Introduction: Pantoprazole is one of the most widely used proton pump inhibitors, but anaphylaxis occurs rarely during its use. The purpose of reporting these two cases is to show that pantoprazole is not a drug without problems; it can also cause anaphylactic reactions. Cases description: A 42-year-old woman presented to the emergency department due to dyspeptic complaints. Immediately at the end of the infusion of pantoprazole, there started to be numbness of the tongue, itching all over the body, and difficulty in breathing. Half an hour after taking a pantoprazole 40 mg capsule, a 58-year-old woman started to experience redness of the face, thickening of the tongue, itching, bloating, and dizziness. Arterial pressure was 80/60 mmHg, pulse 150/minute, while saturation had dropped to 88%. In both cases, fluids, adrenaline, antihistamines, methylprednisolone, and calcium were immediately started. After the improvement of their general conditions, both patients were discharged home. Discussion: The first case relates to anaphylaxis after the intravenous administration of pantoprazole, and the second case relates to the appearance of anaphylaxis after its oral administration. Conclusion: Health workers need to be informed about the possibility of anaphylaxis in patients taking both oral and parenteral pantoprazole.

Background: The interaction between adenosine receptor blockers and anticholinergic substances in the treatment of bronchial asthma is an area of interest. The efficacy of such combinations in managing bronchial asthma and bronchial hypersensitivity needs to be explored further. Understanding lung function parameters such as airway resistance and intrathoracic gas volume is crucial for evaluating the effects of these medications. Objective: This study aimed to investigate the effect of combining the adenosine receptor blocker, bamifylline, with the anticholinergic substance, ipratropium bromide spray, in patients with bronchial asthma. Specifically, the study sought to assess changes in lung function parameters, including airway resistance and intrathoracic gas volume, after administering ipratropium bromide alone and in combination with bamifylline. Methods: Sixteen patients with bronchial asthma were enrolled in the study. Lung function was evaluated using body plethysmography, with measurements of airway resistance (Raw), intrathoracic gas volume (ITGV), airway specific resistance (SRaw), and airway specific conductance (SGaw). Patients initially received ipratropium bromide inhalation (2 inhalations x 20µg), followed by Raw and ITGV measurements at intervals (5, 30, 60, and 120 minutes). Subsequently, patients received bamifylline (2 x 600 mg) daily for seven days at home. On the eighth day, they were administered ipratropium bromide spray (2 inhalations x 20µg), and lung function parameters were assessed similarly. Results: Administration of ipratropium bromide alone led to a significant reduction in airway resistance (p<0.05). However, the combination of ipratropium bromide with bamifylline did not significantly enhance the effects of adenosine receptor blockade (p<0.05). Specifically, there were no significant changes in Raw, ITGV, SRaw, or SGaw after combining ipratropium bromide with bamifylline. Conclusion: The study findings suggest that the addition of anticholinergic substances did not potentiate the action of adenosine receptor blockers in patients with bronchial asthma. Therefore, the anti-inflammatory effects of xanthines, such as bamifylline, were not augmented by anticholinergic substances in this study. These results highlight the need for further research to explore alternative therapeutic approaches in the management of bronchial asthma.

Biomedical and Pharmacology Journal (BPJ) is an international, open access, peer reviewed, quarterly research journal.

Background: The inappropriate and empirical use of antibiotics in early childhood remains a major global public health concern, contributing significantly to the rise of antimicrobial resistance (AMR). In Kosovo, the COVID-19 pandemic further influenced prescribing behaviors in primary care, increasing the reliance on symptom-based treatment in the absence of laboratory confirmation and age-appropriate formulations. Aim: This study aimed to assess the prevalence and patterns of antibiotic prescribing among children aged 1–7 years in primary health care centers in Prishtina and Ferizaj from January 2022 to December 2025, and to compare regional differences in prescribing practices and guideline adherence. Methods: A retrospective observational study was conducted using data from the national electronic health record system and protocol books. All pediatric visits for children aged 1–7 years with infectious diagnoses were included. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used to evaluate prescribing prevalence, demographic and seasonal variations, and independent predictors of antibiotic use, including assessment of appropriateness based on international pediatric guidelines. Results: Of 4320 pediatric visits, 1328 (30.7%) resulted in an antibiotic prescription. Prescribing prevalence was higher in Ferizaj (34.2%) than in Prishtina (28.5%, p < 0.01). Amoxicillin–clavulanic acid (42.9%) and amoxicillin (21.5%) were the most frequently prescribed agents, while macrolides (11.7% vs. 6.2%) and cephalosporins (7.9% vs. 3.4%) were more common in Ferizaj. Only 61.4% of prescriptions were fully guideline-concordant. Younger age (1–3 years), winter season, and residence in Ferizaj were independently associated with higher odds of receiving an antibiotic. Conclusions: Pediatric antibiotic prescribing in Kosovo remains high and predominantly empirical, reflecting real-world limitations in diagnostic capacity and formulation availability. Significant proportions of partially appropriate and inappropriate prescriptions highlight the need for standardized pediatric guidelines, improved diagnostic support, and strengthened stewardship initiatives within primary care.

Background: Pharmacovigilance is a critical component of patient safety, particularly among older adults with chronic diseases who are frequently exposed to polypharmacy. In Kosovo, adverse drug reactions (ADRs) reported by patients remain insufficiently recognized within the healthcare system. Polypharmacy, limited access to pharmaceutical counseling, and self-medication practices may contribute to increased medication-related harm. Capturing ADRs directly from patients provides valuable insight into medication safety challenges and communication gaps in clinical care. Objective: To assess the frequency, characteristics, and reporting behavior of adverse drug reactions among adults aged 60–75 years with chronic diseases in Kosovo, and to identify factors associated with awareness and reporting practices. Methods: A multicenter cross-sectional study was conducted between January and September 2025 in four major cities in Kosovo (Prishtina, Prizren, Peja, and Gjilan). A total of 1024 patients receiving continuous therapy for at least one chronic condition were surveyed using a structured questionnaire covering demographic characteristics, drug exposure, ADR experience, and reporting behavior. Statistical analyses included descriptive statistics, chi-square testing, and multivariable logistic regression to identify predictors of ADR reporting. Results: Overall, 47.3% of participants reported experiencing at least one ADR in the preceding 12 months. Among those, 39.5% reported the event to a healthcare professional, whereas 60.5% did not seek professional advice. The most frequently implicated drug classes were antihypertensives (32.8%), analgesics and non-steroidal anti-inflammatory drugs (27.4%), and antirheumatic agents (14.6%), with mainly gastrointestinal (24.1%) and cardiovascular (18.9%) manifestations. Approximately 19.8% of participants reported discontinuing medication due to adverse effects. Female patients were more likely to report ADRs compared to males (p < 0.01). Lack of prior counseling about potential side effects was independently associated with lower reporting (OR = 2.17; 95% CI: 1.41–3.33). Patients using more than six medications had a higher prevalence of ADRs (61.2%). Conclusion: Adverse drug reactions were frequently reported by older patients, while formal reporting to healthcare professionals remained limited. Strengthening patient education, improving patient–provider communication, and integrating clinical pharmacists into primary care may enhance pharmacovigilance practices and medication safety.

Background: The overuse and inappropriate prescribing of antibiotics in early childhood remains a global public health concern, mainly due to the risk of accelerating antimicrobial resistance (AMR). During and after the COVID-19 pandemic, primary care services in Kosovo underwent notable changes in prescribing practices. Aim: This study aimed to examine the prescribing rate and patterns of antibiotic prescribing among children aged 1–7 years in primary health care centers in Prishtina and Ferizaj between January 2022 and January 2025, and to compare regional differences in prescribing behaviors. Methods: A retrospective observational study was conducted using data from the national electronic health record system. All pediatric visits for children aged 1–7 years were included. Antibiotic prescriptions linked to infectious diagnoses were analyzed. Descriptive statistics, Chi-square tests, and multivariable logistic regression were applied to evaluate prescribing prevalence, regional differences, and associated factors. Results: Out of 4,320 pediatric visits, antibiotics were prescribed in 1,328 cases (30.7%). Prevalence was significantly higher in Ferizaj (34.2%) than in Prishtina (28.5%, p < 0.01). Amoxicillin–clavulanic acid (42.9%) and amoxicillin (21.5%) were the most prescribed antibiotics. Metronidazole accounted for 16.4% of prescriptions, while Ferizaj showed a significantly higher use of macrolides (11.7% vs. 6.2%) and cephalosporins (7.9% vs. 3.4%). Only 61.4% of prescriptions were consistent with international clinical guidelines. Younger age (1–3 years), winter season, and residence in Ferizaj were independently associated with higher odds of antibiotic prescribing. Conclusions: Antibiotic prescribing among Kosovar children aged 1–7 years remains high, with concerning regional differences and suboptimal adherence to clinical guidelines. These findings underline the urgent need for standardized pediatric prescribing protocols, enhanced physician education, and robust antibiotic stewardship programs in Kosovo’s primary care system.