3^rd International Conference on Clinical Pharmacy December 07-09, 2015 Atlanta, USA

Dr. Sathish Amirthalingam, B.Pharm., M.Pharm., Ph.D., PGDHM., is a clinical pharmacist from India and currently working in International Medical University, Malaysia. He was a state first and distinction research scholar in Post-Graduation level. He has a teaching and professional experience of 13 years in the field of pharmacy. He received 6 awards from various bodies from pharmacy fields including state and national levels for best research paper and research project. He had written 2 books in pharmacy field like clinical pharmacy and pathophysiology for pharmacy students. He has published 21 national and international papers, 2 copyright of his innovative clinical software and he has presented 18 papers in national and international conferences. He has guided 4 under graduate, 8 post graduate projects and he is guiding 4 more under graduate projects currently. He also associated with life member in various professional bodies like IPA, IHPA and he was a member of board of studies in Dept. of pharmacology, S. P. University.

Topical antibacterial drugs are generally used to treat superficial bacterial infections. In Malaysia, topical antibacterial drugs are mostly available as over-the-counter (OTC) products that enable the patients to gain access easily. Since indiscriminate use of topical antibacterial drugs had been recognized as a factor to drive antibacterial resistances, the roles of community pharmacists (CPs) are vital to ensure the appropriate use of these medications. Therefore, this study was conducted to assess the perceptions and experiences of CPs in Kedah state, Malaysia on the dispensing of topical antibacterial drugs. A cross-sectional study involving a pre-validated questionnaire was conducted in community pharmacies within Kedah state, Malaysia. 53.4% of CPs in Kedah state perceived that topical antibacterial is not necessary for every topical bacterial infection. Patients’ information gathering and patient counselling were agreed to be important. Fusidic acid was the most frequently dispensed topical antibacterial drug while superficial wound was reported to be the most frequently encountered topical bacterial infection. 12.60% of CPs encountered antibacterial resistance cases but none of them reported. The drug that was having resistance issue was identified to be Neomycin. CPs in Kedah state generally had the right perceptions on the dispensing of topical antibacterial drugs. However, their knowledge on the rational use of topical antibacterial drugs and vigilance on the antibacterial resistance issue should be improved. Nevertheless, vigilance of CPs on antibacterial resistance issue were low. Thus, more training and educational programmes should be implemented to promote rational antibiotic use and improve CPs’ vigilances on antibacterial resistance issues.

Ms N. A. Sanjeewani has completed B Pharm degree and MS in Biotechnology from University of Peradeniya, Sri Lanka. She is a Lecturer (probationary) of Department of Pharmacy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka. She is young and energetic researcher and currently carrying out a research project on “Determination of hypoglycemic activity and formulation of a tablet using leaf extract of Adenanthera pavonina”. Her immediate goal is to pursue a PhD in Pharmaceutical Sciences from a US University.Ms N. A. Sanjeewani has completed B Pharm degree and MS in Biotechnology from University of Peradeniya, Sri Lanka. She is a Lecturer (probationary) of Department of Pharmacy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka. She is young and energetic researcher and currently carrying out a research project on “Determination of hypoglycemic activity and formulation of a tablet using leaf extract of Adenanthera pavonina”. Her immediate goal is to pursue a PhD in Pharmaceutical Sciences from a US University.

Emulsions are made by the agitation of the pure immiscible liquids and those are very unstable and break rapidly to the bulk phase. Such emulsions stabilize by addition of surface active material which protects the newly form drops from re coalescence. Formation of nano droplets occurs when correct compositions of water, hydrocarbon, surfactant, and co-surfactant are mixed in the right sequence. Nano emulsion drug delivery system is a popular application to enhance the solubility and bioavailability of lipophilic drugs. The objective of this study was to evaluate the stability of an emulsion containing VCO as the oil phase and Tween 20® as the surfactant. Primary emulsions were prepared in different ratios of oil, water and surfactant. To the resulting mixture water was added drop by drop while mixing with the aid of magnetic stirrer. Secondary homogenization was done by applying high shear homogenization. Stability evaluation was done for 60 days after the formulation of 12 different formulae. The formulations were observed visually for phase separation, sedimentation, creaming and flocculation. Centrifugation tests were performed for visually stable formulations. Most stable formulation throughout the study period was with oil 32 % (w/w), surfactant 32 % (w/w) and water 36 % (w/w) and particle size of that formula is 484.25 nm. It was highlighted from this study VCO can be used to formulate nano emulsion for transdermal drug delivery system and it shows good stability. Using VCO in emulsion system is a new delivery method. This formulation can be used as an alternative system for preparation of nano emulsion which is a good carrier of several active ingredients for transdermal drug delivery that can minimize several side effects upon oral administration, such as non-steroidal anti-inflammatory drugs.

Celso Dias Batista is 26 years old. He is currently a student in the course of Pharmacy of Faculty Single Ipatinga, which he joined in 2013 and the course completion is scheduled for 2017. He worked in a large pharmacy in the region as manager, which awakened in him the search for knowledge and scientific support to act in the area as a health professional.

The HPV vaccines have shown promise in protecting against infection and the development of related injuries to some types of HPV (LEPIQUE; RABACHINI and VILLA, 2009). Goals: To present the bivalent vaccine against high-risk HPV (16 and 18) as a way to prevent cervical cancer. Methodology: Literature review, documental, retrospective based on national and international journals indexed and Qualis A. Development: It was in this work specifically the bivalent vaccine because of the fact that a vaccine that only protects against the types of high oncogenic risk. The bivalent vaccine containing 20 micrograms like particle HPV L1, 16 and 20 micrograms of virus-like particle HPV 18 L1 at each dose associated with AS04 adjuvant containing 500 micrograms of aluminum hydroxide and 5 micrograms of monophosphoryl lipid- 3-deacylated. Clinical studies in humans have demonstrated that the HPV 16/18 VLP AS04 adjuvant with an initial induce significantly higher antibody response than that obtained with aluminum hydroxide as adjuvant alone, and that it stays response for at least 4 years (HARPER , 2008). Conclusion: The vaccine has proven to be most effective when administered before onset of sexual activity and vaccination campaigns should target the tweens and teens. It is expected that the increase in the use of vaccine to be a prophylactic strategy to reach 70% or more of the cases of cervical carcinogenesis.

Hend Shubar has completed her Ph.D at the age of 36 years from Berlin Free University, Germany in 2009. She is working as an assistant Professor at the department of Microbiology and Immunology and she is the head of Study and Exams department, faculty of Pharmacy, Tripoli University, Libya. She has published 6 papers in the field of drug targeting.

We investigated whether coating of atovaquone nanosuspensions (ANSs) with apolipoprotein E (apoE) peptides improves the uptake of atovaquone into the brain. The passage across the blood-brain barrier (BBB) of ANSs stabilized by polysorbate 80 (Tween 80), poloxamer 184 (P184), or poloxamer 338 (P338) and the same formulations coated with apoE peptides were analyzed in vitro and in vivo. Passage through a rat coculture model of the BBB did not differ between individual atovaquone formulations, and the addition of apoE peptides did not enhance the transport. Following the induction of toxoplasmic encephalitis (TE) in mice, treatment with all atovaquone formulations reduced the number of parasites and inflammatory foci compared with untreated mice. Uptake of atovaquone into the brain did not depend on coating with apoE. Finally, incubation of apoE peptide–coated ANSs with brain endothelial cells for 30 min did result in the accumulation of nanoparticles on the cell surface but not in their uptake into the cells. In conclusion, ANSs coated with Tween 80 or poloxamers showed therapeutic efficacy in murine toxoplasmosis. ApoE- and apoE-derived peptides do not induce the uptake of ANSs into the brain. Alternative mechanisms seem to be in operation, thereby mediating the passage of atovaquone across the BBB.

Hui-Gek Ang graduated in Pharmacy from the National University of Singapore, attained Grad Dip in Clinical Pharmacy from Australia and achieved a distinction in MBA from University of Hull, UK. She started her career as a hospital pharmacist and rose through the ranks to her current role as hospital administrator overseeing pharmacists, therapists and other allied health professionals. Besides administrative responsibilities, she teaches leadership programs. Her current research interests include effectiveness of clinical training, leadership development and leadership measurement tools.

Background: Pre-registration pharmacists’ training is an important continuum of education. Effective training is critical to prepare graduates ready for practice. This study seeks views from preceptors and trainees to better understand key aspects that impact the training. Purpose: To survey preceptors’ and trainees’ perceptions on the factors influencing current training program and identify areas for improvement Methods: Two focus groups discussions were held to elicit the elements and a survey questionnaire comprising 50 elements with 11-point scale were organized. All elements were grouped under the factors: training program, preceptor-trainee relationship, trainee-, preceptor- and environmental-related. All preceptors and trainees were invited to participate in the survey. Descriptive statistic was performed. Results: Forty preceptors and 17 trainees responded to the survey with overall response rate of 77%. More than 60% of both groups ranked training program highest for its impact on effectiveness. Highest scores were reported for trainees’ receptivity to feedback. Sufficient protected time for teaching and learning had the lowest scores and current workload pressure appears to have affected both groups negatively. Trainees and preceptors ranked preceptor-trainee relationship and training program, respectively, as most important. Overall, current training is effective with mean score of 7.34(0.62); majority (92%) are positive responses and nearly half (48%) of all responses rated 8 and above. Conclusion: Current training program was rated as very impactful for its effectiveness. The key issue concerns providing sufficient protected time for learning and teaching.

Wenbin Zhou is in her second year of PhD in Shanghai University of Traditional Chinese Medicine, China. Her major reseach is about metabonomics. She has published one paper in Journal of Chromatography B.

Endogenous monoamine neurotransmitters play an essential role in neural communication in mammalians. Many quantitative methods for endogenous monoamines have been developed during recent decades. Yet, matrix effect was usually a challenge in the quantification, in many cases asking for tedious sample preparation or sacrificing sensitivity. In this work, a simple, fast and sensitive method with no matrix effect was developed to simultaneously determine four endogenous monoamines including serotonin, dopamine, epinephrine and norepinephrine in rat brain tissues, using hydrophilic interaction liquid chromatography coupled with atmospheric-pressure chemical ionization tandem mass spectrometry. Various conditions, including columns, chromatographic conditions, ion source, MS/MS conditions, and brain tissue preparation methods, were optimized and validated. Pre-weighed 20 mg brain sample could be effectively and reproducibly homogenized and protein-precipitated by 20 times value of 0.2% formic acid in cold organic solvents (methanol-acetonitrile, 10:90, v/v). This method exhibited excellent linearity for all analytes (regression coefficients > 0.998 or 0.999). The precision, expressed as coefficients of variation, was less than 3.43% for intra-day analyses and ranged from 4.17% to 15.5% for inter-day analyses. Good performance was showed in limit of detection (between 0.3 nM and 3.0 nM for all analytes), recovery (90.8-120%), matrix effect (84.4-107%), accuracy (89.8% to 100%) and stability (88.3% to 104%). The validated method was well applied to simultaneously determine the endogenous serotonin, dopamine, epinephrine and norepinephrine in four brain sections of 18 Wistar rats. The quantification of four endogenous monoamines in rat brain performed excellently in the sensitivity, high throughput, simple sample preparation and matrix effect.

Hai Wei has completed his PhD from University of Alberta. He is the director of the Center for Chinese Medical Therapy and System Biology, Shanghai University of Traditional Chinese Medicine, China. He has published several papers in reputed journals. His reasearch interests include biopharmaceutics and pharmacokinetics, pharmaceutical analysis, drug metabolisms in gut and drug delivery technology.

Metabolomics investigation of biological fluids following physical competition may provide useful information in understanding exercises biochemistry. In the present study, we applied metabolomics approach to monitoring the endogenous metabolomic status of volleyball athletes during the competition program and identifying metabolomic variation of athletes with different exercise seniority. Analysis of pre-competition, post-competition and 1-week recovery urine sample by GC-MS and subsequent multivariate statistical analysis revealed alteration in the levels of 16 metabolites in senior group and 21 metabolites in junior group. Separation of post- from pre-competition urine samples in senior group was assigned mainly to phosphate, creatinine, amino acids, and compounds of the Krebs cycle. These metabolites altered in urine with competition suggested the possible malfunction of the kidney caused by the intensive exercise. However, in junior group, the changed metabolites after competition were almost sugars, polyols, organic acids and short-chain fatty acids. These metabolites decreased more with the post-competition compared to the pre-competition, thus indicating that junior players elicited great metabolic disturbances related with energy expenditure, oxidative stress response and gut flora metabolism disorder. Both in senior and junior group, the recovery group were not significantly separated with post-competition group as a result of the limited time available for recovery. Thus, metabolomics is a useful tool to monitor physical status in volleyball sport during different periods of the competition

Humpher Faria de Souza has 31 years old. He is student and is completing the sixth period of the Pharmacy Course at the Faculty Pythagoras of Ipatinga, Minas Gerais, Brazil. He intended as a researcher and do master's degree in Clinical Pharmacy.

Metabolic syndrome (MS) results from a number of risk factors for cardiovascular disease, and the main, central obesity, hypertension and abnormalities in glucose and lipid metabolism. As obesity in the world has taken pride of place, we can conclude that adipose tissue is a component of the pathogenesis of MS, which demonstrates the importance of body fat distribution, especially visceral. As a risk factor fastest growing in prevalence and severity, and a negative aesthetic issue, obesity should be today a priority for public health. Due to its complexity, including clinical, epidemiological and psychosocial, requiring a comprehensive and multidisciplinary approach. Based on survey data, there are doubts about the existence of the association of obesity and metabolic syndrome. Experimental studies in humans and also show obesity is a risk factor capable of causing an increase in blood pressure. There is evidence on the involvement of insulin resistance and hyperinsulinemia, although not yet available long-term prospective studies that can provide one. Insulin resistance is associated particularly with abdominal distribution of body fat. It is believed that the high cardiovascular risk attributed to intra-abdominal adiposity is related to the development of metabolic syndrome, which is attended obesity and hypertension among others. This work had as main objective to define and describe the metabolic syndrome, as well as its causal factors, consequences and treatment. The methodology was systematic literature review from the databases indexed in LILACS, BIREME, Medline and others. Conclusion: The metabolic syndrome may therefore be defined as a chronic degenerative metabolic disease characterized by association between insulin resistance, hypertension, dyslipidemia, diabetes mellitus type 2 (DM2), and other metabolic abnormalities. And, being a metabolic syndrome, it is important that the pharmacist know this disease and the health damages caused by it, so it can be diagnosed and treated correctly associating drugs, diet and physical activity provide a better physiological condition, health and quality of life for individuals.