BAHRAIN PHARMACISTS SOCIETY

JANUARY 2011
ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN
‫كلمة رئيس الجمعية‬
‫يسرني باسمي شخصيًا وباسم مجلس‬
‫اإلدارة أن نتقدم لجميع أعضاء الجمعية‬
‫بجزيل الشكر على الثقة التي منحونا‬
‫إياها متمنين أن نكون عند حسن‬
‫ ونؤكد أننا سنعمل كجسم واحد‬،‫الظن‬
‫وسنواصل ما بدأه زمالؤنا في اإلدارات‬
‫ ولنكمل المسيرة سنبدأ من‬، ‫السابقة‬
.‫حيث انتهوا‬
‫سنواصل اهتمامنا ومتابعتنا للقضايا‬
‫ إال أن كادر الصيادلة سيبقى أهم أولويات‬، ‫المهنية والعلمية‬
‫ وسيستمر سعينا في هذا الصدد‬،‫مجلس اإلدارة لهذه المرحلة‬
.‫لحين إقراره من قبل الجهات المختصة‬

‫الصيدالنية أقبال العامر‬

‫رئيسة جمعية الصيادلة البحرينية‬

President’s Welcome Note

Firstly, I would like to thank the Society members for
placing their trust in the Board of Directors that I have
the honor of chairing. As a new Board of Directors,
We shall continue previous Boards’ initiatives while
maintaining the one team spirit.
The scientific and professional issues will continue to
be within our core attention however, the Cadre shall
remain the top priority of this board until approved by
the Government.

Pharmacist Iqbal Al-Amer

President - BPS
Society News:

Interview with the Minister

His Excellency, Dr. Faisal Al Hamar, Minister of Health,
met with the board members of Bahrain Pharmacist
Society in the Ministry headquarters in Juffair on
Tuesday 8th June 2010. The meeting was attended
by the assistant undersecretary of financial affairs, Mr.
Jaffar Shubbar, Ph. Sahar Al Qahtani, Deputy Director
of Drug Control and the BPS Board members; Ph.
Iqbal Al-Amer, President. Ph. S. Ali Al Wedaei, the Vice
President. Ph. Raja Al Qameesh, Head of Scientific
Committee, Ph. Yaser Sakheer, BPS Treasurer and
Ph. Khulood Bu Hussain, Head of Social Committee
and Media and Ph. Fadheela Al Khayat, Head of His Excellency The Minister of Health with the
Membership Committee. Board Members of the Bahrain Pharmacist
Many important issues were discussed during the Society
meeting including the pharmacy cadre and profiling the benefits entitled to pharmacists. The subject of
the amendments to law No. 14 for the year 1997 in the law of pharmacy profession was also reviewed.
Additionally, the Bahrain Pharmacist Society discussed with the Minister upgrading of the Pharmacy
Technician Program in the College of Health Science to Bachelor level to enhance the pharmaceutical
services in the Kingdom Of Bahrain. Furthermore, improvement of the pharmaceutical services in the
Ministry by adopting strategic methods to reduce workload was also discussed. Finally the members
discussed the enhancement of professional development of the pharmacy personnel in order to bring
them in line with international standards.
At the end of the meeting, the pharmacists thanked the minister for this opportunity to discuss all
matters of important to pharmacists in the Kingdom.

Pharmacists’ Day Celebration

A celebration marking the Pharmacists’ Day
was held at the Gulf Hotel last April. The
celebration was attended by Pharmacists
and Pharmacy technicians from all over the
Kingdom. The highlight of the celebration was
the various speeches delivered by Ph. Iqbal Al
Amer, President of the BPS and Ms. Seema
Zainal, Director of Health Centers. Pharmacists
who had served for over twenty five years and
Members of the previous Board of the BPS
were honored with trophies in the celebration.
Additionally, pharmacists who had participated
in organization of the BPS society events were
also honored on this day. Two students from the
Pharmacy technician program at the college
of health sciences were honored for their
excellence in the poster presentation. Attendees of the Pharmacist Day

BAHRAIN PHARMACISTS SOCIETY


ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN JANUARY 2011

Memories of Pharmacy
The society organized a gathering entitled “Memories of
Pharmacy in Bahrain” on the 6th of June 2010 in the Crowne
Plaza Hotel. Two lectures were presented by Dr. Rasoul Al
Jishi, the first Bahraini pharmacist and Mr. Jaffar Abdulla,
one of the first Bahraini senior technician, who spoke of

Senior Technician Pharmacist

Jaffar Abdulla Rasoul Al Jishi

their memories, experiences and feelings over their

Bahrain Pharmaceutical Society attending an
evening “Memories of Pharmacy”
years of practice of the pharmacy profession. In a
friendly atmosphere, the audience joined the two
lecturers in rekindling memories and discussing
the development of pharmaceutical services in the
Kingdom of Bahrain.

Gulf College of Clinical Pharmacy (GCCP) Meeting

In collaboration with the Royal Medical Services, The
Bahrain Pharmaceutical Society organized the second
GCCP (Gulf College of Clinical Pharmacy) summer
meeting on the third of June, 2010. The meeting, held at
the Bahrain Sheraton Hotel, was entitled “Critical Care
Pharmacotherapy Updates”. The meeting commenced
with a speech by the President of the GCCP, Ph. Saud
Al Abdulmohsin, who briefed the audience about the
objectives and mission of the GCCP. This introduction was
followed by three scientific talks entitled:

• “ Primary and Secondary Prevention of Cardiovascular

Disease and Stroke”, presented by Dr. Hisham Al
Momattin, BS. Pharm, MHSA, Pharm. D., Critical Care
Cardiology Pharmacy Specialist at Saudi Aramco Medical
Services Organization (SAMSO).

• “Updates on the Management of Gout and Hyperuricemia”,

presented by Dr. Jawahir Al Zayani, Pharm. D., PhD.,
Clinical pharmacist in the family medicine group.

• “ Improving Antimicrobial Prescribing for Critically Ill

Patients; The Pharmacist Role”, presented by Ph. Nadia
H. Ismail, BS. Pharm., MSc., Surgical and Medical
Intensive Care Units, Pharmacy Specialist at King Fahd
University Hospital.

The audience included a large number of pharmacists,

physicians and other members of the healthcare team from
Members of the BPS at the GCCP Meeting the Kingdom of Bahrain, the Kingdom of Saudi Arabia and
other GCC countries, who effectively interacted through
discussions, questions and opinions facilitated during the talks. This meeting was an opportunity to introduce a
large number of healthcare professionals to the activities and vision of the GCCP, which is a chapter of the ACCP
(American College of Clinical Pharmacy) serving the Gulf Area. The event was sponsored by GSK, Janseen-Cilag,
Al-Hekma and Gulf Pharmacy.

BAHRAIN PHARMACISTS SOCIETY


Lecture on Imigran® (Sumatriptan) Nasal Spray by GSK
A lecture on “Imigran Nasal Spray” was held in
the Gulf Hotel, Bahrain on Wednesday 30th June
2010. The lecture introduced BPS members to the
importance and advantages of the new dosage form
of the widely used drug, Imigran® (Sumatriptan)
launched by Glaxo Smith Kline. This was followed
by a discussion between the BPS members and
GSK representatives on the prescribing information,
dosing, safety and price of the new product. The
lecture and debates were very informative to the
audience on the new technique for management of
BPS members who attended the presentation
migraine headaches. with GSK medical representatives.

Lecture on Awareness of Drugs Presentation on Procoralan®

at Abdulla Al-Othman Council
by Servier
A presentation was given on the new
cardiovascular medication Procoralan®
(Ivabradine) by the Pharmaceutical company
Servier. The event was held at the Gulf Hotel
on Monday 25th October 2010 and was
actively attended by members of the Bahrain
Pharmaceutical Society.

Ph. Yaser with his audience in Abdulla

Al-Othman Council
BPS members who attended the lecture
BPS treasurer, Ph. Yaser Sakheer delivered a lecture
on “Awareness of Drugs” in Abdulla Al Othman
Council, Arad in response to an invitation by Mr.
Lecture on “All Statins Are
Abdulla Al-Othman. His talk included tips on how to Not The Same” by Pfizer
avoid mistakes related to drugs, advice on keeping A lecture titled “All Statins Are Not The Same”
copies of prescriptions, informing the physician of was given by Pfizer on the 5th of December 2010
other medications used, enquiring about drug-food at the Gulf Hotel and was attended by members
of the Bahrain Pharmaceutical Society.
interactions and asking for proper instructions on
drug administration especially in case of doubts
arising due to drug substitution. Additionally,
the lecture covered guidelines on avoiding child
poisoning by medications, cautioning elderly
patients on the proper use of their drugs, and the
stressing the importance of monitoring the expiry
date and the returning of expired medications to
health center pharmacies. The audience thanked
Ph. Yaser for his informative lecture. BPS members who attended the lecture

BAHRAIN PHARMACISTS SOCIETY


ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN JANUARY 2011

Participation of Society Members at the International and

Arabic Meetings, Events and Conferences

Ph. Iqbal Al Amer attends the 8th Saudi International Pharmaceutical

Conference and Exhibition
Under the Auspices of Prince Fahad Bin Sultan Al Saud, Governor of Tabuk
Region and the Honorary President of Saudi Pharmaceutical Society (SPS),
SPS organized the 8th Saudi International Pharmaceutical Conference and
Exhibition during the period from Monday April 26th to Wednesday April 28th,
2010 in Riyadh City. Ph. Iqbal Al Amer president, Bahrain Pharmaceutical
Society accompanied by Ph. Yaser sakheer attended this conference along
with participants of many local and international organizations.

The conference topics covered Pharmacy Education and Training, Leadership

in Health System, Leading Change in Organizations, Group Purchasing of
Pharmaceuticals, Medication Safety, Hospital Accreditation, Pharmacy
Management, Risk Management, Herbal Medicine, Nanotechnology and
Targeted Drug Delivery in Medicine. Ph. Iqbal Al Amer

The 30th meeting of the High 18th “Quality Assurance in Pharmacy

Council of the Arab Pharmacists Practice” Conference in Lebanon
Union
In response to the invitation from the Pharmaceutical
Ph. Raja Al-Qameesh, represented Bahrain Syndicate of Lebanon, Ph. Yaser Sakheer, treasurer
Pharmacists Society at the 27th scientific of the BPS, attended the 18th “Quality Assurance in
conference and the 30th meeting of the High Pharmacy Practice” Conference in Lebanon, in place
Council of the Arab Pharmacists Union which of Ph. Iqbal Al Amer, President of the BPS. The two day
was held in Damascus ,Syria from 11th to conference, held in the Habtour Hotel last of October
23rd May 2010 . The event was under the included many lectures including drug misuse and
patronage of the Syrian president Dr Bashaar addiction, GMP regulations in Lebanon, quality
Al Asad and it was organized by Arab clinical laboratory services, product substitution and
Pharmacists Union and the Syrian Pharmacists the latest updates in drug-drug interaction.
Society . The conference was for the first
two days, where there were many speakers
from Arab as well as other countries. The
theme of the conference was “The Future and
Perspectives of the Pharmacy Profession”.
On the third day there was a meeting of the
High Council of the Union were new election
was conducted. The Syrian candidate Dr.
Adeeb Shanen replaced the Jordanian as
a president of the Arab Pharmacists Union.
Bahrain was represented as a member in the
scientific committee and the legislation and
professional committee. There was a social
program and a visit to Syrian heritage village.
The event was an excellent opportunity for
the society to interact with pharmacists from Ph. Yaser Sakheer in Lebanon for the 18th Conference
many countries and share experiences. on “Quality Assurance in Pharmacy Practice

BAHRAIN PHARMACISTS SOCIETY


The 97th meeting of the Executive Board of the Arab Pharmacist Union
Ph. Yaser Sakheer and Ph. Fadheela Al-Khayat
participated in the 97th meeting of the Executive Board
of the Arab Pharmacist Union, held in Tunisia. Sessions
included discussions on the financial status of the Union,
a report from the General Secretary of the Union on the
activities of the Union during the year 2010. Additionally,
Dr. Adeeb Shanen, President of the Arab Pharmacist
Union, presented the Board’s recommendations for
discussion and feedback by participating countries.

Under the patronage of the Tunisian Minister of Health

and the sponsorship of the Arab Company for Drug
Ph. Yaser and Ph. Fadheela in the Executive
Industries and Medical Appliances “ACDIMA”, a seminar
Meeting of the Arab Pharmacist Union in Tunisia
on “Impedance of Counterfeit Medications” was
conducted on the 11th of December, 2010. Lectures were
followed by questions from the audience and included
the following topics:

“Drug Quality Assurance and Impeding the Trade of

Counterfeit Medications in Tunisia” by Dr. Kamal Al-Din.

“Clarification of the Definitions of Generic and Counterfeit

Medications” by D. Mohammed Khalil, the Executive
Manager of the Bioequivalency Center, ACDIMA, Jordan.

“Role of Interpol Authorities in Impeding Trade of Counterfeit

Ph. Yaser and Ph. Fadheela in the
Medications” by Alain Belanson from the Interpol.
ACDIMA Seminar
“Role of New Technologies in Impeding Trade of Counterfeit Medications” by Dr. Ali Ebrahim, where he
demonstrated the bar code technique and compared it with those available in the USA and the EU.

National Medicine Policy

A National Medicine Policy is a commitment to a goal and a guide, set by the government, for co-
ordination of activities by the pharmaceutical sectors, including both public and private. The policy
is needed to set national goals, objectives and priorities of the pharmaceutical sector and to identify
strategies needed and entities responsible for implementing those objectives. In general, the main
objectives of the policy are to ensure access, quality and rational use of drugs by health professionals
and patients, however, specific objectives may be customized for each country according to
requirements, priorities and resources.
The policy developed should be in line with the framework of the current healthcare system and
compatible with the broader general health objectives of other medical practices. The general health
policy, level of service provision, drug situation and the economic considerations are all points of
consideration in the policy.
Development of the document should be done through systematic consultation with interested parties by
a well designed policy process to bring all parties together and to achieve a sense of ownership of the final
policy.

By Ph Hassan Al-Majed

References:
Bahrain National Medicine Policy 2009

BAHRAIN PHARMACISTS SOCIETY


ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN JANUARY 2011

Hospital policies and practices on prevention and treatment of infections caused by methicillin-
resistant Staphylococcus aureus.
Yoojung Yang, Martin V. McBride, Keith A. Rodvold, Frank Tverdek, Anne Marie Trese, Joel Hennenfent, Gordon
Schiff, Bruce L. Lambert, and Glen T. Schumock

Reviewed by:
Ph. Yaser Sakheer (B.Sc.), Senior Pharmacist, BDF Hospital
Ph. Jayanthi S. Kotian, (B.Sc., M Pharm), Lecturer, Pharmacy Technician Program, CHS
Ph. Sherry N. Nasralla, (B.Sc., M.Sc.), Lecturer, Pharmacy Technician Program, CHS

Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to

improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial
resistance. With antimicrobial resistance on the rise worldwide and few new agents in development,
antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy
of available antimicrobials. The design of antimicrobial management programs should be based on
the best current understanding of the relationship between antimicrobial use and resistance. Such
programs should be administered by multidisciplinary teams composed of infectious diseases
physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should
be actively supported by hospital administrators. (MacDougall and Polk, 2005)
Methicillin Resistant Staphylococcus Aureus (MRSA), has become an increasingly serious public health
concern. A study conducted in the United States, aimed at characterization of the use of policies and
practices regarding surveillance, decolonization, and treatment of MRSA infections and the formulary
status of various antimicrobial agents used to treat MRSA.

The study was based on the responses of pharmacy directors of acute care hospitals to a 61 item
questionnaire, addressing hospital policies and practices on surveillance, contact precautions,
antibiotic stewardship and treatment of MRSA. The results provided insight into the status of current
practice compared with national recommendations and identified areas for potential improvement in the
prevention and management of this important pathogen. It was found that, although a formal antimicrobial
stewardship team did not exist in most hospitals, most had mechanisms for review of antimicrobial use
and recommendations for alternative therapy as well as formulary restrictions or a preauthorization
requirement for selected antimicrobial agents. Surveillance policies including adopting proper culturing
methods, use of gowns and hand gloves before entering and leaving the patients’ rooms and hand
hygiene procedures, were followed to control MRSA infections in most hospitals. Vancomycin was on
the formulary in all hospitals with few restriction policies, while the newer anti-MRSA agents (linezolid,
daptomycin and tigecycline) were on the formulary in most hospitals but with restrictions.

Vancomycin was the most commonly used antimicrobial for the treatment of various MRSA infections,
followed by linezolid. Results also revealed that most hospitals did not have guidelines specifically
addressing the treatment of MRSA infections, yet a large percentage of the hospitals reported the
existence of guidelines on the use of vancomycin. The study concluded that although hospitals varied
in their policies and practices for the management of MRSA infections, most were consistent with
national guideline recommendations. (Yang et al, 2010).
References:
MacDougall, C., Polk, R.E., 2005. Antimicrobial Stewardship Programs in Health Care Systems. Clinical Microbiology Reviews,
18 (4), p. 638-656.

Yang, Y., McBride, M.V., Rodvold, K.A., Tverdek, F., Trese, A.M., Hennenfent, J., Schiff, G., Lambert, B.L., Schumock, G.T.,
2010. Hospital policies and practices on prevention and treatment of infections caused by methicillin-resistant Staphylococcus
aureus. Am J Health-Syst Pharm, 67, p. 1017–1024.

BAHRAIN PHARMACISTS SOCIETY


Pharma Tips
Tips on Patient’s Counseling

Written by:
Dr. S. Mahmood Alqallaf, BPharm, MPharm, PhD, Head, Pharmacy Technician Program, CHS

Sufficient information regarding the drug needs to be given to the patient or his/her care-giver in order
to enable them to use the medicine safely and effectively.
Some points that should be taken into consideration about patient’s counseling:

• Tone of voice and body language combined

• For a good explanation remember the
contribute more towards communication mnemonics “KISSER”, which stands for:
than the words in the message. There are • Keep
five main areas of body language: gaze or • It
eye contact, facial expression, proximity • Simple
and orientation, posture, and touch. • Short
• Empathetic
• In order to ensure that a message is received
• Relevant.
correctly, the message sender needs to:
speak clearly, speak slowly, use appropriate
• Remember, there are three parts to a good
language, check understanding.
explanation:
• Planning
• In asking the patient, remember the • Presentation
mnemonics “WWHAM”, which stands for: • Feedback.
• Who is the medicine for?
• What are the symptoms?
• How long have you been ill?
• Action taken so far?
• Medicines being taken at the moment?

References:
1. Marrow, N. and Hargie, O. (2005). Effective Communications. In: Taylor, K. M. G. and Harding, G. eds. Pharmacy Practices,
Second ed., Taylor & Francis.
2. Patient counselling and communication (2009). In: Langley, C. A. and Belcher, D. Applied Pharmaceutical Practice, First ed.
Pharmaceutical Press.
3. Howard, R. L. (2008). Compliance, adherence and concordance. In: Whalley, B. J., et al. eds. Foundation in Pharmacy
Practice, First ed. Pharmaceutical Press.
4. Communication Skills and patient Counselling (2010). In: Azzopardi, L. M. Lecture Notes in Pharmacy Practice, First ed.
Pharmaceutical Press.

Can you read it?!

One of the challenges facing a dispensing pharmacist on
a daily basis is the need to decipher the handwriting of
physicians on prescriptions!

A non-english speaking patient arrived with this scrawled

prescription at a pharmacy. The pharmacist on duty
pondered over it for a long time but was unable to figure it
out. Can you help the pharmacist identify the drug, dose
and duration of therapy??

Test your ability ... Send your answers to Ph. Yaser Sakheer
on the following email address yasersakheer@hotmail.
com, no later than March 15th to win a fine prize.

BAHRAIN PHARMACISTS SOCIETY


ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN JANUARY 2011

Article Review
Combination therapy for the management of hypertension: A review of the evidence.
Nitesh Sood, Kurt M. Reinhart, and William L. Baker

Reviewed by:
Ph. Yaser Sakheer (B.Sc.), Senior Pharmacist, BDF Hospital
Ph. Jayanthi S. Kotian, (B.Sc., M Pharm), Lecturer, Pharmacy Technician Program, CHS
Ph. Sherry N. Nasralla, (B.Sc., M.Sc.), Lecturer, Pharmacy Technician Program, CHS

Numerous clinical trials have demonstrated

the importance of early aggressive lowering
Thiazide Diuretics
of blood pressure, especially in patients at
high cardiovascular risk. However, one of
the difficulties with achieving these blood
pressure goals quickly is that monotherapy β-Blocker ARB
is often insufficient. Many large randomized
trials have shown that two or more
antihypertensive agents are required for
patients to reach their treatment goals.
Recent data have suggested that the use
of combination therapy in patients with α-Blockers CCB
hypertension may be beneficial in terms of
improving blood pressure lowering efficacy,
obtaining blood pressure goals earlier, and ACE Inhibitors
reducing major adverse cardiovascular
events. This article reviews the evidence
regarding combination therapy for the
Figure 1 Potential combination among various classes
management of hypertension. antihypertensive agents. The solid lines indicate preferred
combinations. The boxed drug classes indicate those with benefits
Studies have found that therapy with a supported by randomized controlled trials. Reprinted from Mancia
et al., 2007. ARB = Angiotensin Receptor Blocker, CCB = Calcium
calcium channel blocker (CCB) combined Channel Blocker, ACE = Angiotensin Converting Enzyme.
with an angiotensin converting enzyme
(ACE) inhibitor, significantly reduces both blood pressure and major clinical events compared with ACE
inhibitor-diuretic combination. Combination ACE-CCB therapy has also demonstrated superior blood
pressure lowering efficacy and safety compared with either group used as monotherapy, including
lower rates of peripheral edema compared with those achieved with increased doses of CCBs. The
combination of ACE inhibitors and an angiotensin II receptor blocker has not been found to be superior
to either group as monotherapy in patients with hypertension and should not be recommended at this
time (Figure 1).

In conclusion, combination drug therapy for the treatment of hypertension is supported by numberous
randomized trials and clinical management guidelines. The addition of a diuretic or CCB to Renin-
Angiotensin-Aldosterone system blocker therapy may provide an effective combination for reducing
blood pressure and cardiovascular events.
References:
Sood, N., Reinhard, K.M., Baker, W.L., 2010. Combination therapy for the management of hypertension: A review of the
evidence. Am K Health-Syst Pharm, 67, p. 885-894.

Mancia, G., DeBacker, G., Dominiczak, A. et al., 2007. Guidelines for management of arterial hypertension: The task
force for the management of arterial hypertension of the European Society of Hypertension (ESH). J Hypertens.2007,
25, p. 1105-1187. (Erratum, J Hypertens. 2007, 25, p. 1749.)

BAHRAIN PHARMACISTS SOCIETY


Article Review:
Phytosterols for Dyslipidemias
Jennifer M. Malinowski and
Monica M. Gehret
Reviewed by:
Mr. Yaser Sakheer (B.Sc.), Senior Pharmacist, BDF
Hospital
Ph. Jayanthi S. Kotian, (B.Sc., M Pharm), Lecturer,
Pharmacy Technician Program, CHS
Ph. Sherry N. Nasralla, (B.Sc., M.Sc.), Lecturer,
Pharmacy Technician Program, CHS
Elevated total cholesterol and low density
lipoprotein (LDL) cholesterol concentrations are
well-established risk factors for coronary heart
disease (CHD). Statins reduce the morbidity and
mortality associated with heart disease and they
are also the preferred agents for decreasing LDL
cholesterol levels. Unfortunately not all patients
attain their lipid goals with statin therapy alone.
Plant sterols and stanols, known as phytosterols
are useful as an adjunct to other antihyperlipidemic
agents for reducing LDL cholesterol. They act
by limiting cholesterol absorption from the
small intestine and also promoting cholesterol
elimination in the feces.
Phytosterols are present in small amounts in
fruits, vegetables, nuts, legumes and edible oils;
marketed sources are primarily derived from
soyabean and pinetree oil. Phytosterols find
application in patients who cannot reach their
treatment goals by diet alone, or who are taking
maximum tolerated doses of statins. These
products offer an alternative to statins in patients
who cannot take statins or whose statin dosage is
restricted because of potential drug interactions
or concomitant diseases. Phytosterol products are
well tolerated and have few drug interactions, but
their long term safety has not been established.
Commonly reported adverse effects of phytosterols
are gastrointestinal in nature. This review provides
sufficient evidence to recommend phytosterols
for lowering LDL cholesterol in adults.
References
Malinowski, J.M., Gehret, M. M., 2010. Phytosterols for
dyslipidemia. Am J Health-Syst Pharm., 67, p.1165-1173.
BAHRAIN PHARMACISTS SOCIETY
10
Technician Corner
I am a pharmacy technician working in Hamad Town
Health Center. My job roles and responsibilities
include dispensing medicine, counseling patients,
compounding and assisting the pharmacist in
various areas. I have been working for three
years in Hamad Town Health Center. Since then,
Health Centers have managed to get the Canadian
accreditation and a continuous attempt is being
made to strengthen our drawbacks. Although this
calls for more workload on the staff, yet these efforts
are done with an intention to offer better services to
the patients.
Talking about my pharmacy we have a great
team, together we try to make many changes,
managing fast moving medicines, arranging
all medicines by pharmacological groups and
repackaging. Since Hamad Town Health Center
is one of the busiest, all technicians work
together as a team to deliver the best service
possible. Recently we added a computerized
system for the referral patients and soon we will
have a record for all chronic patients!
I really want to thank my work team they are doing
a great job... Working in unity we could provide
better services to the community. Patients trust
our knowledge and commitment, so it becomes
our duty to keep ourselves updated with current
developments in pharmacy and pharmacology. I
leave with this message to my fellow technicians,
“Patients’ lives are in your hands... be committed
to your profession!”.
Written by:
Khadija Hussain
Pharmacy Technician,
Hamad Town Health Center
ANNUAL NEWSLETTER OF BAHRAIN PHARMACISTS SOCIETY, KINGDOM OF BAHRAIN JANUARY 2011

Some Events and Advancement in 2010

Reviewed by:
Ph. Raja Al Qameesh, (B.Sc., M.Sc.) Associate Professor, College of Health Sciences

• Fingolimod received FDA approval as the first oral treatment for multiple sclerosis (MS). The
drug is approved to reduce relapses, reduce the frequency and severity of symptoms and
delay disability progression in patients with relapsing forms of MS.
• Using the combination oral antiretroviral therapy emtricitabine/tenofovir (Truvada) as a Preexposure
chemoprophylaxis (PrEP) demonstrated significant effectiveness against HIV infection in a major,
multicontinent clinical trial. The HIV infection rate was 44% lower for those in the treatment group
((men only)than for those in the placebo group., The risk for infection decreased by more than 70%
for individuals who took their pills on 90% or more of the days in the study. Follow up studies will
be conducted to investigate the effectiveness in other groups.

Drugs Recall
• Abbott Laboratories pulled the obesity drug sibutramine from the market in light of clinical trial
data. Called the Sibutramine Cardiovascular Outcomes Trial (SCOUT), which demonstrated a
16% increase in the risk for serious cardiovascular events.
• (FDA) pulled propoxyphene. New clinical data showed that the drug puts patients at risk for
potentially serious or even fatal heart rhythm abnormalities. A phased withdrawal of propoxyphene
is already underway in Europe. The European Medicines Agency made that decision in June 2009.
An estimated 10 million patients have used these products.

Warnings and Alerts

FDA warned about the following:
• 80-mg dose of simvastatin is associated with an increased risk for myopathy, including
rhabdomyolysis
• Opioid tramadol is linked to increased suicide risk
• Bisphosphonates used to treat osteoporosis have a possible increased risk for atypical femur
fractures
• Long-acting beta agonists LABAs alone in the treatment of asthma in adults or children.
Instead, they should be combined with an asthma “controller” medication. Recent analyses of
clinical trials show that LABAs are associated with a higher risk of severe worsening of asthma
symptoms
• FDA allowed Rosiglitazone to remain available under a stringent restricted access program including
additional safety labeling and restrictions for use, despite adverse cardiovascular effects. However,
the European Medicines Agency (EMA) has recommended the suspension of the marketing
authorizations for all rosiglitazone-containing antidiabetes medications.
• Tigecyline was linked to an increased risk for death in patient with certain severe infections.

References
1. Ludwig Kappos, M.D., Ernst-Wilhelm Radue, M.D., Pascale Burtin, M.D., Ph.D. for the FREEDOMS Study Group, etal. A
Placebo-Controlled Trial of Oral Fingolimod in Relapsing Multiple Sclerosis. N Engl J Med 2010; 362:387-401
2. Robert M. Grant, M.D., M.P.H., Javier R. Lama, M.D., M.P.H., Peter L. Anderson, Pharm.D., etal. Preexpose Chemoprophylaxis
for HIV Prevention in Men Who Have Sex with Men. N Engl J Med 2010; 363:2587-2599
3. W. Philip T, James, M.D., D. Sc., Ian D. Caterson, M.D., Ph.D., Cheryl L. Renz, M.D. for the SCOUT Investigators, etal.
Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects. N Engl J Med 2010; 363:905-91
4. FDA Drug Safety Communication: Ongoing safety revew of high-dose Zocor (simvastatin) and increased risk of muscle
injury
5. FDA Drug Safety Communication: FDA recommends against the continued use of propoxyphene
6. http://www.fda.gov/Drugs/DrugsSafety/ucm234338.htm#references
http://www.medscape.com/features/slideshow/year-in-medicine
http://www.medscape.com/viewarticle/732887

BAHRAIN PHARMACISTS SOCIETY

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Pharma-Crossword

Across:
• A proton pump inhibitor.
• The process of synthesis of glucose in the liver.
• Inhaled salbutamol is applied for this condition.
• A mineral that is essential for bone development.
• An oral hypoglycemic agent also applied for polycystic ovarian
syndrome.
• A second generation antihistamine.
• A type of cell division.
• The only drug useful in Type I Diabetes mellitus.
• A thiazide diuretic.
•A folate reductase inhibitor administered weekly for the management of
rheumatoid arthritis.
• Triple therapy for H. pylori includes: Omeprazole + Amoxacillin +
............
• A condition also referred to as “The Silent Killer”.

Down:
• A COX inhibitor used as an anti-platelet aggregant.
• Lozenges containing xylitol are recommended for this condition.
• Photophobia, phonophobia and auras are classic symptoms of this
condition.
• A condition in which there is an increase in intra-ocular pressure.
• An inotropic agent used in the management of congestive heart
failure.
• A side effect of ACE inhibitor therapy.
• An antibacterial agent useful for anaerobic bacterial and protozoal
infections.
• A renin inhbitor.

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Editorial Board
16
Ph. Raja Al-Qameesh
Associate Professor, College of Health Sciences
17
Ph. Yasser Sakheer
Pharmacist, BDF Hospital
18
Ph. Jayanthi S. Kotian
Lecturer, College of Health Sciences
19
Ph. Sherry Nasralla
Lecturer, College of Health Sciences

Bahrain pharmacists society web address www.baph.org

BAHRAIN PHARMACISTS SOCIETY
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