Introduction : Drug–drug interactions (DDIs) influence treatment outcomes, particularly in complex diseases such as coronavirus disease 2019 (COVID-19). This study aimed to evaluate the impact of DDIs in COVID-19 patients. Materials and methods : A study was conducted on 200 patients with mild, moderate, or severe COVID-19 infections. Next, DDIs were classified into five risk categories (A–X). Results : Altogether, 1689 DDIs were identified (maximum of 64 per patient). Most interactions were category C (65.3%). Clinically significant DDIs (C–X) accounted for 73.6% of interactions. Positive correlations were found between the total number of DDIs and both the total number of drugs (very strong) and comorbidities/diagnoses (strong). Patients with severe COVID-19 infections had significantly more DDIs and drugs used. Polypharmacy was highly frequent (97.5%, average of 9.9 drugs per patient). Conclusion : Overall, COVID-19 patients often have clinically significant DDIs resulting from polypharmacy and comorbidities, especially in severe cases. Systematic DDI assessment is essential.

Background: Adolescents are a susceptible population in terms of medication use. They are not only inclined to abuse illegal substances but are also prone to nonmedical medication use, which exposes them to a significant risk of various adverse drug reactions (ADR). Objective: This research aims to assess medication use among adolescents in Sarajevo Canton. Methods: This paper features information about the most frequently used medications, reasons for their use, sources of their procurement, ADR and concurrent use with other medications and/or alcohol. To obtain this data, a questionnaire with open- and close-ended questions was created. The survey was conducted online and 444 participants were included. Results: Medications were used by 90.1% of adolescents. The most commonly used medications were non-opioid analgesics, antibiotics, dietary supplements, antihistamines and benzodiazepines. Mild to moderate pain was the most frequent reason for medication use. Participants were at risk of ADR, drug-drug interactions (DDI), and drug-alcohol interactions. Conclusion: It is up to healthcare workers, especially pharmacists, to educate and guide adolescent patients on rational medication use and inform them about potential dangers following the use of these medications.

Background: The pathophysiology and therapy of coronavirus disease-19 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), are a dilemma for scientists and health professionals, and the fact that patients show different symptoms and severity of the clinical picture also contributes to that. Objective: This paper aims to evaluate the effectiveness of therapeutic protocols (the use of immunomodulators) in the treatment of COVID-19 patients of various severity of the clinical picture by monitoring inflammatory markers (ESR and CRP), as well as the impact of the type and number of comorbidities patients had on these markers. Methods: A total of 200 patients with a mild (n=76), moderate (n=70) or severe (n=54) clinical picture was included. Inflammatory markers [ESR (erythrocyte sedimentation rate), CRP (C-reactive protein)] were examined on three occasions: twice during hospitalization and once after hospital discharge. Immunomodulators used intrahospital were corticosteroids (methylprednisolone, dexamethasone, methylprednisolone + dexamethasone), tocilizumab or metenkefalin/tridecactide. Posthospital, patients were taking either methylprednisolone or did not use any immunomodulators. For statistical analysis, SPSS 26.0 and Microsoft Excel 2019 were used, with a level of significance of α=0.05. Nonparametric tests (Kruskal-Wallis and Wilcoxon Signed-Rank) were applied and effect size (ES) was calculated. Results: Three corticosteroid therapies used intrahospital caused a significant decrease in both inflammatory markers, especially in patients with a severe clinical picture, but the ES was the biggest with methylprednisolone + dexamethasone, then dexamethasone, and lastly methylprednisolone. Posthospital, methylprednisolone caused a significant decrease in both inflammatory markers, especially in patients with a severe clinical picture. The most common comorbidity in all patients, as well as in patients with a severe clinical picture, was hypertension. There was no statistically significant impact of the number of comorbidities patients had on ESR and CRP, but the highest number of comorbidities was in patients with a severe clinical picture. Conclusion: The use of immunomodulators, especially methylprednisolone + dexamethasone intrahospital and methylprednisolone posthospital, is justified in most COVID-19 cases as there is a significant correlation between this disease’s pathophysiology and the immune response. There is also a positive correlation between the number of comorbidities patients have and the severity of the clinical picture.

Background: Patients infected by coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), display various symptoms and severity of the clinical picture. Thus, the therapy and pathophysiology of this disease are a dilemma for health professionals and scientists. Objective: This paper aims to evaluate the effectiveness of therapeutic protocols (the use of anticoagulants) in the treatment of COVID-19 patients of various severity of the clinical picture by monitoring coagulation markers (PT, INR, aPTT and D-dimer), as well as the impact of the type and number of comorbidities patients had on these markers. Methods: A total of 200 patients with a mild (n=76), moderate (n=70) or severe (n=54) clinical picture was included. Coagulation markers [PT (prothrombin time), INR (international normalized ratio), aPTT (activated partial thromboplastin time), D-dimer] were examined on three occasions: twice during hospitalization and once after hospital discharge. Anticoagulants used intrahospital were fraxiparine, rivaroxaban or unfractionated heparin. Posthospital, patients were taking either rivaroxaban or did not use any anticoagulants. For statistical analysis, SPSS 26.0 and Microsoft Excel 2019 were used, with a level of significance of α=0.05. Nonparametric tests (Kruskal-Wallis, Wilcoxon Signed-Rank and Bonferroni) were applied and effect size (ES) was calculated. Results: Three anticoagulants used intrahospital caused a significant decrease in PT, INR and D-dimer and a significant increase in aPTT, especially in patients with a severe clinical picture, but the ES was the biggest with fraxiparine, then rivaroxaban, and lastly unfractionated heparin. Posthospital, rivaroxaban caused a significant decrease in PT, INR and D-dimer and a significant increase in aPTT, especially in patients with a severe clinical picture. Hypertension was the most common comorbidity in all patients, as well as in patients with a severe clinical picture. There was a statistically significant impact of the number of comorbidities patients had on D-dimer, and none on PT, INR and aPTT, but the highest number of comorbidities was in patients with a severe clinical picture. Conclusion: The use of anticoagulants, especially fraxiparine intrahospital and rivaroxaban posthospital, is justified in most COVID-19 cases as there is a significant correlation between this disease’s pathophysiology and the coagulation process. There is also a positive correlation between the severity of the clinical picture and the number of comorbidities patients have.

Aims: This study aimed to investigate whether the place of the survey makes a significant impact on the responses regarding the process of self-medication, as well as the present pharmacists’ engagement in this process in the Sarajevo Canton. Study Design: An anonymous questionnaire-based survey. Place and Duration of Study: One public pharmacy and various public places in the Sarajevo Canton, Bosnia and Herzegovina, for five months, February–June 2019. Methodology: A total of 312 respondents was included. The first group (165 respondents) was surveyed in the pharmacy after buying an over-the-counter (OTC) drug, and the second group (147 respondents) was surveyed outside the pharmacy. Results: Pharmacists instructed 65% of respondents (72.73% in the first group and 57.14% in the second group) on how to take the purchased OTC drug and checked whether 55% of respondents (70.91% in the first group and 38.1% in the second group) bought an appropriate drug for their health problem. Only 25% of respondents (36.36% in the first group and 12.24% in the second group) was informed about the adverse effects, whereas 29% of respondents (41.82% in the first group and 14.97% in the second group) was informed about the potential contraindications or interactions of the purchased OTC drug. The statistical analysis showed a significant relationship between the responses to the questions and the place of the survey about providing information on the adverse effects (P = .03), comorbidities (P = .049), and general information about the purchased OTC drug (P = .04). Conclusion: In the Sarajevo Canton, pharmacists should be more actively involved in the process of self-medication and provide the necessary advice to patients consuming OTC drugs. Further research is needed so general conclusions could be drawn.