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  1. Loh P, Lee JW, Karuppannan M, Chua SS
    BMC Health Serv Res, 2023 Jun 20;23(1):657.
    PMID: 37340333 DOI: 10.1186/s12913-023-09642-x
    BACKGROUND: Community pharmacy practice worldwide has been shifting from product-focused to patient-oriented. However, due to the absence of separation between prescribing and dispensing in Malaysia, community pharmacists may have limited roles in the provision of pharmaceutical care to patients with chronic diseases. Therefore, the main functions of community pharmacists in Malaysia are related to self-medication requests for minor ailments and the supply of non-prescription medications. The objective of this study was to determine the practice of pharmaceutical care by community pharmacists within the Klang Valley, Malaysia in response to self-medication requests for a cough.

    METHODS: This study utilised a simulated client method. A research assistant, acting as a simulated client, visited community pharmacies in the Klang Valley, Malaysia to consult the pharmacists on the treatment of a cough experienced by his father. Upon leaving the pharmacy premise, the simulated client entered the pharmacist's responses in a data collection form which was structured based on pharmacy mnemonics for the response to symptoms, OBRA'90 on counselling elements, the five practice principles of pharmaceutical care by the American Pharmacists Association and literature review. Visits to the community pharmacies were conducted from September to October 2018.

    RESULTS: The simulated client visited a total of 100 community pharmacies. None of these community pharmacists practised adequate patients' data collection, with only a low proportion who practised all the components studied under medication information evaluation (13%), formulating a drug therapy plan (15%) and monitoring and modifying the plan (3%). Of the 100 community pharmacists, 98 recommended treatment but none of them provided all the counselling elements studied in implementing the drug therapy plan.

    CONCLUSION: The present study showed that community pharmacists within the Klang Valley, Malaysia were not providing adequate pharmaceutical care services to patients seeking self-medication for a cough. Such practice may compromise patient safety if inappropriate medicines or advice are given.

    Matched MeSH terms: Cough/drug therapy
  2. Chan PWK, Debruyne JA
    Med J Malaysia, 2001 Dec;56(4):408-13.
    PMID: 12014758
    The efficacy of inhaled nedocromil sodium (NS) for children with a persistent cough was studied. Children aged 4-12 years with a persistent cough for >1 month were recruited and entered a 2-week baseline period during which an asthma diary was kept. Children with a cough score of >20 received inhaled NS via a spacer, 4mg qid for 2 weeks followed by 4mg bd for another 4 weeks. Twenty-two (42%) of 52 children recruited fulfilled treatment criteria. Four children were withdrawn from the study (2 developed wheezing and 2 were not compliant). The baseline cough score (29.1 +/- 13.6) improved after 2 weeks of treatment (15.2 +/- 9.3, p < 0.01) and improvement was sustained after 6 weeks (14.2 +/- 13.0, p = 0.01). Parents and patients had a more favourable perception of its efficacy compared to physicians (72% vs 50%, p = 0.01) Inhaled NS may be considered for treatment of persistent cough in children.
    Study site: Paediatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Cough/drug therapy*
  3. Manoharan S
    Molecules, 2023 Jun 02;28(11).
    PMID: 37299008 DOI: 10.3390/molecules28114532
    Despite many publications related to the identification of new angiotensin-I-converting enzyme (ACE) inhibitors, especially peptides from natural products, the actual reason/s for why new ACE inhibitors need to be discovered are yet to be fully understood. New ACE inhibitors are pivotal to address serious side effects caused by commercially available ACE inhibitors in hypertensive patients. Despite the effectiveness of commercial ACE inhibitors, due to these side effects, doctors often prescribe angiotensin receptor blockers (ARBs). Recent evidence has shown the benefits of ACE inhibitors over ARBs in hypertensive patients and hypertensive-diabetes mellitus patients. In order to address these side effects, the somatic ACE's enzyme structures need to be revisited. The peptides isolated from the natural products need to be verified for their stability against ACE and several important gastrointestinal enzymes. The stable peptides sequence with the presence of favourable ACE inhibitory-related amino-acids, such as tryptophan (W), at the C-terminal need to be subjected to molecular docking and dynamics analyses for selecting ACE inhibitory peptide/s with C-domain-specific inhibition instead of both C- and N-domains' inhibition. This strategy will help to reduce the accumulation of bradykinin, the driving factor behind the formation of the side effects.
    Matched MeSH terms: Cough/drug therapy
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