Self-Medication Perceptions and Practice of Medical and Pharmacy Students in Serbia.

BACKGROUND: Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. METHODS: This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. RESULTS: The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. CONCLUSION: Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.

Pharmacoeconomic Analysis of the Different Therapeutic Approaches in Control of Bovine Mastitis: Phytotherapy and Antimicrobial Treatment.

Mastitis in dairy cows is responsible for major economic losses on dairy farms worldwide as the most expensive and prevalent disease in dairy cattle. In spite of the fact that antibiotic therapy still remains the main treatment strategy for bovine mastitis, concerns about the shortcomings of this treatment approach are continuously raised. Hence, research on alternative treatments with increased effectiveness and reduced costs is needed. Therefore, we conducted a pharmacoeconomic analysis of conventional antibiotic vs. a proposed Phyto-Bomat treatment based on essential oils in bovine mastitis therapy. Treatments were compared from the farmer's perspective in the domain of costs (expressed in total, direct and indirect, cost differences) and effectiveness (expressed in daily milk yield differences). Economic calculations were based on data from a dairy farm in Serbia. The average cost of conventional antibiotic treatment was estimated at EUR 80.32 consisting of therapy costs, veterinary services and milk rejection costs at EUR 16.54, EUR 17.68 and EUR 46.10, respectively. The average cost of Phyto-Bomat treatment was estimated at EUR 76.34 with therapy costs of EUR 34.34, veterinary costs of EUR 32.00 and rejection of milk costs of only EUR 10.00. Therefore, Phyto-Bomat results in cost savings approximating EUR 4 per each mastitis episode with the highest cost reductions obtained in milk rejection costs. This estimation of Phyto-Bomat's economic benefits could be used as a starting point for the inclusion of this formulation as an alternative treatment approach with a focus on subclinical mastitis since it contributes to most of the financial losses.

Self-medication with antibiotics in Serbian households: a case for action?

Background Irregular antibiotic use, including self-medication contributes to the development of antibiotic resistance. One method of accessing antibiotic use in the community is through obtaining an in house inventory of drugs. Objective The aim of this study was to investigate the extent of storage and self-medication with antibiotics agents in households in Novi Sad, Serbia. Setting Households in Novi Sad. Method The study was performed during a 4-month period (October 2015-January 2016) using a sample of 112 households in Novi Sad, Serbia. Two trained interviewers performed the survey by visiting each household. The study consisted of making an inventory of all drugs in household and a semi-structured interview about drug use practices and perceptions. Main outcome measure Number of antibiotics obtained without prescription. Results Out of 112 surveyed households, antibiotics were encountered in 55 (49.1%). Antibiotics constituted 11.98% (92/768) of total number of drug items in households. Out of all antibiotics in households, 41 (44.57%) were not in current use, and presented left-overs from previous treatment. Antibiotics were usually acquired with prescription (67, 67.7%), while about a quarter of packages were used for self-medication-purchased at pharmacy without prescription (19, 20.65%) or obtained through friends or family member (6, 6.52%).The most commonly used antibiotics for self-medication was amoxicillin (reported indications included common cold, cough, pharyngitis and tooth-ache). Conclusion Antibiotics were present in large share of households in Novi Sad. Self-medication with antibiotics and sale of antibiotics without prescription represent an important problem in Serbia.

Effect of aroma and magnum hops extracts and paracetamol on antioxidant liver parameters in mice.

Hop varieties that are mainly grown in Serbia are Magnum (German variety) and Aroma, which is grown only in the Vojvodina region. About the use of hops extracts as an auxiliary remedy there are divergent opinions. Our findings indicate that extracts of Magnum and Aroma varieties, among the others, enhance and prolong the analgesic action of paracetamol. For this reason we undertook a study of the effects of these extracts alone and in combination with paracetamol, along with the action of paracetamol alone, on the activity of the antioxidant enzymes GSHPx, CAT, Px, XOD, GSHR, glutathione content, LPx intensity, as well as activities of AST and ALT. Paracetamol in the dose applied exerted no influence on the investigated parameters and neither did ethanolic extract of Magnum variety. On the other hand, ethanolic extract of Aroma hops caused a significant reduction of GSH content. In combination with paracetamol, extracts of both Magnum and Aroma varieties reduced significantly the LPx intensity, activities of CAT and GSHPx, as well as GSH content in the liver homogenate. A significant increase in the AST value with respect to control was also observed. These findings indicate the disturbance in the functioning of hepatocytes, probably by decelarating metabolism and elimination of paracetamol.

Interaction of alcoholic extracts of hops with pentobarbital and diazepam in mice.

The interaction of alcoholic extracts of Magnum, Aroma and wild genotype hops with drugs that lower the activity of the central nervous system (CNS) was studied in mice. Hops drying and preparation of extracts were performed according to standard pharmacological procedures for preparing total alcoholic extracts of medicinal plants, i.e. in a ratio of one part dry herbs to two parts of 70% alcohol, with evaporation to dryness so that the extracts no longer contained any alcohol. The mice received four doses intraperitoneally (i.p.) of 0.5% aqueous solutions of the above-mentioned extracts, which were dissolved in warm physiological solution to make up a 0.5% aqueous solution, 24, 16, 4 and 0.5 hours before pentobarbital (40 mg/kg) or diazepam (3 mg/kg) administration. The hypnotic action of pentobarbital and the effect of diazepam on the coordination of movements (rotating rod method) were measured. It was found that hops extracts influenced the action of the investigated drugs, and that the extracts of the Magnum and Aroma genotypes suppressed the hypnotic action of pentobarbital and diazepam. Tert-butanolic extracts also suppressed the action of these two drugs but to a lesser extent, whereas wild hops extracts did not exert any significant effects compared to controls.

Interaction of alcoholic extracts of hops with cocaine and paracetamol in mice.

This work describes a study of the interaction in the mouse model of alcoholic extracts of hops of Magnum, Aroma and wild genotypes with drugs that have excitatory effect on the cerebral cortex (cocaine) and analgesic action (paracetamol). Hop drying and preparation of the extracts were carried out according to standard pharmacological procedures for preparing total alcoholic extracts of dry herbs, consisting of one part of dry drug and two parts of 70% alcohol. The mice received four doses i.p. of 0.5% aqueous solutions of the above-mentioned extracts (10 ml/kg) 24, 16, 4 and 0.5 h prior to receiving cocaine (25 mg/kg) or paracetamol (80 mg/kg). The parameter investigated was the change in spontaneous motility of mice after combined treatment with the extracts and cocaine/paracetamol compared to control animals that received the same dose of the drug after treatment with physiological solution. Only the ethanolic extract of Magnum hops increased the spontaneous motility of mice, while none of the extracts showed analgesic action as measured by the hot-plate method. In the interaction with cocaine, the extract of Magnum hops suppressed almost completely the action of cocaine compared to controls. Extracts of the other hops also decreased the cocaine-induced locomotor activity of mice, but to a lesser extent. Hop extracts exhibited a significant pharmacological interaction with paracetamol, with the most pronounced increase in analgesic action being found for the ethanolic extract of Aroma hops and the tert-butanolic extract of wild hops.

Interaction of alcoholic extracts of hops with pentobarbital and diazepam in mice.

The interaction of alcoholic extracts of Magnum, Aroma and wild genotype hops with drugs that lower the activity of the central nervous system (CNS) was studied in mice. Hops drying and preparation of extracts were performed according to standard pharmacological procedures for preparing total alcoholic extracts of medicinal plants, i.e. in a ratio of one part dry herbs to two parts of 70% alcohol, with evaporation to dryness so that the extracts no longer contained any alcohol. The mice received four doses intraperitoneally (i.p.) of 0.5% aqueous solutions of the above-mentioned extracts, which were dissolved in warm physiological solution to make up a 0.5% aqueous solution, 24, 16, 4 and 0.5 hours before pentobarbital (40 mg/kg) or diazepam (3 mg/kg) administration. The hypnotic action of pentobarbital and the effect of diazepam on the coordination of movements (rotating rod method) were measured. It was found that hops extracts influenced the action of the investigated drugs, and that the extracts of the Magnum and Aroma genotypes suppressed the hypnotic action of pentobarbital and diazepam. Tert-butanolic extracts also suppressed the action of these two drugs but to a lesser extent, whereas wild hops extracts did not exert any significant effects compared to controls.