Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug–dietary supplement (DDSIs) and drug–herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and training.
11 December 2017 in BMC Complementary and Alternative Medicine
The ready availability and use of dietary supplements (DS) by the public means that healthcare professionals require education in this area. In the Republic of Serbia, education related to use of DS is included in undergraduate medical training and it is therefore important to assess the effectiveness of this education. The aim of our survey was to investigate the influence of pharmacological education on the use, attitudes and perceptions of risks associated with DS among medical students. Medical students at the University of Kosovska Mitrovica participated in the survey. Three hundred eighty questionnaires were distributed, yielding a response rate of 89% (n = 334). Data were categorized by year of study, completion of a one-year course in pharmacology and having passed the final exam. The results were compared between 192 (58%) medical students educated in pharmacology (MSEP) and 142 (42%) medical students not educated in pharmacology (MSNEP). The questionnaire was divided into 4 parts: socio-demographic and lifestyle/behavioral characteristics, use of DS, attitudes about efficacy, safety and perception of risk due to DS use. Chi-square test, Student’s t-test, and Mann-Whitney U test were used for statistical analysis. About 53% of respondents used some form of DS. Attitudes regarding the safety of DS consumption showed a difference between the groups. MSEP were more likely to agree that DS have the potential to cause adverse reactions (Likert scale mean 4.1 vs. 3.5, p < 0.001) as well as interactions with conventional drugs (Likert scale mean 4.2 vs. 3.2, p < 0.001) than MSNEP. Finally, MSEP ranked St. John’s wort and ginkgo as the most dangerous DS, but creatine and vitamin C were both ranked as relatively safe. Conversely, MSNEP considered ginkgo and vitamin C the most harmful DS, claiming that omega-3 fatty acids and vitamin D had the least hazardous side effects. Our results showed that pharmacological education gives young medical students a better understanding of the risks of DS-drug interactions and potential adverse effects. However, their overall attitudes and perception of risk indicate the need for further education.
In December 2019, the virus SARS-CoV-2 responsible for the COVID-19 pandemic was detected in the Chinese city of Wuhan. The virus started to spread from China and dispersed over the rest of the world. In March 2020, WHO (World Health Organization) declared COVID-19 a pandemic. The transmission path of the pandemic was accelerated by different types of transportation. With complete analysis of spatial data, population density, types of traffic networks, and their properties, the spatial distribution of COVID-19 was estimated. GIS (Geographical Information System), numerical methods, and software for network analysis were used in this research to model scenarios of virus distribution on a global scale. The analyzed data included air, railway, marine, and road traffic. In the pandemic research, numerous models of possible trajectory of viruses can be created. Many have a stochastic character. This study includes all countries in the world affected by the COVID-19 up to date. In this study, GIS methods such as buffer, interpolations, and numerical analysis were used in order to estimate and visualize ongoing COVID-19 pandemic situation. According to the availability of new data, trajectory of virus paths was estimated. On the other hand, sparsely populated areas with poorly developed and small traffic networks (and isolated island territories) tend to be less or not affected as shown by the model. This low-cost approach can be used in order to define important measures that need to be addressed and implemented in order to successfully mitigate the implications of COVID-19 not only on global, but local and regional scales as well.
Background: Cephalosporins are considered safe antibiotics. However, serious hematological abnormalities may occur, although rarely, after their therapeutic use. Case Presentation: We present a case of pancytopenia in a 72-year-old female patient treated with ceftriaxone for a urinary tract infection. After five days of therapy, pancytopenia was observed. Other causes were excluded through extensive diagnostic evaluation, including immunological tests, viral serologies, bone marrow aspiration, and peripheral blood smear. The patient’s clinical condition significantly improved following the discontinuation of ceftriaxone and the administration of granulocyte colony-stimulating factor (G-CSF). Bone marrow findings revealed hypocellularity without malignant infiltration, and peripheral smear showed no dysplasia, blasts, or hemolysis. Conclusions: This case demonstrates that ceftriaxone, although widely regarded as a safe antibiotic, can induce rare but serious hematologic complications such as pancytopenia. A high index of suspicion is required when patients on antibiotic therapy develop unexplained cytopenias. Detailed medication history, exclusion of other causes, and prompt discontinuation of the suspected drug are essential. The patient’s favorable outcome supports the likelihood of an idiosyncratic, immune-mediated mechanism. Future research should explore pharmacogenomic screening in patients at increased risk, particularly involving HLA variants.
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is widely used to reduce appetite and promote weight loss in patients with type 2 diabetes. However, individual variability may lead to paradoxical responses. We describe a 60-year-old woman with type 2 diabetes who experienced progressive weight gain and increased appetite during 12 months of semaglutide therapy, despite previous successful weight loss with sodium-glucose cotransporter 2 (SGLT2) inhibitors. Her body mass index (BMI) rose from 31.6 to 34.6 kg/m2, accompanied by worsening glycemic control. Eating behavior assessment with the Dutch Eating Behavior Questionnaire revealed a maximum score for emotional eating, suggesting a strong psychological barrier to treatment efficacy. Genetic factors, such as GLP-1 receptor polymorphisms, may also contribute to reduced responsiveness. This case highlights the possible influence of both emotional and genetic factors on treatment outcomes and emphasizes the need for personalized approaches in the management of obesity and type 2 diabetes.
1 January 2022 in Macedonian Pharmaceutical Bulletin