Background: Hormonal contraceptive pills have evolved as a common form of contraception worldwide. Pharmacists play a vital role in providing safe and effective access to these medicines. In many developing countries such as the United Arab Emirates (UAE), these medicines are available to the general public without the presentation of a prescription which requires the pharmacist to shoulder responsibility by assessing and educating patients to assure their appropriate use. Objectives: To evaluate community pharmacists’ current practice of dispensing and counseling on hormonal contraceptives Methods: Simulated patient methodology was used in this study. A single simulated patient visited community pharmacies requesting an oral contraceptive as per a preplanned scenario. Information from the visits were recorded on a data collection form including: pharmacist assessing patient eligibility to take hormonal contraceptives, selecting the appropriate oral contraceptive, providing complete counseling on how to use the pill, adherence, missed dose handlings and side effects of the medication. The Pharmacist was prompted by the simulated patient to provide the information if they did not provide spontaneous counseling. The quality of pharmacists’ counseling was rated and consequently coded as complete, incomplete or poor. Results: A total of 201 community pharmacies were visited. More than 92% of the pharmacists did not ask the simulated patient any question to assess their eligibility to use contraceptives. Twenty three pharmacists (11.4%) selected the proper product. One hundred seventeen (58.2%) of the pharmacists provided spontaneous counseling on how to use the pill, 17 of them had their counsel rated as complete, but none of the pharmacists provided spontaneous counseling regarding adherence or side effects of the medications. On prompting, 10 pharmacists (12%) provided complete counseling regarding how to use oral contraceptives, 14 pharmacists (7.0%) provided complete counseling on adherence and missing dose handling and five pharmacists (2.5%) provided complete counseling about expected side effects. Conclusions: Pharmacists’ practice regarding hormonal contraceptive dispensing and counseling was suboptimal in this study. Areas needing intervention were related to pharmacist assessment of eligibility for oral contraceptive use, choice of optimal oral contraceptive for patient-specific co-morbidities and provision of adequate counseling regarding proper use, adherence and missed dose handlings.

Relatively, a large percentage of world population is affected by diabetes mellitus, out of which approximately 5-10% with type 1 diabetes while the remaining 90% with type 2. Insulin administration is essential for type 1 patients while it is required at later stage by the patients of type 2. Current insulin delivery systems are available as transdermal injections which may be considered as invasive. Several non-invasive approaches for insulin delivery are being pursued by pharmaceutical companies to reduce the pain, and hypoglycemic incidences associated with injections in order to improve patient compliance. While any new insulin delivery system requires health authorities' approval, to provide long term safety profile and insuring patients' acceptance. The inhalation delivery system Exubera® has already become clinically available in the United States and Europe for patients with diabetes as non-invasive delivery system.

Hydroxypropyl methylcellulose (HPMC) is employed for a wide variety of pharmaceutical and food preparations. Its applications as viscolizing agent (thickening agent), coating polymer, bioadhesive, in solid dispersion to enhance solubility, binder in the process of granulation and in modified release formulations have been well documented. One other notable use is in the production of capsule shells, replacing the animal derived gelatin in conventional two-piece capsules. The aim of this review is to systemically survey published literature on the HPMC use in capsule shells and resolve questions regarding their suitability as a replacement for hard gelatin capsules. Future refinements in the production and filling of HPMC capsule shells and improvement in their in vivo/in vitro dissolution would ensure their superiority over hard gelatin capsules.

Conventional formulations of antiviral drug acyclovir have various limitations such as low bioavailability. The current study was aimed at developing polymeric matrices for the controlled delivery of acyclovir using sericin as polymer and acrylic acid (AA) as a monomer. The free radical polymerization technique was used for hydrogel formulation. Briefly, sericin was chemically cross-linked with acrylic acid. N′-N′-methylene bis-acrylamide (MBA) and ammonium persulfate (APS) were used as cross-linker and initiator, respectively. FTIR spectra showed that acyclovir was successfully loaded into sericin hydrogel. SEM micrographs revealed that the outer surface was solid-like and smooth. According to DSC thermograms, the developed polymeric network was thermally stable. Amorphous nature of acyclovir was observed in XRD. The pH of medium and reactants’ concentration affected swelling dynamics and acyclovir release pattern. In addition, drug release occurred through a diffusion-controlled process. Sericin hydrogel suspension was well tolerable up to 3800 mg/kg of rabbits' body weight. Haematology and serum chemistry results were well within the range signifying normal liver and kidney functions. Similarly, histopathology slides of the rabbit’s vital organs were also in normal condition without causing any histopathological change. It was concluded from the findings that sericin-co-AA polymeric matrices are ideal for the pH-dependent delivery of acyclovir.

To evaluate the pharmacist's assessment of patient eligibility for safe use of isotretinoin and the quality of pharmacist's counseling. Patients and Methods: A covert simulated patient (SP) methodology was used in which a trained female researcher, who was 25 years old, played the patient's role through this cross-sectional study by visiting community pharmacies and requesting isotretinoin capsules through a controlled prescription. A data form was used to collect the information following each pharmacy visit by asking about medical/family history and providing comprehensive counseling about the most common adverse effects, proper use instructions, and the importance of adherence to medication. The pharmacists, who did not initiate counseling, were prompted by the SP. Results: The pharmacists in 400 pharmacies who agreed to participate were visited by the SP. Only 7 (2%) pharmacists provided a complete assessment of patient eligibility for using isotretinoin with comprehensive counseling. Most of the pharmacists (84%) provided incomplete assessment as indicated by the overall score. Only 11 (3%) pharmacists asked the six crucial questions for the assessment of patient eligibility. On prompting, only 6 (2%) pharmacists provided complete counseling about the expected adverse effects. The most frequently provided adverse effect was dry skin, specifically dry lips (71.8%). A minority of 108 (27%) pharmacists provided education about the importance of using contraception during isotretinoin therapy. A complete level of counseling was provided by 125 (31.3%) pharmacists regarding the lab tests that the SP needs to undergo during therapy. Female pharmacists were more likely to provide counseling about the pregnancy test (mean=134, p=0.001). Conclusion: Suboptimal level of the patient's assessment was revealed with poor educational counseling by the community pharmacists. New strategies are needed to improve pharmaceutical care services in the UAE.

Self-emulsifying drug delivery systems (SEDDS) are mixtures of oils and surfactants, ideally isotropic, and sometimes containing cosolvents, which emulsify spontaneously to produce fine oil-in-water emulsions when introduced into aqueous phase under gentle agitation.1) Recently, SEDDS have been formulated using medium chain triglyceride oils and nonionic surfactants, the latter being less toxic. Upon peroral administration, these systems form fine emulsions (or microemulsions) in gastro-intestinal tract (GIT) with mild agitation provided by gastric mobility.2,3) Potential advantages of these systems include enhanced oral bioavailability enabling reduction in dose, more consistent temporal profiles of drug absorption, selective targeting of drug(s) toward specific absorption window in GIT, and protection of drug(s) from the hostile environment in gut. [4][5][6] The process of self-emulsification proceeds through formation of liquid crystals (LC) and gel phases, the properties of which significantly affect the formation of droplets and interface available for partitioning of drug.5-9) Many workers claim various rational applications of SEDDS for delivering and targeting lipophilic drugs (e.g., WIN 54954, 1) N-4472, 10) idebenone, 11) coenzyme Q10, 12) vitamin E, 13) halofantrine, 14) and cyclosporin A. 15) However, very few reports are available of SEDDS of water insoluble or poorly soluble hydrophobic compounds. Therefore the concept of using griseofulvin in SEDDS was considered for the present study, where the drug is present in solution form.Griseofulvin is an antifungal agent first isolated from a Penicillium spp. in 1939. It is effective after oral ingestion and reaches the skin and hair. It is deposited primarily in keratin precursor cells. Ingestion with a heavy meal and reduction in particle size enhances the absorption of griseofulvin.16) Griseofulvin systematic (IUPAC) name is (2S,6ЈR)-7-chloro-2Ј,4,6-trimethoxy-6Ј-methyl-3H,4ЈH-spiro[1-benzofuran-2,1Ј-cyclohex[2]ene]-3,4Ј-dione (Fig. 1), and its formula is C 17 H 17 ClO 6 with molecular weight 352.766 g/mol. The compound is insoluble in water (8.64 mg/l). It has a logP/hydrophobicity 2.15 (partition system octanol/water), and its pK a /isoelectric point is not available.17) Griseofulvin inhibits fungal mitosis by disrupting the mitotic spindle through interaction with polymerized microtubules. 18)Griseofulvin is administered orally. Its microcrystalline and ultramicrocrystalline forms are available as tablets. The microcrystalline form also comes in a pediatric suspension form. The typical dose of microcrystalline form is 500-1000 mg/d. Ultramicrocrystalline form is administered at doses of 330-990 mg/d. 19) Since the bioavailability of poorly water-soluble drugs can be influenced by interactions with food or by the physicochemical conditions in the gastrointestinal (GI) tract, 20) oral preparation of griseofulvin is commonly prescribed to be administered according to a fixed dosing schedule. The oral bioavailability of griseofulvin is highly varia...

A BSTRACT Background: Adherence to antiepileptic drugs (AEDs) is an integral component of epilepsy management. There are no previous data in the United Arab Emirates (UAE). Objectives: The aim of this study was to assess the prevalence of AED adherence among patients attending the Neuro Spinal Hospital in UAE and to identify the predictors of nonadherence. Materials and Methods: A cross-sectional study was conducted between April 2018 and May 2019, and included consecutive patients with epileptic who were receiving AEDs for at least 6 months. A validated interviewer-administered questionnaire was used. Adherence was assessed by four-item Morisky’s Medication Adherence Scale with a score between 0 and 4. Patients were considered adherent or nonadherent for a score of zero, or 1 and more, respectively. Chi-square test, binary, and multiple logistic regression analysis were used. Results: The study included 315 respondents, 70.8% ( n = 223) were adherent, the rest were nonadherent. The most common factor affecting adherence was forgetfulness. Lower education level and having a seizure within the last 6 months were significant risk of nonadherence (odds ratio [OR] 95% confidence interval [CI] = 2.6 (1.2–5.8) and 2.5 (1.3–5.2), respectively), whereas levetiracetam intake reduces the risk of nonadherence (OR: 0.5 [0.2–0.9]). Conclusions: The prevalence of AED adherence was 70.8%. Education level and having a seizure in the last 6 months were significant predictors of nonadherence, whereas levetiracetam intake reduces the risk of nonadherence.

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