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-A pharmacy and Medicine Journal published by the college of pharmacy , University of Mosul. -Date of first issue(2001). -No. of issue per year (1). -No. of papers per issue. -No. of issue published between 2001-2019(16)issue. Online published since, 2005. as pdf or HTML IPJ required a 100$ for publishing an accepted manuscript. The IJP is not financially supported by governmental or non- governmental organism. Publishing under license Creative Atttibution 4.0 International by [CC-BY]. DOI in 2019.
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Journal Information

Publisher: Mosul University

Email:  iraqi.journal.pharmacy@gmail.com

Editor-in-chief: Prof. Dr. Faris Thanoon Hamid Abachi

Managing Editor: Ass. Prof. Dr. Zeina Abdul mnium Abdul majeed

Print ISSN: 1680-2594

Online ISSN: 2264-2522

The influence of Tat-derived peptide (Tat-LK15) on the uptake of membrane p- glycoproteins substrate (Calcein AM)

Myasar Alkotaji; Alain Pluen; Harmesh Aojula

Iraqi Journal of Pharmacy, 2019, Volume 16, Issue 1, Pages 1-21
DOI: 10.33899/iphr.2019.165706

Introduction: Cell penetrating peptides (CPPs) have been used in many areas of drug delivery for mediating the delivery of peptides, protein, DNA, siRNA and liposomes. Additionally they have shown an ability to overcome drug resistance in cells and enhancing chemotherapeutic activity. Our group has recently designed a promising multifunctional peptide, Tat-LK15, originating from the fusion of Tat peptide (49-57) with the synthetic amphipathic (membrane lytic) peptide, LK15. To date, Tat-LK15 peptide’s effect on the cell membrane has not been assessed.
Objective: The aim of this work is to study the influence of Tat-LK15 peptide on the uptake of p-glycoproteins substrate (Calcein AM). This could explain the effect of peptide on membrane. Also this work aimed to explore whether the peptide characteristics could be exploited to improve the delivery of the cytotoxic agent, doxorubicin to doxorubicin resistant cells.
Results and discussions: Flow cytometry experiments revealed that Tat-LK15 peptide was not able to overcome multidrug resistance or to reverse the reduced uptake of Ca AM in the doxorubicin resistance sublines (HT29dx and K562dx). In contrast, Tat-LK15 peptide exhibited an inhibitory effect on the calcein fluorescence in both K562 and HT29 cell lines and their doxorubicin resistance sublines (HT29dx and K562dx). The supposed mechanism assumed that Tat-LK15 peptide may change phospholipid architecture/packing in the cell membrane leading to a reduction in the cell membrane permeability to the entry of Ca AM. Interestingly, this study indicates the possible membrane activity of Tat-LK15 peptide, which was confirmed in another work.
 

Investigation of some bioactive compounds in oil and ethanol extracts of ginger (Zingerbiene officlica) using GC-MS

Faris T. Abachi; Khadeeja Younus; Inas Hazim

Iraqi Journal of Pharmacy, 2019, Volume 16, Issue 1, Pages 22-35
DOI: 10.33899/iphr.2019.165707

Objective: The molecular characterization of some bioactive compounds in ginger interest because of their various pharmacological activities.  To the best of our knowledge, we are isolate hydrocarbon (low molecular weight), alcohol, phenol, acid, ester from nonpolar (oil) and polar (ethanol) extracts using gas chromatography-mass spectrometry [GC-MS] technique.
Methods: Gas chromatography-mass spectrometry (GC-MS) analysis of the oil and ethanol extracts of ginger was carried out by using a GC-MS equipment.   
Results: The GC-MS analysis has revealed the existence of different bioactive chemical compounds in the oil & ethanolic extracts of ginger. The major compounds of oil extract are beta-elemene (0.27%), curcumen (3.12%), zingerberene (10.86%) , bisabolene(3.75) , elemol(1.14%), germacrene( 0.23%) , 7-epi trans sesquisabinene (1.82%), zingerberone (35.92%), ethyl palmitate (0.53%),  pardol(3.97%).  A total of 53 compounds identified representing of total ginger oil extract. While, the major compounds of ethanolic extract are elmene (0.51%), zingerbiene (4.43%), alloaromadentrene (0.42%), curcumene(21.83%), gama cadienene(3.24%)8-epi-.gama.-eudesmol( 0.34).  A total of 50 compounds identified representing 99.98% of total ginger ethanolic extract.
Conclusion:  In this study, successful identification some of important bioactive compounds using GC-MS technique.
 

Management of Inguinal Hernia in Pediatric Age Group

Muataz Alani; Nehad kasim; Saad Abdulrazak; Mohammed Abdulkareem Oleiwi

Iraqi Journal of Pharmacy, 2019, Volume 16, Issue 1, Pages 36-49
DOI: 10.33899/iphr.2019.165708

Introduction: Incidence of indirect inguinal hernias in premature infants is reported to be as high as 30% with male predominance. Typically, inguinal hernia repairs are done under general anesthesia which has a high risk of post-operative complications, especially in the premature infant. The purpose of this study was to compare outcomes between early (neonatal) and delayed (older) inguinal hernia repair.
Method: This is a prospective study in the department of pediatric surgery in alkhansaa Teaching Hospital Mosul / Iraq during a period from Jul 2018 to Dec 2019. All children with inguinal hernia were selected for the study and divided in two groups, those below one month and those above. Surgery is performed under general anesthesia with extracanalicular approach. Post-operative complications were observed and finally decided to discharge once patient is fit for discharge on the same day.
Results: During the 18 months' period, we underwent 93 inguinal hernia repair those babies were divided into two groups, neonatal group (23 neonates) and older group (70 babies).  The gender distribution ratio is 7.8 male :1 female. The side distribution among those babies in the neonatal group were 14,6 and 3 as right, left and bilateral respectively. In the neonatal group there were 9 babies presented with incarceration two (8.6%) of them shows testicular infarction and necrosis which necessitate excision at exploration while the other one atrophied in the period of follow up. We do not record any anesthetic complications or mortality in neonatal group in our period of study.
Conclusion: Extracanalicular approach under general anesthesia is easy, safe, can be used for pediatric patients in neonatal age group with indirect inguinal hernia; with minimal complications, low recurrence rate.
 
 

Difference in the inhibitory effect of black seed extract and the commonly used drug on the intestinal parasites in the primary school students in Mosul and Tikrit cities

Maymona Yahya; Abdul_Rahman Altae

Iraqi Journal of Pharmacy, 2019, Volume 16, Issue 1, Pages 50-72
DOI: 10.33899/iphr.2019.165709

Objectives:To detect and compare the inhibitory effect of Nigella sativa extracts and compare their effects with traditional drugs on intestinal parasites.
Materials and Methods: Stool samples were collected from 144 students of primary schools: (Al-Arqam primary school for boys, Al-hady primary school for girls, and Al-Arpachia primary school for (boys and girls) in both sexes out of 252 students of about 6-12 years old. Stools were taken from students in a clean water-proof with a tight fitting container 10 ml saline as a transport medium. Each sample was transported at 37οC and examined directly under the microscope. They were treated by different doses of different conc. of alcoholic and aqueous extracts of N. sativa and compare the effect with Metronidazole and Albendzole as traditional drugs.
Results: The results of this study revealed clear potentiality of N. sativa as a source for antiparasitic drugs and support its use in folk medicine for the treatment of intestinal infections.
Discussion:  There was an inhibitory effect of Nigella sativa on intestinal parasites being isolated but fewer than that of traditional drugs. This finding warrants necessity of further investigation of this product for folk medicine.

Antibiotic misuse and the development of bacterial resistance: Are we losing the battle?

Radhwan Al-Zidan; Ghayth Abdulrazzaq; Wejdan Al-Shakarchi

Iraqi Journal of Pharmacy, 2019, Volume 16, Issue 1, Pages 73-84
DOI: 10.33899/iphr.2019.165710

Objective: The present review targets to shed light on the crisis of developing the antibiotic resistance and specify the contemporary challenges associated with the misuse of the antibiotics.
Methods: The present challenges correlated to the development of the antibiotic resistance are distinctive and vary from the previous challenges because novel bacterial strains are continuously emerging and persist to evolve. Additionally, bacterial strains resistant to various antibiotic classes have arisen for which the use of recent antibiotics have not been reviewed thoroughly.
Results: The outcomes of antibiotic resistance are serious with morbidity and mortality incessantly on the rise. This review also underlines the feasible interventions that can be effective at the individual or micro level, as well as at the national or macro level in the prevention of antibiotic resistance.
Conclusion: To conclude, the rapid emergence of antibiotic-resistant bacteria threatens the astonishing health gains that have been attained since the invention of the antibiotic medications.
 

Design and formulation of piroxicam tablets

Shaimaa Dhia M.S. Al-Shakarchi

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 18-24
DOI: 10.33899/iphr.2008.50090

Piroxicam is a potent nonsteroidal anti-inflammatory drug (NSAID) with a long half-life that permits once daily dose. It exerts a better toleration than other NSAID's with a relatively low incidence of adverse effects. In this study many trials were made to formulate piroxicam as plain tablets with properties comparable to those of capsules and in agreement with pharmacopoeial standards. Different formulas were prepared by the application of direct compression method and wet granulation method with the addition of different excipients. The wet granulation method used in the preparation of piroxicam tablets was modified to improve the properties of the produced tablets. The characteristics of the prepared formulas were tested and the results showed that formula D prepared by wet granulation method, containing PVP as binder and lactose as diluent is the most appropriate formula with a rapid disintegration time and complete dissolution as that of piroxicam capsules.
Accordingly, formula D was chosen to be a promising formula of piroxicam plain tablet that could be manufactured as a mass product.

Synergistic activity of azithromycin combined with metronidazole against toxoplasmosis in experimental mice

Ziad H.Al-jader; Abdulsalam M. Al-Mukhtar

Iraqi Journal of Pharmacy, 2010, Volume 9, Issue 1, Pages 32-35
DOI: 10.33899/iphr.2010.49981

Objective: To evaluate the efficacy of synergistic activity of azithromycin combined with metronidazole against toxoplasmosis experimentally induced in murine model.
Material & Methods: Albino mice model (balb/c mice) acutly infected with tachyzoites, were treated for 10days from day +1 postinfection with administration of azithromycin combined with metronidazol.
Results: The results showed that prolonged survival of albino mice relative to that of untreated control, and the dead mice were found only in the control group. This experiment showed that a remarkable synergistic effect on toxoplasmosis was obsereved when azithromycin was adminstratered in combination with metronidazole at cuurative dosage i.e.(250 and 200 mg/kg/day), respectively. These results showed that azithromycin, which is remarkably active on toxoplasmosis, significantly potentiates the curative effect of metronidazol in the treatment. The treated mice in uncontrolled group were completely cured from toxoplasmosis as their brain were free of T. gondii cyst either microscopically or by bioassay.
Conclusion: Combined drugs of azithromycin and metronidazole showed a cure rate of 100% in experimental murine toxoplasmosis.

Evaluation of CA 15-3, Her-2/neu and estrogen/progesterone status in breast cancer patients treated by surgical removal and chemotherapy

Taha H Taha Al-siagh; Shahbaa A Al-bayati; Faris A Ahmed

Iraqi Journal of Pharmacy, 2012, Volume 12, Issue 1, Pages 1-7
DOI: 10.33899/iphr.2012.62338

Objective: This study was conducted to evaluate serum CA 15-3 in breast cancer patients after surgery and chemotherapy. The relationship between serum CA 15-3 and Her-2/neu, estrogen, or progesterone receptors were also studied in the breast cancer patients.
Patients and methods: This study was conducted at Al-Jammhori Teaching Hospital, and Al-Zahrawi Private Hospital, Mosul, Iraq, during the period from January to Jun 2011. Fifty breast cancer women diagnosed by using triple assessments by a surgeon (history examination, ultrasound mammography, and fine needle aspiration cytology) were included in the study. Blood samples (5 mL) were taken from the patients and analyzed for serum CA 15-3 by monoclonal antibody technique. The blood samples were taken from the patients a week before and after one week of the operation and other blood samples were taken after two weeks of the first cycle of chemotherapy treatment. Combination therapy of 5-fluorouracil, epirubicin, cyclophosphamide, for three cycles every 21 days, was given to the patients, followed by three cycles docytaxil every 21 days. Samples from the tumor on paraffin sections taken from the patients were analyzed for Her-2/neu, estrogen and progesterone receptors by immunochemical methods.
Results: Serum CA 15-3 was significantly decreased by 54% (p ≤ 0.001) after surgical removal of the cancer compared with results before surgery. Chemotherapy of the patients further decreased serum CA 15-3 significantly by 78% (p ≤ 0.001) compared with the results before surgery. CA 15-3 and tumor size in positive Her-2/neu patients were significantly higher than in negative Her-2/neu patients. However, serum CA 15-3 and tumor size in positive estrogen patients were significantly lower than in negative estrogen patients. In progesterone positive patient's serum CA 15-3 was only significantly (p ≤ 0.001) lower than in the negative progesterone patients. Mean ages was significantly (p ≤ 0.001) higher in positive Her-2/neu patients than in negative Her-2/neu patients. However, mean ages was significantly (p ≤ 0.001) higher in positive estrogen and progesterone patients than in negative receptors. Metastasis occurred in 39 patients (78 %) out of the studied patients. Negative significant correlation was noticed between Her 2/neu and estrogen receptors (r= - 0.745, p ≤ 0.001). Negative significant correlation was also noticed between Her 2/neu and progesterone receptors (r= - 0.786, p ≤ 0.001). Weak but significant correlation was found between serum CA 15-3 and tumor size (r= 0.281, p≤ 0.05).
Conclusion: CA 15-3 and Her 2/neu are useful tumor markers for diagnosis of breast cancer in the treatment through surgery and chemotherapy. The co-expression between hormonal and Her-2/neu receptors is negative. The need for more sensitive tumor markers is still wanted.

The effect of antioxidant supplementation in the treatment of epilepsy

Nazar A.K. hamid

Iraqi Journal of Pharmacy, 2011, Volume 11, Issue 2, Pages 27-33
DOI: 10.33899/iphr.2011.49893

Aim: To assess serum level of malondialdehyde (MDA) and total antioxidant status
(TAS) as a representative of oxidative stress in patients with generalized epilepsy and
to evaluate the therapeutic effect of the antioxidant (vitamin E and vitamin C) on the
levels of MDA,TAS and frequency of seizures attacks after two months therapy. for a
period of two months as a supplementation therapy.
Subjects and Methods: The study was conducted in Iben-seena Hospital in Mosul
city-Iraq. Fifty three patients with generalized epilepsy were included in this study
(32 male and 21 female). The study included 40 apparently healthy subjects, age and
sex matched as a control group. Initially from both the patients and controls, blood
samples were taken. Another blood samples were taken from the patients 2 months
after vitamin E and vitamin C treatment, blood samples were analysed for serum
MDA and serum TAS.
Result: Serum MDA was found to be significantly higher ( P<0.001) and serum TSA
was significantly lower (P<0.001) in patients with generalized epilepsy prior vitamin
E and vitamin C supplementation in comparison to controls. After vitamin E and C
supplementation there was a significant reduction (P<0.001) in the serum MDA levels
with a significant increase (P<0.001) in the serum TAS. Also we found a reduction in
seizure frequency of greater than 70% after vitamin E and C supplementation.
Conclusion: a significant reduction of TSA was reported in patients with epilepsy.
Administration of vitamin E and C produced a significant reduction of serum MAD
levels and a significant elevation of serum TAS, associated with a reduction of greater
than 70% of seizure frequency. The study suggests the administration of vitamin E
and C as adjunct to antiepileptic drugs.

Unlicensed and off-label drug use in paediatric wards

Suhair Moayid Rasheed

Iraqi Journal of Pharmacy, 2010, Volume 9, Issue 1, Pages 53-57
DOI: 10.33899/iphr.2010.50063

Objective: To determine the proportion of unlicensed &/or off-label prescriptions in paediatric
patients.
Patients & Methods; This prospective study of drugs administered to children in two
paediatric hospital (ib-A!theer, A!-Kanasaa hospital for pediatrics in mosul city, over 6 months
from 1st Nov. 2007 to 1st May 2008. One hundred-forty children were included in this study
aged from at birth to 6 years admitted to paediatric medical wards. Drug-licensing status of all
prescriptions given to these patients was determined.
Results: Of the 1208 prescription given to these children, more than half of all prescriptions
626 (51 ,8%) were unlicensed or off-label. Where as 582 (48.2%) licensed. The most common
category of off-label use 365 (30.2%) was related to age 217 (17.9%), the other off-label uses
were related to dose and frequency of administration 77 (6.4%), indication 55 (4.6%) and
route of administration 16 (1.3%) and the most common reason of unlicensed preparation
was the administration of preparation not licensed for use at all.
Conclusion: The use of unlicensed or off- label medicines to treat children was found to be
common in paediatric patients, this problem is Widespread in peadiatric wards &the clinical

Design and formulation of piroxicam tablets

Shaimaa Dhia M.S. Al-Shakarchi

Iraqi Journal of Pharmacy, 2008, Volume 7, Issue 1, Pages 18-24
DOI: 10.33899/iphr.2008.50090

Piroxicam is a potent nonsteroidal anti-inflammatory drug (NSAID) with a long half-life that permits once daily dose. It exerts a better toleration than other NSAID's with a relatively low incidence of adverse effects. In this study many trials were made to formulate piroxicam as plain tablets with properties comparable to those of capsules and in agreement with pharmacopoeial standards. Different formulas were prepared by the application of direct compression method and wet granulation method with the addition of different excipients. The wet granulation method used in the preparation of piroxicam tablets was modified to improve the properties of the produced tablets. The characteristics of the prepared formulas were tested and the results showed that formula D prepared by wet granulation method, containing PVP as binder and lactose as diluent is the most appropriate formula with a rapid disintegration time and complete dissolution as that of piroxicam capsules.
Accordingly, formula D was chosen to be a promising formula of piroxicam plain tablet that could be manufactured as a mass product.

Synergistic activity of azithromycin combined with metronidazole against toxoplasmosis in experimental mice

Ziad H.Al-jader; Abdulsalam M. Al-Mukhtar

Iraqi Journal of Pharmacy, 2010, Volume 9, Issue 1, Pages 32-35
DOI: 10.33899/iphr.2010.49981

Objective: To evaluate the efficacy of synergistic activity of azithromycin combined with metronidazole against toxoplasmosis experimentally induced in murine model.
Material & Methods: Albino mice model (balb/c mice) acutly infected with tachyzoites, were treated for 10days from day +1 postinfection with administration of azithromycin combined with metronidazol.
Results: The results showed that prolonged survival of albino mice relative to that of untreated control, and the dead mice were found only in the control group. This experiment showed that a remarkable synergistic effect on toxoplasmosis was obsereved when azithromycin was adminstratered in combination with metronidazole at cuurative dosage i.e.(250 and 200 mg/kg/day), respectively. These results showed that azithromycin, which is remarkably active on toxoplasmosis, significantly potentiates the curative effect of metronidazol in the treatment. The treated mice in uncontrolled group were completely cured from toxoplasmosis as their brain were free of T. gondii cyst either microscopically or by bioassay.
Conclusion: Combined drugs of azithromycin and metronidazole showed a cure rate of 100% in experimental murine toxoplasmosis.

Evaluation of CA 15-3, Her-2/neu and estrogen/progesterone status in breast cancer patients treated by surgical removal and chemotherapy

Taha H Taha Al-siagh; Shahbaa A Al-bayati; Faris A Ahmed

Iraqi Journal of Pharmacy, 2012, Volume 12, Issue 1, Pages 1-7
DOI: 10.33899/iphr.2012.62338

Objective: This study was conducted to evaluate serum CA 15-3 in breast cancer patients after surgery and chemotherapy. The relationship between serum CA 15-3 and Her-2/neu, estrogen, or progesterone receptors were also studied in the breast cancer patients.
Patients and methods: This study was conducted at Al-Jammhori Teaching Hospital, and Al-Zahrawi Private Hospital, Mosul, Iraq, during the period from January to Jun 2011. Fifty breast cancer women diagnosed by using triple assessments by a surgeon (history examination, ultrasound mammography, and fine needle aspiration cytology) were included in the study. Blood samples (5 mL) were taken from the patients and analyzed for serum CA 15-3 by monoclonal antibody technique. The blood samples were taken from the patients a week before and after one week of the operation and other blood samples were taken after two weeks of the first cycle of chemotherapy treatment. Combination therapy of 5-fluorouracil, epirubicin, cyclophosphamide, for three cycles every 21 days, was given to the patients, followed by three cycles docytaxil every 21 days. Samples from the tumor on paraffin sections taken from the patients were analyzed for Her-2/neu, estrogen and progesterone receptors by immunochemical methods.
Results: Serum CA 15-3 was significantly decreased by 54% (p ≤ 0.001) after surgical removal of the cancer compared with results before surgery. Chemotherapy of the patients further decreased serum CA 15-3 significantly by 78% (p ≤ 0.001) compared with the results before surgery. CA 15-3 and tumor size in positive Her-2/neu patients were significantly higher than in negative Her-2/neu patients. However, serum CA 15-3 and tumor size in positive estrogen patients were significantly lower than in negative estrogen patients. In progesterone positive patient's serum CA 15-3 was only significantly (p ≤ 0.001) lower than in the negative progesterone patients. Mean ages was significantly (p ≤ 0.001) higher in positive Her-2/neu patients than in negative Her-2/neu patients. However, mean ages was significantly (p ≤ 0.001) higher in positive estrogen and progesterone patients than in negative receptors. Metastasis occurred in 39 patients (78 %) out of the studied patients. Negative significant correlation was noticed between Her 2/neu and estrogen receptors (r= - 0.745, p ≤ 0.001). Negative significant correlation was also noticed between Her 2/neu and progesterone receptors (r= - 0.786, p ≤ 0.001). Weak but significant correlation was found between serum CA 15-3 and tumor size (r= 0.281, p≤ 0.05).
Conclusion: CA 15-3 and Her 2/neu are useful tumor markers for diagnosis of breast cancer in the treatment through surgery and chemotherapy. The co-expression between hormonal and Her-2/neu receptors is negative. The need for more sensitive tumor markers is still wanted.

The effect of antioxidant supplementation in the treatment of epilepsy

Nazar A.K. hamid

Iraqi Journal of Pharmacy, 2011, Volume 11, Issue 2, Pages 27-33
DOI: 10.33899/iphr.2011.49893

Aim: To assess serum level of malondialdehyde (MDA) and total antioxidant status
(TAS) as a representative of oxidative stress in patients with generalized epilepsy and
to evaluate the therapeutic effect of the antioxidant (vitamin E and vitamin C) on the
levels of MDA,TAS and frequency of seizures attacks after two months therapy. for a
period of two months as a supplementation therapy.
Subjects and Methods: The study was conducted in Iben-seena Hospital in Mosul
city-Iraq. Fifty three patients with generalized epilepsy were included in this study
(32 male and 21 female). The study included 40 apparently healthy subjects, age and
sex matched as a control group. Initially from both the patients and controls, blood
samples were taken. Another blood samples were taken from the patients 2 months
after vitamin E and vitamin C treatment, blood samples were analysed for serum
MDA and serum TAS.
Result: Serum MDA was found to be significantly higher ( P<0.001) and serum TSA
was significantly lower (P<0.001) in patients with generalized epilepsy prior vitamin
E and vitamin C supplementation in comparison to controls. After vitamin E and C
supplementation there was a significant reduction (P<0.001) in the serum MDA levels
with a significant increase (P<0.001) in the serum TAS. Also we found a reduction in
seizure frequency of greater than 70% after vitamin E and C supplementation.
Conclusion: a significant reduction of TSA was reported in patients with epilepsy.
Administration of vitamin E and C produced a significant reduction of serum MAD
levels and a significant elevation of serum TAS, associated with a reduction of greater
than 70% of seizure frequency. The study suggests the administration of vitamin E
and C as adjunct to antiepileptic drugs.

Unlicensed and off-label drug use in paediatric wards

Suhair Moayid Rasheed

Iraqi Journal of Pharmacy, 2010, Volume 9, Issue 1, Pages 53-57
DOI: 10.33899/iphr.2010.50063

Objective: To determine the proportion of unlicensed &/or off-label prescriptions in paediatric
patients.
Patients & Methods; This prospective study of drugs administered to children in two
paediatric hospital (ib-A!theer, A!-Kanasaa hospital for pediatrics in mosul city, over 6 months
from 1st Nov. 2007 to 1st May 2008. One hundred-forty children were included in this study
aged from at birth to 6 years admitted to paediatric medical wards. Drug-licensing status of all
prescriptions given to these patients was determined.
Results: Of the 1208 prescription given to these children, more than half of all prescriptions
626 (51 ,8%) were unlicensed or off-label. Where as 582 (48.2%) licensed. The most common
category of off-label use 365 (30.2%) was related to age 217 (17.9%), the other off-label uses
were related to dose and frequency of administration 77 (6.4%), indication 55 (4.6%) and
route of administration 16 (1.3%) and the most common reason of unlicensed preparation
was the administration of preparation not licensed for use at all.
Conclusion: The use of unlicensed or off- label medicines to treat children was found to be
common in paediatric patients, this problem is Widespread in peadiatric wards &the clinical

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