Knowledge Of Pharmacology Research Articles

Undergraduate nursing students' pharmacology knowledge and risk of error estimate

BackgroundIn the United States alone, medication error causes injury to approximately 1.3 million people every year. Frequently, nurses have been blamed for the high rates of medication administration errors. Factors associated with medication error by nurses are categorized as personal, contextual and knowledge-based. There is evidence in the literature that showed nurses have insufficient knowledge in pharmacology. PurposeThe overall purpose of this study was to estimate the risk of error based on the combined scores on pharmacology knowledge and self-rated certainty scores of undergraduate nursing students. MethodA cross-sectional and correlational study was conducted. Students enrolled in an undergraduate nursing program who completed or were currently taking the pharmacology course were eligible for the study. Based on power analysis, a sample of 156 students was needed to reach 80% power with a level of significance of 0.05. A 42-item Pharmacology Knowledge Questionnaire (PKQ) test was administered, and students were asked to provide their level of certainty for each of their answers. Risk of error was calculated based on the combined scores in PKQ and self-rated certainty scores. Results147 nursing students, 83% females with a mean age of 24 (SD = 5) years, participated in the study. Mean score in the PKQ was 25 (SD = 3.51) out of 42 items, which is equivalent to a grade of 60% (with a calculated weighted mean grade of 56%). Drug calculation was the subject area where students had the lowest mean score. Mean overall risk of error for all 42 items in the PKQ was 1.7 (SD = 0.14), on a scale of 0–3. This means that, on average, high risk of error was noted in 14% of the students who rated incorrect answers with high certainty. Positive correlations were noted between age and pharmacology score, and between when pharmacology course was last taken and risk of error. A negative correlation was noted between when pharmacology course was last taken and pharmacology score.

Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey.

IntroductionDeaths-related to medications errors are common in Pakistan but these are not accurately reported. Recently, the death of a 9 months old baby due to abrupt administration of 15% potassium chloride injection sparked the issue of high alert medications (HAMs) related errors in the country. Since drug administration is the prime responsibility of the nurses, it is pivotal that they possess good knowledge of HAMs. Since there is no published data regarding the knowledge of HAMs among Pakistani nurses, we aimed to assess knowledge of HAMs among registered nurses of Pakistan.MethodsA cross-sectional study was conducted among registered nurses, recruited using a convenient sampling technique, from 29 hospitals all over the Punjab Province. Data were collected using a validated self-administered instrument. All data were entered and analyzed using SPSS version 22.ResultsThe study sample was comprised of 2,363 registered nurses (staff nurses = 94.8%, head nurses = 5.2%). Around 63% were working in tertiary hospitals whereas almost 25 and 12% were from district headquarter hospitals and tehsil headquarter hospitals, respectively. Around 84% of the study participants achieved scores <70%, indicating majority of Pakistani nurses having poor knowledge of HAMs administration as well as regulation. There was no significant difference of overall knowledge among age, hospitals, departments, training, designations, qualification, and experience categories. Major obstacles encountered during HAMs administration were “getting uncertain answers from colleagues” (72.9%), “unavailability of suitable person to consult” (61.1%) and “receiving verbal orders” (55.6%).ConclusionOur study revealed the serious inadequacies in HAMs knowledge among Pakistani nurses which may lead to adverse patient outcomes. Nurses should receive comprehensive pharmacology knowledge not only during in-school nursing education but also as hospital-based continuing education. Moreover, it is of immense importance to bridge the gaps between physicians, clinical pharmacists, and nurses through effective communication as this will help reduce medication errors and improve patient care.

Student Characteristics Associated with Passing the Exam in Undergraduate Pharmacology Courses\u2014a Cross-sectional Study in Six University Degree Programs

Adequate knowledge in pharmacology is crucial in many professions but a non-negligible proportion of students fail the exams and knowledge of underlying factors is largely lacking. This study was performed to evaluate to what extent various factors are related to student performance in pharmacology-related courses in higher education, linking administrative data to attendance at non-mandatory teaching sessions and questionnaire replies. A total of 596 students (median age: 22 years; 70% female) were included from eight courses which are part of either the medical, pharmacy, dentistry, nursing, or biomedical analyst degree programs at the Sahlgrenska Academy, Gothenburg, Sweden. In all, 380 (64%) students passed the regular program- and course-specific exam. Multivariate logistic regression analysis revealed that a high participation rate in non-mandatory teaching sessions, as well as a perceived great interest in pharmacology, was associated with students’ passing of the exam; adjusted odds ratio (95% confidence interval): 1.30 (1.19 to 1.42; per 10 percentage unit increase in attendance) and 3.38 (1.86 to 6.12), respectively. Working for wages during the course weeks and pre-university grades used in the program application were significant factors in subgroups of students, negatively and positively associated with the exam results, respectively. Age, having Swedish as a second language, and time spent studying were only associated with the exam result in the univariate analyses. To conclude, both students and teachers can contribute significantly to successful education within pharmacology, students by participating in the teaching sessions and teachers by encouraging students to find the subject interesting.

Multiview Joint Learning-Based Method for Identifying Small-Molecule-Associated MiRNAs by Integrating Pharmacological, Genomics, and Network Knowledge.

The emergence of a large amount of pharmacological, genomic, and network knowledge data provides new challenges and opportunities for drug discovery and development. Identification of real small-molecule drug (SM)-miRNA associations is not only important in the development of effective drug repositioning but also crucial in providing a better understanding of the mechanisms by which small-molecule drugs achieve the purpose of treating diseases by regulating miRNA expression. However, challenges remain in accurately determining potential associations between small molecules and miRNAs using information from multiomics data. In this study, we adopted a novel framework called SMAJL to improve the prediction of small molecule-miRNA associations with joint learning. First, we use enhancing matrix completions to obtain the network knowledge of small molecule-miRNA associations. Then, we extract the information of small-molecule fingerprints and miRNA sequences into feature vectors to obtain small-molecule structure and miRNA sequence information. Finally, we incorporate small-molecule structure information, miRNA sequence data, and heterogeneous network knowledge into a joint learning model based on a Restricted Boltzmann Machine (RBM) to predict association scores. To validate the effectiveness of our method, the SMAJL model is compared with four state-of-the-art methods in terms of 5-fold cross-validation. The results demonstrate that the AUC and AUPRC of the SMAJL are obviously superior to those of other comparison methods. The SMAJL model also achieved great results in terms of robustness and case studies, further demonstrating its strong predictive power.

Identifying Adverse Drug Effects of Amiodarone through a Pharmacist-Led Comprehensive Review

Purpose: Amiodarone is a medication often utilized in the critical care setting for acute arrhythmic episodes and may be inappropriately continued post-discharge, leading to an increased risk of adverse drug events. The gap in transition of care upon discharge and subsequent failure to discontinue medications initiated during hospitalization can lead to increased healthcare utilization and costs. The presented case serves as an example of the consequences that can result from failure to discontinue amiodarone after hospitalization and demonstrates the role of clinical pharmacists in identifying inappropriately continued therapy to reduce the risk of adverse events. Case: A 66-year-old female presented to her primary care physician complaining of worsening bilateral hand tremors. Unable to determine the origin of this symptom, the physician asked a clinical pharmacist to perform a comprehensive review of the patient’s medications. The clinical pharmacist discovered that the patient was hospitalized a year prior for sepsis with infective endocarditis. During that hospital stay, she was started on amiodarone for an acute episode of atrial fibrillation. The pharmacist determined that the tremors were likely an adverse drug reaction from amiodarone and also recognized amiodarone as a potentially inappropriate medication for this particular patient. The amiodarone was subsequently discontinued. Within several weeks of discontinuation, the patient’s tremors improved significantly. Conclusion: This case demonstrates the importance of medication review after initiation of amiodarone during hospitalization. Due to the high potential for toxicity, the use of amiodarone should be reviewed and re-evaluated routinely. Clinical pharmacists can contribute their expert pharmacological knowledge to evaluate the appropriateness of amiodarone during and after transition of care to prevent future adverse outcomes.

Self-medication patterns and influencing factors in Medicine students from the Faculty of Medical Sciences, National University of Asunción, 2019

Self-medication is a frequent public health problem in the student population, which occurs above all in medical students, given their greater knowledge in pharmacology. As they are future prescribers, it is important to establish the magnitude of the problem in this population. The objective of the study was to determine the pattern of self-medication and associated factors in Medicine students of the National University of Asuncion. It was a descriptive observational cross-sectional study, with non-probability sampling for convenience. It spanned from April 15 to August 7, 2019. The sample was 221 students from the Faculty of Medical Sciences (medicine) of the National University of Asuncion. For the statistical analysis, the samples were analyzed in the PSPP program and the results were presented in tables and graphs for greater compression. Medical students, due to their pharmacological knowledge, have a higher self-medication index, also characterized by easy access to medications.

PERCEPTION AND PRACTICE ABOUT DRUG PRESCRIPTION AMONG DENTAL STUDENTS OF BOLAN MEDICAL COLLEGE/SANDEMAN PROVINCIAL HOSPITAL QUETTA

Objective: This study aimed to assess the perception and practiceoft drug prescription among Dental Students of Bolan Medical College/Sandeman Provincial Hospital Quetta. Materials and Methods: A cross-sectional observational study was carried out from January 2019 to July 2019. A total of 50 Dental Students participated in the Study. Results: 29% of respondents were females, and 21% were male. The age ranged from 21-25 years. Majority of the respondents were between 22-23 years. The mean age was 22 years. According to a present survey, 97% of the respondents considered dental prescription writing vital for dentists, and only 26% had exposure to new scientific knowledge for prescription writing. 88.9% considered that drugs do have a contraindication to some patients as well as to different health conditions. Conclusion: One of the most important problems faced by Dental Students during their study year and house job training was prescription writing. For this, they should have proper knowledge regarding prescription writing and their side effects as well as their interaction with other drugs. Shows that maximum Dental Students have good prescription writing skills along with adequate pharmacological knowledge.

The effects of a virtual learning environment compared with an individual handheld device on pharmacology knowledge acquisition, satisfaction and comfort ratings

BackgroundVirtual reality is reported to improve post-intervention knowledge and skills outcomes of health professionals compared to traditional teaching methods or digital online media. However, providing equitable access to high quality virtual reality resources for large, diverse nursing and midwifery student cohorts within multi-campus settings remains challenging. ObjectivesThis study compared the effect on student learning, satisfaction and comfort following exposure to a three-dimensional pharmacology artefact in a virtual facility (CAVE2™)11CAVE2™ Cave Automatic Virtual Environment is an immersive virtual reality environment with viewing of the same artefact using a mobile handheld device with stereoscopic lenses attached. DesignThe study used a pretest-posttest design. SettingSchool of Nursing and Midwifery in a regional university in Southeast Queensland, Australia. ParticipantsTwo hundred and forty-nine second year undergraduate nursing and midwifery students. MethodsOnline multiple choice tests were deployed to measure knowledge acquisition. Self-reported satisfaction scores and comfort ratings were collected using questionnaires. ResultsParticipants were not disadvantaged in terms of knowledge acquisition by using either CAVE2™ or the mobile handheld visualisation mode (P = 0.977). Significant differences in favour of the CAVE2™ environment were found in between students' satisfaction scores for clinical reasoning (P = 0.013) and clinical learning (P < 0.001) compared to the handheld mode, and there were no significant differences in their satisfaction with debriefing and reflective practice processes (P = 0.377) related to undertaking visualisation activities. A small number of students using handheld devices with stereoscopic lenses reported greater discomfort in relation to the visualisation that negatively impacted their learning (P = 0.001). ConclusionThree-dimensional artefacts using mobile devices is promising in terms of cost-effectiveness and accessibility for students with restricted access to on-campus teaching modes.

Class A G Protein-Coupled Receptor Antagonist Famotidine as a Therapeutic Alternative Against SARS-CoV2: An In Silico Analysis.

The pandemic associated with Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV2) and its disease named COVID-19 challenged the scientific community to discover effective therapeutic solutions in a short period. Repurposing existing drugs is one viable approach that emphasizes speed during these urgent times. Famotidine, a class A G protein-coupled receptor antagonist used for the treatment of gastroesophageal reflux was recently identified in an in silico screening. Additionally, a recent retrospective clinical report showed that the treatment with famotidine provided a good outcome in patients infected with SARS-CoV2. A clinical trial testing effectiveness of famotidine in combination with hydroxychloroquine is currently ongoing in the United States (US). In the 1990s, famotidine was described as an antiviral agent against human immunodeficiency virus (HIV). Interestingly, some HIV protease inhibitors are presently being used against SARS-CoV2. However, it is not clear if famotidine could be effective against SARS-CoV2. Thus, by using a computational analysis, we aimed to examine if the antiviral effect of famotidine could be related to the inhibition of proteases involved in the virus replication. Our results showed that famotidine could interact within the catalytic site of the three proteases associated with SARS-CoV2 replication. However, weak binding affinity of famotidine to these proteases suggests that a successful famotidine therapy could likely be achieved only in combination with other antiviral drugs. Finally, analysis of famotidine’s pharmacokinetic parameters indicated that its effect against SARS-CoV2 infection could be reached only upon intravenous administration. This work will contribute to the pharmacological knowledge of famotidine as an antiviral agent against SARS-CoV2.

Mise au point sur les bêtabloquants en 2020

Beta-blockers (BB) are an heterogenous set of molecules actively blocking β adrenergic receptors. Their pharmacological properties depend on their various effects on the adrenergic signalling. Although they are no longer a first-choice treatment in hypertensive patients, they remain a cornerstone of pharmacological strategy in several cardiovascular diseases such as stable angina, heart failure, arrythmia and aortic related connective diseases. Beyond their usual non cardiovascular indications such as migraine, hepatic cirrhosis, glaucoma, infantile hemangioma, and hyperthyroidism, new therapeutic fields are under scrutiny. Potential BB therapeutic repurposing is being investigated in COPD and cancer patients. This narrative review first encompasses the basic pharmacological knowledge that may be useful for the clinician. Then it will detail BB main indications before exploring new therapeutic fields.

Pathogenesis of Ulcerative Colitis Based on Network Pharmacology and New Therapeutic Targets

Ulcerative colitis (ulcerative colitis) is a kind of intestinal inflammatory disease with easy recurrence and long course. Modern medicine does not have a clear understanding of its pathogenesis, and there are no specific drugs to treat it in the world. Therefore, by analyzing, summarizing and summarizing the possible pathogenesis of the disease in existing studies and combining with network pharmacology research, this paper provides references for exploring the pathogenesis of ulcerative colitis and provides ideas for finding new therapeutic targets. While summarizing the literature research on ulcerative colitis in the past five years, combined with the relevant literature and knowledge of network pharmacology, it is believed that ulcerative colitis is mainly related to genetic, immune, microbial, diet, infection, environment and other factors internationally. In the treatment of ulcerative colitis, nf-kappa signaling pathway, tlr4-m y8-nf-kappa signaling pathway and pi3k-akt-mtor signaling pathway play a key role. Therefore, in the treatment of ulcerative colitis, IKK, kappa kappa, MyD88, TAK1, and nf-kappa can be regarded as new therapeutic targets, so as to have a significant effect on ulcerative colitis.

Current use and abuse of anabolic steroids

Common abuse of anabolic androgenic steroids (AASs) is no longer confined to high performance athletes, as it has spread among the general population. Epidemiological data about the abuse of these substances show that it is a common practice in young populations. Its use is based on the desire to increase muscle mass and strength, as well as improving physical performance. The ease of acquisition of this type of substances has developed a “sophisticated” knowledge of steroid pharmacology based on subjective and anecdotal analysis with no adverse event information, which translates into a public health crisis. Unfortunately, athletes seem to be more influenced by these experiences than by their physician's advice.The abuse of AAS by the athlete and non-athlete population and its adverse events ought to be evaluated in order to improve routine clinical practice on this regard.

EDUKASI GIZI BERBASIS APLIKASI ANDROID MENINGKATKAN PENGETAHUAN EMPAT PILAR PENATALAKSANAAN DIABETES MELITUS PADA PESERTA PROLANIS

Background : Uncontrolled diabetes could lead to serious complication. Diabetes therapy consists of four pillars where nutrition education is very important in managing the disease.Objective : To analyze the effect of nutrition education (Diabetes’ four pillars management) through android mobile application on the knowledge of Diabetes’ four pillars management in patients with DMT2.Method : A quasi experiment research with a pretest posttest control group design. Twenty-six participants were selected by simple random sampling method. Data were collected based on identity and knowledge which were done by interviewing with questionnaires. Changes on knowledge levels were determined by Mann Whitney test.Result : There were significant changes on knowledges related to diabetes (p=0.034), medical nutrition therapy (p=0.008) and physical exercise (0.014) between intervention and control groups, and there was an increase in pharmacological therapy knowledge but we did not observe any significant differences between intervention and control group (p=0.976).Conclusion : Nutrition education (Diabetes’ four pillars management) through android mobile application can increase knowledge of diabetes, medical nutrition therapy and physical exercise.

The rise of non-medical prescribing and medical dominance

This article contributes to the continuing debate on the professional dominance of medicine given the rising number of professions allied to medicine that now have the legal authority to prescribe and could potentially threaten this dominance. The key questions addressed are whether non-medical prescribers represent a threat to the dominance of medicine and if they do not, what has mediated doctors' response to these newer prescribers such that they are able to retain dominance? Drawing on Abbott's work on jurisdictional claims, this paper explores how the rise of non-medical prescribing has led to competing jurisdictional claims over prescribing between doctors and non-medical prescribers. This paper particularly focuses on pharmacist prescribing and how competing jurisdictional claims could be settled. It discusses why the profession of medicine is still dominant and the importance of professional ideologies to influencing the outcome of competing jurisdictional claims. The professional ideology of medicine has shifted from valuing prescribing to valuing the indeterminacy involved in complex clinical decision making, illustrating medicine's ability to adapt, retain dominance and maintain cultural authority over clinical knowledge. In contrast, pharmacist prescribers' professional ideology involves having specialist medicines expertise and being safe prescribers. Pharmacists draw upon this ideology to argue their unique competence as a prescriber: given their pharmacological knowledge and attention to detail which facilitates their role as clinical checker or 'safety net' on prescribing. However, medicine's cultural authority in clinical decision-making enables, when there are competing jurisdictional claims over prescribing, for doctors to retain intellectual jurisdiction: control over the cognitive knowledge base involved in prescribing and clinical decision making. Could this be eroded to a weaker form of control involving advisory jurisdiction? Should political developments further favour the widespread acceptance of prescribing as a core part of the pharmacist's role, an erosion to advisory jurisdiction may yet be possible.

Dereplication and quantification of the ethanol extract of Miconia albicans (Melastomaceae) by HPLC-DAD-ESI-/MS/MS, and assessment of its anti-hyperalgesic and anti-inflammatory profiles in a mice arthritis-like model: Evidence for involvement of TNF-α, IL-1β and IL-6

Ethnopharmacological relevanceMiconia albicans (Sw) Triana (Melastomataceae), a medicinal plant widely used by practitioners of folk medicine in the northeast of Brazil, has been used to treat chronic inflammatory disorders, such as rheumatoid arthritis (RA) and other joint conditions. Oddly, there is little research on the species. Aim of the studyWe aimed to evaluate the anti-arthritic and anti-inflammatory profile of the ethanolic leaf extract of M. albicans (EEMA), as well as to perform dereplication and quantification by HPLC-DAD-ESI-/MS/MS. Materials and methodsThe compounds present in the extracts were identified by HPLC-DAD-ESI-MS/MS. The possible anti-inflammatory effect of EEMA (50 and 100 mg/kg, p.o) was evaluated using the pleurisy model induced by carrageenan and its action on IL-1β and TNF-α levels was also evaluated. The RA model was induced through the intra-articular injection of complete Freund's adjuvant (CFA). ResultsHPLC-DAD-ESI-MS/MS analysis identified 23 compounds, with glycoside flavonoids mainly derived from quercetin, and rutin being the main compounds. EEMA significantly reduced (p < 0.001) leukocyte migration in the pleurisy model and reduced TNF-α and IL-1β levels in pleural lavage (p < 0.001). In the CFA animal model, EEMA significantly reduced the nociceptive and hyperalgesic behaviors demonstrated by the rearing test (p < 0.01 or p < 0.05) and decreased mechanical hyperalgesia (p < 0.001). EEMA produced a significant improvement in mobility in the open-field test (only at the higher dose, p < 0.05). EEMA significantly (p < 0.01) increased hindpaw grip strength. The diameter of CFA-induced ipsilateral knee edema was significantly reduced (p < 0.001) by EEMA, which was related to reduced levels of IL-6 and TNF-α in the joint knee (p < 0.01). No indication of hepatic injury after chronic treatment was found. ConclusionTaken together, these results contribute to the chemical and pharmacological knowledge of M. albicans and demonstrated that this medicinal plant appears to be able to mitigate deleterious symptoms of RA, which supports its use in folk medicine.

Safe and informed prescribing of psychotropic medication during the COVID-19 pandemic.

Treatment with psychotropic medication may sometimes be jeopardised because of the COVID-19 pandemic. One underlying reason is the lack of COVID-19-specific psychopharmacology guidelines. Here, we discuss five considerations arising from our clinical experience and pharmacological background knowledge to enable safe and well-informed psychopharmacotherapy during the COVID-19 pandemic.

Implementation of fuzzy-profile matching in determining drug suitability for hypertensive patients

Treatments of patients with hypertension can be done in two ways, namely modifying lifestyle and antihypertensive drugs. Generally giving hypertensive drugs depends on age, history of illness, smoking habits, obesity and on diseases such as diabetes, kidney failure, heart failure and ischemic heart disease. Inappropriate use of antihypertensive drugs often causes complaints such as fever, diarrhea, diabetes, mouth breathing, nerve disorders, radiation to the neck and head area. In providing hypertensive drugs that are appropriate to the patient’s condition, doctor and medical personnels are required to have high pharmacological knowledge. Not all hospitals have pharmacology experts, therefore this study was conducted to develop a model that can be used as a drug suitability model based on the patient’s condition. The method used in this study is Weight Matching Using Fuzzy Logic. Based on the results of comparisons with expert 1 and expert 2, the results of the average system testing are obtained with a value of 100% precision, recall 96.6% and accuracy 96.5%. Tests show that the application with a fuzzy logic approach can increase the efficiency of 9.5% compared to the interpolation weighting method.

CASSIA FISTULA: BOTANY, PHYTOCHEMISTRY AND PHARMACOLOGICAL LEVERAGES-A REVIEW

Cassia fistula Linn. is also called a “golden shower”. It is aboriginal to India, Sri Lanka and diffused in various countries, including Mexico, China, Mauritius, East Africa, South Africa, and West Indies. Plant and its parts, such as bark, fruit, leaves, and seeds, are used traditionally to cure diseases. Traditionally the plant possesses hepatoprotective, antipyretic, anti-inflammatory, leukotriene inhibition, antitussive activity, antioxidant, wound healing, hypo-lipidemia, anticancer, antidiabetic, central nervous system activity, antiulcer, antibacterial, antifertility, larvicidal and ovicidal, antifeedant, laxative, anti-epileptic, antimicrobial, urease inhibition, antifungal, anti-tobacco mosaic virus activities. The review contains botanical information, constituents and pharmacological leverages of the plant. The review draws attention towards the traditional, phytochemical and pharmacological knowledge accessible on Cassia fistula Linn, which would be beneficial for research scholars to develop novel chemical entities. This review article is written after studying most of the journal’s articles, which were published between 1998 to 2019.

A heart failure themed escape room approach to enhance pharmacy student learning

IntroductionThe purpose of this study was to design, pilot, and evaluate the efficacy of an educational escape room to enhance second professional year doctor of pharmacy students' knowledge of heart failure medicinal chemistry, pharmacology, and therapeutics in an integrated Modular Organ Systems Therapeutics (MOST) course and to assess students' perceptions of the game. MethodsHeart failure pharmacology, medicinal chemistry, and pharmacotherapeutics were taught in MOST prior to the escape room activity. Students were randomized into groups of approximately eight. At the completion of the activity, students were asked to fill out a perceptions survey. A follow up survey of their perceptions was again administered four weeks after the activity. ResultsOne-hundred-ninety-three students participated in the escape room activity. Overall, performance indicated that the escape room satisfactorily reinforced students' learning of the course material. Students expressed satisfaction toward the escape room activity on both surveys, with response rates of 92.22% and 56.99% for the initial and follow up surveys, respectively. Findings revealed no statistically significant differences between the first and the second group of responses, confirming that positive attitudes toward the activity did not alter over time. Students' satisfaction levels were inversely related to their grade point average (r = −0.20, p = 0.05). ConclusionsPositive student perceptions reported immediately after the completion of the escape room activity and measured in the follow-up survey demonstrated that the escape room is a satisfying learning activity that can engage all students.

PharmD: The need for Indians

With gradually increasing hospital faculty in India new challenges are betide in healthcare profession. escalation the concept of clinical pharmacist which turns to lead the PharmD program in India. The pharmacy profession is over the hill in India with unrecognized profession behind the counter of Pharmacy store and traditional workload of pharmacist. But the perspective of PharmD is totally different it aims that to make drastic changes in healthcare sector. Well designed syllabus with detail knowledge of pharmacology and therapeutical aspects as a Pharmacist which make a good clinical practitioner's as a clinical pharmacist. And now this is time to build up more healthier country by providing drug information more accurately by participating in real clinical practice. Keywords: Healthcare profession, Patient counseling, Clinical pharmacist.