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Objective: High concentrations of antituberculosis (anti-TB) drugs can be associated with many adverse drug reactions (ADRs). The objective of this study was to examine the plasma concentrations of rifampicin (RMP) and isoniazid (INH) in patients with and without ADRs. Methods: Concentration monitoring data of patients treated with anti-TB drugs were retrospectively analyzed from 2009 to 2011. RMP and INH plasma concentrations were measured 2 and 3 h after drug administration respectively using high-performance liquid chromatography. Results: A total of 54 out of 120 patients have experienced ADRs to anti-TB drugs. The median concentrations [interquartile range (IQR)] obtained in patients with and without ADRs were 6.7 mg/l (3.7–9.9) and 5.6 mg/l (2.9–8.6) (p = 0.56) for RMP and 4.3 mg/l (2.3–5.3) and 3.1 mg/l (1.7–4.8) (p = 0.04) for INH, respectively. Related median doses (IQR) were 8.7 mg/kg (8.0–10.0) and 8.6 mg/kg (6.5–9.9) (p = 0.42) for RMP and 4.8 mg/kg (4.3–5.0) and 4.0 mg/kg (2.8–5) (p < 0.01) for INH, respectively. Concentrations above the expected range in patients with and without ADRs were not reached for RMP, but were 76% and 65% for INH, respectively. Correlation between concentrations and doses has not been established for RMP or INH. In addition, high INH concentrations showed no association with sex, age, liver injury or renal or diabetes. Conclusions: High INH concentrations were common in patients with and without ADRs whereas RMP concentrations were low or within the normal range in most patients. Further studies are required to assess the association between high INH concentrations and the occurrence of ADRs.

The objective of this work is to demonstrate the interest of integration of pharmacovigilance in Moroccan Tuberculosis Control Program (MTCP). The integration of pharmacovigilance in MTCP was conducted in October 2012with the Global Fund support. We compared the reports notified before and after this integration (period 1: January 2010–October2012; period 2: October 2012–December 2013). The detection of signals was based on the Information Component available inVigiMine. We used the SPSS version 10.0 and Med Calc version 7.3 for data analysis. The average number of spontaneous reports increased from 3.6 to 37.4 cases/month (P< 10-3). The average age was 40.7 ± 17.5 years; the sex ratio was 0.8. Hepatic reactions (32.7%) predominated during the first period, while skin reactions (24.1%) were in the second period (P = 10-4), and40.9% of cases in the first period were serious against 15.8% in second period (P = 0.003). Nine signals were generated (hepaticenzyme increase, cholestasis, jaundice, arthralgia, acne, lower limb edema, pruritus, skin rashes, and vomiting). The integration of pharmacovigilance in Moroccan Tuberculosis Control Program improved the management of ADRs and detected new signals of antituberculosis drugs.

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Dans notre pays, le recours aux recettes de médecine traditionnelle et aux produits cosmétiques artisanaux est très fréquent en raison du taux élevé d'analphabétisme, du faible pouvoir d'achat et du grand nombre d'herboristes. Le camphre est un produit peu coûteux, facilement accessible et omniprésent dans presque toutes les maisons, le rendant potentiellement toxique en cas de mauvaise utilisation, en particulier chez les enfants. Nous rapportons ici l'histoire de 2 cas d'intoxication consécutifs à une recette de beauté à base de camphre en poudre. L'anamnèse donne des informations sur un empoisonnement par une poudre synthétique à base de camphre importé de Chine chez 2 enfants. Patiente 1: fille âgée de 2 mois, sans antécédents, admise aux urgences pédiatriques dans un état de pleurs incessants avec refus de manger. L'examen clinique est sans caractéristique particulière. Le test biologique standard était normal. Le nourrisson était sous surveillance neurologique, digestive et cutanée. Patiente 2: jeune fille de 6 ans admise à la suite d'une crise atonique avec syncope et mousse, suivie d'une douleur abdominale accompagnée d'une douleur abdominale accompagnée de vomissements alimentaires consécutifs à l'ingestion de lait. L'évolution était favorable après 48 heures de prise en charge symptomatique. L'entretien avec les mères a révélé qu'il s'agissait de deux voisins qui avaient reçu une recette traditionnelle pour le soin des cheveux d'un troisième voisin, après quoi ils avaient mélangé du camphre en poudre avec de l'huile d'olive, puis l'avaient appliquée pendant 1 heure sur les cheveux de leurs enfants, provoquant ainsi l'apparition de ces signes.

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national health authorities and several laws govern this notion since the beginning of the 2000s. In our hospital, 34 patient education programmes exist but only five integrate a pharmacist into their team. Purpose The main objective of this qualitative research is to understand why pharmacists are so few in patient education teams by studying the perception of other health professionals on the work of pharmacists. Then, we could propose several solutions to make easier the integration of pharmacists into these multidisciplinary healthcare teams. Material and methods Semi-structured interviews were planned with the healthcare professionals involved in the educational teams where there are no pharmacists. After a word-by-word anonymous transcription, verbatims were coded in the software Nvivo 12 (QSR International; Melbourne, Australia) by two pharmacists trained in qualitative research in order to minimise the subjectivity of this work. Results Fourteen healthcare professionals had been interviewed: six nurses (among whom three executive nurses), four physicians, two psychologists, one dentist and one clinical research associate. These persons represented 11 of the 34 educational programmes. The results showed that the pharmacist was not considered as a part of the healthcare team. Moreover, the pharmacy profession was not well known by others healthcare professionals, which was why patient education was not known as a pharmaceutical mission. The added-value of the pharmacist was contentious (pharmaceutical expertise was recognized but pharmacists had a lack of knowledge of the reallife experience of the disease according to the interviewed). Respondents also mentioned organisational factors such as lack of time and funds. Conclusion All these elements of the response could be used in the aim to make it easier for pharmacists' integration into the educational teams and enhance their multidisciplinary nature. This work allowed reflection with the educational teams, which is essential to the integration. In the team interviewed, there is still no clinical pharmacist and we hope that development of clinical pharmacy could change these representations. Furthermore, it would be interesting to compare our results with the perceptions of European or international health professionals on the role of pharmacists in educational teams.