Abdullah Dayo

Optimization of HPLC method for determination of cefixime using 2-thiophenecarboxaldehyde as derivatizing reagent: A new approach

The determination of cefixime 1 has clinical and analytical importance due to its broad spectrum antimicrobial activity and stability. Cefixime is a significant member of orally active third generation cephalosporin and has excellent activity against many pathogens. It is for first time that we have developed a new HPLC–DAD method for analysis of imine derivative 3 of cefixime by using reflux method at 100 °C for 50 min without any buffer solution. 2 Thiophenecarboxaldehyde (2TCA) 2 was used first time as a derivatizing reagent for cefixime drug. Furthermore, separation of three components, i.e. drug (cefixime), reagent (2TCA) and derivative was carried out using kromasil 100 C-18 (15 mm × 0.46 mm, 5 μm) column with isocratic elution of methanol: 0.1% aqueous formic acid (70:30 v/v) with flow rate of 1 ml min−1 at retention time of 1.8, 2.4 and 3.3 min, respectively; while, total run time was 5 min. The developed method was repeatable with a relative standard deviation (RSD) of 0.81–1.88% for imine derivative. The limit of detection and quantification of imine derivative 3 were obtained within the range of 0.132–0.401 μg ml−1 and compared with cefixime drug as 0.30–0.90 μg ml−1, respectively. However, the formation of imine derivative 3 was confirmed by comparing peak height, retention time and spectral changes. The method is rapid, simple, very stable and accurate for the separation and determination of imine derivative 3 of cefixime 1.

Prescription writing error in general practice: A cross sectional study at tertiary care hospital in Hyderabad, Pakistan

Prescription is an instruction written by a medical practitioner to pharmacist which contains drug name, dose, frequency, directions for compounding, advices for drug consumption etc. Drug induced morbidity is an important problem in ambulatory care patients and its one of the major factor is prescription error. Therefore, the present study was performed to assess the current prescription writing trend for identifying frequent errors and proposing the ways by which these can be overcome. A cross sectional study was conducted by collecting 2120 prescriptions written in outpatient department (OPD) of tertiary care hospital. The prescribing errors were identified on the basis of WHO guidelines for prescription writing and current guidance published in British National Formulary. Most of the prescriptions evaluated did not follow the proper guidelines. Patients weight, prescribers contact, duration of therapy and drug generic name were missed in more than 90% of prescriptions. A significant number of prescriptions were also found to be illegibly written. Overall, prescription wring trend was worse and there is a need of training for proper prescription writing. Implementation of computerized order entry system and participation of pharmacists at all points of medication process may also substantially improve prescription writing trend.

Pharmacovigilance Studies of Antihypertensive Medications in Teaching Hospital of Hyderabad, Sindh

Objective: To assess the adverse drug reactions due to anti hypertensive therapy among hypertensive patients at teaching hospital of Hyderabad, Sindh, Pakistan. Methodology: The current study was performed in a teaching hospital of Hyderabad, Sindh, Pakistan. A cross sectional study was conceded in medicine and cardiac outpatient department during the period of study. A total of 1271 hypertensive patients were enrolled during the period of 2 years by purposive sampling procedure. A series of questions were asked by the hypertensive patients. The questionnaire contains the demographic details of the patients, prescribing trend and various ADRs found in patients due to antihypertensive therapy. The written consent was also taken from the health care professionals as well as patients. Results: Out of 1271 patients, 57.99% belong to male gender, 79.78% to urban areas, 69.16% enrolled from cardiac OPD, 32.33% were aged between 49-58 years of age, 21.40% had 1 parent positive history of hypertension and 44.22% had 3-5 years duration of hypertension. Maximum patients were on dual therapy i.e. 42.64% and the most common combination therapy was valsartan+amlodipine i.e. 11.99%. Moreover the most common combination therapy that caused maximum ADRs was telmisartan+hydrochlorothiazide i.e. 17.54%. Conclusion: The existing passive pharmacovigilance department should be active again under Drug regulatory authority of Pakistan. A council will create under the Drug regulatory authority of Pakistan that helps to communicate with international organizations such as Uppsala monitoring center under World Health Organization, Food and Drug Administration etc. Moreover council will also establish a system of ADRs reporting throughout the country and then data will share with all stake holders. Key words: Pharmacovigilance, Teaching hospital, Hypertension, Dual Therapy, Adverse Drug Reaction and Antihypertensive medications.

A retrospective study of NSAIDs containing medication orders for evaluating prescribing errors in outpatient clinical settings of a metropolitan city

Prescription is an order for medications issued by a physician, veterinarian, dentist or other properly licensed medical practitioner to pharmacist. Incorrect prescription writing habits may lead to substandard therapeutic goals and even can cause drug induced injuries. Non-steroidal anti-inflammatory (NSAIDs) drugs are used in various inflammatory diseases such as arthritis. The missed or wrong information regarding NSAIDs in prescription may lead to irrational drug use and can cause gastrointestinal, cardiovascular and other problems. The present study was carried out to evaluate the prescribing errors in NSAIDs containing prescriptions. We collected a total of 2712 prescriptions by randomly visiting the pharmacies located beside outpatient clinical settings in various towns of Karachi city, Pakistan. Among the omission errors, the absence of prescribers registration number (94.5%), prescribers qualification (93.7%), drugs generic name (86.5%), patients diagnosis (86%) and patients weight (83.90%) were the most frequent errors. Regarding the commission errors the error of writing an ambiguous order (77.7%) was the most common followed by the use of non-standard or abbreviated drug names (37.6%), wrong dose (26.9%) and wrong dosage form (23.2%). Overall a low compliance to the standards of prescription writing was observed which may cause serious or fatal NSAIDs induced injuries. Implementation of electronic prescribing systems, educational programs on prescription writing and proper reviewing of the orders by pharmacists may be valuable to reduce the errors.