalence of micro vascular complications in diabetes

    Diabetes mellitus is the commonest metabolic disorder and has a high prevalence in India. The prognosis of the diabetic patients largely depends on the complications seen in the natural course of illness. It was decided to undertake observational study to record various complications and the influence of various risk factors.(1) Diabetes mellitus is a long term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.(2) Diabetes is a syndrome characterised by chronic hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiencies in insulin secretion and/or insulin action(3). Complications of diabetes The longer duration of diabetes the less controlled of blood sugar levels leads to development of diabetic complications which are divided into microvascular ( damage to small blood vessel) and macrovascular (damage to large blood veseels). • Micro vascular complications: These are Long term complications that affect retina, kidney and nervous system(3). Permanent disability is a common outcome of diabetes, with late complications of diabetes being major determinants for disability. Diabetic eye disease particularly retinopathy, has become a major cause of blindness throughout the world. • Macro vascular complications: Type 2 diabetes can also affect the large blood vessels, causing plaque to eventually build up and potentially leading to a heart attack, stroke or vessel blockage in the legs (peripheral vascular disease) Diabetic foot also occur with higher frequency in diabetes(4,5).

  • Case Study of Gabapentin Induced Exfoliate Dermatitis

    OBJECTIVE : To report a case of possible Gabapentin-induced Exfoliate Dermatitis CASE SUMMARY : A 62 old male patient with the chief complaints of rash since 10 days . He was on treatment with Gabapentin and Pregabalin for paraesthesias by neurosurgeon from last month. Developed rash all over the body since 10 days. Past history includes similar rashes due to Diclofenac. No history of Psoriasis/eczema/no history of weight loss/cough/blood in stools. On examination patient has generalised scaling over background of erythema all over the body, exfoliation with rise of temperature. This presentation is consistent with the features of Exfoliative Dermatitis. Resolution of the clinical manifestations was observed after discontinuation of the drug; all other drugs, infections, or immunologic disorders that could have caused this syndrome were carefully excluded. An objective causality assessment revealed that exfoliative dermatitis was possibly associated with the use of Gabapentin. CONCLUSIONS: Although Gabapentin administration seems to be the underlying cause of the Exfoliative Dermatitis observed in our patient, establishment of a definite causal relationship requires additional cases and supportive data.