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.

Although there is clear dose-dependence of pulmonary toxicity caused by inhalation of normobaric oxygen in animal studies, the threshold of toxicity in humans remains largely unknown. The aim of this systematic review of published clinical studies was to establish threshold in terms of total oxygen dose administered under normal pressure by inhalation that causes first clinical signs of toxicity. MEDLINE, EBSCO, The Cochrane Central Register of Controlled Trials (Central), SCIndeks, Scopus, Google Scholar, and ClinicalTrials.gov were searched from their foundation to April 2022. The systematic review was performed according to the pre-registered protocol at PROSPERO. The studies were included if describing toxic effects of normobaric oxygen therapy in humans. In total 11 human studies of poor quality were found, with either experimental or observational design. In none of the analyzed studies did oxygen therapy cause toxic effects on the respiratory tract if the concentration of oxygen in the inhaled air was below 50%, regardless of the rate of administration. The toxic consequences of inhaling oxygen at a concentration of more than 50% occurred only after oxygen was administered for more than 6 hours, at a rate of more than 7 L/min, and were mainly reflected in inflammation of the tracheobronchial mucosa, with epithelial erosions. Normobaric oxygen therapy can have toxic effects in humans if the oxygen concentration in the inhaled air is higher than 50%, if the administration rate is above 7 L/min, and if the application lasts at least 6 hours.

Conventional ophthalmic dosage forms, although being simple to apply and presenting great patients' compliance, display poorer drug bioavailability and retention time on the eye surface. To cope with these problems, one must formulate novel drug delivery systems, such as nanosystems, for ocular drug delivery. Different formulation methods of nanoparticles have been developed, but some of them, such as the supercritical fluid method, have not reached their full potential in ocular drug delivery. This article aims to present the possibilities of the supercritical fluid method when preparing nanosystems for ocular drug delivery. This method could be used more frequently and efficiently because it is environmentally friendly and produces nanoparticles of the desired physicochemical properties, which is especially important in ocular drug delivery considering its peculiarities. Modifications of the supercritical fluid method can be used when a drug has some specific properties, which is an additional benefit in ocular drug delivery.

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.

Glaucoma is considered to be one of the biggest health problems in the world. It is the main cause of preventable blindness due to its asymptomatic nature in the early stages on the one hand and patients’ non-adherence on the other. There are several approaches in glaucoma treatment, whereby this has to be individually designed for each patient. The first-line treatment is medication therapy. However, taking into account numerous disadvantages of conventional ophthalmic dosage forms, intensive work has been carried out on the development of novel drug delivery systems for glaucoma. This review aims to provide an overview of formulation solutions and strategies in the development of in situ gel systems, nanosystems, ocular inserts, contact lenses, collagen corneal shields, ocular implants, microneedles, and iontophoretic devices. The results of studies confirming the effectiveness of the aforementioned drug delivery systems were also briefly presented.

Hyperuricemia is a potential marker of cardiovascular diseases, and its relation to hypertension and arteriosclerosis, as well as the outcomes of certain cardiovascular events, is interesting. The research was carried out a sample of 50 subjects of both sexes, who were either on allopurinol or febuxostat treatment. Effects of allopurinol and febuxostat on concentrations of uric acid and some lipid fractions (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol) were observed in 25 subjects on allopurinol treatment, and in 25 subjects on febuxostat treatment, who were chosen by defined criteria, with each patient serving as his or her control. The total observation period was six months and the cut was made after the first three Original Research Article Ziga Smajic et al.; JPRI, 32(35): 44-54, 2020; Article no.JPRI.63434 45 months and at the end of the research. Evaluating the effectiveness of allopurinol in subjects with hyperuricemia, it was established that concentrations of uric acid decreased by 126.28±20.36 μmol/L, at the end of the research, compared to the initial concentration. In subjects who used febuxostat, at the end of the research, concentrations of uric acid decreased by 252.80±94.17 μmol/L, compared to the initial concentration. Evaluating the effectiveness of febuxostat on concentrations of lipid fractions, a statistically significant increase of 0.17±0.02 mmol/L in concentrations of HDL and a statistically significant decrease of 0.37±0.14 mmol/L in concentrations of LDL were noted. Subjects with gout treated with allopurinol had significantly lower average concentrations of cholesterol compared to subjects with gout and metabolic syndrome (p=0.001). Subjects with gout and metabolic syndrome had significantly higher concentrations of LDL at the beginning and the end of the research, regardless of therapy (p=0.045;p=0.049, respectively). Both drugs showed effectiveness in the treatment of hyperuricemia, and a certain effect on concentrations of lipid fractions.

Introduction: Self-medication has been very popular and globally prevalent for a long time. Aim: This research aims to present pharmacists’ engagement in the process of self-medication in the Sarajevo Canton. Methods: A total of 312 respondents completed an anonymous questionnaire-based survey. The first group (165 respondents) was surveyed in the pharmacy after buying a non-prescription drug, and the second group (147 respondents) outside the pharmacy. Results: The most commonly purchased drug was paracetamol, whereas headache was dominant amongst health conditions for which treatment respondents intended to use the purchased drug. A belief that respondents could cure themselves was the most common answer when asked why they had not visited a doctor, whereas previous experience with the purchased drug prevailed as an answer when asked from whom they had gotten information about the adequacy of the purchased drug for their health problem. Respondents mostly bought drugs for themselves. Pharmacists instructed 65% of respondents on how to take the purchased drug and checked whether 55% of respondents bought an appropriate drug for their health problem. Only 25% and 29% of respondents were informed about the adverse effects and potential contraindications or interactions of the purchased drug, respectively. According to 45% of respondents, pharmacists spent up to one minute in a conversation with them about the purchased drug. 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 non-prescription drugs. Further research is needed to create a clearer picture.