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The plant world represents an important source of potential therapeutic agents, but concomitant administration of herbal and conventional medications may result in interactions with subsequent beneficial or adverse effects. This study was designed to examine the analgesic effect of thyme tincture and thyme syrup, two commonly used thyme formulations, and their interactions with codeine, paracetamol, pentobarbital and diazepam in mice. The identification and quantification of thymol and carvacrol were carried out by GC/MS and GC/FID. The analgesic activity was studied using a hot plate method. Effects of thyme syrup on diazepam-induced motor coordination impairment in rotarod test and on pentobarbital-induced sleeping time were also determined. Thymol (175.3 µg/mL and 9.73 µg/mL) and carvacrol (10.54 µg/mL and 0.55 µg/mL) concentrations were measured in tincture and syrup, respectively. Thyme syrup and tincture exhibited effective analgesic activity in the hot plate pain model. Pretreatment with thyme formulations reduced analgesic activity of codeine, and potentiated the analgesic activity of paracetamol. Co-administration of thyme formulations has led to potentiation of diazepam and pentobarbital depressive central nervous system effects. Thyme formulations interacted with tested conventional drugs, probably through interference with their metabolic pathways and succeeding altered concentrations and pharmacological effects.

Background. Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. Methods. This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. Results. The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. Conclusion. Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.

Objective: Considering that adherence level affects diabetes treatment success and maintenance of glycemic control greatly, the aim of this study was to examine diabetes patients’ adherence to oral hypoglycemic agents (OHAs) and knowledge about their mechanism of action, dosing regimen, and side effects. Material and Methods: This cross-sectional study was conducted on a sample of 100 patients with type 2 diabetes in order to assess their knowledge of OHAs using anonymous questionnaires. Results: Most patients had used OHAs between 2 and 5 years (61.0%), where 78.0% were treated with metformin, and the remaining 22.0% were prescribed sulfonylurea derivatives. Besides drugs used for the treatment of type 2 diabetes, 58.0% of patients took another 1-3 drugs daily for the treatment of other conditions. Although 75.0% achieved a score of 5-6 out of the maximum score of 8, only 2.0% of respondents listed at least 2 side effects of the OHA they used, and none of them could explain its mechanism of action. Most of the information about OHAs was given to patients by endocrinologists (53.0%). Conclusion: More than half of participants considered their knowledge of OHAs insufficient. Results clearly indicate that the respondents were not sufficiently familiar with the mechanism of action and possible side effects of such medications. Information about OHAs given in written form as well as via community pharmacists would contribute to educating type 2 diabetes patients significantly.

Objective: This study aimed to examine the contents of home pharmacies and medication use, as well as storage and disposal habits in urban and rural households in Serbia. Material and Methods: This prospective research was conducted within 70 households in Novi Sad (urban setting) and Laćarak (rural setting) from October 1, 2015 to January 15, 2016. The data were collected using a standardized questionnaire, as well as by direct examination of drugs stored in households. Results: The most common groups of drugs stored were cardiovascular drugs, drugs for the nervous system, antirheumatic products and antimicrobials. A high percentage of drugs for the alimentary tract were found stored in Laćarak, while drugs for the respiratory tract were discovered in Novi Sad. Prescription only medications (POMs) made up 69.7% of all medications in Laćarak and 60.6% in Novi Sad. POMs were purchased independently in high amounts (13.2% in Laćarak and 9.1% in Novi Sad). Presence of expired medications was higher in Laćarak (12.0%) than Novi Sad (5.8%). Over two-thirds of the households stored medications properly; however, only 10.0% of respondents reported the proper disposal of unused medications. Conclusion: The structures of home pharmacies in Novi Sad and Laćarak differ, which implies different healthcare needs. The practice of self-medicating was noted both in Novi Sad and Laćarak. While Laćarak residents rely more on the advice of friends and family, Novi Sad residents buy medicine mostly without any consultation. Medications in both environments are stored properly in the majority of households, but mostly disposed of improperly together with household waste.

An ongoing issue of expired medications accumulating in some households is a universal problem around the world. The aim of the study was to investigate the extent and structure of expired medications in Serbian households, and to determine which therapeutic groups generated the most waste.This was an observational, cross-sectional study conducted in households in the city of Novi Sad, Serbia. The study had been performed over 8 month period (December 2011 - July 2012) and it consisted of personal insights into the medication inventory in households.Of 1008 families, 383 agreed to participate and complete the questionnaire (38.3% response rate). In almost a half of households (44.4%), expired medications were maintained. The amount of expired medications was 402 items, corresponding to 9.2% of total medications presented in surveyed households. The majority of expired medications (64.7%) was in solid dosage (tablets, capsules, granules, lozenges), following semisolid (ointments, creams, gel, suppositories) and liquid dosage forms (drops, syrups). Expired medications in the households belonged mostly to 3 categories: antimicrobials for systemic use (16.7%), dermatological preparation (15.9%) and medications for alimentary tract and metabolism (14.2%).This study revealed that there were relatively large quantities of expired medications in Serbian households, with a high prevalence of antibiotics for systemic use, anti-inflammatory and antirheumatic products, and medications for alimentary tract and metabolism.Težava s kopičenjem zdravil s pretečenim rokom trajanja v gospodinjstvih je velik problem po vsem svetu. Cilj te študije je bil raziskati obseg in sestavo zdravil s pretečenim rokom trajanja v srbskih gospodinjstvih in določiti, katere terapevtske vrste zdravil predstavljajo največji odpad.Opazovalna, presečna raziskava je bila izvedena v srbskih gospodinjstvih v Novem Sadu. Trajala je osem mesecev (od decembra 2011 do julija 2012). Sestavljena je bila iz osebnega vpogleda v zalogo zdravil v gospodinjstvih.Od 1008 družin se jih je 383 odločilo za sodelovanje in izpolnilo vprašalnik (38,3-odstotna odzivnost). V skoraj polovici gospodinjstev (44%) so imeli zdravila s pretečenim rokom trajanja. Skupno sta bili najdeni 402 zdravili s pretečenim rokom trajanja, kar predstavlja 9,2% vseh zdravil v anketiranih gospodinjstvih. Večina zdravil s pretečenim rokom trajanja (64,7%) je bila v trdi obliki (tablete, kapsule, granule, lozenge), sledila so zdravila v poltrdni obliki (masti, kreme, geli, suspenzije) in tekočine (kapljice, sirupi). Večina zdravil s pretečenim rokom trajanja v gospodinjstvih pripada eni od naslednjih treh skupin: antimikrobna zdravila za sistemsko rabo (16,7%), dermatološki preparati (15,9%) in zdravila za bolezni prebavil in presnove (14,2%).Raziskava je pokazala, da je v srbskih gospodinjstvih shranjenih relativno veliko zdravil s pretečenim rokom trajanja. Najpogosteje se pojavljajo antibiotiki za sistemsko uporabo, protivnetni in antirevmatski pripravki ter zdravila za bolezni prebavil in presnove.

Background/Aim. Hypertension is one of the leading causes of cardiovascular morbidity and mortality and more than a half of all health insurance expenditures for reimbursed medicines are allocated to antihypertensive drugs in Serbia. The aim of this study was to identify the antihypertensive drug utilization patterns among hypertensive outpatients in the city of Novi Sad, Serbia, determine the adherence to clinical guidelines and address the economic aspects of current prescribing practices. Methods. This retrospective observational study was conducted in Novi Sad over a period of six months. The data on the number of packages, size of packages, and retail price of antihypertensives issued on prescription in outpatients with the diagnosis of essential arterial hypertension was collected from all state-owned pharmacies in Novi Sad. Drug consumption was analyzed using the Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) methodology. Results. Total consumption of antihypertensives issued on prescription over 6 month period in the city of Novi sad, Serbia was 283,48 DDD per 1,000 inhabitans per day (DID). Angiotensin converting enzyme inhibitors (ACEi) were most commonly prescribed drugs, and were used 3 times more often than calcium channel blockers and 5 times more than betablockers. The consumption of diuretics and angiotensin receptor antagonists was low within all groups of outpatients. Both national and international guidelines state superiority and effectiveness of diuretics in treatment of hypertension in the elderly, but their consumption was unreasonable low despite the fact that over 70% of all antihypertensive drugs in the city of Novi Sad were dispensed in people aged > 60. The use of more expensive ACEi was observed, despite the guidelines deeming all the drugs of these class equally effective in treatment of hypertension. Conclusion. Large differences in utilization of different groups of antihypertensive agents were noted in this study. Underutilization of valuable, efficacious, and cost-effective thiazide diuretics and over use of expensive ACE inhibitors is unjustifiable. There is a potential for large savings with switching to low-price ACEi, modeling the practice of Scandinavian countries. [Projekat Ministarstva nauke Republike Srbije, br. III 41012]

This study investigated the chemical and nutritional profile and antioxidative properties of cultivated Coprinus comatus . Proximate analysis revealed that C. comatus is rich in carbohydrates, dietary fibres and proteins, and could also be a valuable source of phenolics. Additionally, fat content is low, consisting mainly of polyunsaturated and omega-3 fatty acids. Furthermore, the safety profile of C. comatus is satisfactory, with all elements of toxicological importance within the proposed limits. Oral treatment with C. comatus for 42 days improved the antioxidant capabilities and ameliorated carbon tetrachloride-induced liver damage in rats, marked by decreased serum aminotransferase levels and lipid peroxidation intensity. Glutathione concentrations increased in a dose-dependent manner. Histological morphometric and immunohistochemical analysis confirmed antioxidative and hepatoprotective potential. These findings imply that cultivated C. comatus could be considered a nutraceutical, having beneficial nutrient and therapeutic properties.

Dietary supplements based on soybean extracts are widely used for a myriad of indications, but there is evidence that isoflavones, components of these supplements affect cytochrome activity. Alteration in pharmacodynamics of cytochrome-substrate drugs after co-administration with dietary supplements based on soybean extracts offers information on clinically significant herb-drug interactions that can cause unanticipated adverse reactions or therapeutic failures. Moreover, herbal drugs can contribute to the development and severity of drug-induced liver injury. Therefore, the aim of this study was to examine the effect of commercially available dietary supplements based on soybean extracts on liver and renal function, oxidative stress and pharmacodynamics of several conventional drugs. After quantification of isoflavones in the supplement using HPLC-DAD, pharmacological tests such as hot-plate, rotarod, pentobarbital-induced sleeping time were performed on Swiss albino mice treated with soybean extracts and several central nervous system acting drugs. Liver, renal function, and oxidative status in liver homogenates were determined in healthy and Wistar rats subjected to oxidative stress with CCl4. Dietary supplements based on soybean extracts weakened the analgesic activity of codeine, significantly potentiated diazepam-induced motor coordination impairment at 10th and 30th minute after diazepam administration, but had the opposite effect on alprazolam effect. Soybean extracts pretreated group also exhibited significantly shorter pentobarbital sleep induction and sleeping time. Soybean extracts administration did not affect the liver and renal function and ameliorated oxidative stress caused by CCl4. Despite exhibiting no negative effects on liver and renal function and demonstrated antioxidant in vivo potential, the safety of soybean extracts in addition to conventional drugs is questionable. The results of our study implicate the potential of dietary supplements based on soybean extracts for serious herb-drug interactions.

Background Worldwide data indicate that self-medication is frequently used inappropriately. Although self-medication is encouraged in most of the countries by introducing over-the-counter drugs, it bears the risk of misuse of drugs issued on prescription due to low observance of legislation of medicines requiring prescription by some pharmacies. Objective The objective of this study was to explore the self-medication practice, with an emphasis on self-medication with prescription-only medications. Setting Households in Novi Sad city, Serbia. Method The study was conducted over 8 month period (December 2011–July 2012) and involved a random sample of households. The questionnaire-based study and personal insight into household drug supplies was performed by a trained interviewer. Main outcome measure Number of drugs obtained without prescription or without consulting a physician in surveyed households. Results The total number of drug items present in the 383 households was 4,384 with a median of 11 drugs per household. More than a half of drugs in households were prescription-only medication (58.5 %). Approximately one third of prescription-only medications were obtained without prescription. The most common drugs obtained without prescription were anti-inflammatory and antirheumatic products and antibacterials for systemic use. Ibuprofen and diclofenac were the most common self-medicated drugs. Number of prescription-only medications bought with ought prescription was significantly higher in households with children under 12 years of age compared to other types of households. Conclusion Our survey indicated that self-medication with prescription drugs appeared to be a rather common practice, which is far away from the concept of “responsible self-medication”, especially regarding antibiotics.

Este trabajo invita a una reflexión sobre el papel actual de la ciudadanía europea en el corazón del debate político y jurídico europeo. Los retos y desafíos que amenazan y minan la unidad de la Unión Europea en la actualidad afectan indefectiblemente a su ciudadanía, desplazándola a un segundo plano y colocándola en una posición de “paro sistémico”. En plena celebración del sesenta aniversario del Tratado de Roma y los treinta años de entrada de España en la Unión Europea y la relevante Declaración Schumann, hemos de afrontar un reto todavía pendiente: que los ciudadanos nos identifiquemos cada vez más con la Unión Europea, desarrollando una opinión pública, una conciencia política y una identidad europea. This article reflects on the current role of European citizenship at the heart of European political and legal debate. Currently, the challenges that threaten and undermine the unity of the European Union inevitably affect his citizenship, moving to a second term and placing it in a position of “systemic arrest”. On the 60th anniversary of the Rome Treaty and thirty years of Spain’s entry into the EU and the relevant Declaration Schumann, we face a pending challenge, that citizens identify ourselves increasingly with European Union, developing public opinion, political consciousness and a European identity.

Aims The aims of this study were to assess patients’ non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). Methods We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foca municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method. Results The majority of patients were treated with oral therapy (84.21%). Half of the patients (48%) treated pharmacologically were non-adherent and patients on oral and insulin combination therapy showed better adherence than those on oral therapy. Age (B = −0.749; p = 0.004), copayment (B = 0.549; p = 0.028) and oral therapy (B = 0.827; p = 0.045) were the strongest predictors of poor adherence. Conclusion About half of the patients were non-adherent to antidiabetic medication. Interventions oriented towards policy changes regarding availability of antidiabetic medication through copayment reductions, and providing healt education to younger population and patients on oral therapy could lead to better adherence among T2DM patients in eastern part of BiH.

Introduction: With the growing trend for legalization of cannabis and its derivatives in Serbia, pharmacists are likely to be consulted on the safety, efficacy, and drug-drug or drug-disease interactions of medical cannabis. Thus, the aim of our study was to assess pharmacy students’ knowledge and attitude toward medical cannabis use in Serbia to determine if additional education is needed. Subjects and methods: In the study students from the final year of the study program of integrated academic studies of pharmacy at the Faculty of Medicine, University of Novi Sad were asked to complete an anonymous questionnaire regarding their knowledge and attitudes on the use of cannabis and its derivatives in medical purposes. After giving their written informed consent, they were instructed by the researchers on how to complete the questionnaire. All questionnaires were administered between August 1, 2017 and August 15, 2017. The study was approved by the Ethical Committee of the Faculty of Medicine in Novi Sad; a total of 80 questionnaires were distributed. The questionnaire consisted of 3 groups of statements on which they should mark level of their agreement related to students’ knowledge about the use of cannabis and its derivatives in therapeutical purposes, potential negative effects, dispensing in a pharmacy and legalization of cannabis and its derivatives in medical purposes. Results: Although 91.2% of the respondents agreed that cannabis and its derivatives could potentially have therapeutical effects, much lower percentage of respondents (51.3%) were familiar with possible therapeutical effects of cannabis. The same percentage of respondents learned about therapeutical effects of cannabis from sources other than school. About third (31.3%) of our respondents thought that the use of cannabis and its derivatives in therapeutical purposes could cause their abuse and the similar percentage of respondents (33.8%) thought that issuing cannabis and its derivatives in the pharmacy could expose a pharmacist to the certain dangers such as insisting on the issuing without the prescription or robbery. About 90% of the respondents agreed it is necessary to create clear guidelines for the use of cannabis and its derivatives in therapeutical purposes and 76.3% of the respondents thought that doctor’s prescription is necessary for their dispensing in a pharmacy. Most of the respondents (75%) agreed that, based on the experiences of the countries which have approved the use of cannabis and its derivatives in therapeutical purposes, its use in those purposes should be approved in Serbia. Conclusion: The majority of pharmacy students supported medical cannabis legalization but only with strict legal regulations and clear guidelines for their use implemented. Further education of the pharmacist about therapeutical effect of cannabis is necessary.

The purpose of this systematic review was to determine the practice of medication disposal around the world and get insight into possible association between environmental awareness and people's behavior regarding this issue. A literature search (2005-2015) was performed to identify reports with quantitative data on disposal practices published in peer-reviewed literature. The most common method for disposal of unused medications in households is disposal in the garbage (Kuwait, United Kingdom, Lithuania, Qatar, Serbia, Ghana, Bangladesh, Malta and Saudi Arabia). The practice of flushing drugs into the sewage system still takes place in New Zealand, USA and Bangladesh. Only in Sweden and Germany, practice of returning drugs to pharmacy was practiced to a larger extent. The environmental impact of improper medication disposal is expected in countries with poorly functioning waste management schemes (Middle Eastern, Asian and African countries). Lack of the adequate information and clear instructions on proper manners of drug disposal was reported in many surveyed countries (USA, New Zealand, Bangladesh, Malta and Ireland). Clear and definite connection between knowledge about environmental detrimental effects of improper drug disposal and the preference towards disposal methods could not be established. Many respondents were generally concerned with issues of inadequate medicines discarding but the behavior regarding disposal of unused drugs often did not equate the awareness (Serbia, USA, Kuwait, Malta and UK). The current data emphasizes the global issue of improper medicine disposal, prevalent in environmentally-aware people.

The purpose of this systematic review was to determine the practice of medication disposal around the world and get insight into possible association between environmental awareness and people’s behavior regarding this issue. A literature search (2005–2015) was performed to identify reports with quantitative data on disposal practices published in peer-reviewed literature. The most common method for disposal of unused medications in households is disposal in the garbage (Kuwait, United Kingdom, Lithuania, Qatar, Serbia, Ghana, Bangladesh, Malta and Saudi Arabia). The practice of flushing drugs into the sewage system still takes place in New Zealand, USA and Bangladesh. Only in Sweden and Germany, practice of returning drugs to pharmacy was practiced to a larger extent. The environmental impact of improper medication disposal is expected in countries with poorly functioning waste management schemes (Middle Eastern, Asian and African countries). Lack of the adequate information and clear instructions on proper manners of drug disposal was reported in many surveyed countries (USA, New Zealand, Bangladesh, Malta and Ireland). Clear and definite connection between knowledge about environmental detrimental effects of improper drug disposal and the preference towards disposal methods could not be established. Many respondents were generally concerned with issues of inadequate medicines discarding but the behavior regarding disposal of unused drugs often did not equate the awareness (Serbia, USA, Kuwait, Malta and UK). The current data emphasizes the global issue of improper medicine disposal, prevalent in environmentally-aware people.

Introduction The objective of this study was to investigate the knowledge, attitudes and behavior regarding antibiotics of the general population. Methods The study sample consisted of adult subjects who consulted general practitioners at health centers in Serbia and agreed to complete the questionnaire. A total of 668 questionnaires were distributed; 500 respondents completed the entire questionnaire (response rate 74.85%). Results The average age was 51.65 ± 16.56 years, 60.80% of the respondents were women. The median antibiotic knowledge score was 9. Predictors of adequate antibiotic knowledge were higher education level and a family member whose ocuppation was related to health-care. Overall, 58.4% of respondents believed that antibiotics could be used to treat common cold. Around a half of the respondents (47.2%) self-medicated with antibiotics at least once during their life-time, and around a quarter (24.2%) during the last treatment of infection. Patients with inadequate knowledge had 3 times higher chances of self-medicating with antibiotics compared to those with adequate knowledge. Although 98.20% of respondents claimed that antibiotic treatment should be started after a visit to a doctor and receiving a prescription, only 65.8% obtained antibiotics with prescription from a doctor during the last infection. Conclusions Although these results demonstrate that respondents had a relatively adequate level of knowledge regarding antibiotics use, some areas of misconceptions and improper behavior were identified. Therefore, further rationalization should be focused on educational campaigns targeting the behavior of patients with regard to antibiotic use.

O planejamento estratégico nas universidades vem se destacando como ação primordial para o desenvolvimento de uma gestão eficiente e, neste âmbito, a construção do Plano de Desenvolvimento Institucional (PDI) é seu principal mecanismo. O PDI é uma exigência legal, entretanto, deve ser visto como uma oportunidade da universidade parar, refletir e planejar seu desenvolvimento e crescimento. Objetivou-se neste trabalho descrever e analisar o processo de elaboração do PDI em uma Universidade Federal, elaborado com fundamento teórico nos modelos gerencial, com foco no planejamento estratégico, e societal de Administração Pública. Trata-se de pesquisa qualitativa, do tipo estudo de caso, elaborada por meio do método pesquisa-ação. Verificou-se que o PDI da Universidade pesquisada foi elaborado conciliando ferramentas dos modelos gerencial e societal de Administração Pública, na medida em que utilizou de ferramentas de gestão eficientes e com foco nos resultados, mas com ampla participação da comunidade acadêmica.

Fast moisture determination methods in flour samples