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Pharmaceutical Journal of Kenya, Volume 24, No. 4 (2020)

Volume: 24, No. 4 (2020)
ISSN: 2411-6386;
Publisher: The Pharmaceutical Society of Kenya
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Articles in the journal

Editorial: Reporting on Adverse Drug Reactions

Author: Prof. A. Maima
Keywords: ADR

Medication Related Problems in Patients with Head and Neck Cancers at Kenyatta National Hospital

Author: Gaceri P.G., Karimi P.N.
Keywords: Cancer, Medication related problems, prevalence
Background: Treatment of cancers is often associated with a wide range of medication-related problems (MRPs) due to the toxic nature of the regimens used. Studies have characterized the extent of these therapy problems in specific subsets of cancer, but no data is currently available for head and neck cancers. This group of patients faces unique challenges that have a significant impact on the administration, adherence, effectiveness, and safety of medications used.
Objective: The study assessed the medication-related problems among patients on treatment for head and neck cancer patients at Kenyatta National Hospital.
Methods: A cross-section design was used, and ninety participants were randomly sampled at Kenyatta National Hospital oncology clinic after voluntarily consenting to participate. Data was collected using a researcher administered questionnaire and data abstraction form from the hospital records and through a patient interview between February and April, 2019. The collected data were entered into Microsoft Excel 2016 workbook and exported to STATA version 14 for analysis.
Results: The study had 90 participants, and the majority (58, 64.4%) were male. The mean age was 49.4 ± 17.08 years. Participants with at least one MRP were 83 (92.2%). The three most prevalent MRPs were adverse drug reactions (71, 78.9%), the need for additional drug therapy (28, 31.1%), and unnecessary drug therapy (14, 15.6%). The majority (80, 88.9%) of the patients were appropriately managed and 43 (48%) were treated with chemoradiation. Moderate to severe drug-drug interactions and those requiring monitoring or therapy change were found in 40 (44.4%) participants. The reasons for non-adherence were adverse reactions to treatment (11, 12.1%), forgetting to take drugs (6, 6.7%), cost of drugs (3,3.3%), unavailability of medications (3, 3.3%), and difficulty in using the medications (3, 3.3%).
Conclusion: Adverse drug reactions, the need for additional medication, and unnecessary drug therapy were identified as the most commonly occurring MRPs among the participants.

Prevalence and Antimicrobial Susceptibility of Urogenital Pathogens in a Kenyan Tertiary Health Facility

Author: Musembi Y.W., Karimi P.N.
Keywords: Prevalence, susceptibility, pathogens, urogenital
Background: Urogenital infections are among the most commonly reported infections in outpatient care and are caused by bacteria, protozoa, or fungi. They occur in both males and females, but the incidence is much higher in females. Most patients respond well to antimicrobial treatment, but there has been an increase in the incidence of recurrent infections due to the development of resistance.
Objective: The study aimed at evaluating the prevalence and antimicrobial sensitivity patterns of bacteria implicated in urogenital infections at Kenyatta National Hospital (KNH).
Methodology: A retrospective descriptive cross-sectional study design was adopted for the study. The study population comprised patients whose urine samples had undergone antimicrobial susceptibility testing at the KNH microbiology laboratory. Simple random sampling was used to select patient records between January 2019 and May 2019. The data was collected using predesigned forms. Data collected included biodata, type of organisms isolated and antimicrobial susceptibility. The data was analyzed using STATA version 14.
Results: Out of 330 participants, 204(61.8%) were females. The most affected age groups were between 18 and 25 years (25.7%) and those between 26 and 35 years (34.8%), respectively. Gram-negative uropathogens were the most common isolates. The most prevalent microorganism was Escherichia coli (50.6%), followed by Staphylococcus aureus (12.8%), Klebsiella spp (11.5%), Proteus spp (10.0%), Coagulase negative staphylococci (8.2%) and Pseudomonas aeruginosa (7.0%). Escherichia coli showed high sensitivity to Ceftriaxone (94.0%), Ciprofloxacin (91.0%) and Gentamicin (81.4%), while sensitivity to Ampicillin was low (15.0%). Other Gram-negative isolates including Klebsiella spp, Proteus spp, and Pseudomonas aeruginosa were generally sensitive to Ciprofloxacin at, 86.8%, 97.0%, and 82.6% respectively.
Conclusion: Gram-negative bacteria were the most common cause of urinary tract infection,and they were generally sensitive to ciprofloxacin.

Therapeutic Drug Monitoring: A Golden Opportunity for Pharmacists

Author: Mayoka, G. W.
Keywords: Therapeutic drug monitoring, Drug levels, Toxicity, Pharmacist role.
Clinical outcomes following therapeutic intervention can be confounded by drug-related side effects and comorbidities. Therapeutic drug monitoring involves measuring and adjusting drug levels to maximize clinical benefits and reduce adverse effects. The aim of this opinion article is to revisit the principles and applications of therapeutic drug monitoring as well as the challenges and opportunities in the local context. The article argues for the role of pharmacists in lending their expertise in this specialty.

Effects of UV, Red and Sun Light on the Stability of Phytochemicals, Antioxidant and Antimicrobial Activity in the Rhizomes of Zingiber officinale (Zingiberacea)

Author: Njinga N.S.1*, Bakare-Odunola, M.T., Abdullahi S.T., Abdulmajeed, F.F., Bello H.R., Adediran J.O., Muhammad, Z.T. , Egharevba G.O., Shittu, A.O. and Attah F.A.U.
Keywords: Zingiber officinale, radiation, antioxidant assay, Antimicrobial assay, phytochemical assay
Phytochemicals have been reported to be degraded by environmental factors such as heat, light and oxygen. Zingiber officinale (Rosc.) is widely consumed worldwide with remarkable medicinal properties due to its phytochemicals. This study investigates the effect of exposure to sun, red and ultraviolet light of Z. officinale for 168 hours on the stability of the phenols, flavonoids, saponins, antioxidant and antimicrobial activity of this plant. Total phenolic and flavonoids content was determined using Folin-Ciocalteau reagent with gallic acid (GA) as standard and Colorimetric aluminium chloride method with quercetin as standard respectively and total saponin was also determined. The antioxidant and antimicrobial analysis of the irradiated rhizomes extracts were carried out using 1,1-Diphenyl-2-picrylhydrazyl (DPPH) and agar diffusion methods. The total phenolic, flavonoid and saponin content before exposure were 1.30±0.019 mg/g GA, 1.27±0.351 mg/g and 28.4±7.35% respectively while after exposure the values ranged from 1.21-1.40 mg/g GA for phenols, 0.981–2.0 mg/g of quercetin for flavonoid and 22.4-33.2% for saponins content respectively. The IC50 before exposure to the different light sources was 0.2025 mg/mL while after exposure the IC50 ranged from 0.0024 - 0.9262 mg/mL. Exposure to sunlight caused changes in the phytochemicals present as well as its antioxidant activity. Upon irradiation with the different light sources, there was significant increase (P<0.05) of DPPH radical scavenging activity as well as decrease in activity against Staphylococcus aureus 25913, Staphylococcus aureus 41, Escherichia coli and Candida albicans. These changes may be due to degradation of the phytoconstituents. Appropriate storage of herbal materials is necessary to prevent phytodegradation.

A review on Psychological Impact of Disease Outbreaks and how to RESPOND to the IMPACTS of COVID-19

Author: Uwizeyimana P.T, Odhiambo D.
Keywords: Mental health, Pandemic, Psychological support, Capacity Building and Advocacy
Disease outbreaks have been known to cause substantial devastation in the world. The impact of such outbreaks on mental health has been documented but unfortunately these haven’t been mainstreamed into emergency response preparedness. Low-income countries are the most disadvantaged in this front especially considering mental health care hasn’t been much developed with countries having limited capacity for psychological support. These are put to test at times of such crisis when far reaching mental distress is caused with need for remedy.
To correlate research findings, proposals and recommendations from different sources on mental health and the impact of disease outbreaks on mental health, we did desktop review of literature sources to establish some of the findings and align them with the current COVID-19 outbreak. These have then been used to propose feasible approaches that can be used to mitigate the immediate, sustained and long-term psychological impacts of this disease outbreak while at the same time cushioning the public from mental health problems.