Background: Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and describe the changes in work environment of community pharmacists in Vojvodina during the state of emergency due to COVID-19 pandemic. Moreover, the COVID-19 pandemic effects on job related stress were assessed. Methods: Community pharmacists from Vojvodina completed an online questionnaire on work environment changes related to COVID-19 (cross-sectional study). Results: Out of the 1574 licenced pharmacists in Vojvodina, 392 completed the survey. Workload increase, reported by 90.8% of pharmacists, was caused mostly by higher demand for safety equipment, antiseptics and disinfectants, dietary products and medicines. Most pharmacists (93.1%) considered pharmacy workflow to be more complex than before the pandemic. Clients’ behavior was described as less pleasant since the start of the pandemic by 67.6% of the community pharmacists. Many were concerned for their health and the health of their families (68.9%). Community pharmacists rated their stress levels higher if they i) were working in larger chains, ii) experienced clients’ behavior as less pleasant or/and iii) were concerned for their/their family health. Conclusions: Current research pointed out the need for a more robust healthcare system which would allow rapid introduction of new activities and roles for community pharmacists that could possibly decrease job-related stress. Legal steps to improve the work environment in community pharmacies are necessary and urgent in order to fully utilize their skills and knowledge.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic and one group of patients has developed a severe form of COVID-19 pneumonia with an urgent need for hospitalization and intensive care unit (ICU) admission. The aim of our study was to evaluate the prognostic role of MDW, CRP, procalcitonin (PCT), and lactate in critically ill COVID-19 patients. The primary outcome of interest is the 28 day mortality of ICU patients with confirmed SARS-CoV-2 infection and sepsis (according to Sepsis 3 criteria with acute change in SOFA score ≥ 2 points). Patients were divided into two groups according to survival on the 28th day after admission to the ICU. Every group was divided into two subgroups (women and men). Nonparametric tests (Mann–Whitney) for variables age, PCT, lactate, and MDW were lower than alpha p < 0.05, so there was a significant difference between survived and deceased patients. The Chi-square test confirmed statistically significant higher values of MDW and lactate in the non-survivor group. We found a significant association between MDW, lactate, procalcitonin, and fatal outcome, higher values were reported in the deceased group.

This study aims to find the effects of high (75%) and low (30%) humidity conditions and its correlation with formulation composition on dissolution kinetics of lamotrigine (LMT) from prepared immediate-release tablets during one- and four-week periods. Two types of fillers microcrystalline cellulose (MCC) or anhydrous lactose (LAC), disintegrant sodium starch glycolate (NaSG, 0.5% or 4%), and lubricant magnesium stearate (MgST, 0.25% or 5%) were used. A three-factor two-stage complete factorial design (2³) was used to assess the influence of the composition of the tested formulations. The tablets were produced by direct compression and characterized using a disintegration test, a resistance to crushing test, and dissolution tests (pH 1.2 and pH 6.8). Using Design Expert software, it was concluded that in addition to the effect of fillers on pH 6.8, NaSG has a significant impact after exposure to high and low humidity, as well as its interaction with LAC and MCC. In the dissolution medium pH 1.2, under conditions of high humidity, the content of MgST and NaSG and their interaction show a significant influence. The release rate of LMT was affected by humidity as well as type of excipients and their interactions.

Current human health risk assessment for perfluorooctanoic acid (PFOA) has proven inadequate due to a lack of innovative approaches. Here, we applied benchmark dose-response modeling to derive benchmark concentrations (BMCs) for apical and transcriptomic changes in human endothelial cells EA.hy926 following both high-concentration short-term (48 h) and human-relevant long-term (6 and 12 weeks) PFOA exposures. BMCs were translated into human equivalent doses (HEDs) using a physiologically based toxicokinetic model. Long-term exposure produced sensitive biological responses: 10th percentile HEDs for apical and transcriptomic data were 0.59 and 3.84 ng/kg bw/week, respectively, both below the estimated U.S. general population exposure level (9.91 ng/kg bw/week). Predicted 10th percentile HED thresholds in individuals with certain conditions were: end-stage renal disease 0.50 ng/kg bw/week, moderate to severe reductions in glomerular filtration rate 0.18-1.00 ng/kg bw/week, cirrhosis class A 0.18 ng/kg bw/week, NAFLD 0.79 ng/kg bw/week, and class 1 obesity 0.43 ng/kg bw/week, compared to healthy individuals (1.18 ng/kg bw/week), suggesting that PFOA can elicit adverse effects in endothelial cells at exposure levels below those currently experienced by the general population. Given the global prevalence of health conditions investigated in this study, a substantial portion of the population may face increased vulnerability to PFOA-induced health effects.

Liquid-filled hard gelatin capsules may have pertinent advantages both for therapeutic effect and extemporaneous preparations of medicines. Alpha lipoic acid is a substance used in medicines and dietary supplements and there is a need for creating an appropriate formulation which would be suitable for each individual patient or consumer. Based on its biopharmaceutical and physical chemical characteristics, eight different capsule formulations were designed and characterized. Silicon dioxide was added to form a semisolid content and prevent leakage. The formulation filled with alpha lipoic acid solution in polyethylene glycol 400 showed the best performance. Although the addition of silicon dioxide to the formulation with polyethylene glycol 400 led to a change in both flow character and viscosity, the release rate did not show a statistically significant decrease (more than 85% of content was released after 5 min testing). Applied technique is a simple and an appropriate approach for compounding and could be used for other substances with similar properties.

Pantoprazole is a model substance that requires dosage form adjustments to meet the needs of all patients. Pediatric pantoprazole formulations in Serbia are mostly compounded as capsules (divided powders), while in Western Europe liquid formulations are more common. The aim of this work was to examine and compare the characteristics of compounded liquid and solid dosage forms of pantoprazole. Three syrup bases were used: a sugar-free vehicle for oral solution (according to USP43-NF38), a vehicle with glucose and hydroxypropyl cellulose (according to the DAC/NRF2018) and a commercially available SyrSpend Alka base. Lactose monohydrate, microcrystalline cellulose and a commercially available capsule filler (excipient II, composition: pregelatinized corn starch, magnesium stearate, micronized silicon dioxide, micronized talc) were used as diluents in the capsule formulations. Pantoprazole concentration was determined by the usage of the HPLC method. Pharmaceutical technological procedures and microbiological stability measurements were performed according to the recommendations of the EP10. Although dose appropriate compounding with pantoprazole is suitable using both liquid vehicles as well as solid formulations, chemical stability is enhanced in solid formulation. Nevertheless, according to our results, if liquid formulation is a pH adjusted syrup, it could be safely kept in a refrigerator for up to 4 weeks. Additionally, liquid formulations could be readily applied, while solid formulation should be mixed with appropriate vehicles with higher pH values.