Background There is a risk of adverse neurodevelopmental outcomes in offspring from exposure to antidepressants during pregnancy. Objective This study was performed to systematically review the available evidence regarding the impact of in utero exposure to antidepressants on motor and intellectual disability outcomes in children. Patients and Methods A systematic literature search for published observational studies examining the effects of antidepressants on motor development or intellectual disabilities in children was conducted using the Cochrane Central Register of Controlled Trials, PubMed/Medline, and Google Scholar. Results A total of 14 studies were included in this review. Studies have reported conflicting effects on motor development in infants with maternal exposure to antidepressants. Furthermore, not all of the studies included that assessed intellectual disabilities in infants found an association between maternal exposure to antidepressants and intellectual disabilities. However, methodological flaws existed in the studies, such as the use of scales with inadequate reliability or validity, a lack of statistical power, or confounding by indication or disease severity. Conclusion The available literature provides inconclusive evidence on the relationship between in utero exposure to antidepressants and adverse effects on motor development outcomes or neurocognitive skills. Further observational studies with robust methodologies are needed to comprehensively evaluate the potential risks of prescribing antidepressants during pregnancy.

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The lack of inclusion of pregnant women in clinical trials evaluating the effectiveness of medicines to treat COVID-19 has made it difficult to establish evidence-based treatment guidelines for pregnant women. Our aim was to provide a review of the evolution and updates of the national guidelines on medicines used in pregnant women with COVID-19 published by the obstetrician and gynecologists’ societies in thirteen countries in 2020–2022. Based on the results of the RECOVERY (Randomized Evaluation of COVID-19 Therapy) trial, the national societies successively recommended against prescribing hydroxychloroquine, lopinavir–ritonavir and azithromycin. Guidelines for remdesivir differed completely between countries, from compassionate or conditional use to recommendation against. Nirmatrelvir–ritonavir was authorized in Australia and the UK only in research settings and was no longer recommended in the UK at the end of 2022. After initial reluctance to use corticosteroids, the results of the RECOVERY trial have enabled the recommendation of dexamethasone in case of severe COVID-19 since mid-2020. Some societies recommended prescribing tocilizumab to pregnant patients with hypoxia and systemic inflammation from June 2021. Anti-SARS-CoV-2 monoclonal antibodies were authorized at the end of 2021 with conditional use in some countries, and then no longer recommended in Belgium and the USA at the end of 2022. The gradual convergence of the recommendations, although delayed compared to the general population, highlights the importance of the inclusion of pregnant women in clinical trials and of international collaboration to improve the pharmacological treatment of pregnant women with COVID-19.

ObjectivesTo evaluate implementation of safety standards of compounded sterile preparations in different hospitals.MethodsThis cross-sectional study included 124 hospitals from 19 countries. A survey was developed based on the guidelines and safety practices of the Institute for Safe Medication Practices (ISMP) for sterile preparations compounding, and was sent to the members of the Intravenous and Parenteral Nutrition experts’ network (IV PN experts’ network) in the Gulf region and beyond using SurveyMonkey software.Results124 pharmacists were invited to participate in this study. Only 39 (31.5%) pharmacists from seven countries responded: 16 (41%) of the participants were pharmacy supervisors, and 23 (59%) had >10 years of work experience. However, a majority, 27 (69%), of the respondents were from Saudi Arabia. Written policies and procedures for sterile preparations compounding were available in 37 (95%) hospitals. The concentrated electrolytes were removed from all patient care areas in 28 (72%) hospitals, and 30 (77%) hospitals clearly labelled those as high-alert medications. The use of advanced technologies, such as bar code verification or IV robotics, for compounding sterile preparations were not implemented in 27 (69%) hospitals.ConclusionsMinimum standards and best practice recommendations to ensure safety of sterile preparation compounding were implemented in many hospitals of different countries. However, advanced technologies were not implemented by the majority of the hospitals.

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Introduction: There is a general perception of the safety of use for herbal medicines. Moreover, limited studies addressed herbal-drug interactions (HDI). The Saudi Food and Drug Authority (SFDA) established Herbal-Drug Interaction project to detect and assess HDIs to ensure safety. The aim is to detect safety signals and assess them based on available evidence. Methods: First, a number of SFDA-registered herbal products (n=30) were selected and prioritized based on commonly used herbs. Second, reported HDIs were retrieved from the World Health Organization (WHO) global database of individual case safety reports (VigiBase), AdisInsight® and Natural Medicines database. We excluded non-registered drugs by SFDA and labeled interactions in the product information of SFDA, the U.S. Food and Drug Administration (FDA), and European medicines agency (EMA). Finally, a comprehensive evaluation of potential HDIs using several evidence sources; literature, global cases, local cases and other relevant documents. The Drug Interaction Probability Scale (DIPS) scale used to assess the probability of a causal relationship between interacting herb-drug and the event. Results: The search yielded 566 potential signals, and 41 had published evidence and referred for assessment. The assessment results using DIPS were; 22 possible (53.6 %), 7 probable (17%), and 12 doubtful (29.2%) interactions. Recommendation was to include probable HDIs in the product information, including Turmeric-Tacrolimus, Etoposide-Echinacea, Ginkgo Biloba-Ibuprofen, Green Tea-Warfarin, and Licorice-Thiazides interactions. Conclusion: The HDI project assessed in the screening and identification of potential herbal-drug interactions. The action plan of this project can be used in post-marketing activities to identify potential drug interactions.