Assessing pharmacists' awareness of financial indicators in community pharmacy management: A cross-sectional study.

Background: Community pharmacists play a vital role in the healthcare system, serving as accessible healthcare providers and entrepreneurs. To effectively manage community pharmacies, pharmacists must possess financial literacy and utilize appropriate financial indicators. However, studies addressing community pharmacists' awareness of financial indicator concepts are scarce. This study assesses the awareness of community pharmacists in Jordan regarding financial indicators. Methods: Employing a cross-sectional study design, we utilized a structured and validated questionnaire to collect data from 353 community pharmacy owners across Jordan. The questionnaire assessed pharmacists' awareness and utilization of financial indicators in pharmacy management. Descriptive statistics summarized demographic data, while analytical statistics examined associations between demographic factors and financial indicator awareness. Results: The study revealed varying levels of awareness among pharmacists regarding financial indicators, with younger pharmacists exhibiting higher awareness levels. Factors such as educational background and years of experience were found to influence awareness. Furthermore, pharmacists predominantly utilize profitability indicators to assess financial performance. Conclusion: The findings underscore the importance of enhancing pharmacists' financial literacy and integrating financial management principles into pharmacy education. Continuous professional development programs are essential to improve financial competence among pharmacists. This study provides valuable insights into the awareness of financial indicators among community pharmacists in Jordan, emphasizing the need for collaborative efforts from policymakers, pharmacy faculties, and associations to enhance financial education and promote research in this critical area.

Pharmacokinetics and Pharmacodynamics: A Comprehensive Analysis of the Absorption, Distribution, Metabolism, and Excretion of Psychiatric Drugs.

The two main classifications of antidepressant medications are selective norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs). Out of the available choices, selective serotonin reuptake inhibitors (SSRIs) have emerged as the most commonly prescribed option. The class demonstrates a greater degree of diversity in its structural characteristics in contrast to its neurochemical effects. Nevertheless, it is important to acknowledge that the chemical composition of a drug within this specific class does not carry substantial significance in the selection process. A comprehensive analysis of the pharmacodynamic and pharmacodynamic properties of antidepressant drugs proves advantageous for clinicians and managed care providers responsible for selecting preferred selective serotonin reuptake inhibitors (SSRIs) from a roster of authorized medications. The physicochemical characteristics, which possess considerable significance, are frequently disregarded except during the drug development stage. Pharmacodynamic properties refer to the physiological and biochemical effects that drugs exert on the human body. It is noteworthy that the inclusion of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in a comprehensive depression management protocol may demonstrate enhanced effectiveness in clinical environments as opposed to controlled trials.

Financial indicators utilization among community pharmacists: A comprehensive study for pharmacy management.

BACKGROUND: The financial management of community pharmacies is a critical aspect of healthcare delivery, as pharmacists often operate as healthcare providers and business managers. Understanding pharmacists' awareness, perceptions, and practices related to financial indicators is essential for effective pharmacy management. There is a paucity of research addressing this issue regionally and locally. OBJECTIVES: This study aimed to investigate the perceptions and utilization of financial indicators among community pharmacists in Jordan and identify demographic and contextual factors influencing their financial practices. METHODS: A cross-sectional study was conducted, surveying 353 community pharmacists from various regions of Jordan. The developed and validated survey assessed demographic characteristics, utilizations of financial indicators, and perceptions of their significance. Pharmacists were queried about their financial practices, including the use of various financial indicators. Descriptive and analytical statistics were used to portray the study's findings. RESULTS: The study included a diverse group of community pharmacists in terms of demographic characteristics. Most pharmacists exhibited awareness of financial indicators, with a higher awareness of profitability and liquidity indicators. Pharmacists generally had positive perceptions of the importance of these indicators in daily practice. High agreement was observed in financial practices, including following up on payables and receivables, monitoring changes in monthly revenue, and preparing income statements. There was significant variation in the utilization and perception of financial indicators based on factors such as pharmacy ownership, province, foundation age, and practical experience. CONCLUSION: The findings indicate a positive correlation between utilization and perception, emphasizing the importance of raising awareness of financial indicators among pharmacists. The study also highlights the significance of tailored financial training programs for pharmacists at different stages of their careers and the importance of regional context in financial practices. Understanding these variations can lead to more effective financial management and improved healthcare services in community pharmacies.

The Validation and Determination of Empagliflozin Concentration in the Presence of Grapefruit Juice Using HPLC for Pharmacokinetic Applications.

Type 2 diabetes mellitus is a multifactorial disorder whose primary manifestation usually initiates with elevated blood sugar levels. Several antidiabetic agents are used to manage type 2 diabetes mellitus, of which empagliflozin is an oral sodium-glucose co-transporter (SGLT-2) inhibitor in the kidney. This research aims to develop and validate a simple analytical method for determining empagliflozin levels in biological fluid and to further evaluate grapefruit juice's impact on empagliflozin pharmacokinetics in rats. High-Performance Liquid Chromatography (HPLC) was used to establish a simple, rapid, and accurate method for determining empagliflozin levels in rat plasma, in the presence of grapefruit juice. Four groups of rats (n = 10 rats in each) were used in the preclinical study. Group A (healthy rats) received empagliflozin alone; Group B (healthy rats) received empagliflozin with grapefruit; Group C (diabetic rats) received empagliflozin with grapefruit; and Group D (healthy, negative control) received no medication. The rats (n = 10) were given grapefruit juice instead of water for seven days before receiving the empagliflozin dose (0.16 mg/kg). Some pharmacokinetic parameters for each group were determined. The maximum plasma concentration (Cmax) and area under the curve (AUC) of empagliflozin in Group A without grapefruit intake were 730 ng/mL and 9264.6 ng × h/mL, respectively, with Tmax (2 h). In Group B, Cmax was 1907 ng/mL and AUC was 10,290.75 ng × h/mL in the presence of grapefruit, with Tmax (1 h); whereas, in Group C, the Cmax was 2936 ng/mL and AUC was 18657 ng × h/mL, with Tmax (2 h). In conclusion, our results showed that the co-administration of grapefruit with empagliflozin should be cautiously monitored and avoided, in which grapefruit elevates the plasma level of empagliflozin. This may be attributed to the inhibition of the uridine enzyme in the grapefruit by hesperidin, naringin, and flavonoid.

Test of insulin resistance in nondiabetic and streptozotocin-induced diabetic rats using glycosylated hemoglobin test and other interventions.

Type 2 diabetes is common globally. Pioglitazone (PGZ) is an oral TZD antidiabetic, whereas chromium-picolinate (Cr-PL) and Cr-glucose tolerance factor (Cr-GTF) are useful type 2 diabetes mellitus (T2DM) supplements. Cr-PL/GTF antioxidants cure T2DM. They may fail in diabetes with or without insulin-sensitizing medications. It examined how Cr-PL, Cr-GTF, PGZ, and their combination affected glucose, glycosylated hemoglobin, insulin, and HOMA-IR. Sixty-three adult Sprague-Dawley rats (220-300 g) were selected, and nine rats were randomly assigned to a normal nondiabetic group. In contrast, 54 rats were randomly split into 9 rats per each of the 6 major groups and injected intraperitoneally with 40 mg/kg STZ to induce T2DM. Rats were administered PGZ = 0.65 mg/kg (rat weight)/day, Cr-PL = 1 mg/kg, Cr-GTF = 1 mg/kg, and their combinations (PGZ + Cr-PL and Cr-GTF) daily for 6 weeks per intervention. The PGZ + Cr-PL and PGZ + Cr-GTF groups had substantially lower insulin levels than the PGZ group (13.38 ± 0.06, 12.98 ± 0.19 vs. 14.11 ± 0.02, respectively), with the PGZ + Cr-GTF group having the lowest insulin levels (12.98 ± 0.19 vs. 14.11 ± 0.02, 13.38±0.06, respectively). Intervention substantially reduced HOMA-IR in the PZ + Cr-PL and PZ + Cr-GTF groups compared to PGZ (7.49 ± 0.04, 6.69 ± 0.11 vs. 8.37 ± 0.04, respectively). This research found that combining PGZ with Cr-GTF resulted in considerably lower HOMA-IR levels than the PGZ and Cr-PL groups (6.69 ± 0.11 vs. 8.37 ± 0.04, 7.49 ± 0.04, respectively). Both Cr-PL and Cr-GTF may control T2DM. Both Cr complexes improved T2DM biomarkers more than the control diabetic group without medication. PGZ alone and PGZ + Cr-PL had less pharmacological synergy than Cr-GTF and PGZ in altering insulin and HOMA-IR blood levels. These encouraging discoveries need more study.

The impact of adherence to community-acquired pneumonia (CAP) management guidelines on improving clinical outcomes in hospitalized patients

Objectives: Community-acquired pneumonia (CAP) is linked with high morbidity and mortality, particularly among the elderly. Because of the high incidence and accompanying financial expenses, accurate diagnosis and adequate care of this group hospitalized with CAP are required. The purpose of the study was to assess the level of adherence to CAP national guidelines at a private hospital, as well as the impact of adherence to these national recommendations on clinical outcomes. Methods: Data from electronic medical records of adult patients hospitalized with CAP between 2018 and 2019 were retrieved for a quantitative observational retrospective cohort research. Results: This study comprised 159 patients, with 76 patients (47.8%) receiving therapy according to the recommendations of the guidelines. A total of 75 (98.7%) of those patients were hospitalized across the ICU wards. In contrast, 98.4% (64/65) of patients who had received empiric antibiotic treatment within isolation floors were non-compliant. There was a statistically significant relationship between the level of adherence to CAP clinical guidelines and the following variables: The 72-hour reassessment (P = 0.01), medications altered OR retained when culture findings were revealed (P = 0.01), primary diagnosis (P = 0.028), and total intended period of antibiotic therapy (P = 0.007). Conclusions: According to the findings of this study, higher adherence to the guidelines amongst ICU patients was linked to better outcomes, such as a significant reduction in the overall planned period of antibiotic therapy. (AU)

Effect of date molasses on levetiracetam pharmacokinetics in healthy rats.

Twelve healthy eight-week-old male Wistar rats weighing 200 g were used. Rats were chosen randomly, and their tails were identified and separated into cages/groups. The first group received an oral dose of 11.5 mg of levetiracetam in 5 mL of water, and the second group was given date syrup (250 g mixed with 250 mL water) for seven days, then 11.5 mg LEV in 5 mL water on day 7. One week of preadministered date molasses significantly decreased levetiracetam pharmacokinetic parameters in rats, such as Cmax (72 vs. 14 ng/mL, p = 0.01), Tmax (1.78 vs. 0.44 h, p < 0.001), and AUC (880 vs. 258 ng.h/mL, p < 0.001). This decrease in plasma levetiracetam levels caused by date molasses could be attributed to decreased levetiracetam absorption. On the other hand, the current study discovered that rats given date molasses for a week had a reduced rate and extent of absorption. As a result, date molasses might increase the risk of epileptic seizures in oral LEV-treated ones.

Ameliorative effect of selenium yeast in combination with pioglitazone on diabetes outcomes in streptozotocin-induced.

Anti-diabetic therapies possess many side effects; thus, searching for alternative strategies with low cost, minimal side effects, and high therapeutic value is very important. The present study aimed to explore the combined use of selenium yeast (SY) and standard anti-diabetic drug pioglitazone (PGZ) for diabetes mellitus (DM) treatment in streptozotocin (STZ)-induced DM. STZ was injected daily intraperitoneally with a low dose (40 mg/kg) into Sprague-Dawley rats to induce DM. The synergistic effect of the SY (0.2 mg/kg) and PGZ (0.65 mg/kg) on DM complications was evaluated after 88 weeks of treatment. The impact of our medication on glucose levels, insulin sensitivity, lipid abnormalities, oxidative mediators, and inflammatory markers was assessed by biochemical techniques. STZ-induced diabetes has toxic effects, including toxic hepatic tissues, lipid disturbances, massive oxidative damage, and hyperinflammation. Experimental rats either treated with monotherapy alone or combined therapy resulted in a significant anti-diabetic effect. The PGZ+ SY combination has the best effect, as illustrated by significant (P < 0.05) decreases in fasting blood glucose, (FBG) insulin, HbA1c, and HOMA-IR levels. This combination attenuated (P < 0.05) lipid disturbances and their associated elevated atherogenicity biomarkers. At the same time, treatments with PGZ+ SY exhibited an anti-inflammatory effect as they ameliorated the increase in inflammatory parameters (CRP, TNF-α, IL-6). Also, it restored the total antioxidant capacity and peroxisome proliferator-activated receptor (PPARƔ) levels that were decreased by STZ-DM induction. In conclusion, this study finds PGZ+ SY as a promising DM therapeutic alternative. This synergistic combination alleviates most DM-related complications and insulin resistance.

Esomeprazole and apixaban pharmacokinetic interactions in healthy rats.

Esomeprazole is used in various clinical settings where a decrease in gastric acid production is desired since it is a proton pump inhibitor. Apixaban, an anticoagulant, is used to reduce the risk of stroke in patients with certain cardiovascular diseases. This research aims to examine the effects of giving esomeprazole and apixaban to rats simultaneously, as well as to measure their pharmacokinetics and look for statistical differences or interactions. A method for the simultaneous determination of esomeprazole and apixaban in rat plasma was developed using HPLC/MS and validated by ICH guidelines. Five groups of Wistar rats were created, and the drugs were administered as follows: esomeprazole (5 mg/kg) intravenously, apixaban (125 mcg/Kg) intravenously, esomeprazole (5 mg/kg) orally, apixaban (250 mcg/kg) orally, and esomeprazole (5 mg/kg) and apixaban (250 mcg/kg) both orally. Both drugs' concentrations were measured in plasma samples collected on a predetermined schedule. The pharmacokinetics of both drugs were calculated and statistically analyzed using a 90% confidence interval and non-compartmental analysis. When the two drugs were combined, apixaban's Cmax and AUC increased while esomeprazole's Cmax and AUC decreased. On the other hand, Apixaban's Tmax decreased with an increase in esomeprazole's Tmax, indicating a possible interaction between the two drugs. When both drugs were taken together, their bioavailability was reduced, implying that less esomeprazole was absorbed over time.

Pharmacokinetics and Bioequivalence of Two Empagliflozin, with Evaluation in Healthy Jordanian Subjects under Fasting and Fed Conditions.

The current study is a randomized, open-label, two-period, two-sequence, two-way crossover pharmacokinetic study in healthy Jordanian subjects to evaluate the pharmacokinetics and bioequivalence profile of two cases of empagliflozin 10 mg under fasting and fed conditions. The plasma concentrations of empagliflozin were determined using an HPLC-MS/MS method. Tolerability and safety were assessed throughout the study. This study included 26 subjects, 26 in both fasting and fed groups.The pharmacokinetic parameters, which included the area under the concentration-time curve from time zero to infinity (AUC0-inf) and the final quantifiable concentration (AUC0-last), maximum serum concentration (Cmax), and time to reach the maximum drug concentration (Tmax) were found to be within an equivalence margin of 80.00-125.00%. The pharmacokinetic profiles show that the empagliflozin test and parent reference cases were bioequivalent in healthy subjects. The two treatments' safety evaluations were also comparable.

Implication of parabens in cosmetics and cosmeceuticals: Advantages and limitations.

Cosmetics, cosmeceuticals, and variable healthcare products used parabens, among other excipients, for their preservative and antimicrobial activities. Paraben derivatives exhibit distinguished physiochemical properties that enable them to be compatible with the formulation of cosmetic agents in different dosage forms. In addition to their potency and efficacy, parabens are economically efficient as they have low-manufacturing costs. Despite the desirable characteristics, the safety of parabens use is controversial after detecting these chemicals in various biological tissues after repetitive and long-term use of formulations containing them. The use of parabens drew public health attention after scientific reports linked skin exposure to parabens with health issues, in particular, breast cancer. In response, worldwide authorities set regulations for the allowance concentrations of paraben to be used in variable cosmetic products.