Background: Pharmaceutical expenditure has been a major concern for decision-makers worldwide. One strategy to control medication costs involves applying pharmacoeconomic (PE) methods in the approval and listing of new medications. Pharmacists need to possess the knowledge, skill, and competence to analyse and implement PE study findings. This study aimed to evaluate the predictors of pharmacy professionals' knowledge and awareness towards PE and their ability to apply its concepts. Furthermore, this study sought to identify the barriers to the practical application of PE. Methods: A cross-sectional study was conducted between October 2022 and June 2023. A chi-square test was employed to examine the associations between dependent and independent variables while multiple binary logistic regression was performed to identify predictors of PE knowledge and awareness. Results: A total of 204 pharmacists were included. The mean age was 29.34 years (SD: 6.45) and 75.5%of participants were male. Of the participants, 46.6% held a bachelor's degree. A total of 81.4% were aware of PEs and 65.2% exhibited low knowledge levels. Around 60% of participants agreed to all the questions concerning the pharmacists' attitudes towards PE. Females were 2.6 times more likely than males to have good PE knowledge (AOR = 2.62, p < 0.01). Participants aged 26-35 and those over 36 were 2.6 times (AOR = 2.6, p < 0.05) and 2.8 times (AOR = 2.83, p < 0.01) more likely to have good knowledge than those under 25, respectively. Conclusion: This study highlighted a gap in the knowledge, and ability to apply PE concepts in practice. Key predictors such as being aged 30 or older, having longer years of work experience, and holding advanced pharmacy degrees were linked to higher levels of PE knowledge, positive attitudes, and awareness and enhanced the ability to apply PE concept. Future research should assess the effectiveness of PE courses offered in pharmacy colleges across Saudi Arabia.

Background: Medications including unused ones, might lead to financial and environmental costs. Not only they could have economic impact but also, harm the population safety. However, the nature and extent of leftover and unused medications in Saudi families and its economic impact remain unknown. Objectives: The aim of this study is to assess the potential economic cost of the unused medications in Saudi households. Method : A crosssectional, observational study was conducted using a snowball method for recruiting the families. Descriptive data were collected face to face using a structured questionnaire. Result: A total of 116 family included in the study, 536 unused medications were found in their houses during the study period (December 2021- April 2022). Approximately, 42 % (227) of unused medications were stopped due to symptoms improvement. A total of 56 types of unused medications with different dosage forms were found at houses because of receiving excess medication in the packet (17%, 90) and purchased for emergency (14% 78) use. The total cost was SR 26249. ($ 6995.60) for the unused medications which found at 116 households. Of the total 41(34%) of the total households with unused medication have unused medication range between 1-99SR. The stoke of left over medication worth of above 500 SR for around six (5%) of the families. Conclusion: A significant number of unused medications were found at family's. The study also identified that there were different reasons for unused medications that can be prevented. The unused medications result in relatively high economic impact. Educational interventions are highly needed for families on unused medications.

Background: According to the American College of Cardiology/the American Heart Association (ACC/AHA) recommendations, health-related risk behaviors for secondary prevention of myocardial infarction (MI) are critical to determine. Objective: This study aimed to compare health-related risk behaviors between MI survivors and propensity-score matched non-MI controls using nationally representative data. Methods: This cross-sectional, matched case-control study used publicly available Behavioral Risk Factor Surveillance System (BRFSS) 2017 data. Older adults with MI were propensity-score-matched to their non-MI controls. The 10 dependent variables included body mass index (BMI), smoking status, heavy alcohol consumption, influenza vaccine, length of time since last routine and cholesterol checkup, alcohol consumption, fruit and vegetable consumption, and physical activity. Chi-square tests and binomial logistic regression were used to examine the health-related risk behaviors differences between MI survivors and propensity-score-matched non-MI controls. Results: The final study sample consisted of 18,021 MI survivors and 54,063 non-MI controls after propensity score matching. Multivariable logistic regression analysis showed significant differences between MI survivors and matched non-MI controls in terms of cholesterol checkup, smoking status, and alcohol consumption. For example, multivariate analysis of health-related risk behaviors showed MI survivors were more likely to be smokers (AOR = 1.46, 95% CI: 1.28-1.68). Conclusion: Based on this national survey of adults, MI survivors were more likely to be smokers but less likely to consume alcohol compared to their propensity-score-matched controls. Moreover, MI survivors were more likely to have their cholesterol checkup within the past 2 years compared to matched non-MI controls. Although lower alcohol consumption and greater chances of cholesterol checkups are reassuring health-related behaviors, interventions are needed to minimize the chances of smoking in this population.

Introduction: During the 2020 COVID-19 pandemic, suspension of many educational activities occurred to mitigate the risks of infection spread. For pharmacy students in their internship year, many efforts have been made to move their experiential training to a virtual platform without compromising learning outcomes. Objectives: Redesign the advanced pharmacy practice experience (APPE) to remote learning without compromising the learning outcomes; Develop an appropriate teaching modality/strategy and assessment method for remote APPE; To drive the change in experiential education by providing guidance for other pharmacy schools dealing with similar situations. Restructured APPE: Eighty-seven interns were switched to an online internship with five specialties based on the availability of the preceptors, namely internal medicine, infectious diseases, oncology, total parenteral nutrition, and psychiatry. Experiential education activities such as drug information questions, case presentations, and clinical pharmacy topic discussions took place on virtual platforms. Student assessment was done using adjusted rubrics to suit the online platforms. Student feedback was taken using an online questionnaire and was mostly positive, indicating that they improved their clinical pharmacy knowledge. Conclusion: The authors highlighted the various restructuring modalities and learning methods used for different clinical rotations to achieve the learning outcomes in difficult situations. In future, the authors plan to work with their colleagues in other health colleges to adapt their practices together.

A burgeoning literature documents the confluence of ovarian steroids and central serotonergic systems in the injunction of epileptic seizures and epileptogenesis. Estrogen administration in animals reduces neuronal death from seizures by up-regulation of the prosurvival molecule i.e. Bcl-2, anti-oxidant potential and protection of NPY interneurons. Serotonin modulates epileptiform activity in either direction i.e administration of 5-HT agonists or reuptake inhibitors leads to the activation of 5-HT3 and 5-HT1A receptors tending to impede focal and generalized seizures, while depletion of brain 5-HT along with the destruction of serotonergic terminals leads to expanded neuronal excitability hence abatement of seizure threshold in experimental animal models. Serotonergic neurotransmission is influenced by the organizational activity of steroid hormones in the growing brain and the actuation effects of steroids which come in adulthood. It is further established that ovarian steroids bring induction of dendritic spine proliferation on serotonin neurons thus thawing a profound effect on serotonergic transmission. This review features 5-HT1A and 5-HT3 receptors as potential targets for ameliorating seizure-induced neurodegeneration and recurrent hypersynchronous neuronal activity. Indeed 5-HT3 receptors mediate cross-talk between estrogenic and serotonergic pathways, and could be well exploited for combinatorial drug therapy against epileptogenesis.

Background: Parsley (Petroselinum crispum L) (PAR) is used widely as an antioxidant, antihyperlipidemic, diuretic, and medication to reduce hypertension. At the same time, conventional drugs such as Simvastatin (SV) are also used to manage hyperlipidemia in hypertensive patients. However, no studies have reported any interactions for the concomitant use of PAR and SV. Objectives: The study aimed to evaluate the enzyme-inducing or inhibiting role of PAR for SV at the level of cytochrome P-450 metabolic enzyme. Methods: This is an open-label (unblinded) study conducted with 24 healthyalbino rats (4X6 =24), at ImamAbdulrahman Bin Faisal University, Saudi Arabia, in the year 2018 with protocol approval No. IRB-2018-145-Pharm and approval date 18/04/2018. The animals were administered with a loading single oral dose of SV (80 mg), Clarithromycin (CLAR; 80 mg), Carbamazepine (CBZ; 80 mg), and PAR, i.e., dried herb powder (200 mg), in order to achieve a steady state concentration in the blood. Blood samples were collected at specified time points including pre-dose (0.0) and after-treatment, i.e., 0.5,1,1.5, 2, and 3 hours, and centrifuged. The plasma was extracted to analyze for SV by LC-MS using a previously developed method. Results: The analysis of pharmacokinetic parameters revealed enhanced C-max (mean plasma maximum concentration) and AUC(0-infinity)(area under the concentration-time curve) as 2 and 2.2 folds, respectively, for SV+PAR(P < 0.01) as compared to SV alone. A decrease in CL/F (total-body clearance of drug from the plasma) for SV (P < 0.01) and an increased t(1/2) (mean half-life) from 3.20 to 6.12 hours for SV co-administered with PAR were observed. Conclusions: Parsley combined with Simvastatin increased the C-max and AUCs for Simvastatin as 2 and 2.5 folds; thereby, the moderating enzyme-inhibiting role of Parsley for CYP 3A enzyme may be proposed. Hence, caution is required when administering Parsley with Simvastatin for any therapeutic purpose.