Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4-85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug; spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.

A systematic observational study is performed in general population of age group 18-60 years to collect enough data on the irrational dispensing pattern and self medication of benzodiazepines. There were two separate specially designed Performa's, one for the OPD pharmacy or dispensary in different communities of Karachi and one for the general population of variable demographic status duly filled by 190 out of 200 OPD pharmacies approached, (n = 190 with response rate 95 %) and 478 out of 508 people approached (n = 478 with response rate 94.09 %) In this study 478 individual participated. Mean age of population was 43.62 ± 17 years. 44.6 % were male (n = 213) and 55.4 % were female (n = 265) the common Benzodiazepines reported to be used by study population are Alprazolam 54 %, Bromazepam 40 %, Clorazepate, Lorazepam and Azolam 2 % each. The three primary reasons reported lead to the use of benzodiazepines by general population are depression 64 %, sleep disturbance 19 % and pain 17 %. There were 68 people (29 %) confessed that they are using it without any prescription from GP. By the Performa filled by OPD community pharmacies findings are benzodiazepines are the 6 th largest selling drug class. Alprazolam and Bromezepam both are the top most selling benzodiazepines members 88.52 % followed by Lorazepam 6.39 %, Clorazepate 0.09 % and others 5.0 %. Among 190 pharmacies visited, around 79 pharmacies (41.57 %) reported to dispense benzodiazepines without prescription. Significant variable with respect to rate of use of benzodiazepines in the community were educational status, socio-economical background, occupation, marital status etc with p < 0.000 when Pearson chi-square test were applied.

Herbs have always been a preferred choice of treatment for people of the subcontinent and the Indo-Pak subcontinent has a long tradition of the use of herbs as medicines. In the given study ethanolic extract of Tribulus terrestris (EETT) has been screened for its anxiolytic potential in experimental mice using LDB, EPM and Head Dip models of anxiety. It showed an increase in the number of entries and time spent in the light compartment in LDM model. Further time spent in Open Arm has also been significantly increased with p<0.05 in comparison with a control group in EPM apparatus. Increase number of head dips are also suggestive of the possible anxiolytic potential of EETT.

Patient counseling is a critical component of dispensing process that provides information, advice and assistance to help patients using their medication properly. The objective of our study was to analyze whether patient counseling services are provided or not and how efficiently it is being conducted. For this purpose a questionnaire based cross sectional survey of pharmacists was done in different hospital set ups of the Karachi city with a sample size of 30. The results show that counseling services are provided by all the Hospitals in which survey was conducted, medication charts are used by 15 (50 %) samples while patient education program is not organized by 18 (60 %) samples. The results obtained from the survey conclude that patient counseling is conceptually present in all hospital setups but not done efficiently or in appropriate manner. Steps should be taken by the authorities, pharmacists and the patients to make counseling more effective.