FAPA2016 Abstract Book

FAPA Congress 2016 26th Federation of Asian Pharmaceutical Associations Congress “Integrating Asian Pharmacy Wisdom for Better Global Health.�

9-13 November 2016 Bangkok International Trade and Exhibition Centre (BITEC), Bangkok, Thailand

Editors: Srisagul Sungthongjeen, Worawut Kriangkrai, Parapat Sobharaksha, Pornsak Sriamornsak

Table of Contents Preface .................................................................................................................................................... 1 Plenary lecture abstracts ........................................................................................................................ 2 Invited lecture abstracts ......................................................................................................................... 7 I.

Scientific ...................................................................................................................................... 7

II.

Hospital and Clinical Pharmacy ................................................................................................. 15

III. Community Pharmacy ............................................................................................................... 19 IV. Industrial Pharmacy and Marketing .......................................................................................... 24 V.

Pharmaceutical Education ........................................................................................................ 30

VI. Administrative, Social Pharmacy and Ethics ............................................................................. 35 VII. Pharmacoepidemiology and Pharmacoeconomics................................................................... 39 VIII. Pharmaceutical Legislation, Regulatory Science and Pharmacopeia ....................................... 43 Oral presentation abstracts .................................................................................................................. 49 I.

Scientific .................................................................................................................................... 49

II.

Hospital and Clinical Pharmacy ................................................................................................. 65

III. Community Pharmacy ............................................................................................................... 75 IV. Industrial Pharmacy and Marketing .......................................................................................... 85 V.

Pharmaceutical Education ........................................................................................................ 92

VI. Administrative, Social Pharmacy and Ethics ............................................................................. 99 VII. Pharmacoepidemiology and Pharmacoeconomics................................................................. 106 Poster presentation abstracts ............................................................................................................. 109 I.

Scientific .................................................................................................................................. 109

II.

Hospital and Clinical Pharmacy ............................................................................................... 186

III. Community Pharmacy ............................................................................................................. 287 IV. Industrial Pharmacy and Marketing ........................................................................................ 323 V.

Pharmaceutical Education ...................................................................................................... 338

VI. Administrative, Social Pharmacy and Ethics ........................................................................... 354 VII. Pharmacoepidemiology and Pharmacoeconomics................................................................. 359 VIII. Pharmaceutical Legislation, Regulatory Science and Pharmacopeia ..................................... 367

Preface This abstract book includes all the abstracts of the papers presented at the 26th Federation of Asian Pharmaceutical Associations (FAPA) Congress, 9-13 November 2016, hosted by Pharmaceutical Association of Thailand under Royal Patronage, in Bangkok, Thailand. In total there were 5 plenary lectures, 33 invited lectures, 53 oral presentation abstracts and 252 poster presentation abstracts.

The congress was organized into 3 plenary sessions and 9 satellite symposium sessions that included many areas in pharmacy and pharmaceutical sciences, such as, Scientific, Hospital and Clinical Pharmacy, Community Pharmacy, Industrial Pharmacy and Marketing, Pharmaceutical Education, Administrative, Social Pharmacy and Ethics, Pharmacoepidemiology and Pharmacoeconomics, Pharmaceutical Legislation, Regulatory Science and Pharmacopeia.

Our mission is to make FAPA Congress a place where academics, researchers and practitioners from all over Asia meet to discuss the developments of their discipline and present their work. To serve this purpose, conferences are organized along the lines of well established and well defined scientific disciplines.

We are pleased to take this opportunity to acknowledge the excellent organizational skills of the conference chairman and his hard working local team from Pharmaceutical Association of Thailand under Royal Patronage in Thailand. The success of the conference was a tribute to all of them. We also are indeed grateful to all authors and referees for their cooperation and support, which have been essential in enabling us to prepare this abstract book in such a timely manner.

Srisagul Sungthongjeen Worawut Kriangkrai Parapat Sobharaksha Pornsak Sriamornsak Editors

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Plenary lectures

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PL-2 VACCINE DEVELOPMENT IN THAILAND Sumana Khomvilai Technical Director Queen Saovabha Memorial Institute, Thailand

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PL-3 THE NEED TO INTEGRATE BIOLOGY INTO PHARMACEUTICS Crispin R Dass Curtin University, Bentley 6102, Australia In the past, there has been a separation of the roles played by pharmaceutical science and biological science. This separation was absolute in academia and thus persisted in research.

Nowadays, with the need to prepare graduates for a more 'wholesome' experience, there is a slow but steady realisation, and thus push, for pharmaceutics curricula to incorporate aspects of relevant biology. Certainly, in the pharmaceutical research arena, biological science is a necessary accompaniment for success. In this talk, I will present some examples of cases where this marriage became necessary, albeit not planned at the outset of the studies. The secret to success in this alliance is constant dialogue and the need for both parties to be flexible and open to new ideas.

Keywords: pharmaceutics, pharmacy, biology, education, curriculum, research

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PL-4 DISCOVERING NEW APPROACHES TO HELPING COMMUNITY PHARMACISTS BECOME MORE EFFECTIVE IN PROVIDING PHARMACEUTICAL CARE Rich Segal University of Florida, HPNP 4332 Death from drug therapy is much more common than most people realize. Adverse effects of drug therapy may be the fourth leading cause of death in United States and it is actually a worldwide problem. Some episodes of drug therapy will involve drug therapy problems.

Among those problems are adherence problems, which results from the actions the patient makes concerning his or her willingness or ability to use the medication as instructed. Poor medication taking practices represent one of the more vexing problems limiting the effectiveness of medications. Improving medication adherence has been particularly challenging among certain ethnic groups with hypertension, especially since antihypertensive medications can cause side effects that lead patients to feel worse. Cultural experiences, especially among these groups, shape their medication-use practices. For example, some beliefs about how to treat hypertension are passed down from generation to generation and those cultural beliefs shape decisions made by patients. Further, beliefs and self-treatment decisions are not often shared with medical providers, which may lead providers to conclude a medication is ineffective when, in fact, patients are altering their medication-use practices to be consistent with culturally-based beliefs. This presentation speaks to the need for creating a new role for Community Health Workers (CHW) and a new relationship between CHWs and community pharmacists.

Keywords: pharmaceutical care, interdisciplinary practice models, preventing adverse drug events

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PL-5 ALIGNMENT OF PHARMACIST'S PRACTICE WITH GLOBAL AND REGIONAL HEALTH TRENDS AND PRIORITIES Roderick Layug Salenga University of the Philippines Manila, Philippines Pharmacists' roles continue to evolve and expand as the health needs of patients and populations change over time. Given the complex health care environment in the Asian region beset by socioeconomic-political challenges and competing priorities for overstretched resources, timely and equitable access to essential medicines of assured safety, efficacy and quality remains a major challenge. Unfortunately, this lack of access to essential medicines continues to place an unacceptable burden on health as well as on economic development to the countries and the whole Asian region. With the articulation of the Sustainable Development Goals for 2030, opportunities for more active involvement of the pharmacy sector in the health system and social development have opened. Certain traditional roles have been reaffirmed, but new functions have emerged. The objective of this paper is to discuss perspectives on how the profession can effectively move forward by using various practice entry points where pharmacist-initiated/provided services can deliver maximum impact to the society. An analysis of the major challenges, priority needs and what can be considered as strategic actions to address these shall be made in an effort to spell out a blueprint for relevant pharmacy practice in Asia.

Keywords: pharmacy practice, health priorities, health trends, sustainable development goals

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Invited lectures I. Scientific

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S-AW DEVELOPMENT OF CHITOSAN AND ITS WATER SOLUBLE DERIVATIVES FOR DRUG/GENE CARRIERS Praneet Opanasopit Department of pharmaceutical technology, Faculty of Pharmacy, Silpakorn Univerity, Nakhonpathom, 73000, Thailand Chitosan, the cationic polysaccharide obtained by alkaline deacetylation of chitin, is non-toxic, biocompatible, and biodegradable. These properties make chitosan a good candidate for the development of drug delivery systems. As a polycationic polymer with favorable properties, it has been widely used to form polyelectrolyte complexes with polyanions for various applications in the drug and gene delivery fields. Moreover, it has been studied as a potential absorption enhancer across mucosal epithelia for transmucosal drug delivery. However, the main drawback of chitosan is its water-insoluble property at the physiological pH (pH 7.4). Chitosan is a weak base, and in neutral and basic environments, chitosan molecules lose their charge and precipitate from solution. With suitable chemical modification, these chitosan derivatives can provide better materials for drug delivery systems. In this presentation, an overview highlights not only the favorable properties of chitosan and its water soluble derivatives, but their various types of application as drug carriers are also presented. Different types of chitosan derivatives developed as drug carriers include (1) amphiphilic chitosan derivatives as drug delivery carriers, (2) the quaternary ammonium chitosan derivatives for gene carriers and for absorption enhancing properties and oral protein drug delivery, (3) chitosan-based nanofiber mats loaded with Garcinia mangostana extracts as wound dressings and dental caries prevention. These novel modified chitosans have the potential to be used as drug/gene carriers, oral absorption enhancers of therapeutic macromolecules and also for wound dressing. In conclusion, chitosan and its derivatives are promising materials as delivery carriers of various types of therapeutic agents.

Keywords: chitosan, chitosan derivatives, gene carriers, drug delivery, absorption enhancer

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S-IV-1 STUDIES ON SPECIALIZED METABOLISMS BY GENOMICS, TRANSCRIPTOMICS AND METABOLOMICS Mami Yamazaki Graduate School of Pharmaceutical Sciences, Chiba University, Chuo-ku, Chiba, Japan The recent advances of plant omics help us to understand about the molecular basis, the reaction mechanisms and regulatory systems, in plant specialized metabolisms. We applied the integral analysis of transcriptome and metabolome to understand molecular mechanisms of alkaloid production in medicinal plants. The genes associated with alkaloid production were profiled and some of them were characterized. The pathways were predicted from metabolome change in engineered cells. Furthermore, some of molecular evolution of alkaloid biosyntheses has been traced by the comparative study among related and unrelated species. In this presentation, I will report our recent investigation on gene discovery for biosynthesis of plant specialized products.

Keywords: transcriptome, metabolize, evolution

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S-IV-2 POTENTIAL NATURAL PRODUCTS FOR ANTI-CANCER APPROACHES Pithi Chanvorachote Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok Accumulative evidences have proved that natural products are the promising sources of bioactive compounds for anti-cancer drug discovery and development. Herein, we have reported several natural product-derived compounds that possess anti-cancer activities demonstrated in lung cancer cell model. Compounds isolated from several plants were shown to mediate cancer cell death via apoptosis, inhibit cancer cell migration and invasion, and sensitize drug resistance and anoikis. According to the recent evidence suggesting that cancer stem cells (CSCs), unique cancer cells with capabilities of self-renewal and differentiation, are central players of cancer initiation, progression, metastasis and aggressive behaviors, CSCtargeted therapy has attracted tremendous attentions due to the promising of this unique therapeutic approach may attenuate the progression of cancer as well as improve the clinical outcome. We have provided information regarding activities and underlying mechanisms of pure active compounds isolated from natural products in suppressing CSC and their stemness in lung cancer. In closing, the presented information may encourage the further investigation and development of these potential natural product-derived compounds for novel anti-cancer approaches.

Keywords: natural product, anti-cancer, cancer stem cell, lung cancer

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S-IV-3 PHARMACOGENOMICS OF DRUG-INDUCED HYPERSENSITIVITY REACTIONS: CHALLENGES, OPPORTUNITIES AND CLINICAL IMPLEMENTATIONS Wichittra Tassaneeyakul Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Thailand Cutaneous adverse drug reactions are the most common types of adverse drug reactions in Thailand. These reactions are idiosyncratic and some of them including Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and the drug reaction with eosinophilia and systematic symptoms (DRESS) are severe life-threatening reactions. It has been hypothesized that drug-induced hypersensitivity reactions may be related to the patients’ genetic backgrounds, however, genes that are definitely involved in these reactions were not known until the last decade. Recent advances in pharmacogenomic studies have provided evidence for associations between the polymorphism of gene encoding for human leukocyte antigens (HLA) and SCAR induced by abacavir, allopurinol, carbamazepine, phenytoin or dapsone. Moreover, polymorphism of drug metabolizing enzymes may also play a significant role in the interindividual susceptibility to drug-induced SCAR as demonstrated in the phenytoin-induced SJS/TEN. It is noteworthy that associations between genetic polymorphisms of HLA and SCAR induced by some drugs are specific to certain phenotypes of SCAR and ethnicities. The HLA-B*15:02 is strongly associated with CBZ-induced SJS/TEN but not in other CBZinduced cutaneous reactions and these associations occur in Han Chinese, Thai, Malaysian and Indian populations but not in Japanese or Caucasian populations. Recent evidence suggests that the HLA is not only a genetic biomarker of SCAR but it is a key element of immunopathogenesis of drug-induced SCAR. Screenings of HLA genotypes in order to ensure the safety of drug therapy in patients who may be at a higher risk of SCAR induced by allopurinol, abacavir or carbamazepine are routinely available in several countries.

Grants from the National Science and Technology Development Agencyand Fauclty of Medicine, Khon Kaen University, Thailand Keywords: SJS, TEN, SCAR, DRESS, HLA

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S-IV-4 SUPERSATURATION STRATEGY FOR ENHANCED ABSORPTION OF POORLY WATER-SOLUBLE DRUGS Kunikazu Moribe Chiba University, Japan Dissolution enhancement is one of the strategies to improve the absorption a poorly watersoluble drug when it is administered by an oral route. Amorphous solid dispersions, where a drug is dispersed in the polymer matrix as the molecular or the cluster state, have been developed and some of the related formulations are on the market. The mechanism of dissolution enhancement is based on drug supersaturation by crystallization inhibition of drug and/or on drug solubilization in the presence of polymer. The contribution depends on kind of polymers and drug. In many cases, drug dissolution enhancement due to solubilization does not contribute to the membrane permeation. Not only the dissolution enhancement but also the dissolution rate from solid dispersion has to be taken into account for the formulation optimization. In this presentation, effect of crystallization inhibition on drug permeation was compared with that of the solubilization. Drug supersaturation properties in the physiological condition was evaluated using NMR. Finally, correlation between crystallization inhibition of drug and the dissolution rate from solid dispersion was investigated. Characterization of drug dissolution should be crucial to estimate membrane permeation of drug as well as the formulation optimization.

Keywords: supersaturation, solubilization, absorption enhancement, NMR

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S-IV-5 RECENT APPLICATIONS OF CAPILLARY AND MICROCHIP ELECTROPHORESIS IN PHARMACEUTICAL ANALYSIS Leena Suntornsuk Faculty of Pharmacy, Mahidol University, Bangkok 10400 Thailand Electrophoresis-based methods such as capillary (CE) and microchip electrophoresis (ME) are novel trends in analytical chemistry because of their unique separation mechanism, speed, and efficiency. Separation in CE is based on different mobility of analytes under an electric field, which occurs in a capillary filled with buffer. A large surface area to volume ratio of a capillary provides effective heat dissipation. The small dimension of a capillary requires small amounts of samples and buffer and the automation of CE requires less time and labor consuming. ME is a miniaturized platform of CE and is now considered as a simpler and more convenient alternative, which provides high-throughput, cost-effectiveness and portability for point-ofcare application. During the past decades, both techniques have grown from a simple to sophisticated methods due to several innovations (e.g. new modes, in-line derivatization, nanomaterials, etc.). These result in multiplied applications to various analytes including pharmaceutical and biomedical analysis. Recent applications of CE and ME in these areas (e.g. measurements of opioid peptides, amino acids in microdialysis samples and determination of adamantane drugs in dosage forms) will be discussed in the presentation.

Keywords: capillary electrophoresis, microchip electrophoresis, pharmacueitcal analysis, opioid peptides, amino acids, adamantanes

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S-IV-6 TABLETS PREPARED FROM COAMORPHOUS INDOMETHACINARGININE Peter Kleinebudde Heinrich Heine University DĂźsseldorf, Germany Coamorphous systems consist of an API and a second small molecule to stabilize the single phase amorphous state. They have a potential to improve oral bioavailability of poorly watersoluble drugs through drug dissolution enhancement as a result of the amorphous nature of the material. Recently, amino acids were suggested as components in coamorphous systems.

However, the downstream processing to achieve a final dosage form has not been shown. First results to prepare tablets from a coamorphous system containing spray dried indomethacinearginine are reported. It was possible to produce tablets, which were physically stable. The tablets eroded during dissolution test and provided a high supersaturation over a longer time compared to tablets from a physical mixture of the crystalline materials. However, even the tablets from the physical mixture resulted in a supersaturation due to in situ amorphisation of indomethacine. The dissolution behaviour and the solid state properties of the tablets will be discussed in detail.

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Invited lectures II. Hospital and Clinical Pharmacy

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H-IV-1 PHARMACIST’S ROLES IN A SUCCESSFUL ANTIBIOTIC STEWARDSHIP PROGRAM – EXPERIENCES FROM TAIWAN Yuh Lih Chang Taipei Veterans General Hospital, Taipei, Taiwan The misuse of antibiotics has contributed to the growing worldwide problem of antibiotic resistance, which has become one of the most serious and rising threats to public health.

Improving the use of antibiotics is an important issue and a national priority. To optimize the appropriate use of antibiotics, the Centers for Disease Control of Taiwan conducted a three year national Antimicrobial Stewardship Program (ASP) since January 2013. Taipei Veterans General Hospital was one of the leading demonstration centers of ASP and the director of pharmacy was recruited as a steering committee member of the program. We led to set up the national accreditation criteria for pharmacists in ASP including clinical pharmacist staffing, involvement of antibiotic control policies, percentage of in-time prescription evaluation, clinical pharmacy services, established clinical decision support functions in prescribing, patient education, statistics and outcome evaluation, etc. On the other hand, we built up inhouse policies and novel mechanisms for proper use of antibiotics with favorable outcome.

With the efforts of multidisciplinary cooperation, the ASP in Taiwan not only making the profession of pharmacist more visible, but also demonstrating that pharmacists indeed play an essential role in planning, executing, auditing and educating in the collaborated teamwork of ASP. Keywords: Antimicrobial Stewardship Program, antibiotic

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H-IV-2 EXPANDING THE ROLE OF PHARMACISTS - EXPERIENCE OF MANAGING PHARMACIST CLINIC Yanqun Evonne Lee National Healthcare Group Pharmacy, Singapore The role of pharmacists has evolved today and has moved beyond just compounding and dispensing medicines to patients at the pharmacy counters. Clinical pharmacists, especially, are more involved in direct patient care during ambulatory care clinic sessions. At the National Healthcare Group (NHG) Pharmacy, clinical pharmacists manage and care for patient on Warfarin in the Anticoagulation Clinic (ACC) as well as complex patients with diabetes mellitus (DM), hypertension and/or dyslipidemia in the Hypertension-Diabetes-Lipids (HDL) clinic. Besides our ACC and HDL clinics, our pharmacists are also actively involved in smoking cessation counselling and medication review for our patients. This session aims to give a brief overview of the clinic’s protocols and processes, followed by case studies to illustrate patient management through continuity of care and close monitoring for better clinical outcomes, and suggestions for future improvements to these services.

Keywords: direct patient care, ambulatory care clinics, pharmacists' role

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H-IV-3 USING MEDICATION RECONCILIATION TO PREVENT ERRORS Sutthiporn Pattharachayakul Faculty of Pharmaceutical Sciences, Prince of Songkla university, Thailand Medication reconciliation is the process of comparing a patient's medication orders to all of the medications that the patient has been taking. Since this process had been proofed in several studies to be able to prevent medication errors, many health care institutes now adopt this practice to assure patient safety. Pharmacists should establish themselves as a key person in this process.

Keywords: medication reconciliation

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Invited lectures III. Community Pharmacy

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C-AW THE ROLE OF COMMUNITY PHARMACIST HOME HEALTH CARE IN COMMUNITY Sirirat Tunpichart Community Pharmacy Association (Thailand), Bangkok 10310, Thailand Background: Thailand, the burdens of health was diabetes, cardio-vascular diseases, and kidney diseases that impacts to health care cost and quality of life. Especially, stroke is the long term disability and cause of death. Stroke have impact on the family members that provide care for ailing patients. The drug related problems (DRPs) frequently occur, side effect and drug interactions, leading to problems on disease controlled. The objective of this study was implied the community pharmacist home health care services for medication management for stroke patients by patient center care model. Methods: An action research was conducted during 20112015 in Bangkok. The stroke patients were purposively selective by neurologist and nurse from Taksin Hospital. The community pharmacist provided the home health care visiting in 3 to 6 times as intensive service design. This service included the medication management, and empowering caregivers. The medication therapy management was services for stroke patient.

Results: Data were gathered for 33 stroke patients that discharge from hospital. They were taking drug on average of 6 medications with the high alert drug especially such as warfarin.

The pharmacist identified the problems and improved in safety issues (adverse drug reactions, drug interaction and over used), adherences and effectiveness issue. The side effects of warfarin and mistaken administration were prompt detected and collected data to physician. The caregiver improved the food and drug management for stroke patients. Conclusion: The stroke patients was delivering effective care by the multidisciplinary teams. This study established that community pharmacist home health care could alleviated patients’ medication utilization problems and would thus improve overall quality of patient care.

Keywords: drug related problems (DRPs), home health care, medication therapy management, multidisciplinary teams

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C-IV-1 THE IMPORTANCE OF COMPLEMENTARY MEDICINES FOR PHARMACISTS AND CUSTOMERS Lesley Braun PhD, BPharm.

Blackmores Institute, Sydney Australia; National institute of Complementary Medicine; Western Sydney University, Australia Complementary medicines refer to nutritional supplements, herbal medicines and food concentrates which are available over-the-counter in pharmacies. Surveys indicate they are very popular amongst the public who use them to maintain good health, treat disease, manage symptoms and prevent future disease. Whilst they are used as therapeutic agents, there is also the potential to induce drug interactions. The risk of drug interactions is highest when patients are taking multiple medications or those drugs with a narrow therapeutic index self-select their products and don’t receive professional guidance about a safe and appropriate choice. This is particularly the case for older customers. As healthcare professionals, pharmacists are ideally placed to provide advice about the rational use of complementary medicine to ensure patients select appropriately, have realistic expectations and use them safely. Choosing the correct dosage, time frames for use and high quality products will help maximise the benefits and customers may also need guidance with these selections. According to a national survey of Australian pharmacy customers, the vast majority want pharmacists to take a more active role in guiding their complementary medicine selection. More specifically, 92% thought pharmacists should provide safety information and 87% thought they should recommend effective supplements.In contrast, a national survey of Australian pharmacists identified that few feel confident discussing complementary medicines, have received training or have the knowledge to provide evidence based information. There is an urgent need for pharmacists to upskill in this area inorder to provide and informed opinion to their customers.

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C-IV-2 INFORMATION SYSTEM OFFERS COMMUNITY PHARMACY TO PROVIDE PROFESSIONAL HEALTHCARE IN TAIWAN Bluce Huang Taipei Pharmacists Association (TPA), Taiwan In Taiwan, community pharmacy provides diverse services to people such as dispensing prescriptions, healthcare consultation, providing over-the-counter drugs, Nutritional Supplements and medical devices. Sometimes people come to a community pharmacy for measuring their blood pressure, blood sugar and body composition. The health care service is now developing new horizon and individualized. To follow the trend, it is important to know the data including medical history, medical record, consuming behavior‌etc. However, some of these data are incompletely collected or not integrated. Therefore, how to make use of these data via information system and let pharmacists have more complete information to exert their professional skill and to promote people health is worthy to be discussed.

Keywords: Information system

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C-IV-3 COMMUNITY PHARMACY IN JAPAN Mitsuko Onda Osaka University of Pharmaceutical Sciences, Japan Japan has the fastest-ageing society in the world, with a population that is rapidly decreasing.

As such, sufficient medical care for the elderly, and control of the associated costs, is an issue in Japan, and one that is shared by many countries. Therefore, there is an urgent need to build a sustainable, comprehensive system for resolving health- and welfare-related issues. For instance, better steps need to be taken to address medication-related problems that result from the use of multiple prescription medications (i.e. poly-pharmacies), in older individuals. In line with this situation, community pharmacies/pharmacists are expected to be a key component of community care. In Japan, there are approximately 58,000 pharmacies, with 55% of pharmacists working in community pharmacies. Recently, the government has launched a new policy, titled “Family pharmacist/pharmacy.� This policy requires active contributions from family pharmacists/pharmacies to strengthen medication safety, by enhancing patient information sharing with multidisciplinary (i.e. collaborative, team-approached) care, 24-hour home care support, and health promotion through self-medication support. To date, community pharmacies have been developed throughout Asia. However, the roles and activities of such enterprises can differ significantly by country. While their precise role is only beginning to be considered, the function of Japanese community pharmacies as a key component of community care will certainly increase in the coming years. As such, the current presentation aims to further explore the perspectives of community pharmacies.

Keywords: community pharmacy, poly-pharmacies, self-medication

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Invited lectures IV. Industrial Pharmacy and Marketing

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IM-AW INDIAN PHARMACEUTICAL INDUSTRY Subodh Priolkar

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IM-IV-1 OPEX, LEAN PRACTICES, TOTAL PRODUCTIVE MAINTENANCE, TOTAL QUALITY MANAGEMENT, EFFECTIVE MANAGEMENT SYSTEM, & JIT Rajeshwar Bhaskar Smarta The Institute of Management Consultants of India (IMCI), Indian Drug Manufacturer’s Association (IDMA), Indian Pharmaceutical Congress (IPC), Fellow of Royal Society of Arts and Commerce (FRSA) and Honorary Secretary of Health Foods and Dietary Supplements Association (HADSA) Asia Pacific’s robust growth is due to the market perspectives of the pharmaceutical market scenario from Social, Legal, Economical, Political and Technological point of view. The market here is expanding rapidly due to several broad trends like rising disposable incomes, increased healthcare expenditure, exploding population, rising life expectancies, consumer health awareness, and the growing incidence of chronic developed-lifestyle diseases. In the next few years, the region’s market is likely to be shaped by competitive trends, profitability and tension between small and large firms. Along with the market dynamics, challenges in the region are likely to come from environmental factors, communicable and non-communicable diseases, health issues revolving around reproductive health, child and adolescent health and development of healthcare delivery systems and infrastructure. The whole world is looking at the Asia Pacific region for sustained growth because of low-cost generics, innovation, competitive intensity and profitability index. As these challenges are addressed in an environment of potential market, the Asia Pacific region will move towards better health.

Keywords: Asia Pacific’s perspectives pharmaceutical market, market dynamics, challenges, sustained growth through innovation, competitive intensity and profitability index.

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IM-IV-2 INNOVATION FROM BIOMATERIALS FOR GLOBAL COMPETITIVENESS Pornanong Aramwit Bioactive Resources for Innovative Clinical Applications Research Unit Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand

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IM-IV-3 OPEX INITIATIVES FOR AFFORDABLE HEALTH CARE DELIVERY Kaushik Desai Section Chair, Industrial & Marketing, FAPA; Hon. General Secretary, Indian Pharmaceutical Association & Pharma Consultant The global pharmaceutical sector is embarking on a transformational journey. The phenomenal growth of Pharmaceutical sector globally has offered both, exciting opportunities as well as challenges to the pharmaceutical industry. By 2020, the global pharmaceutical market is expected to be about $ 1.4 trillion, with E7 countries accounting for about 20% of sales.

Emerging markets are likely to outgrow developed markets in the next decade. Many factors like rise in competition, drug price control, pressure from government, health care reforms, health insurance and ever expanding generic market has compelled pharmaceutical companies to look inward in the area of Operational Excellence. Operational Excellence philosophy has originated from Japanese automotive industry and then expanded to pharmaceutical industry by the beginning of this century. Since then OPEX has gained momentum and become a priority for both top management as well as workforce alike in pharmaceutical manufacturing in every part of the world. US FDA started pushing the industry to use innovative technologies like process analytical technology (PAT) for better process control leading to a new paradigm: Quality and productivity thereby paving way for OPEX. The latter has to be understood as the balanced management of cost, quality, and time while at the same time focusing on the customer needs. Continual improvement is the key to success of any OPEX initiative.

Operational excellence is achieved by cross functional team from R&D, Manufacturing, Engineering, Quality Control and Quality Assurance with active support from top management. Various initiatives of OPEX focusing on lean practices like Total Productive Maintenance (TPM), Total Quality Management (TQM), Just-in-Time (JIT) and Effective Management Systems (EMS) will be discussed in the deliberation. In conclusion, the OPEX initiatives are expected to be the corner stone of future operation strategies in fulfilling the objective of providing affordable medicines.

Keywords: OPEX, lean practices, total productive maintenance, total quality management, effective management system, JIT

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IM-IV-4 NANOMEDICINE AND ITS DRUG DELIVERY COMPLICATIONS AT SKIN AND PULMONARY INTERFACES Tin Wui Wong Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia Oral administration of drug is met with challenges associated with first pass metabolism due to harsh gastrointestinal pH and enzymatic conditions. Alternative routes of drug administration, such as skin and lung, have gained a widespread interest particularly when labile protein drugs are concerned or in delivery of therapeutics directly for the treatment of skin and pulmonary diseases. With reference to skin and pulmonary drug delivery, the use of nanomedicine is deemed favourable on the note that particles of nanogeometry can penetrate and permeate the mucosa/membrane more readily than the larger counterparts, and this promotes drug bioavailability and therapeutic effectiveness. Nonetheless, the nanomedicine often does not perform to the expectation due to physiological/anatomical limitations or constraints imposed by the physicochemical attributes of the nanomedicine. This presentation aims to share the recent research findings of our laboratory where the latest active technology, namely microwave, is used as skin penetration enhancer to overcome the barrier property of stratum corneum, the uppermost layer of epidermis, in skin administration of drug packaged in the form of nanomedicine. The presentation will also highlight the complications of using polymeric nanoparticles in delivering drugs to lung macrophages, for the treatment of pulmonary tuberculosis, as a function of polymer and carrier properties.

Keywords: Asian market dynamics and challenges for better health

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Invited lectures V. Pharmaceutical Education

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PE-AW INTERPROFESSIONAL EDUCATION AND INTEGRATED CURRICULUM TO OVERCOME THE CHALLENGES IN YIELDING BEST PHARMACIST GRADUATES Yahdianan Harahap

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PE-IV-1 THE ART OF EDUCATING TO TRANSFORM PHARMACY PRACTICE Claire Anderson University of Nottingham, Nottingham, UK These are challenging and exciting times for pharmacy and pharmacists. The global profession makes a broad and vital contribution to the health of patients and economic growth through roles in community, hospital, industrial and academic pharmacy. However, there are strong pressures on pharmacists to make deeper contributions to clinical practice and patient outcomes through improved knowledge, interprofessional team working and enhanced competencies based on local needs. These pressures originate from the profession raising its own aspirations via bodies like the WHO, the International Pharmaceutical Federation (FIP) and initiatives such as the independent Commission on Education of Health, the changes to PharmD in India and Thailand and the introduction of clinical pharmacy in China. There are also external pressures originating from, increased patient life expectancy, increased chronic disease burdens, new classes of drug and therapeutic interventions, and cost saving initiatives that will be a feature of healthcare for many years to come. I will draw on the example of our integrated MPharm degree course at University of Nottingham. It is designed to prepare our students for careers that could span 40 years or more. Graduates will need to demonstrate their value to the patient and to the healthcare system as innovation, new business models and healthcare reforms challenge current modes of practice.

Keywords: education, local needs, transforming, practice

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PE-IV-2 E-LEARNING IN PHARMACY EDUCATION – WHAT IS THE IMPACT? Vivian Lee The Chinese University of Hong Kong, Hong Kong E-learning is a new pedagogy and growing area in pharmacy education. In a recent published meta-analysis, it confirmed the role of e-learning in pharmacy education. Among all the 459 published work in pharmacy education up to June 4 2013, only 17 studies had documented effectiveness outcomes using e-learning in pharmacy education. In this presentation, I would like to share with the audiences about my e-learning experience and its impact. I have started the first cross-disciplinary e-learning platform for medication safety (MELODY) and documented the impact of e-learning platform can improve knowledge and attitudes toward medication safety awareness among students. In addition, I have pioneered e-learning using micro-modules in the pharmacy curriculum in cardiology pharmacotherapy training of Hong Kong. It was shown that students welcomed micro-modules and their understanding of cardiology pharmacotherapy was enhanced. In my previous micro-module experience, students’ understanding of cardiology therapeutics increased from 41.9% to 67.4% (net increase: 25.5%) after the implementation of the micro-modules. Their attitude and awareness toward cardiology therapeutics increased from 27.9% to 76.7% (net increase: 48.8%) after the implementation of the micro-modules. Students’ interest in using e-learning platform for study increased from 39.5% to 62.7% (net increase: 23.2%) after the implementation of the micromodules. 83.8% of students found that micro modules were helpful in understanding cardiology pharmacology and therapeutics. Finally, 79.1% of students found that micromodules enhanced understanding and stimulate interest in classroom teaching.

Keywords: pharmacy education, e-learning, impact

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PE-IV-3 INTEGRATING TEACHING METHODS WITH A PHARMACY PRACTICE COURSE Chanuttha Ploylearmsang Faculty of Pharmacy, Mahasarakham University, Kamriang, Kantarawichai, Maha Sarakham Province, Thailand To achieve the desired learning outcomes in students and their improvement in knowledge, skills and attitude, the suitable teaching methods should be designed and used by the educator.

The appropriate and efficient teaching methods should be selected in relation with the characteristics of the learners and the type of learning. Pharmacy education in Thailand, we are in the trend of encouraging students’ creativity and the 21st century skills, integrating and designing teaching methods to meet those learning outcomes are now the challenge issues for pharmacy educators. The main purpose of a pharmacy practice course is the integration of learning, we need our students be able to integrate their knowledge and skills into practice.

Several teaching methods to enhance students’ active learning not only in the classroom but also in the practice settings have been used such as case-based learning, problem-based learning, activity-based learning, project-based learning, team-based learning, communitybased learning, and bedside teaching. From a survey of 200 pharmacy students, the most preferred method that provides their understanding on theory and knowledge is the lecture. For skills improvement, problem-based learning is a chosen method. For transforming attitude, the inter-professional education (IPE) is chosen the most. On student’s preference, the methods they preferred are the lecture and case-based learning. Concerning students’ benefit, the integrated learning is the chosen method. IPE and team-based learning are the methods that most of students have chosen as the suitable methods for the next generation in this transformative learning age.

Keywords: teaching methods, students’ learning, knowledge, skills, practice

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Invited lectures VI. Administrative, Social Pharmacy and Ethics

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FAPA Congress 2016 | Bangkok, Thailand

A-IV-1 RESEARCH AND EVIDENCE FOR ADVANCING PHARMACISTS' PRACTICE Surakit Nathisuwan Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

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A-IV-2 HEALTH POLICY SUPPORTING THE ADOPTION OF PHARMACEUTICAL CARE John Jackson

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FAPA Congress 2016 | Bangkok, Thailand

A-IV-3 SUPPORTING PATIENTS THROUGH THE USE OF IT AND ELECTRONIC HEALTH RECORDS Sawaeng Watcharathanakij Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Thailand Information technology (IT) and electronic health records (EHRs) play a pivotal role in healthcare system development. IT can support delivery of medical services to patients in remote areas, improve health information exchange and increase patient safety and quality of care. Although EHRs are designed longitudinally to collect health information at individual level to improve clinical outcomes, EHRs can also support both organizational and societal outcomes by reducing costs and increasing the ability to conduct research. EHRs functionality includes clinical decision support (CDS) tools, computerized physician order entry (CPOE) systems, and health information exchange (HIE). Even if EHRs were used in many public and private hospitals, with or without incentive and support from the government, EHRs adoption in community pharmacy sector, particularly in some developing countries, was at the initial stage. Consequently, knowledge and skills related to IT and EHRs are important for pharmacists to help implement IT and EHR system nationally and must be included in pharmacy curriculum. Moreover, pharmacists’ attitude towards EHRs adoption must be investigated thoroughly.

Keywords: information technology, electronic health records, adoption, pharmacist

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Invited lectures VII. Pharmacoepidemiology and Pharmacoeconomics

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FAPA Congress 2016 | Bangkok, Thailand

PP-IV-1 PHARMACOECONOMICS OF ROTAVIRUS VACCINE: FROM ACADEMIA TO NATIONAL IMMUNIZATION POLICY Arthorn Riewpaiboon Division of Social and Administrative Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Due to the limited resources of healthcare, the efficiency of public health management is crucial. Thus, the principles of economics are applied to health management, called Health Economics. Pharmacoeconomics is one of these applications to study the intervention by medications and pharmaceutical services. In Thailand, Pharmacoeconomics has been added in the curriculum of undergraduate degree (Pharm D) and graduate degree (Social and Administrative Pharmacy). In addition to academic responsibility, social service is one of the responsibilities of universities. For example, the case study of “rotavirus vaccine� which was registered in Thailand in 2008 for the prevention of rotavirus diarrhea. WHO has recommended incorporating this vaccine into the national immunization program (NIP) since 2013. In order to include a vaccine in the NIP, the economic data is one of the factors. The Advisory Committee on Immunization Practices (ACIP) of the Ministry of Public Heath of Thailand has asked the Faculty of Pharmacy, Mahidol University to conduct the economic study of this vaccine using modeling technique. We discovered that the vaccine was not cost-effective.

However, break-even price from the analysis was negotiated, then, a pilot study was implemented. The faculty also involved this pilot project on economic assessment. This study was assigned as a part of a PhD thesis. Currently, the study results have been submitted to further steps of the national immunization policy. In conclusion, this case study has shown the important roles of the university on human resource and academic development which in turn, providing the efficient and quality health service to public.

Keywords: academia, university, national health policy, pharmacoeconomics, rotavirus, vaccine

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FAPA Congress 2016 | Bangkok, Thailand

PP-IV-2 THE ROLE OF PHARMACOECONOMIC & PHARMACOEPIMDEMIOLOGY IN INFORMING MALAYSIA DECISION MAKERS Asrul Akmal Shafie School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia As pharmacist move from behind the counter to a more public position, its role and service has significantly change - from a manual and mundane role as compounder, to one in a decision making role. In this new role, accurate information on the prevailing value, effect at the population level and how the society use pharmaceutical product and service are critical to make informed decision on prioritization of scarce health resources. Pharmacoepidemiology and pharmacoeconomic are two disciplines that frequently used to provide this information.

Pharmacoepidemiology, a study on the effect of drugs on large population allow us to gain insight into the distribution and determinant of that effect at population level.

Pharmacoeconomic, a study on how to make a choice in a limited resources environment allow us to gain insight into the value of each decision. In this symposium, I will first discuss what usually the scope of both disciplines are. Then, I will discuss how pharmacoepidemiology methods were used to estimate and compare the drug utilization rate in Malaysia with the global rate. This will be followed by discussion on how the cost effectiveness of Respiratory Medication Therapy Adherence Clinic, an enhanced pharmacy service in Malaysia, was evaluated. Finally, I will discuss the challenge in their application and how this can be improved.

Keywords: pharmacoeconomic, pharmacoepidemiology, Malaysia

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FAPA Congress 2016 | Bangkok, Thailand

PP-IV-3 CERVICAL CANCER TREATMENT COSTS AND COSTEFFECTIVENESS ANALYSIS OF HUMAN PAPILLOMAVIRUS VACCINATION IN VIETNAM: A PRIME MODELING STUDY Tuyet My Thi Nguyen Hanoi School of Public Health, Vietnam Background: Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. Objective: The study aims to perform a cost-effectiveness analysis of HPV vaccine introduction in Vietnam. Methods: The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. Results: The cost of cervical cancer treatment ranged from US$368 – 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per DALY averted in the range US$18 – 1100. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000.

Conclusion: While there is no accepted cost-effectiveness threshold for Vietnam, HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.

Keywords: cost-effectiveness analysis, cervical cancer, Vietnam, PRIME

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Invited lectures VIII. Pharmaceutical Legislation, Regulatory Science and Pharmacopeia

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RE-IV-1 PHARMACEUTICAL LEGISLATION TOWARDS AFTA AND GLOBAL TRENDS Maura Linda Sitanggang

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RE-IV-2 REGULATORY SCIENCES DEVELOPMENT: IMPLICATION FOR ACADEMY, HEALTH AUTHORITY AND INDUSTRY Rungpetch Sakulbumrungsil Department of Social and Administrative Pharmacy, Chulalongkorn University, Bangkok

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FAPA Congress 2016 | Bangkok, Thailand

RE-IV-3 EVOLUTION OF PHARMACIST ROLES AND CHALLENGES IN TAIWAN Weng-Foung Huang National Yang-Ming University, Taipei, Taiwan This presentation elaborates the changing policies and roles that affect the pharmacy profession in Taiwan over the past two decades. Challenges as the result of such policies will also be discussed. First, the implementation of the National Health Insurance (NHI) in 1995 resulted in the reimbursement-oriented practices of health care in Taiwan. The mandatory separation policy was followed in 1996, two years after the effectiveness of NHI. Physicians can only dispense their own prescriptions in medical emergency situation. Finally, the 2007 Amendment of the Pharmacists Act introduced the pharmaceutical cares that transferred the pharmacy practice from product-oriented to service-oriented. During the past decade, pharmacy education in Taiwan evolved from the four years programs to a six years Pharmacy Doctor program. Though there are some four-year pharmacy schools continued and their graduate are eligible to take the national board examination. Clinical pharmacy oriented PharmD graduates definitely are more competitive as an active contributive member of health care team. When most of the health care professionals suffered stagnation of payroll over the past two decades, the pharmacist enjoyed nearly zero unemployment rate and formidable pay scale. The challenges to pharmacist in Taiwan includes: complete separation policy is still far from reality as the prescription releasing rates remained low, it has been constrained as the releasing of prescription to community pharmacies tremendously affect drug-derived revenue among NHI contract medical institutes. The introduction of tax-based long term care program is another major challenge to pharmacist in the rapidly aging society of Taiwan.

Keywords: pharmacy policy, pharmacist role, challenges

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FAPA Congress 2016 | Bangkok, Thailand

RE-IV-4 PREPARING STUDENTS TO BE PRACTICE AND TEAM READY: CURRENT TRENDS IN AMERICAN PHARMACY EDUCATION Jan Engle Department of Pharmacy Practice Senior Associate Dean for Clinical Education University of Illinois at Chicago College of Pharmacy Chicago, Illinois, USA Pharmacy education in the United States is continually evolving in order to meet the needs of the profession and our patients. In July 2016, new accreditation standards were established by the Accreditation Council for Pharmacy Education requiring all accredited schools of pharmacy to update their programs and curriculums to meet the new standards. Pharmacy graduates are now required to be well prepared to enter advanced pharmacy practice experiences, provide direct patient care in a variety of settings and contribute as a member of a collaborative interprofessional team. This session will highlight the new expectations and curricular changes for pharmacy programs in the US. Participants attending this session will be able to: • • • •

Discuss the Accreditation Council for Pharmacy Education (ACPE) Standards 2016 for US pharmacy education and highlight the new requirements in the standards Review the Center for Advancement of Pharmacy Education (CAPE) 2013 Educational Outcomes Explain the Pharmacists’ Care Process Describe the role of co-curricular offerings in pharmacy programs

Keywords: American pharmacy education

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RE-IV-5 COMPRESSION FORCE MEASUREMENT OF ROTARY TABLETING MACHINES Peerayoot Pimhataivoot

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Oral presentations I. Scientific

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S-O-1 MILD SYNTHESIS OF ANTI-INFECTIVES AND CYTOTOXIC AGENTS BASED ON ELECTROPHILIC α/β-UNSATURATED CARBONYL STRUCTURES Aldrick B. Verano1, Allan Patrick Gose Macabeo1, Hans-Martin Dahse2 1

Organic Synthesis Laboratory, Research Center for Natural and Applied Sciences, University of Santo Tomas, España blvd., 1015 Manila; Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University, Sampaloc, 1015 Manila 2 Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI), Beutenbergstraße 11a, 07745, Germany Electrophilic α/β-unsaturated carbonyl compounds presented in the intricate structures of natural products have shown to be responsible for the inhibitory effects of important metabolic processes. However, despite broad range of bioactivities, exploitation of these electrophilic compounds as key pharmacophore, in synthetic side, seems to be at its infancy. Thus, herein reports a mild synthetic preparation of functionalized 2-cyclopentenone derivatives via basecatalyzed aldol condensation of benzils with aliphatic 2-alkanones at room temperature.

Structural characterizations of the corresponding 4-hydroxycycloalkenone derivatives were carried out using 1H and 13C Nuclear Magnetic Resonance (NMR), (High resolutionelectrospray ionization mass spectrometry) HR-ESIMS, and IR spectroscopy. Antimicrobial, anti-proliferative and cytotoxic properties were measured using Rezasurin-based microtiter plate assay (REMA) and MTT colorimetric assays. Results indicate propitious cytotoxic and anti-infective properties of 3,4-diphenyl-2-cyclopentenone derivatives and furnished in fair to moderate yields (40-65%).

Keywords: cytotoxic, cyclopentenone

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FAPA Congress 2016 | Bangkok, Thailand

S-O-2 INHIBITION OF ANO1 CHLORIDE CHANNEL BY LUTEOLIN AND ITS CYTOTOXICITY TO PROSTATE CANCER CELL LINES David Ryu, Kunhi Ryu, Yohan Seo 1

College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon 406-840, Korea

Anoctamin 1 (ANO1), a calcium-activated chloride channel, highly amplified in prostate cancer, and downregulation of ANO1 expression and its functional activity is known to inhibit prostate cancer progression by reducing proliferation, migration and invasion. We performed a cell-based screening of natural products for the identification of ANO1 inhibitor. Screening of 300 selected natural products revealed that luteolin is a novel potent inhibitor of ANO1.

Electrophysiological studies indicated that luteolin potently inhibited ANO1 chloride channel activity in a dose-dependent manner without significant effect on intracellular calcium signaling in FRT cells expressing ANO1. Luteolin showed significant inhibition of cell proliferation and migration in PC-3 cells expressing high levels of ANO1. In addition, luteolin not only inhibited ANO1 channel activity, but also decreased protein levels of ANO1 in PC-3 cells. Our results suggest that downregulation of ANO1 by luteolin may be a possible mechanism of anticancer effects of luteolin.

Keywords: ANO1, Ca2+-activated chloride channel, flavonoid, luteolin, prostate cancer

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FAPA Congress 2016 | Bangkok, Thailand

S-O-3 THE GASTROPROTECTIVE PROPERTY OF CENTELLA ASIATICA LINN. ETHANOLIC LEAF EXTRACT AND OMEPRAZOLE ON INDOMETHACIN-INDUCED ULCER IN MALE SPRAGUE-DAWLEY RATS Michelle Dalisay-Bartolome, Thryssa Johanna Cardenas, Joseph Rigo Atienza, Christopher Timothy Azarraga, John Karol R Cabredo, Alec Marion Callao, Gina Castro, Mary Grace E Angelo Department of Pharmacy, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippiness Centella asiatica is an ethno-medicinal herb used for the management of central nervous system, skin, and gastrointestinal conditions. The leaf extract of Centella asiatica has been used to prevent the formation of scar tissue and to treat leprous. The present study aimed to compare the gastroprotective property of Centella asiatica leaf extract and omeprazole against indomethacin-induced ulcer in Sprague-Dawley rats. The leaf extract was initially prepared by percolation of air-dried, powdered leaves in ethyl alcohol and subsequently fractioned using hexane, chloroform and ethyl acetate as solvents. High Performance Liquid Chromatography analysis showed that the ethyl acetate fraction contained the highest amount of asiaticoside, an active component associated with several pharmacological activities of Centella, thus, the ethyl acetate fraction was utilized in both subchronic and gastroprotective study. The organ weights manifested a slight increase but the plant extract did not manifest any toxicological side effects.

The gastroprotective property of the ethyl acetate fraction at 250 and 500 mg/kg BW and Omeprazole at 20 mg/kg BW were assessed after pre-treatment with test agents for 21 days and induction of ulcers with single-dose indomethacin. The pH levels of Centella and Omeprazole were relatively higher compared to the control group and the lesion size of both groups were smaller and less distinctive as compared to the control group. Omeprazole had an ulcer with a shallower depth compared to the ulcers found in Centella. The findings showed that Centella leaf extract promotes gastroprotective activity as ascertained grossly and histopathologically compared to the control group.

Keywords: Centella asiatica, fractionation, gastroprotective, indomethacin-induced ulcer

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S-O-4 POLYPHENOLIC EXTRACT OF ICHNOCARPUS FRUTESCENS MODULATES GLUCOSE UTILIZATION VIA GLUCOSE TRANSPORTERS IN STREPTOZOTOCIN-NICOTINAMIDE INDUCED DIABETIC RATS Kumarappan Chidambaram1, Cini Mathew John2, Sunil Christudas3, Fazlin Fauzi2 Department of Pharmacology, School of Pharmacy, Taylor’s University, Subang Jaya 47500,

1

Malaysia Department of Pharmacology, Faculty of Pharmacy, University Technologi Mara, Puncak Alam, 2300, Malaysia

2

Department of Ethno-Pharmacology, Entomology Research Institute, Loyola College, Chennai

3

600034du, India

The decoction of Ichnocarpus frutescens leaves has been used for a long time in Ayurveda for the treatment of diabetes. Experimentally, diabetes mellitus was induced in Wistar rats through i.p. injection of freshly prepared solution of streptozotocin (45 mg/kg). This was done 15 minutes after the administration of nicotinamide (120 mg/kg, ip). Glucose metabolism by the hepatocytes and adipocytes were also analyzed by quantitative RT-PCR mRNA expression levels of phosphoenolpyruvate carboxykinase 1, GLUT2 in the hepatocytes, and GLUT4 in the adipocytes. The hemi-diaphragms were also isolated and processed to study the in-vitro peripheral glucose utilization. Results of the present investigation suggest that STZ-NA induced diabetes is associated with hyperglycemia, altered levels of PCK1 and GLUTs gene expression as well as decreased levels of insulin and c-peptide. On the other hand, the outcome of the daily oral administration of PPE to STZ-NA induced diabetic rats at different doses (150 and 300 mg/kg body weight) for 30 days supports our hypothesis by showing significant improvement of hyperglycaemia, glucose tolerance (IPGTT), insulin levels, c-peptide level, down-regulation of PCK1 and up-regulation of GLUT (2, 4) mRNA expression levels when compared to those of diabetic rats. Findings from this study demonstrate that PPE may enhances peripheral glucose uptake through glycogenesis pathway, mediated by up-regulation of GLUT2 and GLUT4, and down-regulation of PCK1. Our study suggests that the leaf of I. frutescens is a rich source of polyphenolic compounds, including those with an insulin sensitizing function that may have the potential role for treating diabetes mellitus.

Keywords: Ichnocarpus frutescens, glucose transporters, hemidiaphragam, polyphenol, streptozotocin- nicotinamide, diabetes mellitus, glucose uptake, mRNA expression

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S-O-5 COMPARATIVE PHARMACOKINETICS OF ASIATICOSIDE AND MADECASSOSIDE ALONE AND IN THE STANDARDIZED EXTRACT OF CENTELLA ASIATICA, ECA 233 IN RATS Patcharaporn Hengjumrut1, Tosapol Anukunwithaya1, Mayuree H. Tantisira2, Phisit Khemawoot1 1

Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand 2 Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand

ECa 233, the standardized extract of Centella asiatica, contains triterpenoid glycosides not less than 80%, with the ratio of madecassoside and asiaticosid at 1.5 Âą 0.5 : 1. In this study, we performed a pharmacokinetic comparison of madecassoside and asiaticoside following intravenous and oral administration of ECa 233 (100 mg containing 51 mg of madecassoside and 38 mg of asiaticoside) or equivalent dose of individual compound were investigated in rats.

Blood, tissues, urine, and feces were collected after dosing to determine drug and metabolite levels using liquid chromatography-tandem mass spectrometry. The results revealed that the maximum concentration and absolute bioavailability of madecassoside following a dose of ECa 233 were higher than the corresponding values for a pure compound (Cmax 69,377.01 vs 45,643.28 Âľg/L, F 1.22 vs 0.58, p < 0.05). The elimination half-life and mean resident time of asiaticoside were significantly prolonged following the oral administration of ECa 233 (T1/2 7.61 vs 3.40 h, MRT 12.43 vs 5.49 h, p < 0.05). In tissue distribution studies, asiaticoside was more widely distributed to observed organs than madecassoside and displayed higher tissue to plasma ratio in the ECa 233 treated group. Regarding their metabolism, madecassoside and asiaticoside were hydrolysed to obtained aglycone, madecassic acid and asiatic acid and mainly excreted via the fecal route. Interestingly, we found bidirectional interconversion between asiaticoside and madecassoside resulting in an increased exposure of madecassoside and asiaticoside in ECa 233. The data obtain from this study is useful for developing ECa 233 as a future phytopharmaceutical product.

Keywords: ECa 233, madecassoside, asiaticoside, pharmacokinetics

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FAPA Congress 2016 | Bangkok, Thailand

S-O-6 PHARMACOKINETICS OF PUERARIN IN RATS Pilaslak Poo1, Natthaphon Hunsakunachai1, Suchinda Malaivijitnond2, Phisit Khemawoot1 1

Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand 2 Department of Biology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand Pueraria mirifica is a medicinal plant which is promoted as a Champion Product by the Government of Thailand. Puerarin is the major bioactive component of this plant, but there is insufficient pharmacokinetic data regarding its pharmacodynamics activity. The present study aimed to determine the pharmacokinetics of puerarin including absorption, distribution, metabolism and elimination to support investigation of its pharmacodynamics activities in rat.

Female rats were administered intravenously 1 mg/kg or orally 5-20 mg/kg of puerarin. Blood, tissue, urine and feces were collected and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results showed that puerarin reaches its maximum concentration in the blood ranging from 40-230 Îźg/L rapidly within 1 hr after oral administration. Oral bioavailability of puerarin was approximately 7% and decreased with increasing doses. Puerarin was widely distributed in several tissues, including the hippocampus, heart, lung, stomach, liver, mammary gland, kidney, spleen, femoral bone, and tibia bone. Moreover, we found that glucuronide metabolites of puerarin were detected in the biological samples as major metabolites, and were mainly excreted via fecal route. Our experiments confirm that puerarin is widely distributed to pharmacological related organs especially in hippocampus, mammary gland and bone. This will be useful scientific information to develop Pueraria mirifica as a phytopharmaceutical product for the prevention and therapeutics of aging diseases.

Keywords: Pueraria mirifica, puerarin, pharmacokinetics

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S-O-7 DNA BARCODING OF MORINGA OLEIFERA LAM. [FAM. MORINGACEAE] AND ZINGIBER OFFICINALE ROSC. [FAM. ZINGIBERACEAE] PLANTS AND HERBAL PRODUCTS Nikki Francine D. Balde, Nikolai Thadeus Quinto Mappatao College of Pharmacy, University of the Philippines Manila The rise in popularity of herbal products has precipitated problems such as misidentification of medicinal plants and adulteration in herbal products. This study aims to barcode malunggay and luya, plants listed in the Philippine Pharmacopeia which are commonly manufactured and sold as herbal products in the Philippine market. The identity of commercially-sold malunggay and luya products were also confirmed using DNA barcoding techniques. Four markers namely rbcL, trnH-psbA, matK, and ITS were evaluated based on PCR success rate, sequence quality, and resolution power. ITS had a PCR success rate of 100% while matK had a PCR success rate of 9.09% for malunggay leaf. The trnH-psbA and rbcL regions were not successfully amplified.

ITS produced good quality sequences bidirectionally, while matK produced a good quality forward sequence and a poor quality backward sequence. In the BLAST analysis, both ITS and matK markers were successful in identifying the samples up to species level, but ITS had a higher resolution power (8.8%) compared to matK (1.6%) for malunggay leaves based on the higher mean interspecies divergence from Moringa ovalifolia. Mean intraspecies divergence of sequences was determined using the best-fit substitution model for each plant, with 7.8% divergence between malunggay leaf and malunggay product, and 13.3% divergence between luya leaf and luya product. In conclusion, ITS can be used to barcode malunggay and luya for authenticating plant materials and confirming the identity of commercial herbal products.

Keywords: DNA, barcoding, malunggay, banaba, quality control, Philippine pharmacopeia

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S-O-8 PREPARATION AND CHARACTERIZATION OF SEMI-SYNTHETIC ANDROGRAPHOLIDE ANALOGUE-LOADED AMPHIPHILIC CHITOSANS MICELLES FOR CANCER THERAPY Teeratas Kansom1, Warayuth Sajomsang2, Pawinee Piyachaturawat3, Praneet Opanasopit1 1

Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand 2 National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathum Thani, Thailand 3 Department of Physiology, Mahidol University, Bangkok, Thailand

Semi-synthetic andrographolide analogue 3A.1 (19-tert-butyldiphenylsilyl-8,17-epoxy andrographolide) is a C-19 substituted andrographolide which is the major compound from Andrographis Paniculata Nees (Acanthaceae). Previously, this analogue has been reported to be highly cytotoxic against several cancer cell lines. However, the pharmaceutical application of this compound was limited due to its poor water solubility. Therefore, the present study was aimed to increase aqueous solubility of 3A.1 by using chitosan base polymeric micelles. In addition, the influence of the physical entrapment methods, type of amphiphilic chitosan derivatives, amount of 3A.1 on entrapment efficiency, loading capacity, particle size, zeta potential and stability of 3A.1-loaded polymeric micelles were evaluated. The three types of amphiphilic chitosan, namely N-benzyl-N,O-succinyl chitosan (BSCS), N-octyl-N-O-succinyl chitosan (OSCS) and N-naphthyl-N,O-succinyl chitosan (NSCS) were synthesized and then, they were used for micelles formation. 3A.1 (0-40% weigh to polymer) was loaded into the micelles using different entrapment methods, including dialysis, O/W emulsion, dropping and evaporation method. The results revealed that 3A.1 was incorporated into the inner core of polymeric micelles and show potential for improving of solubility of 3A.1. The hydrophobic part (benzyl, octhyl and napthyl) of polymer affected the entrapment efficiency. 3A.1-loaded NSCS micelles prepared by dropping method showed the highest entrapment efficiency and loading capacity. Increasing the initial amounts of 3A.1 resulted in the increase in particle size.

The different entrapment methods also affected the particle size. The micelles ranged in size from 78-309 nm with negatively charge. Therefore, these NSCS micelles have promising potential as 3A.1 delivery systems.

Keywords: andrographolide analogue, anticancer, chitosan, polymeric micelles, physical entrapment methods

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S-O-9 CELL UPTAKE ASSAY AND CYTOTOXIC ACTIVITY OF RIP MJCHITOSAN-ALGINATE NANOPARTICLE AGAINST T47D BREAST CANCER CELL-LINES Sismindari Sismindari1, Muhammad Radifar2, Psycha Anindya Wicaksono2, Ronny Martien1 1

2

Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia High Degree Program of Biotechnology, Universitas Gadjah Mada, Yogyakarta, Indonesia

Ribosome-Inactivating Proteins isolated from Mirabilis jalapa L. leaves (RIP MJ) has cytotoxic effect on breast cancer cell line (T47D) but less toxic on normal cells (Vero). However, proteins including RIP MJ have problem on the stability, it easily be degraded following administration.

Therefore, RIP MJ need to be formulated into nanoparticles to increase its stability, since nanoparticle found to have capabilityon delivering, maintaining the integrity, and conserving the function of protein during therapy process. In this study, nanoparticle chitosan-alginate RIP MJ was designed and determined the cytotoxic effects against breast cancer cell line (T47D) and normal cells line (Vero). The cells uptake assay was carried out using chitosan-alginate BSA-FITC nanoparticle formula. Results indicated that formulated chitosan-alginate of RIP MJ could increase the cytotoxic effect of unformulated RIP MJ. In addition, chitosan-alginat RIP MJ nanoparticle had more cyotoxicity against breast cancer (T47D) than normal (Vero) cell lines. These results were supported by the cells uptake assay.

Keywords: chitosan, alginate, nanoparticle, ribosome-inactivating proteins, RIP MJ, cytotoxic effect, breast cancer cell line

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S-O-10 DEVELOPMENT OF NANOCARRIERS FOR TRANSDERMAL DELIVERY OF CAPSAICIN Sureewan Duangjit1, Tassanan Nimcharoenwan2, Nutcha Chomya2, Natthporn Locharoenrat2, Tanasait Ngawhirunpat2 1

Faculty of Pharmaceutical sciences, Ubon Ratchathani University, Ubon Ratchathani 34190 Thailand 2 Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand

Capsaicin (CAP) is a major pungent component and hydrophobic compound that has been widely used in both oral and topical for pain relief. However, the strong pungency and the water insoluble of CAP lead to its limitation in the design and development of CAP for drug delivery system. The aim of this study was to design and develop the nanocarriers for transdermal delivery of capsaicin. The optimal nanocarriers (liposomes, transfersomes, invasomes) were defined as a nanocarriers system with simultaneously high entrapment efficiency and high skin permeability. The model formulations of nanocarriers obtained from the experimental design.

The lipid compositions and the physicochemical characteristics of the nanocarriers formulations were determined as causal factors (Xn) and response variables (Yn), respectively.

The physicochemical characteristics, i.e., the vesicle size (Y1), size distribution (Y2), charge (Y3), entrapment efficiency (Y4) and skin permeability (Y5), of the nano-carriers formulations were examined. The relationship between the causal factors and the response variables was used to predict the optimal nanocarriers formulation using Design ExpertÂŽ program. The results indicated that the vesicle size of nanocarriers formulations containing 0.15% capsaicin were smaller than 200 nm, narrow size distribution (less than 0.3) and had negative zeta potential value (less than -2 to -20 mV). The skin permeability of transfersomes and invasomes was significantly higher than liposomes and commercial product. The nanocarriers formulation (transfersomes and invasomes) composed of the surfactant and terpene was successfully developed as a transdermal delivery carrier for CAP. Keywords: capsaicin, nanocarriers, liposomes, transfersomes, invasomes

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S-O-11 PREPARATION AND CHARACTERIZATION OF HERBAL OILENCAPSULATED PVP/ HPΒCD NANOFIBER MATS FOR ORAL CANDIDIASIS Prasopchai Tonglairoum1, Tanasait Ngawhirunpat1, Theerasak Rojanarata1, Ruchadaporn Kaomongkolgit2, Praneet Opanasopit1 1

Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Thailand

2

This study investigated the fabrication of herbal oil-incorporated PVP/ HPβCD nanofiber mats with antifungal activity for the oral candidiasis. Betel oil or clove oil (20–40% weight to polymers) was added to the polymer solution containing various amount of HPβCD, and the mixtures were stirred overnight to allow the oil incorporate into the HPβCD. The betel oil or clove oil-loaded nanofiber mats were fabricated via electrospinning process and characterized using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC) and mechanical testing. The nanofiber mats were further investigated for release characteristic, antifungal activity, and cytotoxicity. The nanofiber mats had a smooth surface without bead. Increasing the amounts of HPβCD resulted in the increase in diameters of the nanofiber mats. The incorporation of the herbal oils into the nanofiber mats reduced the fiber diameters. The DSC and FT-IR results verified the presence of the oil in the nanofiber mats. A rapid release of the herbal oils from the nanofibers mat was achieved. The herbal oil loaded mats could inhibit the growth of candida cells within only few minutes after contact. Further in vivo studies are needed to investigate for their application in oral candidiasis.

Keywords: polyvinyl pyrrolidone, hydroxy propyl-beta-cyclodextrin, betel oil, clove oil, electrospinning, oral candidiasis

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S-O-12 CATIONIC NIOSOMES-BASED PLASMID DNA ENCODING OVALBUMIN ENHANCING IMMUNE RESPONSE BY SKIN VACCINATION WITH HOLLOW MICRONEEDLE Boonnada Pamornpathomkul1, Lalita Leksantikul1, Nattisa Niyomtham2, Praneet Opanasopit1 Faculty of Pharmacy, Pharmaceutical Development of Green Innovations Group (PDGIG), Silpakorn University, Pathom, Nakhon, Thailand 2 Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Ramkhamhaeng University, Bangkok, Thailand

1

The purpose of this study was to evaluate a hollow microneedle device in delivery of cationic niosomes complexed with plasmid DNA encoding ovalbumin (pOVA) into mice for enhance vaccine immunogenicity by targeted delivery to skin. In addition, we evaluate the factors affecting the transfection efficiency and cell viability of cationic niosomes including type of central core structures in cationic lipids (di(oxyethyl)amino, di(oxyethyl)amino carboxy, 3amino-1,2-dioxypropyl and 2-amino-1,3-dioxypropyl), molar ratio of cationic lipids in formulations (0.25, 0.5, 1, 1.5, 2), weight ratios of cationic vesicles to pDNA (0.1, 0.5, 1, 2.5, 5 and 10) in human cervical carcinoma cell line (HeLa cells) using pDNA encoding green fluorescent protein (pEGFP-C2). These effects were evaluated to compare with LipofectamineTM 3000 as a positive control. In this study, cationic niosomes formulated with Span 20, cholesterol and novel synthesized spermine-based cationic lipids with four different central core structures were examined as gene carriers. Cationic niosomes composed of Span20:cholesterol:di(oxyethyl)amino in the molar ratio of 2.5:2.5:0.5 mM at weight ratio 2.5 showed high transfection efficiency. We observed no significant difference in the transfection efficiency between cationic niosomes and LipofectamineTM 3000. The serum IgG levels of mice using hollow microneedle that received cationic niosomes formulation (2.5:2.5:0.5 mM)/pOVA at the weight ratio of 2.5:1 were significantly higher than received LipofectamineTM 3000/pOVA. Additionally, hollow microneedle vaccination in the skin was superior to subcutaneous immunization in higher of IgG levels in mice. Accordingly, the use of a hollow microneedle to deliver cationic niosomes-based pDNA has great potential in skin vaccination.

Keywords: cationic niosomes, gene transfection, spermine derivatives, skin vaccination. hollow microneedle

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S-O-13 VISUALIZATION AND UNDERSTANDING OF BINDER DISTRIBUTION IN GRANULES USING NEAR-INFRARED CHEMICAL IMAGING Pattaraporn Mongpraneet, Nattawut Charoenthai, Waree Limwikrant, Satit Puttipipatkhachorn Department of Manufacturing Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Binder distribution is one of important factors that affect the properties of granules and tablets prepared by wet granulation. The aim of this study was to use near-infrared chemical imaging (NIR-CI) to visualize the binder distribution in granules prepared by high shear speed mixer.

Loratadine was used as model drug. Two types of binders, i.e. polyvinyl pyrrolidone K30 (PVP K30) and pregelatinized starch, were used and incorporated by two different methods, i.e. dry addition and wet addition. The process variables (mixing time and method of binder addition) and formulation variables (type and amount of binder) were optimized using the design of experiment. NIR-CI integrated with chemometric algorithms such as principal component analysis (PCA) and partial least square regression-discriminant analysis (PLS-DA) was used. The mixing index to assess homogeneity of binder distribution was evaluated by macropixel analysis and histograms of chemical image. The results indicated that different types of binder had no significant effect on the binder distribution in granules. The wet addition method gave the granules with higher binder homogeneity than the dry addition method and the binder distribution was more homogeneous with increasing of mixing time. The wet addition method and longer mixing time gave the tablets with higher hardness and longer disintegration time. In conclusion, more homogeneity of binder distribution was thought to be closely related to the increase in hardness and disintegration time of tablets.

Keywords: NIR-chemical imaging, binder, high shear granulation, loratadine

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S-O-14 SELF NANO-EMULSIFYING DRUG DELIVERY OF CURCUMIN ANALOGUE GAMAVUTON-0 AS AN ANTI RHEUMATOID ARTHRITIS Lutfi Chabib1, Zullies Ikawati2, Hilda Ismail2, Ronny Martien2 1

Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Islam Indonesia, Yogyakarta 2 Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta

Gamavuton-0 (GVT-0), 1,5-bis(4’-hydroxy-3’-metoxiphenyl)-1,4-pentadien-3-one, is a curcumin analogue synthesized by a carbonyl group and a methylene reduction of Curcumin. GVT-0 has been studied to possess anti arthritic effect through inflammatory attenuation and arthritis index reduction, cartilage destruction inhibition, and suppression on inflammatory cytokines Tumor Necrosis Factor-α (TNF- α) and Interleukin-1β (IL-1β) tissue expressions in vivo on rat rheumatoid arthritis (RA) model. As a promising anti RA agent, GVT-0 burdens low water solubility therefore poorly absorbed in oral administration. In current research, a self-nanoemulsifying system has been developed to formulate GVT-0 into a more effective oral anti RA candidate using various oils and surfactants. A formula of myritol with surfactant combination of cremophore and Tween 20 and Proplylene glycol as co-surfactant showed a reliable system for 220.27 mg GVT-0 per 5 mL system, was able to form a clear emulsion in artificial gastric and intestinal fluid in less than a minute with a homogenous droplets of 98.8 nm in average, and kept stable for 90 days room temperature storage. In vivo study on rat RA model showed an improved inhibition of cartilage destruction of GVT-0 self nano-emulsifying system compared to GVT-0 without formulation. These results indicate a potential further development of the system to become a candidate for oral delivery of an anti RA drug.

Keywords: Gamavuton-0, self nano-emulsifying system, rheumatoid arthritis

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S-O-15 VALIDATED RP-HPLC METHOD FOR QUANTITATIVE ANALYSIS OF LEVOFLOXACIN IN HUMAN PLASMA AND ITS APPLICATION IN BIOEQUIVALENCE STUDY Endang Lukitaningsih1, Dion Notario2, Fathul Jannah1, Arief Rahman Hakim3 1

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Gadjah Mada University, Jl. Sekip Utara, Sekip, 55281, Yogyakarta, Indonesia 2 Department of Pharmacy, Faculty of Science and Technology, University of Ma Chung Jl. Villa Puncak Bukit Tidar N-01, Malang, Jawa Timur, 65151, Indonesia 3 Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, University of Gadjah Mada, Jl. Sekip Utara, 55281, Yogyakarta, Indonesia

To conduct a bioequivalence study for a copy product of levofloxacin (LEV), a simple and validated analytical method was needed. For this reason, a simple and rapid high performance liquid chromatography method was developed and validated for LEV quantification in human plasma. Chromatographic separation was performed under isocratic elution on a Luna Phenomenex® C18 (150 × 4.6 mm, 5 µm) column. The mobile phase was comprised of acetonitrile, methanol, and phosphate buffer 25 mM that adjusted at pH 3.0 (13:7:80 v/v/v) and pumped at a flow rate of 1.5 mL/min. The optimized method meets the requirements of validation parameters which included linearity (r = 0.995), sensitivity (LLOQ and LOD was 1.77 and 0.57 µg/mL respectively), accuracy (%error above LLOQ ≤ 12% and LLOQ ≤ 20%), precision (RSD ≤ 9%), and robustness in the ranges of 1.77-28.83 µg/mL. The validated method is successfully applied in pharmacokinetic and bioequivalence study of levofloxacin tablet in small number of subjects. From bioequivalence study, the 90% confidence intervals (CIs) for the test formulation/reference formulation ratio for the logarithmic transformations of Cmax, AUC(0-12) and AUC(0-∞) were within the bioequivalence limit of 80% to 125% (96.08%; 101.00%; and 102.02% respectively). According to the obtained data, it can be concluded that the test formulation (Tablet “X”) met the regulatory criteria for assuming bioequivalence in healthy subjects.

Keywords: method validation, levofloxacin, bioequivalence, human plasma

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Oral presentations II. Hospital and Clinical Pharmacy

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H-O-1 POPULATION PHARMACOKINETICS FOR CONTINUOUS INFUSION OF VANCOMYCIN IN CRITICALLY ILL PATIENTS RECEIVING CONTINUOUS VENO VENOUS HAEMOFILTRATION Lidya Karina1, Widyati2, Doddy de Queljoe1, Wouter Bult3, Daan J Touw4 1

Departement of Clinical and Community Pharmacy, Faculty of Pharmacy, University of Surabaya, Surabaya, Indonesia 2 Departement of Pharmacy RSAL Dr. Ramelan (Navy Hospital), Surabaya, Indonesia 3 University of Groningen, University Medical Center Groningen, Departement of Clinical Pharmacy and Pharmacology and Departement of Critical Care, Groningen, The Netherlands 4 University of Groningen, University Medical Center Groningen, Departement of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands Continuous veno venous haemofiltration (CVVH) is a life support system used in critically ill patients during severe renal failure. The objective of this study was to develop a population pharmacokinetic model for continuous infusion of vancomycin in critically ill patients receiving CVVH. A population pharmacokinetic model was developed using standard twostage Bayesian population analysis (MW/Pharm version 3.82) from a total of 535 plasma observations in 69 patients. This study utilized retrospective data from January 2011 until December 2014 from patients admitted at the ICU of the Unversity Medical Center Groningen, the Netherlands treated with continuous infusion of vancomycin and receiving CVVH. Metabolic clearance of vancomycin was fixed at a literature value of 0.2147 ± 0.0738L/h/1.85m2. Serum creatinine concentration was used to calculate a surrogate creatinine clearance comprising renal clearance plus extracorporeal clearance. The model was internally validated using bootstrap analysis (250 replications). The ratio of the renal plus extracorporeal clearance to the surrogate creatinine clearance was 0.1931±0.2777. The central volume of distribution was 0.3697±0.4051L/kg. The peripheral volume of distribution was 1.2921±1.2934L/kg. The inter-compartmental clearance was 4.5666±3.4141L/h/1.85m2. The extraction ratio was 0.1425 ± 0.1180. Bootstrap analysis demonstrated that the model was valid.

Population pharmacokinetic model for continuous infusion of vancomycin in critically ill patients receiving CVVH has been developed and was internally validated using an estimated creatinine clearance as surrogate for the sum of the patients’ own clearance and the clearance

by CVVH. This model can be used to optimize continuous infusion of vancomycin therapy in critically ill patients receiving CVVH. Keywords: continuous infusion, vancomycin, critically ill, continuous renal replacement therapy (crrt), continuous veno-venous hemofiltration (cvvh), pharmacokinetics, population pharmacokinetic

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H-O-2 A REAL CHALLENGE OF ADEQUATE EMPIRICAL ANTIMICROBIAL THERAPY AGAINST MULTIDRUG RESISTANCE GRAM NEGATIVE BACTERIA USING OPTIMIZED PHARMACOKINETIC AND PHARMACODYNAMIC ANTIBIOGRAM FOR CLINICAL DECISION SUPPORT Suphannika Prateepjarassaeng1, Nirun Jangkong2 1

Faculty of pharmaceutical sciences, Burapha University, Chonburi 20130 Thailand/ Pharmacy resident, FAPA-CP Thailand 2

Ratchaburi Hospital, Ratchaburi 70000 Thailand

The emergence of resistant gram negative bacteria (MDR-GNB) is occurred, endangering the efficacy of available antimicrobial agents, as well as a lack of new active drugs. To propose an optimized pharmacokinetic and pharmacodynamic (PK/PD) antibiogram for determination of the optimal empirical antibiotic therapies against multidrug resistance MDR-GNB, MDR A.baumannii, MDR P.aeruginosa and ESBL producing Enterobacteriaceae, especially, intermediate resistant strain. This cross-sectional study was conducted to develop a PK/PD antibiogram from bacterial isolates of hospitalized patients at Ratchaburi hospital, Thailand, during October 2014 through September 2015. High resistance rates were observed among 8,075 isolates. Clinically standard regimen of cefepime, imipenem, and piperacillin/tazobactam were not able to cover intermediate resistant strain. Based on PK/PD optimized regimens of the selected antimicrobial agents in comparable to the standard regimens. Percentages of the isolates inhibited by the optimized PK/PD dosing regimens (%Spk/pd) versus by the standard regimens (%S) for MDR A.baumannii, were 20% vs 10%, 1% vs 0%, and 1% vs 0%, for cefepime, piperacillin/tazobactam and imipenem respectively. The %Spk/pd versus %S for MDR P. aeruginosa were 49% vs 46%, 63% vs 39%, and 9% vs 3%, for cefipime, piperacillin/tazobactam and imipenem respectively and for ESBL producing Enterobacteriaceae were 36% vs 9% and 97% vs 96% for cefipime and imipenem respectively. The optimized PK/PD antibiogram should be conducted for clinical decision support of antimicrobial regimen selection as an empirically use against MDR-GNB infections. Further studies are needed to conduct a combination antibiogram to expand spectrum of antimicrobial regimen against MDR-GNB. Keywords: optimized pharmacokinetic and pharmacodynamic antibiogram, multidrug resistance gram negative bacteria, clinical decision support

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H-O-3 USING E CODES AS A TOOL TO IDENTIFY UNDER-REPORTING OF ADVERSE DRUG EVENTS Tzu-Yu Lin, Chi-Yuan Cheng, Chi-Hua Chen, Shin-Tarng Deng Department of Clinical Pharmacy Service, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan Objectives: External injury cause of injury codes (E codes) is a part of the ICD-9 -CM codes.

Among them, E930*–E949* describe the drug class that possible external cause of adverse effects in therapeutic use. The objective of this study was to determine the validity and effectiveness of E codes in identifying adverse drug events (ADEs). Methods: We established the E Codes Surveillance System (ECSS) to detect E930*–E949* regarding discharged patients during Jan 2015 to Dec 2015. Those cases were screened by clinical pharmacists. If the ADEs were uncertain or with severity needed to be warned or avoided, the cases would be further assigned to other independent clinical pharmacists to evaluate. If an ADE was confirmed and the culprit drug(s) must be avoided next time, clinical pharmacists would report it to the ADE Reporting System on line and then the culprit drug(s) would be encoded to the Drug Allergy & ADEs Alarming System automatically in our hospital. Results: There were 506 ADEs detected by the ECSS. Among them, 58 ADEs had already been encoded before screening, and 239 ADEs were confirmed by clinical pharmacists’ evaluation. Finally, 115 ADEs were reported to the ADE Reporting System. The positive predictive value (PPV) in detecting true ADEs through the ECSS was 58.7% (297/506). Conclusion: E codes method provided an acceptable PPV to detect ADEs. This method is also an effective tool to find out under-reporting of ADEs. Pharmacists play an important role to interpret the result of ADEs by the ECSS. Keywords: adverse drug event, E codes, pharmacist

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H-O-4 A SIMPLE TOOL FOR ASSESSING THE EFFICACY OF ANTIPSYCHOTIC MEDICATIONS IN SCHIZOPHRENIA Kanchana Hattasin1, Sayam Kaewvichit2, Wirat Niwatananun2, Chidchanok Ruengorn2 1

Suan Prung Psychiatric Hospital, 131 Changlor Rd., Haiya, Muang, Chiang Mai 50100 Thailand 2

Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50100 Thailand

Continuous long-term treatment of schizophrenia with antipsychotic medications needs effective management for symptom control. Objective: To develop and assess the pharmacy mental status examination (PMSE) for Thai pharmacists to monitor the clinical response in schizophrenic patients. The PMSE was constructed based on mental status examination Thai version (MSE-T) and the Positive and Negative Syndrome Scale Thai version (PANSS-T). The reliability and validity were assessed by three experienced psychiatrists and two experienced pharmacists. Forty-eight patients with schizophrenia from Suan Prung Psychiatric Hospital, Chiang Mai, Thailand were enrolled in the study during July to August, 2015. The MSE-T was carefully screened by three experienced psychiatrists and 4 from 15 items which were consciousness, attention & concentration, memory, and judgment were excluded as they need specific skills and too much time. The content of the remaining 11 items showed good validity (IOC=0.67-1). General appearance and speech were deleted because of their very low corrected item-total correlation (0.159 and 0.144, respectively) resulted in increasing internal consistency (Cronbachâ&#x20AC;&#x2122;s alpha = 0.853). Concurrent validity was a strong, positive correlation between the PMSE and MSE-T, which was statistically significant (rs (34) = 0.963, p < 0 .001). The inter-rater reliability for test of agreement between one psychiatrist and one pharmacist using the PMSE in the same time was very good {Kw = 0.976 (p < 0 .001)}. The PMSE is a very promising tool for Thai pharmacists in monitoring the clinical response of antipsychotic medications in patients with schizophrenia due to its good validity and reliability.

Keywords: mental status examination, schizophrenia, antipsychotic medications

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H-O-5 SUITABILITY OF ANTIBIOTIC UTILIZATION FOR GASTROINTESTINAL DISORDERS Abdullah Dayo, Muhammad Ali Ghoto, Mudassar Iqbal Arain Department of Pharmaceutics, Faculty of Pharmacy University of Sindh Jamshoro Pakistan One of most common sold drugs in developed countries is antibiotics. Utilization of antibiotics without prescriptions are not only to develop the bacterial resistance but it can also lead the economical burden and adverse drug reactions. To evaluate the suitability of antibiotic utilization and their adverse effect in gastrointestinal disorders at secondary care hospital of Hyderabad, Sindh Pakistan. A prospective study was conducted for a period of 1 year from June 2014- June 2015 at secondary care hospital of Hyderabad Sindh Pakistan. A total of 300 patients were enrolled via purposive sampling. The patients were evaluated by using Gyssens criteria and adverse drug reactions using WHO probability assessment scale. Based on decision more than 50% of the antibiotics were prescribed appropriately while remaining were irrational.

Out of 300 patients, 159 drug related problems and 49 adverse drug reactions were noted. The most common bacteria were Escherichia Coli (36.33%), Helicobacter pylori (23.67) and Klebsiella pneumonia (19.67%). More than 60% resistant of cefoxitin were noted due to E. Coli.

Conclusions: Majority of patients were on rational therapy but some patients were also taken irrational antibiotics i.e. occurred due to many factors such as choice, dosage form, dose and duration of therapy. Moreover resistant were also increased due to irrational use of antibiotics.

Keywords: antibiotics, utilization, gastrointestinal, adverse drug reaction.

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H-O-6 PHARMACEUTICAL CARE MODEL IN JCI-CCPC PROGRAMS IN A TAIWAN MEDICAL CENTER Yi-Jung Chiang, Su-Yu Chien Changhua Christian Hospital To achieve effective disease management and improve patient care outcome, multidisciplinary care is the key. Changhua Christian Hospital (CCH) is a JCI accreditation medical center since 2009, and is also a hospital with the largest numbers of JCI-CCPC (Clinical Care Program Certification) programs in the world, including CKD stage 1-4, DM, Ischemic stroke, Asthma, COPD, Pediatric asthma, Total knee replacement, Hepatic carcinoma, Breast cancer, HIV/AIDS, AMI, Pain. To implement the CCPC programs, we established 12 CCPC care teams with team members including case manager, doctors, pharmacist, dietician, physiotherapist, nurse, social worker and pastoral caregiver. The major responsibilities of pharmacists in CCPC programs are (not limited to): 1. Providing individualized patient education about the treatment, the way to use medications correctly, and the management of adverse reaction; 2. Prescriptions verification and medication reconciliation by comprehensively collecting and reviewing medication list; 3. Identify drug related problems and discuss with collaborative team members; 4. Helping set up program guideline and quality indicator; 5. Monitoring patient’s knowledge about the medications, adherence and care outcome. 6. Providing updated drug information to care team members. After pharmacist’s intervention, patient’s pharmaceutical care quality is improved significantly. With the collaborative relationship between other practitioners, pharmacists can learn how to make patient assessment more comprehensively and provide patient education more efficiently.

Keywords: pharmaceutical care, CCPC

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H-O-7 DEVELOPING A MULTIDIMENSIONAL APPROACH ANALYTICAL FRAMEWORK OF POTENTIALLY INAPPROPRIATE MEDICATION EVALUATION TOOLS FOR LARGE-SCALE CLAIMS ANALYSIS Pei-Chen Lee1, Tzeng-Ji Chen2, Yueh-Ching Chou1 1

2

Department of Pharmacy, Taipei Veterans General Hospital, Taiwan Department of Family Medicine, Taipei Veterans General Hospital, Taiwan

Background and objectives: Beers Criteria are the most common tools for evaluating appropriateness of prescriptions. However, the great majority of studies using Beers Criteria were small-scale studies and the judgement of potentially inappropriate medications (PIMs) proceeded manually. Some studies only adopted parts of Beers Criteria to evaluate PIMs and the results were diverse. Above-mentioned phenomena may be due to unstructured, narrative format of Beers Criteria and ambiguous recommendations. The objectives of the study were to establish a multidimensional approach analytical framework in order to analyze the computer interpretability of the 2015 American Geriatrics Society (AGS) Beers Criteria and to apply the framework to the large-scale datasets. Methods: In the first part of the study, a multidimensional framework was established to scrutinize each item of Beers Criteria. The second part of the study was designed as a retrospective study. The framework was applied to the datasets of National Health Insurance Research Database. Ambulatory care visits among patients â&#x2030;Ľ65 years of age in 2011 were identified from the Longitudinal Health Insurance Database 2000.

The utilization of benzodiazepines and aspirin was detected via the multidimensional analytical framework. Results: Four dimensions and fourteen sub-dimensions were established from this study. In the retrospective study, 104,934 patients and 490,460 drugs of items were identified.

The detected PIMs and detection rates decreased when related dimensions were considered.

Conclusion: The innovative framework could evaluate the computer interpretability of AGS Beers Criteria, facilitate the application to large-scale claims analysis and the integration of Beers Criteria into the system of clinical decision support system.

Keywords: potentially inappropriate medication, computer interpretability, large-scale claims analysis, clinical decision support system

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H-O-8 PERCEPTION, EXPECTATION AND ATTITUDE OF HEALTHCARE PROVIDERS TOWARDS THE ROLE OF CLINICAL PHARMACISTS IN THE EMERGENCY DEPARTMENT IN SELECTED TERTIARY HOSPITALS IN METRO MANILA Rosanine V. Adriano, Raileen Bernadette N. Cortez, Ariane Marie G. Bayro College of Pharmacy, Adamson Univerisity, Manila, Philippines Over the years, the role of the pharmacists has progressively changed from a mere dispenser towards more involvement in patient care. Clinical pharmacists (CPs) practicing in the emergency department (ED) is relatively uncommon due to the unique and complex nature of the ED setting. Thus, this study aimed to determine the perception, expectation, and attitude of healthcare providers towards the role of clinical pharmacist in the ED. A cross-sectional survey was conducted with 63.33% response. Descriptive statistics was used to present results. The healthcare providers in ED were very receptive regarding the new services provided by the CPs. The healthcare providers perceived that CPs is an integral part of the ED when it comes to patient counseling because CPs are believed to possess adequate skills to appropriately explain the medication regimen of the patient. The healthcare staff perceives the CPsâ&#x20AC;&#x2122; to be more knowledgeable with regards to medications thus their role in reviewing medications before administration prevents prescription errors. Considering the nature of the ED, the role of the CPs is of great significance for the improvement of the quality care of the patients, wherein the healthcare providers have high expectations towards the roles of the clinical pharmacist. Majority of the medical and nursing staff in ED expect the CPs to maintain complete medication history of patients and medication reconciliation. It would be of great help for the healthcare providers in improving the patientâ&#x20AC;&#x2122;s safety with the participation of the CPs in ED thus the results of this study showed that Keywords: clinical pharmacy, emergency department, knowledge, attitude, perception

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H-O-9 PREVALENCE OF CHRONIC KIDNEY DISEASE DEFINED BY USING CKD-EPI EQUATION AND ALBUMIN-TO-CREATININE RATIO IN THE KOREAN ADULT POPULATION Yucheol Lim, Eunhee Ji Faculty of Pharmacy, Gachon University, Incheon Korea An updated chronic kidney disease (CKD) definition and classification were proposed by Kidney Disease: Improving Global Outcomes (KDIGO), with adoption of a new equation to estimate glomerular filtration rate (GFR) and albuminuria to evaluate kidney structural damage. This study was performed to estimate the prevalence of CKD in the Korean adult population as defined and classified by the KDIGO guidelines. Cross-sectional samples of the fifth Korean National Health and Nutrition Examination Survey for 2011 to 2012 were examined for adults aged ≥19 years. CKD prevalence was determined based on decreased GFR and albuminuria. The GFR was estimated using the CKD Epidemiology Collaboration creatinine equation, and albuminuria was evaluated using the albumin-to-creatinine ratio (ACR) in spot urine. Of the 16,576 subjects participating in the survey, 10,636 (4,758 men, 5,878 women) were included in the present study. The prevalence of CKD was estimated as 7.9% (7.8% in 2011 and 8.0% in 2012, p=0.770). The prevalence of low, moderately increased, high, and very high CKD risk prognosis was 92.0%, 6.3%, 1.1%, and 0.6%, respectively. The prevalence of albuminuria (ACR ≥30 mg/g) in individuals with GFR ≥60 mL/min/1.73 m2 has reached 5.7%. The odds ratios of hypertension and diabetes to CKD were 3.4 and 3.1 in men, and 2.9 and 2.0 in women (all p=0.0001), respectively. A large percentage of CKD patients had albuminuria prior to a decrease in GFR. Regular laboratory tests for albuminuria for the high-risk group, and especially for hypertensive or diabetic patients, might improve detection of CKD at an early stage.

Keywords: chronic kidney disease (CKD), kidney disease, improving global outcomes (KDIGO), glomerular filtration rate (GFR), albuminuria, Korea

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Oral presentations III. Community Pharmacy

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C-O-1 THE ROLE OF COMMUNITY PHARMACISTS’ HOME HEALTH CARE FOR PD PATIENTS IN BANGKOK Wilailuck Tuntayothin1, Khattiya Mangkang2, Sirirat Tunpichart3, Pongsiwa Kunok4 1

2

Faculty of Pharmacy, Chulalongkorn University, Bangkok 10310 Thailand Faculty of Pharmacy, Huachiew Chalermprakiet University, Samutprakarn 10540 Thailand 3 Community Pharmacy Association (Thailand),Bangkok 10110 Thailand 4 Kanok Pharma Chain, Bangkok 10310 Thailand

Background: Continuous ambulatory peritoneal dialysis (CAPD) is the one of a treatment modality for end-stage renal disease (ESRD). PD patients mostly have the drug related problems (DRPs) leading to problems on complication. The objective of this study was implied the community pharmacists’ home health care services for identifying the drug related problems and improve the medication adherence by using medication therapy management (MTM) as the service template. And to develop the model of physician-pharmacists-nurse collaborations in PD patient management. Method: This action research was conducted during June 2014- August 2015 in one community pharmacy in Bangkok. The PD patients were purposively selective by nurse team. The trained pharmacist provided the medication therapy management (MTM) service 3 times as the delivery design. Result: Data were gathered for 16 PD patients. 2 patients were detected for the dialysate over stocking. The non-adherent patient state in each visiting decreased by 18.75% and 81.25%, respectively, when comparing with the first visiting. The pharmacist identified problems and improved in non- compliance. The clinical outcomes found that 25% of patients had the improved blood pressure. All of patients were reported to nephrologist for continuing patient management. For nephrologist’s expectation, this model of the collaborative team was quite benefit for the PD patients especially the ones who were loss following up. Conclusion: This study concluded that community pharmacist home health care could alleviate patients’ medication utilization problems and would thus improve overall quality of patient care. This collaborative model was benefit for the PD management.

Keywords: continuous ambulatory peritoneal dialysis (CAPD), drug related problems (DRPs), medication therapy management (MTM), collaborative model

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C-O-2 SE-I-FE PHARMACY; DETAIL AND EASY TO USE COMMUNITY PHARMACY HEALTH PROMOTION PROGRAM IN SEOUL, INTRODUCTION AND QUALITATIVE ANALYSIS OF SUCCESS CASES Hyungsun Kim, Younghee Kwon, Jinhye Choi Seoul Pharmaceutical Association, Korea Se-i-fe Pharmacy is the partnership program of government and private organizations in Seoul.

The pharmacies that have participated in the program are as followed: 4 districts 48 pharmacies in Y2013, 6 districts 88 pharmacies in Y2014, 12 districts 162 pharmacies in Y2015 and 16 districts 250 pharmacies in Y2016. There are 5 objectives; (1) Comprehensive Medication Management, (2) Adverse Events Monitoring, (3) Smoking Cessation and Management, (4) Support for the Minority or Disadvantaged, and (5) Mental Health Promotion and Suicide Prevention. These programs have been very successful due to the general public's accessibility of community pharmacies and the key role community pharmacists make in recommending over the counter products and health foods. Qualitative Analysis of Y2015 Success Cases.

There were 48 representative sucess cases which includes: 14 Lifestyle disease and drug addiction management, 8 suicidal prevention and smoking cessation, 10 drug compliance improvement, and 16 adverse reaction management. Among 48 patients, 34 (72%) patients were over the age of 50. 25 (53%) patients had chronic diseases and 10 (21%) patients had depression. Pharmacists provided various interventions which included drug counseling, dietary recommendations, lifestyle modifications, exercise counseling and mental health promotion, to each patient because of their unhealthy lifestyles and complex relationship of their disease states. There has been improvements made in most of these patient's quality of life. It is clear that community pharmacies can provide not only pharmacy services but also public health promotion and preventative health services by encouraging patients' lifestyle modifications.

Keywords: community pharmacy, Seoul, Korea

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C-O-3 THE EFFECTIVENESS TO LOCAL RESIDENTS HEALTH WITH FINGER PRICK TEST AT THE COMMUNITY PHARMACY Akiyo Tokubuchi1, Masao Ohmitsu2, Denise Epp2, Naoki Magaribuchi1 1

2

Saga Pharmaceutical Association, Saga, Japan.

Daiichi University of Pharmacy, Minami-ku Fukuoka 815-8511 Japan

Background: Saga Pharmaceutical Association performed SMBG and HbA1c measurements in collaboration with Daiichi University of Pharmacy to verify whether the pharmacy was useful as a Point of Care testing. Aims: The pharmacy will contribute to patient health care through finger prick blood tests, and by encouraging them to have periodic physical check-ups and a regular diabetes treatment. Methods: 164 pharmacies participated in the SMBG or HbA1c testing for around 1400 patients, during November to December, in 2015. 2016. The results were classified into diabetes type, boundary type, normal high type, and normal type, using the Japanese diabetes treatment guide. The patients were also checked for follow-up doctor visits.

Simulated patients were dispatched to verify whether pharmacists were observing the association guidelines. Results: Over 10% patients needed some intervention. Isolated HbA1c testing is not enough to detect potential DM. Almost all the patients had a good impression of their experience with Point of Care testing at pharmacy. Especially, the normal type patients showed improvement in self-management and DM consciousness. The result of the masked investigation was that pharmacists’ need more understanding of the concept of safety and sanitation in point of care testing. Conclusion: This study concludes Point of Care testing in the Pharmacy is useful for prevention of DM or early detection of DM among local residents.

The more patients responded to the pharmacist’s advice, the more health care support pharmacist can do. Considerations are being made for cholesterol testing, as well.

Keywords: SMBG, HbA1C、pharmacy, health care support, point of care testing

C-O-4

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A BASELINE STUDY ON THE USE OF MOBILE MEDICATION MANAGEMENT APPLICATIONS AMONG PATIENTS LIVING WITH HIV (PLHIV) IN METRO MANILA Jeanne Genevive Pillejera, John Lery Fernandez, Christopher John Oteyza, Mar I Jeramil Taguinod, Mark Kenneth Marcos College of Pharmacy, Adamson University 900 San Marcelino Street, Ermita 1000 Manila, Philippines Medication non-adherence is one of the problems faced by patients living with Human Immunodeficiency Virus (PLHIV). Non-adherence to Anti-retroviral Therapy (ART) contributes to increased risk of secondary infections and development of Human Immunodeficiency Virus (HIV) drug resistant (HIVDR) strains. This study aims to establish the baseline data on the use of mobile medication management applications among PLHIV. Specifically, the prevalence of the use of mobile medication management applications among PLHIV in Metro Manila, the features of mobile medication management applications that PLHIV find useful in monitoring their treatment regimen, and a baseline of medication adherence among PLHIV using the ACTG Adherence Questionnaire. Establishing the baseline will allow further researches to be conducted in this field of study. The study involved a single time-point collection of data among PLHIV in Metro Manila, through the Pinoy Plus Association, Inc. (PPAI), a support group for PLHIV. The proposal was submitted to the Adamson University Ethics Review Committee for approval. Fifty-five (55) of the 62 respondents were using smartphones at the time of the study, and 9 of these smartphone users stated that they were already using mobile medication management applications. Analysis of ACTG score shows that adherence is a problem among the respondents. Fisherâ&#x20AC;&#x2122;s Exact Test showed no association between app use and age group and between app use and sex. This indicates that there is no preference between age group or sex regarding app use.

Keywords: medication adherence, HIV, applications

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FAPA Congress 2016 | Bangkok, Thailand

C-O-5 EFFECTIVENESS OF COUNSELING FOR HYPERTENSIVE PATIENTS ON ADHERENCE AND BLOOD PRESSURE CONTROL IN PRIMARY CARE SETTING IN INDONESIA Susi Ari Kristina1, Pipit Puspita Dewi1, Yunilistianingsih2 1

Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia 2 Jetis Primary Health Center, Yogyakarta, Indonesia

Treating hypertension decreases mortality and disability from cardiovascular diseases, but most hypertension remains inadequately controlled. This study was conducted to evaluate the effectiveness of counseling in home pharmacy care (CHP) on patient adherence to antihypertensive medications and blood pressure control. A quasi-experimental intervention was conducted in 4 primary health centers in Yogyakarta province, Indonesia. The study subjects were 150 patients recruited from study sites from November 2015 to February 2016, who were > 45 years of age, on antihypertensive medication, with systolic blood pressure (SBP) of > 140 mmHg and or a diastolic blood pressure (DBP) of > 90 mmHg. Patients who received usual care with those who received CHP during a follow up period of 4 weeks were compared.

The study outcomes were change in antihypertensive medication adherence measured by Morisky Medication Adherence Scale (MMAS), blood pressure control, and patientsâ&#x20AC;&#x2122; satisfaction among CHP group. Of 150 patients, The mean age of the participants was 59 years, 66.7% were women, 93.3% were in low education level, and 70% were not employed. Medication adherence level improved from 2.5 at pretest to 6.6 at posttest for CHP group (p < 0 .001) and 3.4 to 3.5 for usual care (p > 0.05). Mean SBP decreased 8 mmHg in CHP group compared to increased 5.3 mmHg in controls (p < 0 .001). The majority of CHP group were satisfied with the program. The CHP program was effective to improve medication adherence and blood pressure control in hypertensive patients. This program is likely to improve health outcomes and reduce cost of hypertensive management.

Keywords: counseling, home care, hypertension, adherence

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FAPA Congress 2016 | Bangkok, Thailand

C-O-6 DISASTER MANAGEMENT ACTIVITIES OF THE MOBILE PHARMACY DURING THE RECENT KUMAMOTO EARTHQUAKES Hiroko Itoh, Hirokazu Katoh, Akinobu Mitarai, Tetsuya Andou Oita Pharmaceutical Association Disaster Management Committee Background: The Oita Pharmaceutical Association (OPA) set up a disaster management committee in 2012 and set guidelines of action and cooperation with other organizations. In January 2014, they purchased Mobile Pharmacy van (MP). Aim: The OPA employed their Mobile Pharmacy (MP) van to provide pharmaceutical and medical assistance to victims in the earthquake disaster struck areas of Kumamoto. Method: There were 227 pharmacists from the Japan Pharmaceutical Association (19 OPA pharmacists) who participated in disaster relief activities April 15 to May 29, 2016 after the earthquakes in Kumamoto. They were based out of the Mashiki Town Hall and the Health and Welfare Center. Results: These were the pharmacist activities: Dispensing ・They filled 2,162prescriptions. ・They dispensed 300 kinds of prescribed drugs and 60 kinds of over-the-counter (OTC) drugs.

DMAT/JMAT support ・They compounded and dispensed disaster-related emergency prescriptions. ・They identified medications and provided substitute medications and pharmaceutical products.

Rounds in the evacuation centers ・They filled prescriptions as requested and provided consultation with patients about OTC drugs. ・They educated the victims on hygiene and the prevention of sicknesses.

Conclusion: The MP was deployed immediately after the earthquakes on April 15, 2016, to support in essential disaster medical care relief activities. Future plans include updating and revising the MP manual on its maintenance, usage, and the MP pharmaceutical products and drugs lists.

Keywords: mobile pharmacy, disaster management, acute phase of disaster

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C-O-7 EVALUATION OF THE COMMUNITY LONG-TERM PHARMACEUTICAL CARE SETUP AND EFFECTIVENESS IN TAIWAN Peng Zi An1, Jui-Yu Huang1, Chih-Yuan Wu1, Yi-Ru Lai1, Yi-chi Chen1, Kun-po Chen1, Chauyuan chen2, Wan-ying Huang1 1

Chih-Ta Pharmacy, Taiwan Tai-Lin Pharmacy, Taiwan

2

Background: The need of Long-term Care (LTC) increases with the era of senility. By the end of 2005, Taiwan LTCs with authorized licenses have amounted to 1045 facilities, with 42947 residents, occupying a 1.65% of the total elderly population. Due to diversifying local requirements and necessities, the facilities disperse with strong resemblance to locations of community pharmacies. According to long observations, quality of life (QOL) vary with medication safety and pharmaceutical care, this paper therefore aims at the modulations of Community Pharmaceutical Care starting from 2007, transferred from Project by Ministry of Health & Welfare, Taiwan LTC Professional Association and New Taipei City Pharmacists Association. Having prominent achievements, pharmaceutical care was hence been incorporated into LTC facilities Accreditation since 2009. Method: On the basis of project 2007, we established a pharmaceutical care model including agent-training, counseling skill, intervention, data collection and collation, monitoring, and the statistics thereof. The model varies with concurrent policies and social milieus. Result: As was manifested from data collected 2013-2014, there existed 29.31% of Community Pharmaceutical LTC therapeutic drug monitoring intervention; 33.62% improvement of prescription rationality; 37.07% other drug related problems. Conclusion: From point of view of Pharmaceutical Care in Taiwan, we not only achieved significant results and are now heading towards individualized pattern. We look to promote this pattern so as to aspire every pharmacist to dedicate his value of profession, thus heighten the average standard of QOL and medicinal safety in Taiwan.

Keywords: long-term care, community pharmacy, pharmaceutical care

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THE DEVELOPMENT OF SMARTPHONE APPLICATIONS ON SORE THROAT ASSESSMENT FOR COMMUNITY PHARMACISTS. Wirat Tongrod1,2, Chattaporn Choktanomsup1, Natthakit Pengsom1 1

Faculty of Pharmaceutical Sciences, Huachiew Chalermprakiet University, Thailand 2 The Pharmaceutical Association of Thailand under Royal Patronage (PAT)

Antimicrobial resistance (AMR) is the global health concern. This serious threat is happening in every region of the world and affects anyone, of any age, in any country. Increasing public calls for global collective action to solve this problem. A major problem is inappropriate using of antibiotics, especially in upper respiratory infection such as common cold, and flu. To help solving this problem, the researchers have developed the smartphone application (app) as a tool for assessing the sore throat. The processing of the program was divided into 3 steps. 1) Survey the requirements on this app of 20 community pharmacists by semi-structure questionnaires.

The results show that 95 percent of these pharmacists agree and prefer with this app because it is easy to explain to the patients by using the app (70 percent) and demand the app to include McIsacc score screening criterion (70 percent). 2) Developing of app, was divided in 2 part, the platform & graphic designs, and programming by using Google App Inventor. Then we test the accuracy & reliability of the program. The program includes 6 part, 3 main parts are 2.1 throat diagnosis 2.2 McIsaac score diagnosing for Throat Inflammation 2.3 Giving information about causes, using of antibiotics, symptoms severity, self-caring, and valid drugs list. The other parts are 2.4 conditions of uses 2.5 developers 2.6 links to other website such as IDSA guideline. 3) Pilot test: 37 pharmacists were invited to test the app and their satisfaction shows at the average of 4.25.

Keywords: smartphone applications, sore throat assessment, community pharmacists

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FAPA Congress 2016 | Bangkok, Thailand

C-O-9 COUNSELING PATIENTS ABOUT DIABETES MELLITUS PRESCRIBED MEDICINE AT YOGYAKARTA PHARMACIST COMMUNITIES Okti Ratna Mafruhah1, Fauziyyah Dani Fitriana1, Wunawar W2 1

Aphotecary Programme, Faculty of Mathematics and Natural Sciences, Islamic University of Indonesia, Indonesia 2 Farmarin Pharmacy

Counseling patients about prescribed medicine are steps to provides good pharmaceutical service. Diabetic patients are the patients who need information about pharmacological or nonpharmacological therapy. These infomations can help the patients to prevent from microvascular or macrovascular complications. The purpose of the research was to know how counseling patients about diabetes mellitus prescribed medicine at Yogyakarta Pharmacist Communities have been done. It took place at Yogyakarta City and Depok Subdistrict. These place have the most number pharmacy in Yogyakarta Province. The research was cross sectional design with observational method, and it used questionnaires. The number of pharmacist inclusion criteria were 92 from 108 pharmacists. Validity and reliability test was conducted in 30 pharmacists in Ngemplak, Ngaglik, Pakem and Kalasan subsdistrict. The Analysis of Data used Descriptive analysis. The result showed that the pharmacists gave 76.19% drug information and 70.69% another aspect related to management therapy. The biggest internal barrier to do counseling was the pharmacist did not get fee for services. The highest external obstacle came from patient who felt have no more time.

Keywords: counseling, diabetes mellitus, pharmacist community

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Oral presentations IV. Industrial Pharmacy and Marketing

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IM-O-1 DURIO ZIBETHINUS L. (MALVACEAE) SEED GUM: EXTRACTION, CHARACTERIZATION, AND EVALUATION AS PARACETAMOL TABLET BINDER Karl Charlene D. Calderon, Diana Rose S. Ramirez, Judy Mae Mea, Marth Aljohn V. Ona, Rochelle Victoria Monterozo, Danica Mae R. Melencio, Renz Kenneth Cadiang, Agnes Castillo Faculty of Pharmacy, University of Santo Tomas, EspaĂąa, Manila 1008, Philippines Durio zibethinus L. (Malvaceae), known as durian in the Philippines, is an evergreen tropical tree found vastly in regions of Mindanao and Sulu. One-fourth of the fruitsâ&#x20AC;&#x2122; mass is seeds, which are usually discarded. This study aimed to determine the binding efficacy of extracted Puyat variety of durian seed gum in Paracetamol tablet formulation. Durian seed gum was extracted and characterized in terms of its physicochemical properties. Acute oral toxicity study was performed. Differential Scanning Calorimeter was used to test the compatibility of durian seed gum with Paracetamol and its excipients. Different batches of Paracetamol tablet was formulated using durian seed gum, PVP K-30, acacia, and corn starch as binder. Physical evaluation was done on the Paracetamol granules and comparative analysis to show the effectiveness of durian seed gum in contrast with standard binders. Also, the Paracetamol granules were evaluated through quality control tests such as hardness, friability, disintegration, and dissolution tests. The result of the study showed that durian seed gum possesses good physicochemical properties. It is nontoxic and compatible with Paracetamol and its excipient. The formulation containing 9%w/w of unheated durian seed gum as binder showed good binding efficacy with a friability of 0.74%. It displayed the highest dissolution rate (101.3%). The results suggest that it can be used as binder in immediate-released tablets.

Whereas, 9%w/w heated durian seed gum exhibited highest binding efficacy with a friability of 0.15% and a hardness of 184.87N. The results show that it can be used as a binder for sustained-released tablets.

Keywords: Durio zibethinus L. (Durian), seed gum, paracetamol, tablet binder, excipient

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IM-O-2 AN EXPLORATORY STUDY ON THE APPLICATION OF DESIGN OF EXPERIMENTS (DOE) IN THE ASSESSMENT OF THE STABILITY OF AMOXICILLIN CAPSULES Theresa Camille S. Tobillo, Tammy Anne B. Aguilar, Myrnel D. Almoradie, Bryan Paul I. Bulatao Department of Industrial Pharmacy, College of Pharmacy, University of the Philippines Manila, Ermita Manila 1000 Philippines Design of Experiments (DoE), a component of Quality by Design (QbD), is a systematic method for determining the relationship between critical factors and critical attributes of a product to ensure consistent quality. Although QbD has found wide utility in pharmaceutical development, it is yet to be applied in the drug distribution system, where drug degradation is most likely to occur. A common antibiotic sensitive to temperature and relative humidity (RH) is Amoxicillin. This study utilized DoE, specifically a 3-factor, 2-level full factorial design, to assess the impact of temperature, RH and time of storage on the % Amoxicillin content, which resulted to the generation of a design space. Factorial ANOVA revealed that of the main effects, temperature had the highest influence on % Amoxicillin, though it was not statistically significant. Meanwhile, the linear interactions of temperature-RH and temperature-time had statistically significant effects on % Amoxicillin. Contour and surface plots provided visualization of these linear interaction effects. Multiple linear regression was performed to generate an equation (adjusted R2 = 0.5305), which represented the design space. Coefficients derived were all negative, indicating that all factors had antagonistic effects on % Amoxicillin.

Overall, this study demonstrated the application of QbD in the drug distribution system. To improve the predictability of the model, the time factor must be optimized by lengthening the exposure to at least 6 months. Further, increasing the number of levels to at least 3 would allow the examination of higher order interactions that would create a more holistic design space.

Keywords: Quality by Design, Design of Experiments, amoxicillin capsules, stability, temperature, relative humidity, time

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IM-O-3 OPTIMIZATION AND CHARACTERIZATION OF ANDROGRAPHOLIDE-LOADED SELF NANO-EMULSIFYING DRUG DELIVERY SYSTEM (SNEDDS) Yandi Syukri1, Ronny Martien, Endang Lukitaningsih2, Agung Endro Nugroho2 1

Faculty of Pharmacy Gadjah Mada University, Yogyakarta Indonesia and Department of Pharmacy Universitas Islam Indonesia, Yogyakarta Indonesia 2 Faculty of Pharmacy Gadjah Mada University, Yogyakarta Indonesia

Andrographolide is insoluble bioactive drug isolated from Andrographis paniculata Ness. An andrographolide-loaded Self Nano Emulsifying Drug Delivery System (SNEDDS) was developed for improving andrographolide solubility. This study aimed to optimization and characterization of andrographolide isolated from Andrographis paniculata Ness using SNEDDS formulation. The selection of oil, surfactant and co-surfactant components for preliminary screening of SNEDDS formulation were determined by solubility study of andrographolide. Ternary phase diagrams were constructed to identify nano emulsification area for the selected systems. The prepared andrographolide-loaded SNEDDS were assessed for droplet size, transmittant, and zeta potential. The result of screening oil, surfactant and cosurfactant showed that Capryol-90, Tween 20 and PEG 400 exhibited superior solubilizing capacity, respectively. Eight formulations contained Capryol-90 (10–30 %), Tween 20 (50–80 %) and PEG 400 (10–30 %) were optimal andrographolide-loaded SNEDDS with less than 100 nm of droplet size, more than 90 % of transmittant and less than -25 mV of zeta potential. In conclusion, this study demonstrated that andrographolide can be prepared in SNEDDS to obtained optimal formulation for improving andrographolide solubility.

Keywords: andrographolide, andrographis paniculata, SNEDDS, solubility

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FAPA Congress 2016 | Bangkok, Thailand

IM-O-4 OPTIMIZATION OF METFORMIN HCl FLOATING TABLET USING HPMC, SODIUM BICARBONATE, AND ETHYL CELLULOSE Agus Siswanto, Suparman, Rudi Kusuma Werdana, Singgih Wicaksono Faculty of Pharmacy, Muhammadiyah University of Purwokerto, Jl. Raya Dukuh Waluh Purwokerto 53142, Central Java, Tel./Fax. +62-636751, Indonesia Metformin HCl is an anti-hyperglycemic agent used in the treatment of non-insulin dependent diabetes mellitus. It has been reported that oral bioavailability of metformin HCl is 50-60 % due to its selective absorption from upper part of gastrointestinal tract. It has biological halflife of 1.7 hours, hence the development of floating drug delivery system is recommended in order to enhance the bioavailability. The aim of this study was to determine the optimum formula of metformin HCl floating tablet. The tablets were prepared by wet granulation technique, using HPMC K15M CR as hydrophilic polymer, etil cellulose as hydrophobic polymer, and sodium bicarbonate as a gas-generating agent. Simplex lattice design was applied to optimize the formula of metformin HCl floating tablet. The amounts of HPMC K15M CR (A), sodium bicarbonate (B) and etil cellulose (C) were selected as independent variables. The optimum formula was determined based on numeric method with fluidity of tablet mass, floating lag time, total floating time, and the drug dissolution for 2, 10 hours as independent variables. The optimum formula was shown by the greatest desirability value (0.630) with the compositions of 146.29 mg HPMC K15M, 37.5 mg NaHCO3, and 41,21 etil cellulose.

Keywords: metformin HCl, floating tablet, HPMC, ethyl cellulose, sodium bicarbonate

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IM-O-5 ANTIBACTERIAL ACTIVITY DETERMINATION OF THE PREFORMULATED OINTMENT FROM GARCINIA MANGOSTANA RIND EXTRACT AND MANGIFERA INDICA LEAF EXTRACT Salwa S. Marohom, Arianne Jayne G. Olmedo, Christel D. Luna, Wally I. Tapas, Mark Kenneth Marcos College of Pharmacy, Adamson University 900 San Marcelino Street, Ermita 1000 Manila, Philippines Antimicrobial resistance, as stated by the World Health Organization, is an expanding public health concern. This current alarming situation is a large threat to public health since very limited effort has been made in the development of newer and more potent antibiotics in recent years. Garcinia mangostana (GM) fam. Clusiaceae rind and Mangifera indica (MI) fam.

Anacardiaceae leaf extracts were found to possess antibacterial activity, specifically against skin infections caused by gram-positive bacteria. This study focused on the in vitro evaluation of the antibacterial activity of the methanolic extracts of these plants and the pre-formulated ointments containing such extracts. Five concentrations of the plant extracts were prepared, namely, 100% GM, 100% MI, 50% GM + 50% MI combination, 75% GM + 25% MI combination, and 25% GM + 75% MI combination, which were used in the preparation of 2%, 25%, and 30% w/w ointments. The test microorganisms included Staphylococcus aureus, Streptococcus pyogenes, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, and methicillin resistant S. aureus. Results showed that the 25% GM + 75% MI combination exhibited the highest antibacterial activity against B. subtilis with zone of inhibition of 10 mm.

100% MI showed the highest antibacterial activity against the other test microorganisms with zones of inhibition between 7 mm and 17 mm. The activity of the extracts were selective on the microorganisms, with highest susceptibility against P. aeruginosa. The antibacterial activity of the ointments were concentration dependent with the highest antibacterial activity exhibited by the 25% w/w ointment containing 100% MI. Keywords: Garcinia mangostana, Mangifera indica, ointment, antibacterial, combination

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IM-O-6 FORMULATION, COMPARISON OF DISSOLUTION AND BIOEQUIVALENT TESTING OF LEVOFLOXACIN TABLETS AGAINTS CRAVIT AS INNOVATOR Yuti Mutiawati, Diwi Dara Cahayani, Ade Muslihat, Fandji Yuda Yudistira Kimia Farma Levofloxacin is a synthetic third generation flouroquinolones anti-bacterial agent with a broad spectrum of activity against Gram-positive and Gram-negative aerobic bacteria, atypical respiratory pathogens and some anaerobes.The purpose of this research is to develop products, Comparison Dissolution testing the tablet containing Levofloxacin HCl and Levofloxacin Hemihydrate to the Cravit Tablet as innovator, and bioequivalence study of The levofloxacin hemihydrate tablets. The method of tablet formulation used wet granulation, with consisting of Levofloxacin HCl or Levofloxacin Hemihydrate, Corn Starch, Micro Crystal Celulosa PH 101, Cross Carmelose Sodium, Polivinil Pyrolidon VA 64, Pure water, Ethanol 95%, Talcum and Magnesium Stearate. The granules are evaluated for particle size, particle density, flow characteristics, compressibility, moisture content, homogeneity and also the tablets are evaluated for appearance, weight, thickness, hardness, friability, disintegration, assay of content API, dissolution, comparison dissolution testing and bioequivalent testing for levofloxacin hemihydrate tablet. Based on the results of evaluations of granules and tablet , that all parameter meet the requirements, similar in comparison dissolution and meet the requirements of S2, as follow 90% confidence interval of geometric mean ratio of three bioavailability parameters of levofloxacin were 92,23 -119,28 for Cmax, 97,28 â&#x20AC;&#x201C; 106,85 for AUC and 96,58 -106,67 % for AUCinf. The result showed that levofloxacin HCl tablet is similar to levofloxacin hemihydrate tablet, and levofloxacin hemihydrate tablet was bioequivalent to reference product.

Keywords: levofloxacin HCl, levofloxacin hemihydrate, comparison of dissolution testing, bioequivalent

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Oral presentations V. Pharmaceutical Education

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PE-O-1 PERCEPTIONS AND EXPECTATIONS OF PHARMACY INTERNSHIP SITES ON THE KNOWLEDGE, SKILLS AND ATTITUDES OF PHARMACY INTERNS Jamille Dyanne L. Pajarillo, Elaine Grace F. Arguilles, Sheryl E. Salazar, Margarita M. Gutierrez Department of Pharmacy, College of Pharmacy, University of the Philippines Manila Evaluation of pharmacy internship programs has been done by several studies considering student perspective. This study considered the perspective of the community, hospital and manufacturing pharmacy internship sites to determine their expectations and actual assessments on the knowledge, skills and attitude of pharmacy interns and their levels of satisfaction. Descriptive, cross-sectional research design was utilized using a self-administered survey wherein questionnaires were tailored for each setting. Four community, twenty-eight hospital and nine manufacturing internship sites of 10 Philippine Association of Colleges of Pharmacy (PACOP)-accredited schools in Metro Manila participated in the study. Data were analyzed through descriptive analysis, Spearmanâ&#x20AC;&#x2122;s rho correlation and One-Way ANOVA using IBM SPSS Statistics version 22 software. In community setting, most expectations on knowledge, skills and attitude of pharmacy interns were met except for the aspect of laws governing the pharmacy practice and business principles of operating a pharmacy. In hospital setting, all expectations were met. For manufacturing setting, most expectations on knowledge were not met but in terms of skills and attitude, most expectations were met. Overall, the pharmacy internship sites in the three settings were satisfied on the knowledge, skills and attitude of pharmacy interns. However, it is recommended to include Pharmaceutical Jurisprudence and Ethics as a prerequisite subject for internship programs in all practice areas.

Pharmacy Management should also be included as a prerequisite for community and manufacturing internships and Pharmacology for hospital internship. Moreover, community pharmacy internship is recommended to be taken by students in higher year levels.

Keywords: pharmacy internship, expectations, perceptions, knowledge, skills, attitude, level of satisfaction

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PE-O-2 ACCESSIBILITY AND USAGE OF MEDICAL APPS AMONG PHARMACY, MEDICAL AND ALLIED HEALTH SCIENCES STUDENTS IN MANAGEMENT AND SCIENCE UNIVERSITY, MALAYSIA Yeoh Chun Siong, Erwin Martinez Faller School of Pharmacy, Management & Science University, 40100 Shah Alam, Selangor Darul Ehsan, Malaysia Smartphone users have a high regard on health-related mobile apps. Tremendous increase in mobile application usage has brought attention to the medical arena for education and health related services. This research aims to examine the accessibility and usage of mobile medical apps (MMA) among pharmacy, medical, and allied health students in the university. A quantitative survey method of 18-item questionnaire was distributed. Out of 250 respondents, 61.3 % (n=153) were from medical and allied healthcare related courses such as nursing, nutrition, biotechnology, etc. while 38.7 % (n=97) were pharmacy students. The majority of the students have accessed to MMA at least one to three times in a day (69.4%) with Android (67.7%) as the main platform. High level of accessibility was observed due to readiness in downloading MMA in Google play and for Apple apps users. Education-related MMA was most often used by students for informationâ&#x20AC;&#x2122;s on pharmacology (58%), anatomy and physiology (48.9%), drug information (41.4%), pathology (32.8%), clinical studies (31.7%), microbiology (26.3%), pharmacy practice (25.3%), and chemistry (23.7%). The findings also revealed that 60.2% of the students were using one to three apps but were not relevant features to their needs. MMA features suggested more into diseases, clinical guidelines, drug information, pharmacokinetics and pharmacodynamics, anatomy and physiology were useful for medical students. The framework for strategic development of creating new features in mobile medical information application (MMIA) has been suggested (64%) in customizing to students need. In conclusion, medical apps usage is prominent in the medical field education setting Keywords: mobile medical apps, accessibility, usage, management & science university

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PE-O-3 INTER PROFESSIONAL EDUCATION OF PHARMACY AND MEDICAL STUDENTS: IS IT AN ANSWER TO IMPROVE THE PROFESSIONAL COLLABORATION BETWEEN PHARMACIST AND DOCTOR? Aris Widayati Faculty of Pharmacy Universitas Sanata Dharma Yogyakarta Indonesia Inter Professional Education (IPE) is aimed to facilitate the students to develop not only their competencies of knowledge (of drug and disease), but also their acceptance by other health professionals. Pharmacy Faculty Universitas Sanata Dharma (USD) has initiated IPE. We made collaboration with Faculty of Medicine Universitas Kristen Duta Wacana (UKDW). A team teaching from both USD and UKDW worked on preparing cases, scheduling, and managing resources. The IPE was conducted for the Year-3 students. They already studied basic Pharmacotherapy in Year-2. The class has 150 to 160 students, which was divided into groups.

Each group was supervised by one pharmacist and one medical doctor from USD and UKDW, respectively. One pharmacy student was paired with one medical student. The pair was faced a case involving a trained simulated patient. The pharmacy student acted as a pharmacist and so the Medical student as a doctor. They worked at a room set up as a ward in hospital. The process was observed and assessed by the supervisors. Feedbacks were given by the supervisors at the end of the process. Through IPE the students learnt how to communicate effectively with doctor and understand each other’s role. Communication with simulated patient is another excited learning experience. They believed it is imperative to have sufficient pharmacotherapy knowledge and communication skill to make appropriate relationship with doctor. In conclusion, the IPE is challenging, but promising in improving student’s attitude to interact in appropriate manner in health care team and to understand each other’s role.

Keywords: IPE pharmacy medical student

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PE-O-4 KNOWLEDGE, AWARENESS AND PERCEPTION ON FLIPPED CLASSROOM AMONG STUDENTS IN MANAGEMENT & SCIENCE UNIVERSITY, MALAYSIA Ei Ying Lee, Erwin Martinez Faller School of Pharmacy, Management & Science University, 40100 Shah Alam, Selangor Darul Ehsan, Malaysia Teaching and learning in 21st century evolve in the pedagogical innovation from traditional to a flipped classroom setting. Learner-centered instruction is developed in a dynamic and interactive learning environment to cater student learning needs in a digitalized era. The research objective focuses on the knowledge, awareness and perception (KAP) of the university student on flipped classroom. A cross-sectional study has been done with 150 students from different courses using 26-item self-administered questionnaire through online survey. The data was then analyzed using Statistical Package for Social Science (SPSS). The results showed significant knowledge of students (p < 0 .05) on flipped classroom (73%). Most of the students used Edmodo (32%), Youtube (68%), Khan Academy (21%), etc. Flipped classroom benefits students in promoting interaction and collaboration skills (66%), encourage higher student engagement (60%) and make learning central (57%). Awareness of the respondents also indicate high (p < 0 .05) with 80.4% of students aware of the implementation and importance of flipped classroom settings. 85.2% of students agreed that flipped classroom improve their understanding, and 87.2% agreed that students developed their communication skills. In conclusion, students have high level of knowledge and awareness and have a good perception regarding the engagement towards active learning. Hence, flipped classroom has innovative approach in improving the quality of education.

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PE-O-5 METAMORPHOSIS OF LEARNING SYSTEM (PHARMACY EDUCATION) – SCOPE AND ROLE OF VIRTUAL UNIVERSITIES Jayapal Show Reddy Thumma1, Sreedhar Dannapaneni2, Anusha Bompelli1 1

St.Peter's Institute of Pharmaceutical Sciences, Warangal, Telangana, India 506001 2 Teach Global Solutions Pvt Ltd Hyderabad India

Since a couple of decades, we are witnessing a paradigm shift in the learning process i.e., the conventional black board teaching & learning system is gradually being taken over by the digitized teaching & learning system. This transition was neither expected even by the thinkers of the yester years yet the digital era has begun. Now-a-days, majority of the individuals have a smart phone, driven by a passion to get access to all the services available i.e., from “Entertainment to Education”. We made an attempt to understand the newer dynamics of digitized learning system through a survey. A survey was conducted by taking opinions from 25 members each (including young graduates, academicians, and researchers) from 50 countries across the continents. By analyzing the results, we found couple of key observations on the paradigm shift with respect to pharmacy education. 56% preferred a learning system with a right mix of blackboard teaching and digital technology, 32% preferred blackboard teaching, and rest 12% preferred digitized teaching & learning system. The virtual universities based on blackboard teaching and digital technology are on limelight as they have a scope to provide student-centered learning. The interesting features are - the lectures can be accessible at anytime and anywhere and not just confined to any classroom, the lectures are from renowned lecturers, customized syllabi, use of 3D technology for better understanding, assessment test, and global ranking. A virtual university learning in addition to the regular classroom learning could help students in metamorphosing themselves.

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PE-O-6 THE SIGNIFICANCE OF CHEMISTRY CONTENT IN THE PHARMACY CURRICULUM IN INCULCATING COMPETENT PHARMACISTS: PERSPECTIVE OF THE PRACTISING PHARMACISTS Chun Wai Mai1, Ramadas Anitha2, John Jeh Lung Tiong3, Pei Kuan Lai4, Mallikarjuna Rao Pichika1, Alexander Irvine5 1

Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.

2 Department of Pharmacy, Kuala Lumpur Hospital, Jalan Pahang, 50586, Kuala Lumpur, Malaysia.

3 School of Pharmacy, Taylorâ&#x20AC;&#x2122;s University, No. 1 Jalan Taylorâ&#x20AC;&#x2122;s, 47500 Subang Jaya, Selangor, Malaysia 4 Institute for Research, Development and Innovation. International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia 5 University of Strathclyde The high employability of pharmacy graduates across various sectors such as in the community pharmacies and hospital settings, the pharmaceutical industries and academia has lent credence to the versatility of their professional training. Therefore, the aim of this study was to gauge the perception of International Medical University (IMU) pharmacy graduates on the applicability and relevance of the chemistry knowledge and practical skills acquired from their professional education in their working place. The survey was designed based on the pharmacy curriculum of IMU. Qualitative and quantitative responses were collected and analysed by three independent investigators who were not the respondents, and not lecturing in any part of the Chemistry curriculum. The study was completed when the qualitative feedback from respondents reached saturation. Almost equal numbers of pharmacists from the different pharmacy disciplines: (1) industrial and regulatory, (2) hospital and clinical, (3) community and (4) academia, participated in this study. Most of the chemistry topics were rated as essential by the graduates. Some topics were rated very relevant (more than 80%) whereas only up to 30% of the graduates agreed on the essentiality of some topics to their profession. The study concluded that most of the current chemistry content is still essential in nurturing competent pharmacists for their respective disciplines. The outcomes of this study will be used as evidence to support the need for conducting a curriculum review, to better prepare graduates for their future employment.

Keywords: chemistry, competency, fit-to-work, graduates, pharmacy curriculum, pharmacy profession

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Oral presentations VI. Administrative, Social Pharmacy and Ethics

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A-O-1 DEVELOPMENT OF A COMMUNITY-BASED DIABETES SELFMANAGEMENT EDUCATION PROGRAMME IN MALAYSIA: THEORETICAL FRAMEWORK AND MAPPED INTERVENTIONS Yuet Yen Wong1, Mohamed Azmi Ahmad Hassali1, Chin Fen Neoh2, Fahad Saleem1, David Kong3 1

2

School of Pharmaceutical Sciences, Universiti Sains Malaysia Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia 3 Faculty of Pharmacy and Pharmaceutical Sciences, Monash University Australia

Background: Type 2 diabetes mellitus (T2DM) is a complex disease requires not only continuous medical treatment but also multifactorial risk reduction self-care activities performed principally by patients outside of clinic settings. Equipping patients with selfmanagement skills via structured education has pivotal role in managing T2DM, yet not consistently being provided in Malaysia. Hence, a localised type 2 diabetes self-management education (T2DSME) programme was developed. Insufficient description of theoretical framework and development process in educational interventions have been criticised as a possible reason in impeding replication and translation of research findings into practice. Objective: To illustrate the development of T2DSME programme. Methods: A 12member multidisciplinary healthcare team (i.e: pharmacist, diabetes nurse educator, dietitian, physiotherapist and medical doctor) was formed to develop programme materials. Based on empirical evidence available in Malaysia, Bandura’s self-efficacy theory was selected to underpin the development of programme modules. Mapped behaviour change techniques identified through literatures together with the four sources of self-efficacy outlined by Bandura were then used to translate the theory into actual teaching and learning activities in the programme. Results: A total of 5 modules (Living with diabetes, Healthy diet for T2DM, Be physically active, Know your medicines and Complications of T2DM) and a simplified graphicbased patient’s guidebook were developed by the team. These materials were designed to be delivered by the team, in 6-weekly intensive sessions (2.5 hours each), to foster patient’s uptake of the seven self-care behaviours specified by American Association of Diabetes Educators (AADE). Conclusion: A T2DSME programme has been successfully developed and available for use. Evaluation work on the programme is currently in-progress.

Keywords: diabetes, self-care, self-management, patient education

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A-O-2 COST ANALYSIS OF BREAST CANCER PATIENTS WITH CHEMOTHERAPY IN NATIONAL HEALTH INSURANCE AT RSUP Fithria D.A Suryanegara1, Anggra Olgabella Aragon1, Retno Muliawati2 1

Department of Professional Pharmacy (Apothecary), Islamic University of Indonesia, Yogyakarta, Indonesia 2 RSUP DR.Sardjito Yogyakarta, Indonesia

Implementation of INA CBGs for breast cancer patients with chemotherapy require cost analysis and treatment planning. This research aims to know the describe of chemotherapy drug regimen used, the components of direct medical costs, the suitability of the real cost and its compliance against claims of the INA CBGs and clinical outcomes such as Length of Stay (LOS). Research was observational with cross sectional design. Methods of data retrieval in a retrospective with the medical record document scanning, patient payment details and data file BPJS claims on breast cancer with chemotherapy patients in Dr. Sardjito Hospital was the period March 2014-February 2015 who met the inclusion criteria. Data analysis was conducted with one sample t-test to determine the suitability of direct medical costs with INA CBGs tariff claims. The research resulted obtained that the most chemotherapy regiment used is the combination of doxorubicin and cyclophosphamide (31.71%), the largest cost component in the treatment of breast cancer with chemotherapy JKN participants are drug costs (> 38%) and the cost of proceeding (43% on class 2 patients with severe condition), there are direct medical costs to price discrepancy claims INA CBGs that exceeds the price of the package INA CBGs (p<0.05). The most long duration of average LOS is 14 days Âą 8 (severe condition). Large standard deviation indicates that there LOS uniformity in the treatment of breast cancer.

Keywords: cost analysis, INA CBGs, National Health Insurance (JKN), breast cancer

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A-O-3 ASSESSMENT OF KNOWLEDGE AND PRACTICES OF HEALTH PERSONNEL IN TUBERCULOSIS DIRECTLY OBSERVED TREATMENT SHORT-COURSE (TB-DOTS) IN VARIOUS BARANGAY HEALTH CENTERS IN METRO MANILA Hazel Anne L. Catublas, Therese Ann C. Velasco, Mary Chris B. Solis, Gladys M. del Mundo Adamson University, San Marcelino St., Ermita, Manila, Philippines Introduction: The adaptation of the standardized TB management protocols and guidelines is very important for effective implementation in all parts of the country. TB control depends largely on the capacity of various health care facilities like Health Centers. This study aimed to assess the TB control process in terms of case finding, case holding, treatment and monitoring, as well as recording and reporting practices in various Health Centers in three major cities in Manila in reference to standardized guidelines from the Manual of Procedures (MOP) of the National TB Control Program. This study also determined different types of adverse drug reactions reported relating to TB treatment and the involvement of pharmacists in the TBDOTS in community. Methodology: A cross-sectional study design was utilized and a total of 88 respondents from three major cities were included. Data was gathered with the use of structured questionnaire in reference to the MOP. Statistical analysis of data such as reliability, correlation, and comparison was done with the use of Med-Calc Statistical Software. Results & discussions: Overall result showed that there is a high knowledge among health care professionals in all areas covered in the study. However there is a significant difference in case finding comparing the three locations. The researchers also found out that only one of the three cities has Pharmacists involvement in Health Centers with TBDOTS. Different variables in the study such as demographics and trainings attended also reflects significant effect on the level of respondentsâ&#x20AC;&#x2122; knowledge. Adverse drug reactions that are frequently experienced by patients are almost the same for the three geographic locations.

Keywords: TB-DOTS, pharmacists role, knowledge and practice, healthcare, community health

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A-O-4 THE IMPACT OF EDUCATION VIA INSTAGRAM TO THE LEVEL OF KNOWLEDGE ON SELF MEDICATION OF COMMON COLD, COUGH AND FEVER OF NON-MEDICAL UNDERGRADUATE STUDENTS Sandra Ayuningtyas, Githa Fungie Galistiani, Anjar Mahardian Kusuma Faculty of Pharmacy, The University of Muhammadiyah Purwokerto, Indonesia The lack of knowledge of non – medical undergraduate student about self – medication has led them to do a mistake in doing self – medication such as in miss consuming the drug. One of a care action to overcome in doing self-medication is by educating them. This research is aimed to analyze the increase of self – medication knowledge of non – medical undergraduate student after the education treatment via Instagram using an experimental method using one group pretest – posttest research design. The data was collected using a validated online pretest – posttest questionnaire. The respondents were non – medical graduate student (n = 52) which were taken using quota sampling technique by opening respondent recruitment in social media, poster, and leaflet. The data was analyzed by Wilcoxon test to know the result of education impact via Instagram. The result shows that p = 0,000 (p < 0,05) which means there is a significant impact on the knowledge on the education treatment via Instagram of self – medication of common cold, cough, and fever of non – medical undergraduate student.

Keywords: self-medication, instagram, education

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A-O-5 THE DEVELOPMENT OF CASUAL MODEL OF ORGANIZATION COMMITMENT OF THAI PHARMACIST IN THE GOVERNMENT Jadesupha Lalitnantpong, Penpilai Ritakananon, Nonglucki Viratchai Food and Drug Administration, Nonthaburi, Thailand The purposes of this research were to develop and validate the causal models of organizational commitment. The developed model consisted of 3 latent variables and 9 observed variables.

The 475 Pharmacists working on protection consumers were the subjects of this study. Data were collected and analyzed by descriptive statistical analyses using SPSS, and path analysis with latent variables using LISREL version 8.1. The results indicated that the models were consistent with empirical data. The fitted model accounted for 16 percent of variance in the organizational commitment variable, with chi-square goodness-of-fit test = 26.95, p = .08, df = 18, and GFI significant .99 The effects on organizational commitment variables were direct effects from job satisfaction and expectancy work motivation, and indirect effects from expectancy work motivation.

Keywords: expectancy work motivation, job satisfaction, organizational commitment, causal model

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A-O-6 LEVEL OF PREPAREDNESS OF THE FILIPINO PHARMACISTS AS PROVIDERS OF IMMUNIZATIONS FOR ADULT PATIENTS Romeo C. Ongpoy College of Pharmay, De La salle Health Sciences Institute, Dasmarinas, Cavite 4114 Objectives: To investigate the level of preparedness of the Filipino Pharmacists in providing immunizations to adult patients particularly in their knowledge, behavior and skill as well as their assessment of the community pharmacy as an environment for immunization. Methods: To do this, original validated questionnaires were given to 353 Filipino Pharmacists from the major practice fields in the country – community, hospital, academe and industrial where 113 responded. The questionnaires were then consolidated and treated statistically to measure the level of preparedness reported in this study. Results: About this study, it was found out that the Filipino Pharmacists are moderately prepared as to knowledge (2.95 from a scale of 5 and 0.96σ) and skill (3.11 and 1.11σ) but very prepared behavior-wise (3.84 and 1.04σ). On the other hand, the community pharmacy environment in the Philippines is perceived to be moderately suitable for immunization by the respondents. Conclusion: The results show that the Filipino Pharmacists are very prepared (3.56 ) to provide immunization as part of their role. However, the Community Pharmacists who are the ones to immunize among the practice fields are only moderately prepared. The government needs to address the concerns of the Pharmacists in providing immunization like identifying and handling AE (2.81 and 1.12σ), knowledge in the principles of IM administration (2.83 and 1.15σ) and handling parenteral (2.91 and 1.15σ) as well as the training fee to provide immunizations (3.23 and 1.39σ) which is the major concern affecting behavior.

Keywords: Filipino, immunization providers, pharmacists, immunization, vaccination

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Oral presentations VII. Pharmacoepidemiology and Pharmacoeconomics

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PP-O-1 COST EFFECTIVENESS ANALYSIS (CEA) MANAGEMENT ACUTE PHARYNGITIS IN PRIMARY HEALTH CARE, KLUNGKUNG, BALI Dewi Puspita Apsari1, IMAG Wirasuta2, Fauna Herawati3 Department of Clinical Pharmacy, Institut Ilmu Kesehatan (IIK), Bali, Indonesia Department of Pharmacy, Udayana University, Kampus Bukit Jimbaran Bali, Indonesia 3 Department of Clinical Pharmacy, Surabaya University, Surabaya, Indonesia 1

2

Objective: Acute pharyngitis is one of the most frequent causes primary health care visits in Klungkung, Bali; however, there is no agreement about which is the best strategy to manage acute pharyngitis in adult. This study aimed to evaluate cost-effectiveness analysis of treatment management strategies for adult who present with sign or symptoms acute pharyngitis.

Methods: This prospective cohort study included 93 patients aged 12-45 years with pharyngitis and treated at klungkung primary health care. Cost–effectiveness was calculated from primary health care perspective. We measured effectiveness and cost per patient for 3 following management: empirical antibiotic treatment, centor criteria and RADT. Effectiveness was measured as the proportion of patients cured. The cost data came from E-Catalogue that can be accessed through the website www.inaproc.lkpp.go.id. Results: The findings revealed that centor criteria management is the most cost-effective, with cost–effectiveness ratio Rp 2.090,. Centor criteria management also dominance than RADT management with ICER value Rp 969.375,-. ICER value for centor criteria management less than GDP/capita in Indonesia (Rp 25.646.108,-) hence WHO considered that management highly cost–effective. Conclusions: The use of centor criteria is the most cost-effective strategy for management of acute pharyngitis in adult.

Keywords: cost efectiveness analysis (CEA), acute pharyngitis, rapid antigen detection testing (RADT), centor criteria, empirical

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PP-O-2 RISKS ASSOCIATED WITH DEPRESSION IN TYPE 2 DIABETIC PATIENTS: 5-YEAR FOLLOW UP STUDY Sawaeng Watcharathanakij1, Summana Moolasarn1, Nonglek Kunawaradisai1, Aporn Jaturapattarawong2 1 2

Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, 34190, Thailand Department of Pharmacy and Consumer Protection, Warinchamrap Hospital, 34190, Thailand

Background: Depression in patients with type 2 diabetes mellitus (T2DM) can lead to diabetic complications and other negative consequences. Therefore, identifying risks and early detection of depression in these patients are essential. Objective: To identify factors associated with depression in T2DM patients. Methods: The retrospective cohort of patients newly diagnosed with T2DM with ICD10 (E11) during January 1, 2007 to December 31, 2009 was followed up for 5 years or until diagnosed with depression. Patients diagnosed with depression before T2DM or on the same date as T2DM were excluded. ICD10 (F32-33) or receiving antidepressants at least 3 months or presenting signs and symptoms with validated depression screening tool from Department of Mental Health (Thailand) were used to identify patients with depression. Cox proportional hazards model with propensity score matching was used to identify factors associated with depression. Results: 1,460 newly diagnosed T2DM, 60.54% female and 54.76% aged between 50-70 years old, were identified with the incidence rate of depression of 14.83 per 1,000 person-years (95% CI = 12.25-17.96). After propensity score matching, hypertension (Hazard ratio = 1.90, 95% CI = 1.22-2.96, p=0.005) and oral antidiabetic agents (HR = 2.62, 95% CI = 1.27-5.39, p=0.009) were significant risk of depression. Surprisingly, older age diagnosed with T2DM were less likely to be diagnosed with depression (HR = 0.98, 95% CI = 0.97-0.99, p=0.033). Conclusions: T2DM patients diagnosed at younger age, with hypertension or receiving oral antidiabetic agents must be carefully monitored for depression.

Keywords: depression, type 2 diabetes mellitus, risks, longitudinal study

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Poster presentations I. Scientific

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S-P-1 THE EFFECT OF THE DECOCTION OF ANGELICA KEISKEI KOIDZUMI ON DIET-INDUCED METABOLIC SYNDROME IN SPRAGUE-DAWLEY RATS Melanie M. Castro Graduate School, Centro Escolar University, Manila, Philippines

Not so long ago, the plant Angelica keiskei Koidzumi (Ashitaba), was one of the herbs being sought by Filipinos for possible use in cancer, diabetes, hypertension and obesity. However, due to its paucity, a limited number of published scientific studies will cite the benefit of consuming its most common form of herbal preparation, the decoction of its fresh leaves and stalks. The study aimed to evaluate the effect of the decoction of Angelica keiskei Koidzumi on diet-induced metabolic syndrome in male SD rats. Phytochemical screening was performed to determine its bioactive constituents, followed by a biological study to determine its effect on diet-induced metabolic syndrome. After induction, each rat was assigned to any of the five groups (n=5/group): 100, 200 or 300 mg/kg BW bid of the decoction (by oral gavage); standard drugs Metformin 200 mg/kg bid and Simvastatin 100mg/kg BW (by oral gavage) ; and untreated group. The results revealed that the 200 mg/kg dose of A. keiskei Koidzumi and standard drugs caused significant reductions in the FBS of rats. This effect can be attributed to the presence of coumarins, flavonoids, cardiac glycosides, phytosterols and tannins which are believed to synergistically cause increased glucose uptake, resulting to reduced glucose levels. Conversely, no significant improvements were found in the lipids, Anthropometric indices, BMI, LDH and AST levels in all groups after treatment. It can be concluded that the 200 mg/ kg BW dose of A. keiskei Koidzumi decoction play a beneficial role in metabolic syndrome, particularly in the glycemic control.

Keywords: Angelica keiskei, koidzumi, metabolic syndrome, Ashitaba

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S-P-2 ANTI-INFLAMMATORY EFFECT OF FICUS PSEUDOPALMA BLANCO (NIYOG-NIYOGAN) LEAF FRACTIONS ON THE CHORIOALLANTOIC MEMBRANE OF 10-DAY OLD ANAS LUZONICA (DUCK) EGGS Richelle L. Santiago, Jose Emmanuel C. Mariano College of Pharmacy, University of the Philippines Manila, Taft Avenue, Manila 1000 Ficus pseudopalma Blanco (Fam. Moraceae), locally known in some areas as niyog-niyogan, is a tree endemic to the Philippines used as an ornamental plant and as treatment of UTI (Urinary Tract Infection). Many Ficus species have been discovered to have anti-inflammatory activity, although F. pseudopalma in particular has not been studied for such properties. Leaves of F. pseudopalma were characterized through USP (United States Pharmacopeia) assays for articles of botanical origin, exhaustively macerated in ethanol, and extracted through Kupchan partitioning. The leaf ethanolic extract and fractions were subjected to phytochemical screening and TLC (Thin Layer Chromatography), after which select fractions were tested for antiinflammatory activity using the duck egg choriallantoic membrane (CAM) assay. Results showed that at a concentration of 300 ppm, the diethyl ether and aqueous fractions showed moderate inflammation inhibition.

Keywords: Ficus pseudopalma Blanco, Kupchan partitioning, anti-inflammatory, chorioallontoic membrane, inflammation inhibition

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S-P-3 PHYTOCHEMICAL SCREENING AND ANTIMICROBIAL STUDY OF THE DIFFERENT LEAF EXTRACTS OF ALOCASIA SANDERIANA BULL.: AN ENDEMIC PHILIPPINE PLANT Romeo C. Ongpoy College of Pharmacy, De La Salle Health Sciences Institute, Dasmarinas, Cavite, 4114 Objectives: To investigate the phytochemical contents and evaluate the antimicrobial property of Alocasia sanderiana Bull. against a large number of pathogens. Methods: To do this, Alocasia sanderiana Bull. was screened for qualitative phytochemical tests including thin layer chromatography. Aside from the crude extract from the Rotary evaporator, three fractions from the plant were prepared using methanol, dichloromethane (DCM) and hexane. The 4 solvent extracts were then evaluated for antimicrobial activity using disc diffusion method on 18 strains of organisms. Results: About this study, it was found out that triterpenes, tannins and saponins are present during phytochemical screening. Zones of inhibitions during the antimicrobial tests were observed but did not reach the desired zone for antimicrobial activity. The DCM fraction produced 4 mm zone against Proteus mirabilis, 3 mm for Pseudomonas aeruginosa, 1 mm for Pectobacterium carotovorum and 1 mm for Candida albicans. The methanol fraction also produced a 1 mm zone against Pseudomonas aeruginosa. Conclusion: The results show that Alocasia sanderiana Bull. leaf extracts contain polyphenolic compounds but this study shows that it exhibits non-active antimicrobial activity against the 18 strains that it was tested and may not be utilized as a potential antimicrobial drug for the said strains.

Keywords: Alocasia sanderiana Bull, antimicrobial, phytochemical screening

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S-P-4 EFFECT OF USING A COMBINATION OF SONOPHORESIS AND PEGYLATED LIPOSOMES WITH LIMONENE ON THE SKIN DEPOSITION OF HYDROPHILIC COMPOUND Worranan Rangsimawong, Praneet Opanasopit, Theerasak Rojanarata, Tanasait Ngawhirunpat Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand The aim of this study was to investigate the effect of sonophoresis on the skin transport of sodium fluorescein (NaFI)-loaded liposomal formulation. In vitro skin penetration and deposition study were performed through porcine skin. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were used to visualize the penetration pathways. The results showed that low frequency sonophoresis (20 kHz) significantly increased the flux of NaFI solution, whereas it significantly decreased the flux of NaFI-loaded PEGylated liposomes with d-limonene (PL-LI). The NaFI-remaining in stratum corneum and epidermis and dermis in PL-LI with sonophoresis was lower than that in PL-LI without sonophoresis. CLSM images showed the fluorescence intensity of NaFI-loaded PL-LI was observed in the deeper skin depth and along the length of hair inside the skin, whereas in the skin with applied sonophoresis, the fluorescence intensity was detected only on the top of hair outside the skin.

From SEM images, sonophoresis dislocated the corneocytes and reduced the deposition of PLLI around hair follicles. These results revealed that sonophoresis may partially plug hair follicle orifices and reduce percutaneous absorption through the follicular pathway.

Keywords: sonophoresis, PEGylated liposomes, hydrophilic compound, skin deposition

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S-P-5 EVALUATION OF ARENGA SACCHARIFERA LABILL (FAM. ARECACEAE) SEED GUM AS SUSPENDING AGENT IN CALCIUM CARBONATE ORAL SUSPENSION Ranelle Lou C. Dorado, Paulo Martin L. Mendoza, Shaina Mara M. Salvador College of Pharmacy, University of the Philippines Manila, Taft Avenue, Ermita, Manila 1000 The variability in the effectiveness, accessibility, abundance, and affordability of marketavailable suspending agents make the discovery of alternative suspending agents relevant.

Arenga saccharifera, locally known as Kaong in the Philippines, contains galactomannan, a polysaccharide that occupies a large hydrodynamic volume in aqueous solution and affects the rheological behavior of solutions. A. saccharifera gum was extracted and isolated from the endosperm of mature A. saccharifera nuts. The lyophilized gum was used to formulate Calcium carbonate oral suspensions to compare its suspending property to that of Xanthan gum with Microcrystalline cellulose (MCC), and Polyvinylpyrrolidone (PVP). Finished product quality control tests showed that suspensions made with A. saccharifera gum produces suspensions that have small particle sizes, deflocculated characteristics, exhibit pseudoplastic behavior, and produce sediments on storage but are readily redispersible when shaken. Furthermore, the optimal concentration for A. saccharifera gum as a suspending agent was found to be 0.75% w/v.

In comparison with other suspending agents, Xanthan gum with MCC and PVP, A. saccharifera gum produced suspensions with sedimentation volume and particle size less than that of Xanthan gum and MCC but less than that of PVP. Keywords: Arenga saccharifera, suspending agents, sedimentation volume, redispersibility, rheology, particle size distribution, assay

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S-P-6 DESIGN AND EVALUATION OF IRBESARTAN FAST DISSOLVING TABLETS BY USING JACKFRUIT SEED STARCH AS NATURAL SUPERDISINTEGRANT Vidyadhara Suryadevara, Sasidhar RLC, Lakshmi Harika Danda, Ramu Anne Chebrolu Hanumaiah Institute of Pharmaceutical Sciences, Chandramoulipuram, Chowdavaram, Guntur-522019, A.P, India In the present investigation an attempt was made to isolate starch from jack fruit seed powder and utilizing the same as excipient to design of fast dissolving tablets Irbesartan. Starch was isolated from jack fruit seeds by aqueous and alkali extraction process. The physicochemical and phytochemical tests confirmed the presence of only carbohydrates and polysaccharides in the extracts. Acute toxicity studies for the extract indicated that all the rats were healthy with no physiological changes in their behavior. The fast dissolving tablets were prepared by wet granulation technique by using isopropyl alcohol as granulating fluid. All the tablet formulations were found to be stable and meeting I.P specified limits for post compression parameters. In vitro dissolution studies were carried out in 0.1N HCl by using USP apparatus II (paddle method). The dissolution rate of formulations F5 and F8 containing 5%w/w of alkali extracted starch and 5 % w/w of croscaramellose sodium showed faster disintegration and improved dissolution rate than compared to marketed and other formulations. Majority of the formulations displayed first order release kinetics and were found to be linear with R2 values in the range of 0.946-0.993. FTIR and DSC analysis revealed that there were no major interactions between the drug and the excipients used in the tablets. SEM analysis was done to study the surface morphological characteristics of starch extract and drug which indicated that there were no physical and chemical interactions during tabletting process. Accelerated stability studies indicated that the formulations were stable.

Keywords: jack fruit seed starch, superdisintegrants, fast dissolving tablets, Irbesartan

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S-P-7 ANTIOXIDANT ACTIVITY OF ETHANOLIC LEAF EXTRACT OF LOKWAT (ERIOBOTRYA JAPONICA) THUNB. LINDL Maria Hilaria, Ni Nyoman Yulian, Elisma, Nety Toean Department of Pharmacy, Health Polytechnic of Kupang, East Nusa Tenggara, Indonesia Antioxidants play an important role in life because it can help the body against free radicals.

One of the plants that have the potential as an antioxidant is Lokwat (Eriobotrya japonica (Thunb.) Lindl). Has conducted research on antioxidant activity test extract ethanol of Lokwat Leaves (Eriobotrya japonica (Thunb.) Lindl) with DPPH method. Lokwat Leaves extracted by maceration method using 95% ethanol, then the extract liquid concentrated with an evaporation and evaporated to obtain lokwat leaves thick extract. The obtained extractswere madein the5seriesconcentrationis 30 ppm, 40 ppm, 50 ppm, 60 ppm and 70 ppm. Each concentration was reacted with DPPH and was incubated for 30 minutes before the absorbance was measured at 518 nm wavelength. The results showed that lokwat leaves ethanol extract had a very strong antioxidant activity with IC50 values of 42 ppm but is weaker when compared to Vitamin C as a positive control that has the IC50 value of 6 ppm.

Keywords: antioxidant, DPPH, ethanol extract, Lokwat leaves

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S-P-8 THE EFFECT OF GIVING BASIL LEAVES INFUSION (OCIMUM SANCTUM L.) AS A HEPATOPROTECTIVE EFFECTS ON WHITE FEMALE WISTAR RATS INDUCED WITH PARACETAMOL Ni Nyoman Yuliani, Maria Hilaria, Jefrin Sambara, Harlinda Department Of Pharmacy, Health Polytechnic of Kupang, East Nusa Tenggara, Indonesia Indonesia is a country that has biodiversity potential to be developed as medicinal plants, such as basil leaves (Ocimum sanctum L.). Basil is one of the plants in vitro which is reported to have a very high antioxidant activity. The aim of this study was to determine the effect of infusion of basil leaves (Ocimum sanctum L.) to the liver works based on the value of Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) in each dose. This research is a purely nature experimental by using 18 rats were divided into 6 groups. As the normal control group 1 and group 2 as a negative control treated CMC Na 0.5%, 3 as a positive control group was given Curcuma 3.6 mg / 200gBB, groups of 4-6 consecutive given a 80 mg dose infusion basil / 200 gBB, 160 mg / 200 gBB, 320 mg / 200 gBB for 8 consecutive days, on the day of the 4th and 8th all treatment groups induced by toxic doses of paracetamol (500 mg / 200 gBB) except the normal control group 1, The research data in the form of enzyme activity of AST and ALT were analyzed using parametric and nonparametric ANOVA,and Friedman test with the level of trust then followed by SNK test and Bnj test. The statistical test result with a 95% of level of trustthat shown basil infuse with a dose of 80mg / 200gBB, 160mg / 200gBB, 320mg / 200gBB have hepatoprotective effects in rats induced by paracetamol 500mg.

Keywords: hepatoprotective, Ocimum sanctum L, paracetamol

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S-P-9 THE EFFECT OF THE OLD HEATING RICE COOKER TO TOTAL MICROBIAL WHITE RICE WITH TOTAL NUMBER PLATES (TOTAL PLATE COUNT Sambara Jefrin1, Ni NYoman Yuliani1, Fatmawati Blegur1, Yanno Werang2 1

Department of Pharmacy, Health Polytechnic of Kupang, East Nusa Tenggara, Indonesia 2 Department Of Pharmacy, Health Polytechnic of Kupang

Rice is the staple food rice processed products are usually consumed by the people of Indonesia.

Changes of rice into the rice occur because gelatinize the starch granules contained in rice.

When the raw starch put into cold water, the starch granules absorb water and swell. However, the amount of water absorbed only around 30% and Swellings were limited. This swelling occurs because the kinetic energy of the water is stronger than the force of attraction between molecules of starch granules, so that water can get into the grains of starch. Water absorption and swelling of the starch granules can be improved by raising the temperature (Shafwati, 2012).

Rice including food easily damaged, so it is a suitable medium for the growth of pathogenic microorganisms that cause the rice is quickly stale and stinking. Most microbes are microbes mesophyll food destroyer, which grows either at room temperature or at room temperature.

Mesophilic bacteria can live with the optimum temperature of 20-45 0 C. Microbial food and pathogen destroyer mesophyll commonly found in food is bacteria Bacillus cereus sporeforming, gram-positive bacteria Staphylococcus aureus, gram-negative bacteria Salmonella and Escherichia coli. These bacteria can adapt to live and grow Keywords: microorganism, rice, MPN

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FAPA Congress 2016 | Bangkok, Thailand

S-P-10 QUANTITATIVE DETERMINATION OF MERCURY FROM RINSEWATER SAMPLES OBTAINED FROM A SIMULATED CLASS II DENTAL AMALGAM FILLING PROCEDURE Paula Angelica T Ramos1, Judilyn N Solidum2, Katrina j Aquino1, Sheryl E Salazar1 1

College of Pharmacy, University of the Philippines, Ermita, Manila 1000 Philippines 2 Department of Pharmaceutical Chemistry, College of Pharmacy, University of the Philippines, Ermita, Manila 1000 Philippines

In the Philippines wherein most sewage waters do not undergo treatment, the contamination of sewage with mercury can hardly be regulated nor contained. This is a significant issue because mercury is a persistent andbioaccumulative pollutant in the environment with well - documented neurotoxic effects on humans. Dental officesremain as the main source of all mercury pollution entering publicly- owned treatment works, mostly coming from amalgam removal or old fillings or removal of excess in new fillings. With this said, this study aimed to approximately determine how much mercury from a dental amalgam filling procedure enters the sewage. Rinse water samples were collected from a simulated amalgam filling procedure for Class II teeth models, and were subjected to Cold Vapor Atomic Absorption Spectroscopy ( CVAAS). The percentage of mercury released in waste water relative to the total amount of simulated amalgam procedure was found to be 0.0003%. Several factors were effectively reduced to result in low variations among rinse water samples. It was found that sample variability due to amalgam surface area (p=0.096) and drying time (p=0.528) was effectively controlled to a low level.

Keywords: amalgam, simulation, CVAAS, rinse water, mercury

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FAPA Congress 2016 | Bangkok, Thailand

S-P-11 EUPHORBIA HIRTA (EUPHORBIACEAE) DECOCTION ENHANCES COAGULATION IN SPRAGUE-DAWLEY RATS VIA EXTRINSIC PATHWAY Yrene S. Caringal, Angele A. Diaz, Christine Delight S. Ruz, Jovencio G. Apostol Department of Pharmacy, Faculty of Pharmacy, University of Santo Tomas, EspaĂąa, Manila, Philippines Euphorbia hirta (Euphorbiaceae), locally known as tawa-tawa, is traditionally utilized in the Philippines as treatment for dengue and its symptoms. The present study evaluated the blood coagulating effect of the aqueous solution (0.30 g/ml) of the lyophilized decoction of E. hirta whole plant in Sprague-Dawley rats induced with warfarin. Rats were grouped into four. Group A served as the control group. Warfarin (0.5 mg/kg) was induced for three days to Groups B, C, and D. For the next three days, Group B was treated with vitamin K (2.2 mg/kg) while Group C and D were treated with the lyophilized decoction of E. hirta at 200 mg/kg and 400 mg/kg respective doses. Plasma were collected before inducing warfarin, after warfarin was induced, and finally after treatment. These were screened for coagulation parameters, prothrombin time (PT) and partial thromboplastin time (PTT) which measure the activity of the extrinsic and intrinsic pathways of coagulation, respectively. Results showed that after the administration of E. hirta at both doses, PT had significantly decreased while no significant change was observed on PTT. Therefore, E. hirta has shown to exert its effect on the extrinsic pathway of coagulation.

Furthermore, the blood coagulating action of E. hirta showed a comparable result with that of Vitamin K (p=0.097) in a non-dose dependent manner.

Keywords: Euphorbia hirta, coagulation, intrinsic pathway, extrinsic pathway, prothrombin time, partial thromboplastin time

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S-P-12 ABSORPTION PROFILE OF COENZYME Q10 FROM THE GUMMY PREPARATION Taiji Matsukawa,Yoshimi Haza, Satoshi Doi, Akinobu Kishi UHA Mikakuto Co., Ltd. 4-12, Kanzaki-cho, Chuo-ku, Osaka 540-0016 Japan Purpose: Coenzyme Q10 ( CoQ10) is widely used as a nutritional supplement in Western counties. Recently, not only soft gel and liquid preparations but the gummy preparation is increasingly prevalent. However, there is little information of absorption properties of CoQ10 from the gummy preparation. In this report, absorption properties of CoQ10 (reduced form) from gummy preparation were investigated and compared with other preparations. Methods: Twelve participants (aged 21 to 38, male: 6, female: 6) were enrolled in this study. The triple crossover design was employed as follows: participants took in 100 mg of CoQ10 from soft gel, liquid preparations or gummy preparations then CoQ10 concentrations in blood were measured at appropriate intervals. All procedures used in this research were approved by the Ethical Committee of Tana orthopedics, surgery hospital of incorporated medical institution Kaiseikai.Results: There was no significant differences in Cmax, Tmax and AUC010h between soft gel and liquid preparations. In gummy preparations, Cmax and AUC0- 10h of CoQ10 were higher than capsules. However, these differences were nonsignificant in statistically because of small sample size, the blood level of CoQ10 at 4 hours and AUC0- 6h after taken in the gummy preparations were significantly higher than those of soft gel as the AUC0-6h and absorption rate were evaluated to be 45% higher and two times higher. Conclusion: The gummy preparation of CoQ10 was found to be a useful preparation in absorption profile compared with soft gel and liquid preparations.

Keywords: absorption, coenzyme Q10, gummy, soft gel

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S-P-13 IN VITRO CHARACTERIZATION AND CYTOTOXICITY OF NIOSOME LOADED L-GLUTATHIONE Joshua H. Santos1, Oliver B. Villaflores2, Mary Jho-Anne T. Corpuz2 1

The Graduate School, University of Santo Tomas, Espana Blvd., 1015 Manila, Philippines 2 The Graduate School and College of Science, University of Santo Tomas, Espana Blvd., 1015 Manila, Philippines; Research Cluster for Natural and Applied Sciences, University of Santo Tomas, Espana Blvd., 1015 Manila, Philippines Glutathione, γ-L-glutamyl-L-cysteinylglycine, is one of the important thiol antioxidants in the body. It acts as antioxidant, biomarker for cell growth and death, and substrate for conjugation.

However, low bioavailability of glutathione leads to therapeutic failure, thus, glutathione precursors are administered instead. The study aims to formulate and characterize niosomal glutathione, addressing its poor bioavailability. Niosomes was prepared through thin film hydration. The study encompassed three formulations having different molar ratio of Span 60 and cholesterol such as 1:1 (A), 3:2 (B) and 7:3 (C), respectively. The formulation having the highest entrapment efficiency was characterized in-vitro and was used as the basis for the new formulation containing the charge inducer. In vitro characterization shown that Formulation A ( 98. 2% + / - 0. 049% ) had significantly higher mean entrapment efficiency than the other formulations (p < 0 .001). The mean viscosity of Formulation A was 1.78cP. Niosomes formed were nearly spherical as revealed by Scanning Electron Microscopy (SEM) with mean particle size of 308.8 µm. Glutathione was released in phosphate buffer saline pH 7.4 simulating the normal pH of blood. Release of glutathione was only detected at the third hour (1.122mg) of simulation. Differential Scanning Calorimetry showed no immediate and delayed interactions occurred between glutathione and the excipients. Fourier Transform Infrared Spectroscopy data suggested that the thiol group ( 2523. 90cm- 1) in glutathione did not have any interactions.

Niosomes were non-cytotoxic against normal Human dermal Fibroblast (Invitrogen®). Based on the results, it showed the potential use of the niosomal preparation in the controlled delivery of glutathione and other low bioavailable drugs.

Keywords: glutathione, niosomes, bioavailability, nanoparticles, formulation' in vitro characterization, cytotoxicity

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S-P-14 GC-MS ANALYSIS, PRELIMINARY PHYTOCHEMICAL SCREENING AND HEPATOPROTECTIVE ACTIVITY OF METHANOL EXTRACT OF TERMINALIA CORIACEA LEAVES. Jitendra Patel1, Atla Venkateshwar Reddy2, G. Shiva Kumar3 Department of Pharmacognosy, KVK College Of Pharmacy, Surmaiguda (V),Hayathnagar (M), RR Dist.- 501512, TS, India 2 Anwarul Uloom College of Pharmacy, New Mallepally, Hyderabad -500001, TS, India.

3 Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jallil, Kuala Lumpur 57000, Malaysia.

1

Objective: The objective of the present work was investigating the GC-MS analysis, preliminary phytochemical screening and hepatoprotective activity of methanol extract of the leaves of Terminalia coriacea. Material and methods: Group I served as vehicle control, Group II served CCL4 (2ml/kg, s.c.), Group III served as standard Silymarin (50 mg/kg, p.o.) Group IV and V served as methanolic extracts of Terminalia coriacea (METC) at the dose level (250 and 500 mg/kg, p.o.). The degree of protection was determined by measuring level biochemical marker like ALT, AST, ALP, Direct bilirubin, Total bilirubin and Cholesterol. The histopathology study also showed the hepatic protection of extracts. The GC-MS analysis and preliminary phytochemical screening was performed to find out the phytoconstituents responsible for the activity. Results: The marker biochemical level such as ALT, AST, ALP, Direct bilirubin, Total bilirubin and Cholesterol were significantly raised in CCL4 treated rats when compared with the normal group (p < 0 .05), but the METC (500 mg/kg, bw) treated rats exhibited maximum depletion. The histopathology study also showed the hepatic protection of extracts. The GC-MS analysis revealed that the methanol extract contained fourteen phytoconstituents. Preliminary phytochemical screening showed the presence of glycosides, flavonoids, Tannins, triterpenoids, carbohydrates and steroids. Conclusion:The results of in vivo hepatoprotective activity showed that the methanol extract of Terminalia coriacea exhibit significant hepatoprotective activity. This might be due to β - Sitosterol, Stigmasterol, 1H-Inden-1- one,2,3dihydro- 3,3,5,6,- tetramethyl, n- hexadecanoic acid, flavonoids and tannins; which was confirmed their presence in GC-MS analysis and phytochemical tests.

Keywords: Terminalia coriacea (roxb.) wight & arn leaves, GC-MS, methanolic extract, CCL4, hepatoprotective and silymarin

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S-P-15 FORMULATION DEVELOPMENT AND IN VITRO EVALUATION OF BERBERINE-LOADED MONOOLEIN BASED LIQUID CRYSTALLINE NANOPARTICLES FOR TOPICAL DELIVERY Thiagarajan Madheswaran, Shadab Md, Kumar Shiva Gubbiyappa, Brandon Anak Jelek, Le Jun Tuen, Tiong Hwa Lim School of Pharmacy, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia Berberine ( BB) is an isoquinolin alkaloid and exhibit antibacterial activity against Propionibacterium acnes. However, the efficacy of berberine is restricted by its poor solubility and low skin permeation that limits further progression and application of BB to treat local skin infection like acne. These obstacles can be surmounted by loading into suitable nanocarrier such as liquid crystalline nanoparticles (LCN). Hence, the aim of the present study was to develop and characterize BB-loaded LCN and to evaluate its skin permeation. Nanoparticles were prepared by ultrasonication method and characterized for size, shape, stability, in vitro release, and skin permeationâ&#x20AC;&#x201C;retention properties. The particle size, zeta potential ranged from 139.3 to 188.2 nm and -25.5 to -34.7 mV, respectively. Transmission electron microscopical image of nanoparticles appeared as cubical shape and confirmed the formation of LCN. In vitro drug release study showed that there was no significant difference with nanoparticles prepared with different concentration of surfactant with respect to monoolein. LCN formulations presented enhanced the skin permeation and retention of BB in mice skin. Specifically, LCN prepared with cremophor surfactants showed 2.93 fold increase in skin permeation compared with control solutions. In conclusion, the results obtained from this study clearly suggest that monoolein-based liquid crystalline nanoparticles will be a potential carrier for the delivery of BB. Keywords: berberine, acne vulgaris, liquid crystalline nanoparticles, skin permeation

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S-P-16 IN-VITRO ASSESSMENT OF ANTIDIABETIC AND FREE RADICAL SCAVENGING ACTIVITY OF THE LEAF EXTRACTS OF MANGIFERA INDICA (FAM. ANACARDIACEAE), SYZYGIUM CUMINI (FAM. MYRTACEAE) AND TERMINALIA EDULIS (FAM. COMBRETACEAE) Ferdinand Christian L. Soledad, Jose Gerardo S.T. Aquino, Ivan L. Lawag Faculty of Pharmacy, Adamson University, 900 San Marcelino St., Ermita, Manila 1000 Philippines Diabetes, chronic disease characterized by elevated blood glucose level or hyperglycemia.

Hyperglycemia induces production of free radicals by enhancing oxidant production, impairing antioxidant defenses by multiple interacting enzymes (eg. Increase oxidative glucose metabolism, increases mitochondrial production of superoxide anion that will then be converted to hydroxyl radical). This study correlated antidiabetic and antioxidant property of M.indica, S.cumini and T.edulis by in-vitro assay. Alpha-glucosidase inhibition was used to determine antidiabetic property since Alpha-glucosidase is one of key enzymes inhibited in controlling hyperglycemia in Type 2 diabetes; DPPH scavenging activity was used to determine the antioxidant activity because it is one of known stable free radical used in assays.

Alpha-glucosidase inhibition was tested using EON ELISA reader; DPPH scavenging tested using spectrophotometer. All setups were found to be more potent alpha-glucosidase inhibitor than positive controls (N-deoxynojirimycin and Acarbose). Combination of M.indica 50%, S.cumini 25%, and T.edulis 25% yielded greatest alpha-glucosidase inhibitory activity, however there was no observed synergistic activity. All other combination setups (E: M.i 25%, S.c 50%, T.e 25%; F: M.i 25%, S.c 25%, T.e 50%; G: M.i 33%, S.c 33%, T.e 33%) exhibited synergistic alphaglucosidase inhibitory activity. All setups was found to elicit DPPH radical scavenging activity but less potent than positive control (Ascorbic Acid). M.indica was found to be the most potent setup for DPPH radical scavenging activity yielding an IC50 of 67.37Âą1.03ug/mL. Combinations of (D: M.i 50%, S.c 25%, T.e 25% and G: M.i 33% Keywords: alpha-glucosidase, antidiabetic, antioxidant, free radical, synergistic

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S-P-17 NEUROPROTECTIVE POTENTIAL OF FISH OIL FROM BANGUS (CHANOS CHANOS FORSSKAL) IN A 1-METHYL-4-PHENYL-1,2,3,6TETRAHYDROPYRIDINE (MPTP) MOUSE MODEL OF PARKINSON'S DISEASE Kate-Ann Eunice Corpuz, Rose Ann Galera, Genica Janel Geneta, Princess Punzalan, Lara Angelica Tan, Jemaima Shaira Turiano This study dealt with determining the neuroprotective potential of fish oil from bangus through quantifying the existing dopamine in the brain tissues of mice induced with 1-methyl-4-phenyl1,2,3,6- tetrahydropyridine ( MPTP) . Through homogenization in chloroform, methanol and distilled water, and subjecting the chloroform layer in rotary evaporation after filtration, a 14. 08% yield of fish oil was obtained from bangus meat and belly. Through physical and chemical analyses, the resulting fish oil was characterized and all the results yielded positive.

An instrumental analysis determined the composition of the fish oil. Biological assay was conducted which involved an oral pre-treatment of fish oil for 30 days on the experimental groups 4 (5 mg/kg), 5 (10 mg/kg), and 6 (20 mg/kg). On the 31st day, groups 4 to 6 received their usual dose of fish oil and group 2, as the positive control, received their dose of Selegiline (1 mg/kg) orally 30 minutes before the first dose of MPTP (20 mg/kg) intraperitoneally. Group 3, as the negative control, received the same dose of MPTP, while group 1, as the untreated group, received 1 mL/kg of normal saline solution intraperitoneally. Induction of PD lasted for 5 days and the groups were observed for 21 days after. Neuroprotective potential was investigated through quantification of dopamine from the brain samples and statistical analysis. Results showed that 5 mg/kg, 10 mg/kg and 20 mg/kg doses all exhibited neuroprotective potential comparable to the positive control, but the lowest dose was not as effective as the higher doses.

The obtained results showed Keywords: Parkinsonâ&#x20AC;&#x2122;s disease, neuroprotective, MPTP, fish oil, selegiline

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S-P-18 ANTIOXIDANT POTENCY AND ITS CONTENTS OF ETANOLIC EXTRACTS OF CALLUS DEVELOPED FROM CARROT (DAUCUS CAROTA L.) AND TOMATO (SOLANUM LYCOPERSICUM L.) Rumiyati1, Sismindari1, Endang Semiarti2, Sekar Galuh1 1

Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia 2 Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia

( Daucus carota L. ) and tomato ( Solanum lycopersicum L. ) are high potential source of antioxidant compounds such as phenolics and carotenoids. The compounds are known to be able to protect human body cells and tissues from free radical. Callus cell culture from organs of plants as explants can produce secondary metabolite as source of antioxidants. This study was aimed to determine the potency of antioxidant activity of callus developed from the plant organ of carrot (Daucus carota L.) and tomato (Solanum lycopersicum L.) on Murashige and Skoog (MS) medium. Murashige and Skoog (MS) medium used in this study was variated at sucrose concentration of 30 g / L and 40 g / L, whereas the variation of 2,4-D concentrations was (0, 1, 2, 4 and 8) ppm. The results showed that callus of the samples were able to grow at 5-7 days after planting from different part of organ plants. The callus was then sub cultured and extracted using etanol. The etanolic extracts of callus of carrot and tomato were measured on their antioxidants activity using DPPH method. The IC50 etanolic extract of carrot was 1751,29 Âą 4,00mg/mL while etanolic extract of tomato was 620,56 Âą 32,36mg/mL. Quersetin used as standard has IC50 value of 2,85mg/mL. Ethanolic extracts of carrot and tomato callus had lower antioxidant activity when compared to quercetin. It might be due to the callus have not produced secondary metabolite with the high antioxidant activity during the callus stage Keywords: antioxidant, callus, carrot, tomato

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S-P-19 IN-VITRO DETERMINATION OF THE ANTI-PROLIFERATIVE ACTIVITY OF ETHANOLIC CRUDE EXTRACT MURRAYA PANICULATA (KAMUNING) LEAVES AGAINTS HUMAN COLON CARCINOMA (HCT-116) CELL LINE Jhulez Anthony Dayrit, Kim margarett L. Del Rosario, Ma. Concepcion G. Cruz, Carisha C. Gutierrez, Jonnalyn Sanchez Our Lady of Fatima University College of Pharmacy Valenzuela City This study determined the anti-proliferative activity of the crude extract of Murraya paniculata as a source of anticancer drug for Human Colon Carcinoma (HCT-116) Cell Line. The leaves were air dried and macerated using 80% ethanol. The phytochemical constituents present are alkaloids, flavanoids, tannins and glycosides. Functional groups present are alcohol and phenol which has strong and broad intensity. Brine Shrimp Lethality Assay and MTT Assay were used to determine the cytotoxicity. In BSLA, three trials were made for a period of 24 hours. The positive control used was artificial seawater. In MTT Assay, the positive control used was doxorubicin while the negative was dimethyl sufoxide (DMSO). Four concentrations of the crude extract (6.25ug/ml, 12.5ug/ml, 25ug/ml and 50ug/ml) were made for the test (Mosmann, 1983). One-way ANOVA, Games-Howell Post Hoc Analysis, and Probit Analysis were used for BSLA while Levene’ s Test was used for MTT Assay as statistical treatments. BSLA revealed that the extract has significant effect in the mortality of nauplii with LC50=0.2µg/ml.

In MTT Assay, the mean IC50 of 40.56 µg/ml for 3 trials of extract was much higher than the mean IC50 of 1.96µg/ml obtained from the 3 trials of Doxorubicin. Results indicate that 40.56µg /ml of the extract exhibit its anti-proliferative activity on the Human Colon Carcinoma (HCT116) cell line.

Keywords: anti-proliferative, Murraya paniculata, colon cancer, mtt assay, IC50, LC50, chemotherapy

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S-P-20 DEVELOPMENT OF CHITOSAN BASE pH SENSITIVE POLYMERIC MICELLES FOR ORAL MELOXICAM DELIVERY Thisirak Woraphatphadung1, Warayuth Sajomsang2, Theerasak Rojanarata1, Praneet Opanasopit1 1

Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand 2 National Nanotechnology Center, Thailand Science Park, Pathumthani, Thailand

The amphiphilic chitosan derivertives (N-naphthyl-N,O-succinyl chitosan (NSCS), N-octyl-N,Osuccinyl chitosan ( OSCS) and N- benzyl- N,O- succinyl chitosan ( BSCS) ) were developed to prepare pH sensitive polymeric micelles. The amount of initial meloxicam (MX) (0-40%w/w to polymers) was entrapped by physical entrapment method (dialysis, dropping, O/W emulsion, co- solvent evaporation methods) . Effects of physical methods and hydrophobic moieties (naphthyl, octyl and benzyl groups) on entrapment efficiency were determined. MX-loaded micelles was characterized particle size and morphology by dynamic light scattering (DLS) and atomic force microscopy (AFM), respectively. The stability of the MX-loaded micelles, drug release and porcine small intestine permeation were also investigated. The amphiphilic polymers were successfully synthesized and entrapped MX. MX-loaded micelles by co-solvent evaporation showed the highest entrapment efficiency. Among the hydrophobic cores, the Noctyl moiety revealed the highest MX entrapment efficiency and most stable MX- loaded micelles compared to the other hydrophobic cores. The particle size of all polymeric micelles had a tendency to increase with increasing initial MX to polymers and showed spherically shaped. The release behavior of MX from polymeric micelles in mimic gastrointestinal tract was found to be dependent on both hydrophobic cores and hydrophilic shells. MX-loaded OSCS polymeric micelles showed the lowest cumulative MX release in simulated gastric fluid medium. However, when the pH was increased to 6.8, the MX release significantly increased in all MX-loaded micelles. Moreover, the intestinal permeation rates of MX from all MX-loaded micelles were not significantly different. Therefore, OSCS micelle would be desirable to develop MX carrier for oral drug delivery.

Keywords: pH sensitive polymeric micelles, chitosan, meloxicam, hydrophobic cores

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S-P-21 FORMULATION AND OPTIMIZATION OF FINASTERIDE-LOADED MICROEMULSION FOR TRANSDERMAL DRUG DELIVERY BY USING RESPONSE SURFACE METHOD Supatta Rattanachitthawat1, Sureewan Duangjit2, Praneet Opanasopit1, Tanasait Ngawhirunpat1 1

Faculty of Pharmacy, Silpakorn University, Sanamchan Palace Campus, Nakhon Pathom 7300 Thailand 2 Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, 34190 Thailand

The objective of this study was to characterize and optimize the microemulsion (ME) system for transdermal drug delivery of finasteride, the effective 5-alpha reductase enzyme inhibitor for treatment of androgenetic alopecia, by using a response surface method. The microemulsion formulation was composed of cinnamon oil as the oil phase, propylene glycol (PG) as the cosurfactant and reverse osmosis (RO) water as the water phase. The pseudoternary phase diagram of microemulsion with different surfactants, Emulgin®O5, SG-CG®700 and Tween®20, were plotted. The results showed that pseudoternary phase diagram of microemulsion system with the surfactant mixture of Tween®20 and PG in the ratio 3: 1 showed the biggest area of microemulsion, then this formulation was incorporated with 0. 1% of finasteride. The physicochemical properties i. e. particle size, size distribution, conductivity, pH and skin permeation flux, of finasteride- loaded ME were evaluated. The response surface and the optimal ME was determined using Design Expert® Software. The results showed that the formulation factor (Xn e.g. cinnamon oil, Tween®20, PG and RO water) significantly affected the physicochemical properties ( Yn) of model ME. Addition of 0. 1% finasteride did not significantly affect the physicochemical properties of model ME. This study indicated that our ME system had good tendency to use to deliver finasteride via transdermal route.

Keywords: finasteride, microemulsion, response surface method

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S-P-22 THE PHYSICAL STUDY OF PHIKUD NAVAKOT SOLID EXTRACTS Somlak Kongmuang1, Panadda Phattanawasin2, Jankana Buranaosot3, Uthai Sotanaphun3 1

Pharmaceutical Technology Department, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand 2 Pharmacognosy Department, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand 3 Pharmaceutical Chemistry Department, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Phikud Navakot is a set of nine crude drugs using as an important ingredient of several Thai traditional prescriptions. A study on a pilot-scale production of Phikud Navakot extracts was investigated. After drying, a semi- solid extract was obtained and named as NVKE0511. NVK- ES0511 was made by mixing NVK- E0511 extract with N- lokÂŽ carrier to increase flow properties before spray drying. The physical properties of herbal powder were examined. The morphology of NVK-ES0511 and carriers was studied by the scanning electron microscopy. The flow ability of powder was measured using a fixed base method. The hygroscopicity of powder was evaluated at room temperature and at condition of room temperature with 75 percent humidity. Comparing with its carrier, NVK-ES0511 structure was irregular with aggregation. The bulk density, tapped density and Carrâ&#x20AC;&#x2122;s compressibility index of NVK- ES0511 powder were 0. 3504 + 0. 0042 gm/ ml, 0. 4872 + 0. 0299 gm/ ml and 39, respectively. This type of particle shape could affect flow property of the powder. Thus, flow property of NVK- ES0511 was determined as poor ( angle of repose at 45. 59) . The hygroscopicity of both NVK-ES0511 powder and carrier at 75 percent humidity within 2 days were 17.54 and 10.49 percent, respectively. Both NVK-ES0511 and carrier were physically changed from powder into wet mass after hygroscopic examination. The hygroscopicity of herbal extract could be attributed to its chemical constituents. The powder of NVK-ES0511 was determined as highly hygroscopic, thus it was necessary to keep it in a dry place for further preparation into a pharmaceutical solid dosage form.

Keywords: pilot-scale production, phikud navakot, physical study

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S-P-23 MOLECULAR DOCKING ALPHA GLUCOSIDASE INHIBITORS USING COMPARATIVE MODELS OF PROTEIN Teni Ernawati, Abdul Mun'im, Muhammad Hanafi, Arry Yanuar Faculty of Pharmacy, Universitas Indonesia, Depok 16242 Indonesia The aim of this study was to observe molecular interactions between alpha glucosidase inhibitor with enzyme alpha glucosidase derived from Saccharomyces cereviseae, Rattus norvegicus, GANC human. Herein, we was used four alpha glucosidase inhibitors; 1deoxynojirimycin, acarbose, miglitol and voglibose against a target macromolecule enzyme alpha glucosidase. Compared to acarbose, miglitol and voglibose, 1-deoxynoriimycin showed a significant inhibition of three target macromolecules S.cereviseae, R.norvegicus and GANC human enzyme alpha glucosidase. We have been able to compare alpha glucosidase inhibitors by means of a computer-aided drug design protocol involving homology modelling of target protein and the virtual screening with docking simulations in the binding free energy function.

Keywords: docking, alpha glucosidase, S.cereviseae, R.norvegicus, ganc human enzyme alpha glucosidase

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S-P-24 THE OPTIMIZATION OF TEMPERATURE AND TIME FOR THE SYNTHESIS OF ACETYL ISONIAZID BY ACETYLATION REACTION Novi Yantih1, Yahdiana Harahap2, Rianto Setiabudy3, Wahono Sumaryono1 1

Faculty of Pharmacy, Pancasila University, South Jakarta, Indonesia 2 Faculty of Pharmacy, Indonesia University, Indonesia 3 Faculty of Medicine, Indonesia University, Indonesia

Supporting of pharmacokinetic studies of isoniazid in plasma, it is necessary metabolites, i.e. acetyl isoniazid. Acetyl isoniazid can be synthesized through acetylation reaction between isoniazid and acetic anhydride in the variation of temperature and heating time. The characterization is carry out by organoleptic, determination of the melting range, UV- Vis spectrophotometry, FTIR, and mass spectrometry. By using a water bath at a temperature of 60°C for 30 minutes, the synthesis result showed the highest yield of 99.78%. Melting range is 157.2-160.3ºC. Absorption spectrum and the transmittance of the synthesis results have a similar profile to the reference standard. Based on the analysis by mass spectrometry, the molecular weight is 180.05. Acetyl isoniazid synthesized compounds have the same characteristics with the reference standard of acetyl isoniazid.

Keywords: acetyl isoniazid, isoniazid, acetic anhydride, acetylation reaction, synthesis

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FAPA Congress 2016 | Bangkok, Thailand

S-P-25 EFFECT OF PHARMACEUTICAL EXCIPIENTS ON ORGANIC CATION TRANSPORTER 2 ACTIVITY Sirima Soodvilai1, Sunhapas Soodvilai2, Varanuj Chatsudthipong3, Praneet Opanasopit1 Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand 2 Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand and Research Center of Transport Proteins for Medical Innovation, Faculty of Science, Mahidol University, Bangkok, Thailand 3 Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand 1

Renal organic cation transporter 2 (OCT2) plays an important role in excretion of a wide range of organic cations, including therapeutic agents and xenobiotics. Because OCT2 plays important roles for pharmacokinetics and tissue disposition of many cationic drugs, drug-drug interactions, therefore, inhibition of this transporter influences the plasma level of the drugs.

Excipients are essential for the formulation of drugs to support their preparation. It has been reported that some excipients modulate the activity of the efflux transporters such as Pglycoprotein (P-gp). These data indicate that some excipients may alter the pharmacokinetic of drugs. At present, there is no data concerning the interaction of pharmaceutical excipients with uptake transporters. The aim of this study was to examine the effect of excipients on transport function of OCT2 by investigating the interaction of the excipients with OCT2. The OCT2 transport function was determined by monitoring cellular accumulation of radiolabeled methyl4-phenylpyridinium acetate ([ 3H]-MPP+ ), a substrate of OCT2, in a Chinese hamster ovarian cell, stably transfected with rbOCT2 ( rbOCT2- CHO- K1) . Ten of 24 excipients including Tween20, Tween60,Tween80,CremophorRH40, CremophorA6, CremophorA25, Span20, Span60, Gelucire44/ 14, Methylated N- ( 4- N,N- dimethylaminobenzyl) chitosan significantly decreased the uptake of [ 3H]- MPP+ in rbOCT2-CHO- K1 cells. On the other hand other 14 excipients ( quaternized chitosan, PEG400, PEG4000, PEG6000, propylene glycol, pectin, sodium alginate, tragacanth, acacia, methyl cellulose, hydroxylpropyl methylcellulose, carboxymethyl cellulose sodium, poloxamer188, and poloxamer407) had no effect on OCT2 transport function. This study demonstrates that some excipients interact with OCT2, and might alter pharmacokinetic of drugs that are substrates of OCT2.

Keywords: kidney, drug interaction, drug transporters, excipients

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S-P-26 EFFECT OF d-LIMONENE ON SKIN PERMEATION ENHANCER OF KAEMPFERIA PARVIFLORA EXTRACT-LOADED MICROEMULSIONS Paisit Wattanasri, Tanasait Ngawhirunpat, Theerasak Rojanarata, Praneet Opanasopit Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand The aim of this study was to demonstrate the amount of d- limonene on physicochemical properties and skin permeation of Kaempferia parviflora (KP) extract-loaded microemulsions (ME). ME systems composed of oleic acid as oil phase, Tween 20 as surfactant, propylene glycol as co-surfactant and water as aqueous phase were formulated to load KP extract. The effect of d-limonene (1, 5 and 10 % w/w) on skin permeation enhancement of KP extract was investigated. The results showed that the amount of d-limonene played an important role on physicochemical characteristics and in vitro skin permeation of KP extract. The mean droplet size of KP extract-loaded ME was in the range of 37.69-125.08 nm, depending on the amount of d-limonene. The particle size tended to be larger, when the concentration of d-limonene increased. The pH value and conductivity of KP extract-loaded ME were 4.96-5.05 and 44.867.7 ÂľS/cm, respectively. Furthermore, the conductivity value indicated that KP extract-loaded ME were oil in water ME. The in vitro skin permeation studies found that increasing the dlimonene content significantly increased permeation flux through porcine abdominal skin. The highest KP skin permeation was found in the KP extract-loaded ME with 10 % d-limonene which was 16.6-fold and 2.9-fold higher than that of the control (KP extract in water) and ME without d- limonene, respectively. The results suggest the potential use of d- limonene as effective penetration enhancer in the delivery of significant amounts of KP through skin.

Keywords: Kaempferia parviflora, enhancer, microemulsion, skin permeation

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FAPA Congress 2016 | Bangkok, Thailand

S-P-27 IN VITRO RELEASE AND INTESTINAL PERMEATION OF SILYMARIN-LOADED POLYMERIC MICELLES Wajee Tipparos, Tanasait Ngawhirunpat, Theerasak Rojanarata, Praneet Opanasopit Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Thailand Silymarin is a poorly water soluble compound which leads to low bioavailability. In this study, polymeric micelles have been used as drug carrier of silymarin to increase its solubility. The aim of this study was to evaluate the in vitro release of silymarin from the pH responsive polymeric micelles and in vitro intestinal permeation through porcine duodenums. Silymarin was incorporated into amphiphilic chitosan derivatives; N- benzyl- N,O- succinyl chitosan (BSCS), N-naphthyl-N,O-succinyl chitosan (NSCS) and N-octyl-N-O-succinyl chitosan (OSCS) via evaporation method to form the silymarin- loaded polymeric micelles. The release of silymarin-loaded polymeric micelles was investigated in phosphate buffer pH 7.4 medium, and SGF medium (0.1 N HCl, pH 1.2) for 2 h changed to SIF medium pH 6.8 for 6 h using dialysis bag. The release of silymarin from polymeric micelles was found to be dependent on the pH of the medium and was higher than free drug. In SGF medium at 0-2 h, the cumulative silymarin release was similar to free drug. However, when the pH was changed to 6.8, the silymarin release significantly increased in all silymarin- loaded polymeric micelles and higher than silymarin free drug as well as in phosphate buffer pH 7.4 medium. The in vitro permeation studies of silymarin through porcine intestine were performed using Franz diffusion cells. The result revealed that the intestinal permeation rates of silymarin from all silymarin- loaded polymeric micelles were not significantly different. These results suggest that amphiphilic chitosan derivatives could be form pH-responsive polymeric micelles and used as potential silymarin delivery system.

Keywords: silymarin, polymeric micelles, release, intestinal permeation

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FAPA Congress 2016 | Bangkok, Thailand

S-P-28 THE PRODUCTS DEVELOPMENT OF EXTRACTED PLUCHEA INDICA BY GELATINE-BASED PASTILLES Sukannika Tubtimsri, Boonyadist Vongsak, Yotsanan Weerapol Faculty of Pharmaceutical Sciences, Burapha university, Chonburi 20131 Thailand Pluchea indica (L.) Less (Asteraceae) have been used as a traditional medicine for purposes as antioxidant, anti-inflammatory, antibacterial, antidiabetic and anticancer agent. Phytochemical studies reported that complex phenolic compounds are contained in the Pluchea indica leaves. The leaves are ordinarily used as medicinal tea. In this study, the gelatin-based pastilles containing Pluchea indica leaf extracted were developed. The influence factors including amount of gelatin, glycerin and talcum on hardness of pastilles were determined. The phenolic compound was used as an active substance marker. The dissolution of pastilles was carried out by USP apparatus II. The results showed that the hardness was increased as the amount of gelatin or talcum increased. The dissolution study demonstrated that all formulation was dissolved from SGF within 1 h. The system comprising gelatin, glycerin and talcum was the suitable carrier for Pluchea indica leaves extract. From this study, the pastilles containing Pluchea indica leaf extracted can be transferred into the commercial production.

Keywords: pastilles, pluchea indica leaf extracted, gelatin based

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FAPA Congress 2016 | Bangkok, Thailand

S-P-29 METHOD OPTIMIZATION AND VALIDATION OF DDIE, SAFROLE, AND MYRISTICIN ASSAY IN NUTMEG EXTRACT AND HERBAL TABLET BY GAS CHROMATOGRAPHY-MASS SPECTROMETER Bambang Very EB. Abdillah Akbar, Slamet Ibrahim, Ilma Nugrahani School of Pharmacy, Bandung Institute of Technology, Bandung 40132 Indonesia Nutmeg (Myristica fragrans Houtt.) has been proven to be possessed an antidiabetic activity, as the active compound of dehydrodiisoeugenol (DDIE). Nutmeg also contains poisonous and hallucinogenic compounds, i.e. safrole and myristicin. The toxic compound elimination is being conducted by a process and formulated into tablets. A GC-MS method for the determination of DDIE, safrole, and myristicin has been described. The purpose of this study is to develop quantification method by optimizing instrumental system, conducting validation method, and applying on samples. Optimization is conducted by capillary column Durabond® DB-1MS and helium as carrier gas. The optimum condition is obtained as follow. Initial temperature of column is regulated on 70 °C and holded for 5 minutes, elevated to 265 °C by ramp rate 30 °C/minute, and holded for 4.5 minutes. Helium flow is regulated at constant linear velocity on 40.2 cm/second. Split injection is regulated on 300 °C. Ion-source temperature is set on 200 °C. SIM method is applied on each molecule ion by event time at 0.10 seconds. This method has met validation requirements for system suitability test, selectivity/ specificity, linearity, accuracy, repeatability precision, and robustness in normal condition. Detection limit of this method for DDIE, safrole, and myristicin is 9.68 mcg/ml, 0.04 mcg/ml, and 0.36 mcg/ml, respectively, and quantification limit is 29. 03 mcg/ ml, 0. 12 mcg/ ml, and 1. 09 mcg/ ml, respectively. The validated method is able to be applied on nutmeg extract and tablet sample.

Thus, the proposed method could be used as an alternative method for determination of DDIE, safrole, and myristicin.

Keywords: Myristica fragrans, dehydrodiisoeugenol, safrole, myristicin, gas chromatography, mass spectrometer

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FAPA Congress 2016 | Bangkok, Thailand

S-P-30 EVALUATION OF PINEAPPLE STARCH EXTRACTED FROM LEFT STEM AND RHIZOME AS DISINTEGRANT IN TABLET Suchada Piriyaprasarth, Nattapol Wuttisantikul, Thanaporn Jaturapolku, Worapanit Kantar, Krittika Wilai, Chiraporn Kongsanun, Sinwanit Yoskaew, Vipaluk patomchaiviwat Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand The development of green material in the last decade has been increased which tends to reduce the impact of human on the environment. Starch has recently become much popular due to its characteristics such as wide availability, low cost and total biocompatibility without toxic residues. Pineapple is one of the economic crops in Thailand. Pineapple starch obtained from left stem and rhizome which is eliminated by burning and causes pollution to the environment.

To increase the value of agricultural residues, the purpose of this study was to investigate the feasibility of pineapple starch as disintegrant in tablets in comparison with corn starch, Explotab® and starch1500®. Tablets were prepared by direct compression. Pineapple starch was used as disintegrant in formulation at the concentration of 2-10% w/w. All concentrations of pineapple starch provided shorter disintegration time than Starch1500®. At the concentration of 6% w/ w, the disintegration time was starch1500® > corn starch > pineapple starch > Explotab®, respectively while at the concentration of 10% w/w, the disintegration time of the formulation containing pineapple starch was not different from that containing Explotab®. The results suggested that pineapple starch, naturally occurring polysaccharide, biodegradable, edible and harmless biopolymer, could be applied as disintegrant in tablet.

Keywords: pineapple starch, disintegrant, stem and rhizome, tablet

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FAPA Congress 2016 | Bangkok, Thailand

S-P-31 PHYLOGENETIC ANALYSIS OF ORF7 NUCLEOTIDE SEQUENCE OF PORCINE REPRODUCTIVE AND RESPIRATORY SYNDROME VIRUS FROM MYANMAR Yamin Ko Ko1, Busaba Powthongchin1, Suang Rungpragayphan2, Aung Myint3, Aung Zaw Latt3 1

Department of Biopharmacy, Faculty of Pharmacy, Silpakorn University, Muang, Nakorn Pathom, Thailand 73000 2 Department of Health-related Informatics, Faculty of Pharmacy, Silpakorn University, Muang, Nakorn Pathom, Thailand 73000 3 Department of Medical Research, Ministry of Health and Sports, Myanmar

Porcine reproductive and respiratory syndrome (PRRS) causes significant economic losses to swine industries worldwide. It was first reported in Myanmar in 2011. Study on epidemiology and diffusion of the causative virus, PRRSV, is important to control the disease. In this study, nucleotide sequence of ORF 7, encoding the nucleocapsid protein, of a PRRSV isolate from central Myanmar (Magway) collected during the outbreak in 2011 was analyzed and compared with those of PRRSV strains published in the NCBI database. The Myanmar isolate showed 93.8% nucleotide homology and 96.8% amino acid similarity with the North American prototype (VR-2332), implying its source of derivation. High level of similarities were found with highly pathogenic HP-PRRS strains such as JXA1 China isolate in 2006 (nt 98.1%, aa 97.6%), DN694 Vietnam isolate in 2008 (nt 96.5%, aa 97.6%), BH58/10 Laos isolate in 2010 (nt 96.8%, aa 97.6%) and HP/Thailand/19500LL/2010 Thailand isolate in 2010 (nt 96.2%, aa 97.6%). Phylogenetic analysis, using Neighbor- Joining method and Maximum- Likelihood model with 1000 Bootstrapping, showed that the Myanmar isolate was in same cluster with HP strains from China, Vietnam, Laos, and Thailand, and closely related to the China strains. Further studies on more isolates and gene segments are required to confirm the genetic characters of the Myanmar PRRSV strain.

Keywords: porcine reproductive and respiratory syndrome virus, ORF 7, highly pathogenic PRRSV, North American genotype, phylogenetic analysis

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FAPA Congress 2016 | Bangkok, Thailand

S-P-32 THE ANTIOXIDANT ACTIVITY OF LEAF METHANOLIC EXTRACTS FROM VARIOUS PIPER SPECIES Yustina Sri Hartini1, Laurentius Hartanto Nugroho2 1

Faculty of Pharmacy, Sanata Dharma University, Sleman Yogyakarta Indonesia 2 Faculty of Biology, Universitas Gadjah Mada, Sleman Yogyakarta Indonesia

Phagocytic cells play an important role in the immune system mechanism. However, when the phagocytic cells were over activated, the cells will be damaged through their Reactive Oxygen Species (ROS) and Nitric Oxide (NO) productions. In the phagolysosome process, inducible Nitric Oxide Synthase (iNOS) and ROS were activated. Nitric oxide is a product of arginin reaction catalyzed by iNOS enzyme. The methanolic extract of Piper crocatum Ruiz & Pav. ( red betel) leaf is an immunostimulant, which is able to increase macrophages phagocytic activity known relatively high. However the mentioned activity did not over produce of NO. The mention condition may be due to the ability of P. crocatum leaf to keep safe the function of immune cells from the effect of macrophage phagocytic over activity. The aim of the current research was to investigate P. crocatum leaf methanolic extract antioxidant activity and then compared to those of rutin and Piper betle methanolic extract. It is known that rutin is an immunostimulant and antioxidant while the methanolic extract of P. betle is an immunosupressant and antioxidant. Furthermore, the P. crocatum antioxidant activity was compared to those of P. aduncum, P. bacatum, P. cubeba, P. longum, and P. nigrum leaf methanolic extracts. The results show that IC50 values of P. crocatum leaf methanolic extract, rutin, and P. betle leaf methanolic extract are 84.341 ± 6878 µg/ml; 0.135 ± 0.0004 µg/ml, and 26.915 ± 0.455 µg/ml respectively. The antioxidant activity of five others Piper species are in progress.

Keywords: Piper crocatum ruiz & pav, extract, antioxidant, piper species

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FAPA Congress 2016 | Bangkok, Thailand

S-P-33 COMBINATION N-HEXANE FRACTION OF ETHANOL EXTRACT OF MORINDA CITRIFOLIA L. FRUIT AND ISONIAZID IN RATS Ediati Sasmito1, Sri Mulyani Mulyadi2, Disa Andriyani3, Nuraini Ekawati3 1

Laboratory of Medicinal Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada 2 Laboratory of Pharmacutical Chemistry, Universitas Gadjah Mada 3 Laboratory of Immunology, Faculty of Pharmacy, Universitas Gadjah Mada.

The purpose of this study was to observe the fractions of non-soluble n-Hexane (NHF) and soluble n-Hexane (SHF) of ethanol extract Morinda citrifolia L fruit combined with Isoniazid (INH) against ALT enzyme activity (ALTA), creatinine concentration (CC), and the ratio of TCD4+ / TCD8+ lymphocyte proliferation ( TCD4+ / TCD8+ PR) and to determine metabolite compounds in both of the fractions by TLC. Forty female Wistar rats, were divided into normal control, negative control (INH 150 mg/kg BW); INH 150 mg/kg BW combined with 15; 30; and 75 mg/kg BW NHF or SHF respectively p.o daily for 8 weeks of study. Blood samples was collected at weeks 0, 4th, 6th and 8th to evaluate ALTA and CC using commercial assay kit and TCD4+ / TCD8+ P using flowcytometri method following administration. The data were statistically analyzed at 95% confidence level. INH 150 mg/kg BW combined with NHF dose of 75 mg/kg in weeks 6th increased TCD4+ /TCD8+ PR, reduced ALTA, but was not significantly influence of CC; INH 150 mg/kg BW combined with SHF dose of 75 mg/kg in weeks 6th 20 mg / kg body weight reduced CC and ALTA. The results of TLC indicated that NHF containing alkaloids, phenolics, flavonoids, and sugar; SHF containing alkaloids, steroids and terpenoids.

It can be proved that NHF or SHF is a potential candidate as INH cotherapy.

Keywords: isoniazid, Morinda citrifolia L., ALT, creatinine, TCD4+/TCD8+ ratio

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FAPA Congress 2016 | Bangkok, Thailand

S-P-34 NIOSOMES CONTAINING SPERMINE-BASED CATIONIC LIPIDS AS CARRIERS FOR SIRNA DELIVERY Samarwadee Plianwong1, Praneet Opanasopit2, Lalita Leksantikul2, Tanasait Ngawhirunpat2, Theerasak Rojanarata2 1

Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand 2 Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand

Small interfering RNA ( siRNA) has been recognized as a useful tool for the treatment of diseases including cancers, infections and inheritable diseases. The efficient delivery system is one of the important processes in siRNA therapy. In this study, cationic niosomes containing spermine-based lipids (Ni-Sp20-Ay, Ni-Sp20-By, Ni-Sp20-Cy and Ni-Sp20-Dy) were formulated for delivering siRNA into HeLa cells stably expressing green fluorescent protein (EGFP). The binding affinity of niosomes to siRNA was evaluated by agarose gel retardation assay. The siRNA could completely complex with niosomes at the weight ratio of 10, 15, 20 and 15 for Ni-Sp20-Ay, Ni-Sp20-By, Ni-Sp20-Cy and Ni-Sp20-Dy, respectively. The zeta potential of niosomes/siRNA became positive at weight ratio of 5, 10, 7.5 and 5 for Ni-Sp20-Ay, Ni-Sp20By, Ni- Sp20- Cy and Ni- Sp20- Dy, respectively. In vitro gene silencing efficiency was determined by measuring the decreasing of fluorescence intensity in cells treated with niosomes/siRNA-EGFP compared with those treated with niosomes/scrambled siRNA. The result showed that the maximum gene silencing efficiency of Ni-Sp20-Ay, Ni-Sp20-By, NiSp20-Cy and Ni-Sp20-Dy was obtained at the weight ratio of 5 (16.10 ± 0.63%), 7.5 (17.93 ± 0.73%), 15 (24.94 ± 4.16%) and 7.5 (18.86 ± 0.89%), respectively. Moreover, the cytotoxicity test

by MTT assay indicated that all niosomes/siRNA complexes showed low toxicity with cell viability more than 80%. In conclusion, the niosomes containing spermine-based lipids could complex with siRNA and efficiently deliver siRNA into the cells without cytotoxicity.

Keywords: siRNA delivery, noisome, spermine-based lipid

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FAPA Congress 2016 | Bangkok, Thailand

S-P-35 ANTI-RHEUMATOID ARTHRITIC ACTIVITY OF PLANTAGO MAJOR L. ETHANOLIC EXTRACT AGAINST THE EXPRESSION OF CYCLOOXYGENASE-2 AND TUMOUR NECROSIS FACTOR-A: AN IN VIVO STUDY ON MALE SPRAGUE-DAWLEY RAT MODELS Dimas A. Pradana1, Eka P. Abimanyu1, Sitarina Widyarini2 1

Pharmacy Department, Faculty Of Mathematics and Natural Sciences, Islamic University Of Indonesia, Yogyakarta, Indonesia 2 Faculty of Veterinary medicine Gadjah Mada University, Yogyakarta, Indonesia

Rheumatoid arthritis is a chronic inflammation autoimmune disease that is characterized by synovial tissue and joint damage. This study aimed to observe the activities of anti-rheumatoid arthritis of Plantago major ethanolic extract against the expression of cyclooxygenase-2 (COX2) and tumour necrosis factor- α ( TNF- α) on the paw tissue of rats induced with Complete Freund's Adjuvant. A total of 24 male Sprague-Dawley rats weighing 200-300 g divided into 6 groups (N = 4) were fed on ad libitum food and drink. Group I (normal) was untreated, while Group II (negative control) was induced by CFA on day 0 and observed on day 30. Group III (positive control) was induced with CFA on day 0, and diclofenac sodium was given orally in a dose of 5 mg/kgBW/day from day 16 to day 29. Meanwhile, Group IV, V, and VI were induced

by CFA on day 0, and the ethanolic extract of P. major was given orally on day 16 in a dose of 280, 420, and 560 mg/kgBW for each until day 29. On day 30, one rat of each group was sacrificed, and then the tissue of their paws was taken and made into preparations to identify the immunohistochemical expression of COX-2 and TNF-α using anti-TNF-α and anti-COX-2.

Observations using a microscope were performed to examine the expression of positive cells, which was characterized by grain brown colour. The analysis of TNF- α expression was conducted using the Kruskal-Wallis test followed by Mann-Whitney test.

Keywords: P. major, rheumatoid arthritis, immunohistochemistry, COX-2, TNF-α

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FAPA Congress 2016 | Bangkok, Thailand

S-P-36 COMBINATION TREATMENT OF ANNONA MURICATA ETHANOLIC EXTRACT WITH CISPLATIN AGAINST BREAST CANCER CELL LINE Normala Abd Latip, Aizuddin Aiman Maon, Muhammad Azlan Hasnan, Muhammad Syahmi Wafiy Mukhtar Universiti Teknologi MARA (UiTM), Puncak Alam, Malaysia Annona muricata or commonly known as guanabana or soursop is often used as a medicinal plant. A. muricata leaves have been reported in numerous studies of human diseases, including cancer (Moghadamtousi et al., 2015). This plant is getting great attention from the public in Malaysia. The leaves and fruits are being consumed with the belief of its curing effects, especially for cancer. This has raised a concern whether the practice of consuming this plant while undergoing chemotherapy is beneficial to the patient. This study showed the treatment of ethanolic leaves extract of A. muricata significantly reduced the ability of cisplatin to inhibit cell proliferation.

Keywords: Annona muricata, breast cancer, combination therapy

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FAPA Congress 2016 | Bangkok, Thailand

S-P-37 ANTIOXIDANT AND ANTITYROSINASE ACTIVITY OF MULBERRY ROOT (MORUS ALBA L.) EXTRACT Faizatun 1, Effionora Anwar2, Etik Mardliyati3 1

Faculty of Pharmacy, Pancasila University, Jakarta, Indonesia Faculty of Pharmacy, University of Indonesia, Depok, Indonesia 3 Pharmaceutical and Medical Technology Center, BPPT, Indonesia 2

The antioxidant and antityrosinase activities of the extract of mulberry root were investigated.

Powder mulberry root passed through a 40- mesh sieve and then followed by ultrasonic extraction with variation concentration of ethanol or methanol for 40 minutes. Extraction solvents were used ethanol 50, 70, 96% and methanol 60, 85, 100%. The results showed that 96% ethanolic extract exhibited the highest radical scavenging and tyrosinase inhibitory activity than the extract with other solvent. High-performance liquid chromatography (HPLC) analysis was employed to determine the oxyresveratrol content in all of extract mulberry root.

Oxyresveratrol levels were the highest in 85% methanolic extract. The amount of oxyresveratrol was very low in all samples, 0,11 â&#x20AC;&#x201C; 0,267%. The levels of the oxyresveratrol varied in different portions of the varieties of solvents. TLC identification of compounds were fluorescent under UV 254 and 366 nm. Spotting of ethanolic 96% and methanolic 100% of the mulberry root extract had fluorescence which was stronger than the other mulberry root extract. Overall, the results showed that extract might serve as a natural antioxidant and tyrosinase inhibitor.

Keywords: mulberry root, antioxidant activity, tirosinase inhibitor activity, oxyresveratrol

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FAPA Congress 2016 | Bangkok, Thailand

S-P-38 PREPARATION AND CHARACTERISTICS OF NANOSTRUCTURED LIPID CARRIER (NLC) LOADED RED GINGER EXTRACT USING HIGH PRESSURE HOMOGENIZER METHOD Siti Sadiah1, Effionora Anwar1, Mahdi Jufri1, Umi Cahyaningsih2 1

2

Faculty of Pharmacy, University of Indonesia,Depok West Java, Indonesia Faculty of Veterinary Medicine, Bogor Agricultural University, Dramaga Bogor West Java, Indonesia

This study presents the preparation of nanostructured lipid carrier ( NLC) loaded extract of Zingiber officinale. Roxc. Var rubrum or Red Ginger ( RG- NLC) using High Pressure Homogenizer method with different the number of cycles. The RG- NLC formulation was characterized with respect to particle size, polydispersity index (PDI), zeta-potential, particle shape and entrapment efficiency. The morphological study was performed by using Zetasizer Nano S and the entrapment efficiency analysis of NLC was performed using HPLC by detecting (6)-, (8)-, (10)-gingerol and (6)-shogaol as active biomarkers. The average particle size for RG-NLCs ranged from size 131 to 154 nm and a polydispersity index of 0.104 to 0.172. The zeta potential of the RG-NLC ranged − 33.00 ± 1.57 to -46.53 ± 0.38 mV and transmission electron microscopy showed that the particles were spherical in shape. Entrapment efficiency was higher more than 98% for (6)-gingerol, but other active biomarkers were less than 96 %.

Keywords: nanostructured lipid carrier (NLC), red ginger, preparation, characterization

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FAPA Congress 2016 | Bangkok, Thailand

S-P-39 EXPLORATION OF IN VITRO ANTIOXIDANT AND FREE RADICAL SCAVENGING ACTIVITIES OF PEDALIUM MUREX Ashokkumar Durairaj1, Narayana Venkata Tanniru2, Nalini Kuppusami3 Pratishta Institute of Pharmaceutical Sciences, Durajpally (V), Chivmla (M), Nalgonda District, Telangana-508214, India 2 Vikas Institute Pharmaceutical Sciences, Nidigutla (V), Near Airport, Rajahmundry, EG District, Andhrapradesh-533103, India 3 Periyar University, Salem, Tamilnadu 1

The exploration of the activity on total antioxidant, reducing power, DPPH radical, superoxide anion radical, nitric oxide radical, hydroxyl radical, hydrogen peroxide scavenging and total phenol content in methanol extract of Pedalium murex (MEPM) were carried out. The total antioxidant activity of MEPM increases with increasing concentration. The reducing capability and free radical scavenging activity in DPPH also increased in dose dependent manner. The MEPM was found to scavenge the superoxide generated by PMS/ NADH/ NBT system.

Moreover, MEPM found to inhibit the nitric oxide radical generated from sodium nitropruside.

MEPM was also found to inhibit the hydroxyl radical generated by Fe3+ /ascorbate/EDTA/H2O2 system. The MEPM scavenges the hydrogen peroxide in dose dependent manner. The amount of total phenolic compounds was also determined. The results suggest that strong antioxidant activity of the methanol extract of Pedalium murex can be used as natural antioxidant.

Keywords: Pedalium murex, in vitro, free radical scavenging, natural antioxidant

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FAPA Congress 2016 | Bangkok, Thailand

S-P-40 THE EFFECT OF VEGETABLE OILS OXIDATION AS LICORICE FLAVONOID OIL EXCIPIENT TO GLABRIDIN MARKER CONTENT Lisma N W Bachtiar, Tutus Gusdinar School of Pharmacy, Bandung Institute of Technology, West Java Indonesia Obesity is a medical condition with excessive body fat. Excess in visceral fat is closely related to type 2 diabetes mellitus. The use of licorice flavonoid oil (LFO) shows a significant decrease in visceral fat. LFO uses a saturated oil named medium chain triglyceride (MCT) as filler oil. In this research, MCT as filler oil was replaced by several saturated fatty acid contained vegetable oils then their oxidative stability was observed by determining glabridin marker. Analytical method of determination glabridin content was validated by using HPLC at 230 nm. This validation fulfilled parameters of specificity, accuracy, repeatability, linearity and robustness (correlation coefficient is 0.988 at range of 80 ppm and 120 ppm). LOD and LOQ are 2.53 ppm and 7.66 ppm respectively. In stability study, concentration of glabridin in MCT, olive oil, corn oil, soybean oil, canola oil, rice bran oil and sunflower oil was not significantly decrease at three weeks storing in closed container, open container and open container added with 0.1 mg copper per kg oil. In grape seed oil, concentration of glabridin was not significantly decrease at three weeks storing in closed container, but it was statistically significant (p < 0.05) decrease at three weeks storing in open container and open container added with 0.1 mg copper per kg oil.

This research showed that olive oil, corn oil, soybean oil, canola oil, rice bran oil and sunflower oil have potential as LFO filler oil.

Keywords: visceral fat, licorice flavonoid oil, glabridin, vegetable oil, unsaturated fatty acid, oxidation

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FAPA Congress 2016 | Bangkok, Thailand

S-P-41 ASSESSMENT OF THE ANTI-EPILEPTIC ACTIVITY OF COSTUS SPECIOSUS (KOENIG) SM. (FAMILY ZINGIBERACEAE) RHIZOME ON CHEMICALLY-INDUCED CONVULSION IN ALBINO MICE Omar A. Villalobos1, Venice Kaye A. Mariano2, Pia Gerolin Penetrante1, Henedina A. Maini1 1

School of Pharmacy, Emilio Aguinaldo College-Manila, Philippines 2 Emilio Aguinaldo College-Manila

Epilepsy is the most frequent neurodegenerative disease. It is a state of recurrent, spontaneous seizures. Most epidemiological studies of convulsion find an incidence rate of 20 to 70 per 100,000 populations per year. The rates are higher in developing countries, where rates are roughly double those in developed countries. C. speciosus (Koenig) Sm. is the only species in the genus Costus that is medicinally important. C. speciosus rhizome was utilized to assess antiepileptic activity using Pentylenetetrazole and Isoniazid induced epileptic mice model. Latency of convulsion, duration of convulsion and mortality were used as parameters for anti-epileptic activity of C. speciosus. Also, neurological effects of C. speciosus extract was assessed using balance beam test. Kruskal- Wallis, Mann-Whitney U Test and Chi Square test were used to evaluate the results. Based on the result obtained, 250 mg/ kg, 500 mg/ kg and 750 mg/ kg significantly elicited anti- epileptic activity ( p- value < 0 . 05) and were comparable to phenobarbital as the standard anticonvulsant drug (p-value >0.05) by delaying the onset of convulsion and shortening of duration of convulsion. Also, C. speciosus extract were able to protect mice from INH-induced convulsion by not convulsing within half of the observation time and reduce the mortality rate of the convulsions induced by PTZ and INH (p-value < 0 .05). C. speciosus also showed no significant difference on neurological effect on mice when compared to the control group.

Keywords: anti-epileptic, C. speciosus rhizome, isonicotinic hydrazine induced convulsion, and pentylenetetrazole induced convulsion

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S-P-42 INDUCTION OF APOPTOSIS BY SHIKONIN THROUGH A ROS/JNKMEDIATED PROCESS IN PRIMARY EFFUSION LYMPHOMA Kumiko Gotoh1, Ryusho Kariya2, Md. Masud Alam2, Azusa Kawaguchi2, Seiji Okada2 1

Radioisotope Center, Institute of Resource Development and Analysis, Kumamoto University 2 Division of Hematopoiesis, Center for AIDS Research, Kumamoto University, Kumamoto

Primary effusion lymphoma ( PEL) is an incurable hematological malignancy and novel biological- based treatments are urgently necessitated in the clinical settings. In the present study, shikonin (SHK), a napthoquinone has been used to investigate the underlying cellular mechanisms of apoptosis as well as the treatment of PEL. MTT assays showed a significant decrease of PEL cells proliferation in vitro. Flow cytometry with annexin V and propidium iodide (PI) double staining revealed that SHK treatment dose-dependently increased the early apoptotic (1.6 % to 63.8 %) cells. Treatment of PEL cells with SHK (2 µM) resulted in profound induction of apoptosis accompanied by rapid generation of reactive oxygen species (ROS), striking activation of c- Jun- N- terminal kinase ( JNK) and p38, marked decrease the mitochondrial membrane potential (Δψm), activation of caspase-9, -8 and -3. Scavenging of ROS in the presence of N-acetylcysteine (NAC) almost blocked the JNK activation, caspase-3 cleavage as well as the induction of apoptosis in the SHK treated PEL cells. Inhibition of caspase activation in the presence of Q-VD-OPh blocked the SHK-induced apoptosis, but didn’t modify SHK-mediated JNK activation or ROS generation. Therefore, ROS and JNK is the trigger of caspase- 3 activation in PEL cells. In a PEL xenograft Nude- Rag2/ Jak3 double deficient mice model, SHK treatment reduced the amount of ascites without showing significant systemic toxicity. These findings demonstrated that SHK would be a potential antitumor agent on the therapeutic treatment of PEL in HIV/AIDS patients.

Keywords: lymphoma, reactive oxygen species

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S-P-43 DEVELOPMENT OF ANDROGRAPHOLIDE - CARBOXYMETHYL CHITOSAN PARTICULATE SYSTEM AS ANTIMALARIAL AGENT: EFFECT OF CROSS-LINKING ON THE PHYSICAL CHARACTERISTICS Retno Sari1, F. Borgia Tedy A1, Sinta Kusuma A1, Aty Widyawaruyanti2 1

2

Department of Pharmaceutics, Faculty of Pharmacy, Airlangga University Department of Pharmacognosy and Phytochemsitry, Faculty of Pharmacy, Airlangga University

The particulate system can be used to improve the bioavailability of drugs, especially for hydrophobic substance. Andrographolide ( ADG) has various activities such as antiinflammatory, hepatoprotective, antiviral and anticancer. Andrographolideâ&#x20AC;&#x2122;s shortage is the low oral bioavailability because it has high lipophilicity, low water solubility and short half-life.

Carboxymethyl chitosan (CMChi) is a polyanionic polymer that biodegradable, biocompatible and non-toxic. Carboxyl group of CMChi can be cross-linked with cationic compounds forming particle systems. The cross-linked system could enhance the ability to entrap the drug and can also be used to control drug release. This study was conducted to determine the effect of crosslinking on the physical characteristics of the particulate system of ADL- CMChi. Particulate systems were made with ionic gelation method - spray drying using CaCl2 as the crosslinker. The particles were evaluated for its particle size and morphology, the interaction of the material, crystallinity, thermal analysis and drug content. The result of SEM results indicates that the non-cross-linked particles have more spherical morphology. From The X-ray diffractogram and DTA thermogram, it was known that the cross-linked particles indicate low intensity of crystallinity compare to non cross-linked particles and physical mixture of ADLCM Chi. The existence of the ADL which is not entrapped and loss of fine particles during the spray drying process affect the recovery of ADL system. The crosslinking process affects the physical characteristics of ADL that result in the decrease in crystallinity and lower melting range that improve its solubility and dissolution then it will has impact on Keywords: andrographolide, carboxymethyl chitosan, particulate system, physical characterization

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S-P-44 ANTICANCER EFFECTS ON CHOLANGIOCARCINOMA CELLS AND ANTIBACTRIAL EFFECTS OF PROPOLIS EXTRACT FROM TETRAGONULA PAGDENI Pattaravadee Srikoon1, Kulwara Poolpol2, Kulthida Vaeteewoottacharn3 1

Faculty of Pharmaceutical Sciences, Burapha University, Chon Buri 20131 Thailand 2 Faculty of Allied Health Sciences, Burapha University, Chon Buri 20131 Thailand 3 Department of Biochemistry, Faculty of Medicine, Khon Kaen University; Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen 40002 Thailand Propolis has been widely reported for the pharmacological effects such as antioxidant, antiinflammation, antibacterial and anticancer, but not cholangiocarcinomas ( CCA) . CCA are malignancies of the biliary duct system that originate in the liver and extrahepatic bile ducts with high mortality rate due to the difficulty in diagnosis and poor prognosis in late stage cancer. Therefore, we collected propolis of Tetragonula pagdeni from particular multiflora fruit garden in Chantha Buri province to investigate. Methanol crude extract of propolis from T. pagdeni was found to have the antibacterial effects on gram positive bacilli such as S. aureus using disc agar diffusion assay at 10 mg/ml. This concentration was found to have antioxidant capacity. Extract was found to inhibit the proliferation of KKU-M213 and KKU-M214 cells by using MTT assay. Anti- migration and anti- invasion were also found significantly by using wound healing and transwell assays respectively. Moreover, the most abundant compound in propolis extract was recently reported which is Îą-mangostin. We further investigated and found that this compound also showed the effects of anticancer on KKU-M213 and KKU-M214 CCA cells and also antibacterial as found in crude extract. In the future, we further analyze the inhibition effects on bacterial growth and anticancer comparing between propolis crude extract and Îą-mangostin in a comparable concentration of this key compound. These findings may lead to the application use of traditional medicine more concretely supporting by scientific approval.

Keywords: propolis, antibacterial, anticancer, cholangiocarcinoma

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FAPA Congress 2016 | Bangkok, Thailand

S-P-45 FORMATION OF PARA-METHOXYCINNAMIC ACID-ßCYCLODEXTRIN INCLUSION COMPLEX USING MICROWAVE IRRADIATION METHOD Dewi Isadiartuti1, Juni Ekowati2, Nabella R. Amalia1 1

Department of Pharmaceutics Faculty of Pharmacy, Universitas Airlangga Surabaya 60286 Indonesia 2 Department of Pharmaceutical Chemistry Faculty of Pharmacy Universitas Airlangga Surabaya 60286 Indonesia

Para- methoxycinnamic acid ( pMCA) , cinnamic derivatives which can be obtained from rhizomes of Kaempferia galanga L. rhizomes, has analgesic activity. However, pMCA has a low solubility in water. The formation of inclusion complexes pMCA and ß-cyclodextrin (ßCD) using microwave irradiation method is an effort that can be done to improve the solubility pMCA. Advantages of microwave irradiation method is a high product yield and short reaction times. This study was aimed to form inclusion complexes pMCA -ßCD with a high water solubility. pMCA- ßCD inclusion complex with molar ratio of 1: 1 prepared by microwave irradiation method at some period of reaction time. The inclusion product obtained was characterized using differential thermal analysis ( DTA) , fourier transform infrared spectroscopy ( FTIR) , and powder X- ray diffraction ( PXRD) as well as the dissolution in comparison with of the starting compound and the complex prepared by physical mixture. The results showed that there was an interaction between the pMCA and ß-cyclodextrin in the formation of inclusion complex and inclusion complex formed using microwave irradiation method has a faster dissolution than the starting compound and the complex prepared by physical mixture.

Keywords: para methoxycinnamic acid, ß-cyclodextrine, inclusion complex, microwave irradiation method, dissolution

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FAPA Congress 2016 | Bangkok, Thailand

S-P-46 VISUALIZATION OF CANCER METASTASIS WITH RADIOLABELED LIGANDS OF KISS1 RECEPTORS BY SPECT. Gotoh Kumiko1, Hasegawa Koki2, Okada Seiji3 1

Radioisotope Center, Institute of Resource Development and Analysis, Kumamoto University, Kumamoto 860-0811, Japan.

2 Center for Instrumental Analysis Kyoto Pharmaceutical University, Yamashina-ku Misasagishichonocho1 Kyoto 607-8412, Japan.

3 Division of Hematopoiesis, Center for AIDS Research, Kumamoto University, Kumamoto 860-0811, Japan.

Single photon emission computed tomography ( SPECT) is one of the molecular imaging techniques that are used as a diagnostic method. With strong sensitivity and high resolution, SPECT also enables us to visualize receptor expression using the radiolabeled ligands. It has been recently reported that kiss1 receptor is widely expressed in various tumors, such as HEK293, B16-BL6, and CHO-K1 cells and its expression is associated with poor prognosis.

Thus, we examined the expressions of kiss1 receptors in various cell lines and developed a measuring method for kiss1 receptor expression in tumor ceHEK293, B16-BL6, and CHO-K1 cellslls. First, the receptor expressions of kiss1 in 11 cell lines (H69, H69AR, H358, H226, H2170, ECC4, MCC13, TT, RIN5F, PC12, MtT/SM) were determined and found in 8 tumors including TT tumor. We then successfully synthesized and radiolabeled a kisspeptin derivative

by Ga-67 to perform SPECT imaging of TT tumor bearing mice. As the results, TT tumor was clearly visualized. Our results suggested that SPECT can be a good candidate for a noninvasive diagnostic tool for tumor metastasis.

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S-P-47 SCREENING OF CURCUMIN AND OTHER DIETARY COMPOUNDS AS HISTONE DEACETYLASE INHIBITORS Nunung Yuniarti, Dwi Jayanti N Utami, Hanifah A Thain Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara Sleman Yogyakarta 55281 Indonesia Recently, many diseases caused by changes in the expression of certain gene are emerged. One of the mechanism that influence gene expression is epigenetic mechanism through the modification of histone proteins, such as acetylation and deacetylation of histones. Histone deacetylation is catalyzed by the histone deacetylase ( HDAC) enzyme that process the withdrawal of acetyl groups from the histone protein. This process next triggered the inaccessible of transcription factors to DNA resulting in a decrease in gene expression.

Therefore, targeting HDAC is necessary to treat a variety of diseases related to the epigenom modification in particular histone deacetylation. The aim of this study was to determine the ability of dietary compounds including curcumin to inhibit the HDAC2 and HDAC8 enzyme.

Dietary compounds are active substances in foods consumed every day. If dietary compounds able to inhibit HDAC and consumed for long time, it would affect gene expression and can be used as a new strategy to prevent, delay, or heal some diseases caused by changes in the transcription epigenom cells. This study was performed in vitro using spectrofluorometri method by measuring the fluoresence intensity. The dietary compounds used were genistein, daidzein, curcumin, allyl sulfide, benzyl isothiocyanate (BITC), and methyl pyruvate. The result showed that genistein, daidzein, curcumin inhibited HDAC2 but not HDAC8. On the other hand, allyl sulfide and BITC inhibited both enzymes. However, methyl pyruvate inhibited neither HDAC2 nor HDAC8.

Keywords: dietary compounds, HDAC, epigenetic, histone

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FAPA Congress 2016 | Bangkok, Thailand

S-P-48 EFFECTS OF GARLIC (ALLIUM SATIVUM L.) POWDER ON THE REPRODUCTION OF MALE SPRAGUE-DAWLEY RATS (RATTUS NOVERGICUS) Azrifitria Azrifitria, Atiek Soemiati, Endah Wulandari, Maharani Pratiwi The Faculty of Medicine and Health Sciences (pharmacy Study Program) Syarif Hidayatullah State Islamic University Jakarta The effects of garlic (Allium sativum L.) powder on the reproduction in male Sprague-Dawley rats were studied. Twenty four male Sprague Dawley divided equally into four groups were administered with the suspension of garlic powder of Allium sativum L bulb by gavage at doses of 50, 100 and 150 mg/kg BW daily for 30 days. Freeze-drying process was used for producing the dried powder of Allium sativum L bulb. The vehicle 0.5 % sodium CMC was used as control.

Data on body weights, testis weight, sperm motility, concentration of sperm, caspase- 3, testosterone and spermicide activity were obtained and analyzed using one-way ANOVA and Tukeyâ&#x20AC;&#x2122;s test. Significant findings were: increased weights of testis (at medium and high doses); decreased sperm motility ( at high doses) ; increased sperm concentration ( at all doses) . No significant effects on the caspase-3 concentration and the level of the testosterone hormones were obtained on the 31th compared to 0 day by paired t-test sample analysis. Spermicide activity of garlic powder (Allium sativum L.) had the minimum effect concentration (MEC) of spermicide at 250 mg/mL. The study result shown that garlic powder at low and medium dose didnâ&#x20AC;&#x2122;t affect the germ cell apoptosis regulation and infertility.

Keywords: Allium sativum l, reproductive organs, spermicide

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S-P-49 CONSTRUCTION OF BHK-21 CELL WITH A STABLE EXPRESSION OF THE GFP-LC3B PROTEIN Wipawan Sirigulpanit Faculty of Pharmaceutical sciences, Burapha University, Chonburi, 20130, Thailand Currently, as the function of autophagy plays an important role in a number of disease, including cancer and infection. The microtubute-associated protein light chain 3B (LC3B) is a key protein in the formation of autophagosomal membranes. Aggregation of GFP-LC3B fusion proteins in the autophagosome observed under inverted-fluorescense microscopy has become widely used as biomaker of autophagy. In this study, a human LC3B nucleotide sequence was amplified by RT-PCR and inserted into pZSGFP-C1 plasmid for expression of the GFP-LC3B fusion protein. The GFP- LC3B plasmid was transfected into BHK- 21 cell using BioRadelectroporation and stable BHK-21 cell line was selected by G418 screening. The formation of autophagosome was observed by fluorescense microscopy. Furthermore, following rapamycin treatment dramatically increased the formation of autophagosomes, while chloroquine treatment induced a significant decrease in the number of autophagosomes. Therefore, it is crucial to construct stable BHK- 21 cell line expressing GFP- LC3B as the formation of autophagosome assay and may contribute to basic investigations of autophagy function or use as drug screening targeted at autophagy in cancer and infection.

Keywords: GFP-LC3B, autophagy, cancer, BHK-21

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S-P-50 IN VITRO AND IN SILICO ANTI-INFLAMMATORY STUDIES ON URENA LOBATA LEAF EXTRACT Yudi Purnomo, Zakiya Yusnur Rafiqa, Doti Wahyuningsih Faculty of Medicine, University of Islamic Malang, Malang 65144 Indonesia Inflammation is the basis for pathogenesis of several diseases. Urena lobata is a medicinal plant that can be found in Indonesia and has been used locally to cure fever. However, its mechanism of action is still unknown. The study was aimed to examine the anti-inflammation effect of U.lobata leaf extract and it's mechanism. In vitro anti-inflammatory study of U.lobata ethanoloc leaf extract was performed using a protein denaturation inhibition assay. Active substances in U. lobata leaf extract identified by liquid chromatography- mass spectrometry ( LC- MS) .

Furthermore, they were used as a ligands that were docked with protein target cyclooxygenase2 (COX-2). Then, inhibitory activity of active compounds was evaluated in silico using a webbased software application (www.dockingserver.com). Ethanolic extract of U.lobata showed a strong anti-inflammatory activity with an inhibitory concentration (IC-50) value of 35 Âľg/ml compared with aspirin used as a standard (80 Âľg/ml). Docking studies showed that stigmasterol, beta- sitosterol, mangiferin and chrysoeriol in U. lobata have a strong inhibitory activity on COX-2, indicating by a low value in both the binding free energy and the inhibition constant. In conclusion, U. lobata leaf extract has anti- inflammatory effects that may act trough the inhibition of COX-2 activity.

Keywords: anti-inflammatory, in silico, in vitro, urena lobata

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S-P-51 CONJUGATION OF BOVINE SERUM ALBUMINE ON THE SURFACE OF PECTIN COMPOSING RIP MJ-C NANOPARTICLES IN THE PRESENCE OF EDAC AS CATALYST Hilda Ismail, Sismindari, Ronny Martien, Firda Juhairiyah Faculty of Pharmacy, Gadjah Mada University, Indonesia.

Some natural active compounds are known as one of emerging approach for the cure of cancer.

One potential candidate for anticancer is the protein fraction of M Jalapa leaf, which consist of Ribosomal Inactivating Proteins (RIPs) called MJ-C. This RIPs is proven to be cytotoxic to breast cancer cell MCF7 and T47D. However, some improvement is still needed due to the low selectivity of RIPs to the targeted cancer cell. A targeted delivery strategy is then developed to lead the drug reaches the target cell, by making it in nanoparticle form which is conjugated with certain specific antibody. The conjugation process to bind the specific antibody on the nanoparticle surface, is accordingly play an important role. In this project, some studies on the conjugation reaction of antibody with pectin that constitutes the RIPs nanoparticle is done.

Here, protein from Bovine Serum Albumin (BSA) as a model for the antibody is conjugated with pectin in the presence of 1-ethyl-3-(dimethyl aminopropyl)carbodiimide (EDAC) as catalyst.

Some factors influencing the conjugation reaction was studied, resulting some information about the optimum pH, concentration and optimum temperature of the conjugation reaction.

Keywords: Mirabilis jalapa l, nanoparticles, conjugation bsa, pectin, EDAC

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S-P-52 INHIBITION OF HEMOZOIN FORMATION IN PLASMODIUM FALCIPARUM BY INDONESIAN MENISPERMACEAE Arba P. Ramadani, Hady A. Tamhid Department of Pharmacy, Faculty of Natural Science and Mathematics, Islamic University of Indonesia, Yogyakarta, Indonesia Malaria is a tropical infectious disease, which continues to be one of the largest public health problems in developing countries. By 2015 there were approximately 303 million cases of malaria with 653,000 deaths, and more than 60% among which were children under the age of 5. Plasmodium falciparum, digest human erythrocyte haemoglobin resulting in the release of potentially toxic free heme . A parasitespecific heme polymerization activity detoxifies the free heme to form hemozoin or malaria pigment .

This biochemical process is the target of the well-known antimalarial drug chloroquine, which is losing its effectiveness due to its resistance. Therefore, the heme polymerization activity remains a potential target. In this study, we investigated several Indonesian menispermaceae that traditionally used for malaria treatment and its antiplamodial activity has been proved by previous study. We found that ethanolic extract of Arcangelisia flava and Tinospora crispa, and methanolic extract of Cyclea barbata have promising result on haem polymerization inhibition activity with the IC50 4 . 669 mg/ mL, 3. 929 mg/mL, and 5.76 mg/mL respectively, compared to chloroquine.

Keywords: Haem polymerization, malaria, Indonesian menispermaceae

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S-P-53 DEVELOPMENT AND EVALUATION OF KETOPROFEN TRANSDERMAL FILM Oktavia Indrati, Muhammad G. Aryadi, Aris P. Kusuma Department of Pharmacy, Universitas Islam Indonesia, Yogayakarta, Indonesia Ketoprofen, a non-steroidal anti inflammation drugs, can cause gastrointestinal irritation when used orally. This problem can be overcome by transdermal drug delivery system. The aims of this study were to formulate ketoprofen into transdermal film dosage form and evaluate its physical characteristics and in vitro penetration. The transdermal film was made by solvent casting method, combination of hydroxypropyl methyl cellulose (HPMC) and Eudragit RS 100 was used as a film former, while propylene glycol fuctioned as the penetration enhancer and plasticizer. Characterization of transdermal film included thickness, weight variation, folding endurance, drug content, pH evaluation, and in vitro penetration study using Franz cell diffusion. Smooth and transparent transdermal films were obtained. The results showed that the amount of propylene glycol affect on the physical characteristics of the ketoprofen transdermal film and also its in vitro penetration.

Keywords: transdermal, ketoprofen, penetration enhancer, propylene glycol

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S-P-54 ACTIVITIES OF ETHANOL EXTRACT FROM DIPLAZIUM ESCULENTUM LEAVES AGAINST DPPH AND ARTEMIA SALINA LARVAE Tiah Rachmatiah1, Puput Sri Andayani2 1

Faculty of Pharmacy, The National Institute of Science and Technology (ISTN), Jakarta, Indonesia 2 The National Institute of Science and Technology (ISTN), Jakarta, Indonesia.

Activity studies of fern leaves, Diplazium esculentum (Retz) Sw, have been conducted. The purpose of this study was to determine antioxidant activity and toxicity of ethanol extract of the fern leaves. Sample was obtained from traditional market in Bogor, West Java, Indonesia.

Phytochemical screening showed that the fern leaves contain flavonoids, saponins and tannins.

Extract of the fern leaves was prepared by maceration prosedure in 96% ethanol. Antioxidant activity test was carried out by DPPH radical scavenging assay (1,1-diphenyl-2-picrylhydrazyl) and the toxicity by using Brine Shrimp Lethality Test against Artemia salina Leach larvae. The results showed that the ethanol extract of the fern leaves has radical scavenging activity with IC50 of 15.61 µg / ml and potentially toxic to the larvae of Artemia salina Leach with LC50 of 87.09 µg / ml.

Keywords: Diplazium esculentum, antioxidant, toxicity, DPPH, Artemia salina, ethanol extract

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S-P-55 DEVELOPMENT AND EVALUATION OF ORAL DISPERSIBLE TABLET (ODT) FORMULATION USING DIFFERENT TYPES OF COEXCIPIENTS Kampanart Huanbutta1, Yugesvaram Vedewellu2, Pornsak Sriamornsak3 1

Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131 Thailand 2 School of Pharmacy, Management & Science University, Malaysia 3 Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Objective: To develop and evaluate diclofenac sodium as oral dispersible tablets (ODTs) using different types of co-excipients. Methods: The ODTs were prepared by direct compression technique as it is a favorable and cost effective way to produce tablets with sufficient structural integrity. Three different co-processed excipients were used including F-Melt® type C, F-Melt® type M and Pearlitol Flash® along with conventional excipient, Mannitol for comparative purpose of the study. The formulated tablets were evaluated for various physical tests like hardness, thickness, diameter, friability, disintegration time and dissolution profile. Among all the formulation evaluated, the best condition of ODTs from each excipient formulation were selected for in- vitro dissolution, in- vivo drug disintegration and taste evaluation studies.

Results: Among all the formulation, ODTs diclofenac sodium prepared by using F-Melt M, coprocessed excipient, with compression force of 1ton for 5sec was superior in term of mechanical strength, disintegration and dissolution profile compared to other formulations. It shows ODTs diclofenac sodium prepared with F- Melt M provide a tablet hardness of 19.74±1.24 kg/cm2, disintegration time of 53.4±4.72 seconds, and more than 100% drug being released within the first 3 minutes. Conclusion: The results suggested that the co-processed excipient system F-Melt type M act as a satisfying combination of excipient with the active pharmaceutical ingredient (API), Diclofenac Sodium in developing ODTs. Thus, scale studies can be performed for application at industrial sites.

Keywords: oral dispersible tablet, co-excipients

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S-P-56 COMBINATION OF TEMPUYUNG EXTRACTS (SONCHUS ARVENSIS L.) AND EARTHWORM (LUMBRICUS RUBELLUS) SHOWS FIBRINOLITYC ACTIVITY USING FIBRIN PLATE METHOD Rochmy Istikharah, Annisa Fitria, Yandi Syukri, Diny Lidya Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta 55584 Indonesia Earthworms has been widely examined as fibrinolytic due to containing lumbrokinase enzymes. However, its combination with tempuyung containing a luteolin as an antioxidants do not understand yet. The aims of this research was to analyze fibrinolytic activities from combination of tempuyung leaves extracts (Sonchus arvensis L.) and earthworm (Lumbricus rubellus) and effect of tempuyung leaves extracts to the fibrinolytic activities of earthworm powder. Identification of lumbrokinase was performed with molecular weight test using SDSPAGE technique, while fibrinolytic activities were analyzed using fibrin plate method with nattokinase as positive control. The results showed that lumbrokinase has molecular weight at 24, 26, 29 and 32 kDa. The combinations of tempuyung extracts and earthworm show fibrinolytic activity and combination of 1 mg tempuyung extract and 0.6 mg earthworm has the highest fibrinolytic activities, which is 27 units/mg. In addition, the higher concentrations of tempuyung extracts do not show any influence to the fibrinolytic activities of earthworm powder. Therefore, we may conclude that there is possibility to produce herbal medicine of combination of earthworm and tempuyung leaves extracts, which has fibrinolytic activity.

Keywords: Sonchus arvensis, earthworms, fibrinolytic, fibrin plate

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S-P-57 IN-VITRO DETERMINATION OF THE ANTIOXIDANT PROPERTY OF THE PULP EXTRACT OF ARTOCARPUS ODORATISSIMUS BLANCO (MARANG) Angelita A. Rodriguez, Olive M. De Vera, Maria Suzette S. Silva College of pharmacy, our lady of Fatima University,Valenzuela city Philippines The study aims to determine the antioxidant property of the Pulp Extract of Artocarpus odoratissimus Blanco(Marang) in order to make use of the pulp as a source of drug for medicinal purposes. The pulp of the fruit samples were collected and air â&#x20AC;&#x201C;dried . It was macerated with 80% of ethyl alcohol for 48 hours and extracted, evaporated to dryness. The phytochemical constituents of the crude extract include saponins, glycosides, flavonoids , alkaloids ,tannins, polyphenols sterols, reducing sugars, and carbohydrates and proteins as well as cardenolides.

The antioxidant property was determined using DPPH and hydrogen peroxide assay.

Artocarpus odoratissimus Blanco( Marang) extract based on the phytochemical Screening results contains alkaloids ,glycosides, flavanoids, cardenolides, anthraquinones, carbohydrates, proteins, fixed oils, tannins and polyphenols .The 75% concentration of the pulp crude extract of Artocarpus odoratissimus Blanco(Marang) exhibited the highest antioxidant property followed by the 50% concentration . The DPPH assay method gave the highest inhibition percentage compared with the Hydrogen peroxide assay. The F statistics for comparing negative, positive and experimental control at 25mg%, 50mg% and 75mg% concentration are 61176.341, 3533.606 and 852.814, respectively. All computed F are greater than the critical F value of 5.1433 which indicates that negative, positive and experimental control are significantly different with each other (p < 0 .05). Thus rejecting the null hypothesis that there is no significant difference in the antioxidant property of the pulp extract of Artocarpus odoratissimus Blanco(Marang) and the positive and negative control.

Keywords: antioxidant, Artocarpus odoratissimus Blanco, DPPH assay, free radical, hydrogen peroxide

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S-P-58 EFFECT OF BIOPOLYMER TYPE ON PHYSICAL PROPERTIES AND STABILITY OF RESVERATROL-LOADED EMULSIONS Porntip Benjasirimongkol, Pornsak Sriamornsak Department of Pharmaceutical Technology, and Pharmaceutical Biopolymer Group (PBiG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand The aim of this study was to study the effect of biopolymer type on physical properties and stability of resveratrol- loaded emulsions. Resveratrol- loaded emulsions were prepared by simple homogenization. Imwitor® 742 (5-10% w/ w) was used as an oil phase. Biopolymers investigated were pectin ( high methoxy pectin ( HMP) and low methoxy pectin ( LMP) ) , chitosan (M.W. 22,000 Da (22kCS) and 45,000 Da (45kCS)), and sodium alginate (Manugel® DMB ( MDMB) ) , at the concentration of 2% and 3% w/ w. The droplet size, zeta potential, viscosity and morphology of emulsions were examined. The stability of emulsions after storage at ambient temperature ( 25° C) for 7 days and under environmental stress condition ( i. e. , centrifugation test) was investigated by visually observed percent creaming and automatic stability analysis. From the results, resveratrol-loaded emulsions containing 3% HMP, or 3% 45kCS could load higher amount of oil phase (10%) than those containing 3% MDMB (only 5% ) . After centrifugation test, phase separation was not observed for all 7- day stable formulation. However, the results by automatic stability analyzer showed slight phase separation. MDMB provided the highest emulsion viscosity. After 7 days, droplet size of emulsions containing 45kCS and MDMB was not different from day 0. But the size of HMPcontained emulsions significantly increased.

Keywords: emulsions stability, pectin, chitosan, sodium alginate

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S-P-59 TERNARY SOLID DISPERSIONS OF MANIDIPINE WITH COPOVIDONE AND TPGS FOR IMPROVING DRUG SOLUBILITY AND PHYSICAL STABILITY Benchawan Chamsai, Pornsak Sriamornsak Department of Pharmaceutical Technology, and Pharmaceutical Biopolymer Group (PBiG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand Solid dispersion is well established as a formulation system for enhancing the solubility and stability of poorly water-soluble drug. In the present study, ternary solid dispersions (tSD) of manidipine (MDP) with D-a-tocopherol 1000 succinate (TPGS) and copovidone was prepared by melting method. Solid ternary phase diagram was constructed in order to find the homogeneous and non- homogeneous region of the tSD. The potential interaction between MDP and excipients were investigated by Fourier transform infrared (FTIR) spectroscopy. The solubility and stability studied were also investigated. The results showed that tSD in the homogeneous region provided a transparent mass. FTIR results indicated that strong hydrogen bonding between MDP and copovidone was presented, leading to a significant increase in the solubility and dissolution of MDP. The solubility studied show a good linear relationship between MDP solubility and concentration of TPGS; the solubility increased with the increased TPGS in the formulation. After storage at ambient temperature ( 28°C) and under accelerated condition (40°C/75%RH) for 3 months, the tSD showed a higher solubility than that of initial preparation. The results suggested that the tSD not only increased MDP solubility but also improved drug stability.

Keywords: manidipine, ternary solid dispersion, melting method, copovidone, TPGS, solubility

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FAPA Congress 2016 | Bangkok, Thailand

S-P-60 EFFECT OF MOLECULAR STRUCTURE OF ACTIVE PHARMACEUTICAL INGREDIENTS ON PHYSICAL PROPERTIES OF EMULSIONS Srisuda Konthong, Pornsak Sriamornsak Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand The aim of this study was to investigate the effect of molecular structure of active pharmaceutical ingredients ( APIs) on the physical properties of emulsions. The APIs, poorly water- soluble drugs, studied were mefenamic acid, indomethacin, itraconazole, ketoconazole and clotrimazole. The emulsions were prepared by a simple homogenization, using pectin as an emulsifier. Chloroform was used as an oil phase. The effects of type and concentration of pectin and different APIs on the size and size distribution were investigated. The results showed that droplet size and size distribution of the prepared emulsions depended on concentration of pectin. The emulsions obtained from high methoxy pectin (HMP) and pomelo pectin showed that the droplet size decreased with an increased pectin concentration. The size of emulsions containing different APIs (i.e., mefenamic acid, indomethacin, ketoconazole and clotrimazole) was in the micrometer range. The exception is for the emulsions containing itraconazole, which demonstrated the smallest droplet size, in the nanometer range, for HMP and pomelo pectin. It is likely that the added itraconazole molecularly associated with pectin.

Keywords: pectin, emulsions, active pharmaceutical ingredients, molecular structure, physical properties

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FAPA Congress 2016 | Bangkok, Thailand

S-P-61 SYNTHESIS AND CHARACTERIZATION OF THIOLATED PECTIN AND PECTIN-DOXORUBICIN CONJUGATES Pornsak Sriamornsak1, Sathit Niratisai2, Kamonrak Cheewatanakornkool1 1

Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 73000, Thailand 2 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 73000, Thailand

A prodrug strategy was developed for targeted delivery of doxorubicin, a commonly used anticancer drug. For this purpose, the chemical conjugation of doxorubicin onto thiolated pectin was carried out. Firstly, thiolated pectin was synthesized through covalent bond between pectin and cystamine dihydrochloride. Then, the thiolated pectin was conjugated to doxorubicin by oxidation of thiol reaction, which is provided by the formation of disulfide bridges. The zeta potential value of oxidized polymer exhibited more negative, indicating the free thiol group ( - SH) . The successful reaction was confirmed Fourier transform infrared spectroscopy; the peaks at 1,620 and 1,745 cm- 1 were observed. The pectin- doxorubicin conjugates showed the cross- linking efficiency of 18- 33% , depending on pectin type, molecular weight and mole ratio between thiolated pectin and doxorubicin. Scanning electron microscopic images demonstrated that the appearance was not changed after passing through the reaction process. The results suggested that the pectin- doxorubicin conjugates represent promising anticancer drug delivery system.

Keywords: thiolate polymer, polymer-drug conjugate, thiolated pectin, pectin-doxorubicin conjugates, anticancer drug

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FAPA Congress 2016 | Bangkok, Thailand

S-P-62 PRODUCTION OF GAMMA-AMINOBUTYRIC ACID-ENRICHED MUNG BEAN SPROUTS USING COMMON HOUSEHOLD REAGENTS Theerasak Rojanarata1, Samarwadee Plianwong2, Praneet Opanasopit1, Tanasait Ngawhirunpat1 1

2

Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand

Because of several health benefits of GABA, the development and production of GABAenriched plants as nutraceuticals is currently of interest and actively pursued. Here, a facile method to produce GABA-enriched mung bean sprouts is presented using common household reagents. It was found that germinated mung beans soaked with 6 mM monosodium glutamate flavor enhancer solution of which the pH was deliberately adjusted to 5 by using distilled white vinegar for 3 days contained a significantly higher GABA level ( 57. 0 mg/ g dry weight) than that of non-germinated seeds (2.1 mg/g dry weight) and that of germinated seeds soaked with water, pH 7 ( 12. 2 mg/ g dry weight) . Since mung bean sprouts are familiar foods and the reagents used here are easily obtainable and generally recognized as safe, the proposed germination protocol can be practically applied to the production of bean sprouts with enhanced nutritional values.

Keywords: GABA, enrichment, mung bean, germination

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FAPA Congress 2016 | Bangkok, Thailand

S-P-63 CHEMICAL COMPOSITION AND CYTOTOXICITY OF CRUDE EXTRACTS FROM BROUSSONETIA LUZONICA (MORACEAE) BLANCO LEAVES AGAINST HEPATOCELLULAR CARCINOMA (HepG2) CELL LINES Franelyne P. Casuga, Agnes L. Castillo, Mary Jho-Anne T. Corpuz Faculty of Pharmacy, University of Santo Tomas, Manila Context: Chemical compounds present in plants can be potential sources of new drugs. Studies confirm compounds isolated from other Broussonetia sp. were proven to possess pharmacologic activities. To date there are no published scientific evidence to prove the cancer therapeutic potential of Broussonetia luzonica Blanco ( Moraceae) . Objective: To investigate the chemical composition and cytotoxicity of the different extracts from B. luzonica leaves.

Materials and Methods: The powdered air dried leaves were subjected to sequential extraction using three solvents of increasing polarity, namely: nn-hexane, ethyl acetate, and methanol to obtain three different extracts. Their components were determined using gas chromatographymass spectrometry and their cytotoxicity against hepatocellular carcinoma (HepG2) cell lines was evaluated using 3- ( 4,5- dimethylthiazol- 2yl) - 2,5- diphenyltetrazolium bromide ( MTT) assay after 24 hours. Results: The three major compounds present in the methanolic extract are lupeol (21.973%), triatriacontane (16.67%) and γ-sitosterol (14.754%). The n-hexane crude extract contains squalene comprising ( 29. 028% ) followed by tetracosane ( 8. 626% ) and tricontane (7.341%). The ethyl acetate crude extract has phytol (20.288%), 1,2,3-Propanetriol, monoacetate (21.211%) and squalene (6.8%). MTT assay revealed that compared to positive control (Doxorubicin) with IC50 of 5.068 µg/mL, methanol and ethyl acetate extracts exhibited greater cytotoxic effect against HepG 2 cell lines with IC50 of 1.865 µg/mL and 1.119 µg/mL, respectively. The n-hexane extract with IC50 of 31.707 µg/mL indicates lower cytotoxic effect than the standard. Discussion and Conclusion: The results of the study showed that methanol and ethyl acetate extracts from the leaves of B. luzonica manifested more potent cytotoxic activity than the positive control ( Doxorubicin) , indicating promising chemotherapeutic potential of the plant.

Keywords: HepG2 cell lines, cancer, sequential extraction, MTT, GC-MS analysis, endemic

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FAPA Congress 2016 | Bangkok, Thailand

S-P-64 SYNERGISTIC ANTIBACTERIAL ACTIVITY OF MANGOSTEEN EXTRACT AND CHITOSAN-EDTA ON ORAL PATHOGENS Wipada Samprasit1, Praneet Opanasopit2, Ruchadaporn Kaomongkolgit3 1

Department of Pharmaceutical Technology, Faculty of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand 2 Pharmaceutical Development of Green Innovations Group (PDGIG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 73000, Thailand 3 Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand The pericarp of mangosteen ( Garcinia mangostana) has been used as a traditional medicine against infectious diseases such as skin infection and amoebic dysentery. Chitosan also provided antibacterial activity that is an attractive preparation widely used as a pharmaceutical excipient. Thus, the aim of the study was to investigate the antibacterial activity of mangosteen extract, chitosan- ethylenediaminetetraacetate ( EDTA) derivative and the combination of mangosteen extract and chitosan- EDTA against oral bacterial pathogens. The minimal inhibitory concentrations (MIC) and minimal biocidal concentrations (MBC) were determined.

A checkerboard assay was used to evaluate the antibacterial efficacy of the combination of mangosteen extract and chitosan-EDTA. The results showed that mangosteen extract gave the low MIC and MBC values against Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans and Streptococcus sanguinis than those exhibited by chitosan- EDTA. The possible antibacterial activity of mangosteen extract was the induction of a rapid dissipation of membrane potential and leakage of intracellular components. The mechanism of chitosan was the interference of anionic component of the bacterial cells. Checkerboard assay results indicated a synergistic antibacterial activity of the mangosteen extract and chitosanEDTA against these oral pathogens. These findings suggest the use of mangosteen extract as an antibacterial agent in pharmaceutical preparations in combination with chitosan-EDTA. Keywords: mangosteen, chitosan, EDTA, synergistic antibacterial agents, oral pathogens

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FAPA Congress 2016 | Bangkok, Thailand

S-P-65 IN-VIVO EVALUATION OF THE ANTI-INFLAMMATORY EFFECTS OF THE DIFFERENT DOSE LEVELS OF 0.5 % (W/V) CHITOSAN SOLUTION ON LIPOPOLYSACCHARIDE (LPS)-INDUCED INFLAMMATION IN SPRAGUE-DAWLEY RATS Aleth Therese L. Dacanay, Ross D. Vasquez, Renz Kenneth G. Cadiang, Richard G. Ferrer Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines Chitosan is an abundant biopolymer which has many biomedical and pharmaceutical properties. The study aims to evaluate the anti- inflammatory activity of 0. 5% w/ v Chitosan Solution ( CS) against LPS- induced Sprague- Dawley rats. Anti- inflammatory effect was assessed using C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR). Results showed that CS significantly decreased CRP levels and ESR results in the blood in doseâ&#x20AC;&#x201C; dependent manner (p < 0 .05). Histopathological studies were also conducted.

Keywords: anti-inflammatory, chitosan, CRP, ESR, inflammation, lipopolysaccharide, LPSinduced

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FAPA Congress 2016 | Bangkok, Thailand

S-P-66 IN VIVO EVALUATION OF THE WOUND-HEALING ACTIVITY OF WATER-SOLUBLE CHITIN FROM SHELLS OF LITOPENAEUS VANNAMEI (PENAEIDAE) AGAINST HYPERGLYCEMIC SPRAGUEDAWLEY RATS INDUCED WITH STREPTOZOTOCIN AND NICOTINAMIDE Aleth Therese L. Dacanay, May T. Magtoto, Angelica Jane T. Domalanta Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines Wound- healing is a dynamic process which encompasses phases of inflammation, proliferation, and remodeling. It is affected by conditions such as elevated blood glucose levels, which serve as an initial barrier to healing wounds in hyperglycemic patients. This study was done to evaluate and establish the wound- healing property of topically applied water- soluble chitin (WSC) in hyperglycemic rats. Chitin was isolated from shells of Litopenaeus vannamei (Penaeidae) through chemical treatment and was made water-soluble through alkali treatment.

The WSC yielded a yellow osazone crystal with Phenyl Hydrazine Test and it turned black upon performing the Chitosan Color Test. These results confirm that the isolated substance is chitin. Scratch and Patch tests were done to four rabbits for dermal irritation test. Results revealed that there was no edema or erythema on the skin surface of the rabbits; thus, WSC was non-irritating. A group of Sprague-Dawley rats (n=10) were made hyperglycemic through administration of nicotinamide ( 230 mg/ kg) intraperitoneally followed by streptozotocin ( 50 mg/kg) intravenously. Each hyperglycemic rat received two lateral incisions, one treated with WSC ( 0. 05 g/ mL) and the other served as the negative control. After 10 days, rats were euthanized and wound-breaking strengths were measured. Tissue samples were harvested and subjected to histopathological examination. Results suggested that the wounds treated with WSC have significantly greater wound- breaking strength ( p < 0 . 0001) and re- epithelialized extensively compared to the control. As a conclusion, the WSC does not cause hypersensitivity in the skin of rabbits and can be a possible alternative to heal wounds in hyperglycemic rats.

Keywords: wound-breaking strength, incision, scratch test, patch test

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FAPA Congress 2016 | Bangkok, Thailand

S-P-67 IN-VIVO EVALUATION OF THE PREVENTIVE EFFECT OF THE ETHANOLIC LEAF EXTRACT OF HIBISCUS ROSA-SINENSIS LINN. (MALVACEAE) ON CALCIUM OXALATE CRYSTALS IN ETHYLENE GLYCOL AND AMMONIUM CHLORIDE-INDUCED HYPEROXALURIA IN ADULT MALE ALBINO SWISS MICE Aleth Therese L. Dacanay, May T. Magtoto, Greogorio L. Martin, Christine Joy H. Acosta Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines Urolithiasis, the formation of stones caused by the supersaturation of urine. Hibiscus rosasinensis Linn. ( Malvaceae) , known in the Philippines as gumamela have numerous pharmacologic uses. The researchers evaluated gumamela for its antiurolithiatic activity.

Thirty-six male Albino Swiss mice were randomly divided into 6 equal groups. Group I served as the normal group. Groups II, III, IV, V, and VI received ethylene glycol ( 0. 75% v/ v) and ammonium chloride ( 2% ) from day 4 up to day 10. Group II served as the negative control.

Group III ( positive control) received 25mg/ kg Hydrochlorothiazide; groups IV, V, and VI ( preventive groups) received 250mg/ kg, 500mg/ kg, and 1000mg/ kg of ethanolic extract respectively from day 1 up to day 10; first three days as prophylaxis. The mice 24- hour urine samples were collected on day 0, 3, and 10 and was examined for the presence of calcium oxalate crystals. On the 10th day, sub- mandibular blood collection was used for testing of biochemical parameters. The urine crystals of group I (p=0.105), group III (p = 0.368), group IV (p =0.097), and group V (p =0.174) did not have significant changes. However, the urine crystals of the group II significantly increased (p=0.022), specifically at day 10 while the urine crystals of group VI had continuous decrease (p=0.016) from baseline to day 10. The decrease in calcium oxalate crystallization was due to the ability of the ethanolic leaf extract to prevent urinary supersaturation of calcium oxalate in a dose dependent manner. To conclude, gumamela ethanolic extract has a significant therapeutic potential for Keywords: urolithiasis, calcium oxalate, blood urea nitrogen, serum creatinine

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FAPA Congress 2016 | Bangkok, Thailand

S-P-68 FORMULATION AND EVALUATION OF TOPICAL DRUG DELIVERY SYSTEM FOR GOSSYPIN Prasanna D Kumar1, Venkateswara P Rao2, Vijay K3 1

Student of Pharmacy, Sri Sivani College of Pharmacy, NH-5, Chilakapalm Jn., Etcherla(M), Srikakulam Dt, Andhra Pradesh, India- 532402 2 Faculty of Pharmacy, Sri Sivani College of Pharmacy, NH-5, Chilakapalm Jn., Etcherla(M), Srikakulam Dt, Andhra Pradesh, India- 532402 3 Faculty of Pharmacy, Acharya nagarjuna University, Nagarjuna Nagar, Guntur- 522510 Herbal medicines are in great demand in both developed and the developing countries in primary healthcare because of their great efficacy and little or no side effects. Gossypin a pentahydroxy flavone glucosidic compound isolated from Hibiscus Vitifolius is proven to have Anti- Inflammatory property however the same activity as a formulation is still not provided.

The study is aimed at development of topical therapeutic system from Gossypin for the treatment of todayâ&#x20AC;&#x2122; s major problem that is inflammation which may be caused due to several reasons. In the present study gels with Carbopol 974P, HPMC E5cps, Eudragit RS100 were prepared with different permeation enhancers like DMF, DMSO and PEG400. The formulations were characterized for various parameters such as spreadability, viscosity, pH, drug content, Invitro drug release studies and accelerated stability studies. The best formulation of gel was then evaluated for anti- inflammatory activity, skin irritation study and stability study.

Keywords: gossypin, carbopol, hydroxy propyl methyl cellulose, anti-inflammatory studies

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FAPA Congress 2016 | Bangkok, Thailand

S-P-69 ANTISPASMODIC AND ANTI-INFLAMMATORY ACTIVITY OF CLERODENDRUM MINAHASSAE (LAMIACEAE) CRUDE LEAF EXTRACT Kay Ann J. Tongol1, Joseph Mari Baguilod Queriquencia2 1

Department of Pharmacy, College of Nursing and Allied Medical Sciences, Wesleyan University - Philippines, Cabanatuan City, Nueva Ecija, Philippines 2 Pharmacy Department, San Pedro College, Davao City, The Graduate School, University of Santo Tomas, Espana, Manila Clerodendrum minahassae Teijsm. & Binn. is an endemic from the Philippines and is known as bagawak puti that differentiates the plant from Clerodendrum quadriloculare which known as bagawak morado. The plant contains phytochemicals which may contribute to its documented biological properties. Local and international literature have mentioned medicinal uses of the plant for gastric disorders prompting this paper to investigate on the claims as published in literature. Clerodendrum minahassae was subjected to phytochemical analysis by thin layer chromatography, smooth muscle modulating effects using isolated rat ileum and tracheal rings, and anti- inflammatory in- vitro test using 15- Lipoxygenase inhibitory activity.

Phytochemical analysis revealed presence of flavonoids, steroids, triterpenes, coumarins, tannins, phenolics and alkaloids. Organ bath study of the isolated rat ileum is comparable to the relaxation activity of the acetylcholine-induced contraction (EC50 = 1599 µg/mL ± 0.00), as with the standard antagonist, Atropine (p>0.05). Likewise, the same relaxation activity was noted for the organ bath study of isolated rat tracheal rings of the histamine-induced contraction (EC50 = 1370 µg/mL ± 0.03), as with the standard antagonist, theophylline (p>0.05). While the anti- inflammatory potential was established through significant inhibition of15- lipoxygenase enzyme ( with an IC50 value of 0. 38 mg/ mL) compared to ibuprofen ( IC50 = 0. 35 mg/ mL) .

Result of the present study indicates the potential use of Clerodendrum minahassae as an effective treatment for smooth muscle spasm.

Keywords: Philippines, antispasmodic, inflammation

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S-P-70 STABILITY STUDY FORMULATION PLGA (POLY LACTIDE-COGLYCOLIDE) NANOPARTICLES AS CARRIER DEXAMETHASONE SODIUM PHOSPHATE WITH PVA (POLYVINYL ALCOHOL) VARIANCE Bambang H Nugroho, Oktavia Indrati, Adri Alfiza Department of Pharmacy, Universitas Islam Indonesia Polymeric nanoparticles are colloidal carriers in size from 10-1000 nm based on biodegradable and biocompatible polymeric systems that have largely influenced the controlled and targeted drug delivery concept. Nanoparticle had limitation of stability due to interaction of the particle, stability of nanoparticles can be enhanced by stabilizer agents such as PVA (Polyvinyl Alcohol) by preventing agglomeration. This study aims to determine the stability of the formulation of PLGA nanoparticles as carriers of dexamethasone sodium phosphate in the various pH of phosphate buffers. Nanoparticles formulation was made by solvent evaporation method, varying the amount of PVA 1%, 2,5%, and 5%. The particles size, polidispersity indexs (PDI) and zeta potential PLGA nanoparticles was evaluated for 14 day. Formula PVA 2.5% had the better stability with the smaller of the particle size and polydispersity index with the value of the zeta potential most negative in all phosphate buffer pH compared by the formula PVA 1% and formula PVA 5%. Addition of PVA 2.5% can enhance stability of PLGA nanoparticle.

Keywords: dexamethasone sodium phosphate, stability, poly lactide-co-glycolide (PLGA), polyvinyl alcohol (PVA)

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FAPA Congress 2016 | Bangkok, Thailand

S-P-71 DIMINUTION OF DEMENTIA AND COGNITIVE DYSFUNCTION BY PI3K INHIBITOR IC87114 IN ICV-STZ INDUCED SPORADIC ALZHEIMER'S DISEASE RAT MODEL Ramesh Alluri1, A Sivamallikarjuna Reddy1, Supriya Reddy1, Narayana TV2 1

Department of Pharmacology, Vishnu Institute of Pharmaceutical Education and Research, Narsapur, Medak Dist., 502313 2 Vikas Institute of Pharmaceutical Sceinces, Nidigatla village, Korukonda Mandal, Near Airport, Rajahmundry, E.G. Dist, Andhra Pradesh - 533103

Sporadic Alzheimer’s disease is an age allied neurological and psychiatric disorder branded by impaired energy metabolism. Oxidative stress and neuro-inflammation were associated in pathophysiology of sporadic type of dementia. The quest for chemical entities able to kerb the action of the PI3K/AKT/mTOR pathway is evolving as a potential therapeutic stratagem for the treatment and/or prevention of brain aging disorder sporadic Alzheimer’s Disease. The Intra-cerebroventricular (ICV) administration of streptozotocin prompts behavioral and biochemical changes resembling those in sporadic type of Alzheimer’s patients. The current study was intended to investigate the effects of pre-treatment with selective phosphoniositide3 kinase (PI3K) delta inhibitor IC87114 on cognitive dysfunction and oxidative stress markers in ICV streptozotocin-treated albino rats. Treatment with IC87114 orally on a daily basis for a period of 21 days, 1 hr prior to intra-cerebroventricular streptozotocin injection, significantly improved streptozotocin-induced cognitive impairment. Besides, improving cognitive dysfunction, administration of selective PI3K inhibitor IC87114, reduced elevated nitrite levels, and restored reduced glutathione and superoxide dismutase levels, lipid peroxidation, total protein content. In addition, administration of Ic87114 abridged beta amyloid in the cortex region. Taken together, these results demonstrate that PI3K inhibitor IC87113 can be helpful in treatment of sporadic Alzheimer’s disease.

Keywords: Alzheimer's disease, phosphoinositide-3 kinase inhibitor, ic87114, intracerebroventricular administration

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FAPA Congress 2016 | Bangkok, Thailand

S-P-72 INTER-INDIVIDUAL VARIABILITY OF CYTOCHROME P450 2A6 ACTIVITY IN JAVANESE SMOKERS’ URINE Christine Patramurti1, Sudibyo Martono2, Sugiyanto2, Arief Nurrochmad2 1

Faculty of Pharmacy, Sanata Dharma Universtiy, Indonesia 2 Faculty of Pharmacy, Gadjah Mada University, Indonesia

The rate of nicotine metabolism is hypothesized to be a determinant of how much a person smokes, that is, rapid metabolizers would be expected to smoke more than slow metabolizers.

Nicotine is metabolized extensively by the liver enzyme cytochrome P450 2A6, primarily to cotinine. Cotinine then metabolized by cytochrome P450 2A6 to 3’-hydroxycotinine. The ratio of metabolite to parent (i.e., 3OH-Cot/Cot) would be expected to reflect CYP2A6 activity. The ratio of 3OH-Cot/Cot in the 50 urine smokers was measured by HPLC method with a C8 fully endcapped residual silano-type column coupled and UV detection with liquid-liquid extraction.

The ratio of 3OH-Cot/Cot was positively correlated with the number of cigarettes smoked per day ( r = 0. 327, p = 0. 020) . This finding supports the hypothesis that the rate of nicotine metabolism is a determinant of the level of cigarette consumption and supports the use of the 3OH-C/COT ratio as a noninvasive marker of nicotine metabolism.

Keywords: nicotine, cotinine, trans-3′-hydroxycotinine, cytochrome P450 2A6

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FAPA Congress 2016 | Bangkok, Thailand

S-P-73 ANALGESIC EFFECTS OF ETHANOL EXTRACT CASHEW LEAF (ANACARDIUM OCCIDENTALE L) IN MICE WITH WRITHING METHOD Maria Hilaria, Elisma, Dwi P. Suyono Department of Pharmacy, Health Polytechnic of Kupang, Indonesia Many studies dealing with the effects of analgesic cashew nut leaves had been done in animals as well as in human being. Meanwhile, some herbal medicine companies included cashew nut leaves as one of the component of their product to relieve muscle and back pain. So far infusionis tne preparation used in previous studies, so the dose given is high enough, it had unfavourable taste and may caused nausea and vomiting. Due to the reason mentioned aboved, the purpose of this study is to prepare an extract form which can be used in smaller dose.

Twenty five strains of Swiss mice were divided into 5 groups. Test material is given orally.

Group I CMC Na 0.5% w/v and group II was given acetaminophen 0.5% w/v. The group III was given ethanol extract cashew 25% w/v, group IV 50% w/v, group V 100% w/v. After 15 minutes of administration material test, acetic acid dose of 300 mg/ kgbw was given in i rapwritonial. The cumulative number of mice for 60 minutes stretching the calculated % power analgesic and analyzed by one way Anova and SNK test with a level 95%. The result showed that the ethanol extract cashew ( Anacardium occidentale L) 25% w/ v and 50% w/ v showed tbe analgesic effects not equivalent to acetaminophen ( p 0. 05) whereas at a concentration of 100% w/v had an equivalent analgesic dose of acetaminophen.

Keywords: analgesic, ethanol extract, cashew leaf, writhing method

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FAPA Congress 2016 | Bangkok, Thailand

S-P-74 PREPARATION AND EVALUATION OF IMMEDIATE RELEASE ALPHA-MANGOSTIN TABLET USING SELF-EMULSIFYING SYSTEM Kun Sodalee, Chaleeya Visetsripong, Papawee Laohasinnarong, Waree Limwikrant, Satit Puttipipatkhachorn* Department of Manufacturing Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand *

Correspondence: satit.put@mahidol.ac.th

Alpha-mangostin (AMG) derived from mangosteen pericarp has various interesting biological activities, such as antioxidant, anti- bacterial and anti- inflammatory. AMG possesses poor aqueous solubility, therefore it is challenging to improve bioavailability in product development. Recently, we reported the solubility enhancement of AMG by self- emulsifying drug delivery system ( SEDDS) . The purpose of this study was to prepare and evaluate the immediate release AMG tablets using SEDDS ( AMG- SEDDS tablet) . Liquid- SEDDS of AMG, mixture of Captex速 200 P, Tween速 80 and CapryolTM 90 was prepared and adsorbed with solid carriers, including PVP K30 and PVP K90 to obtain the solid- SEDDS. The solidSEDDS was completely blended with diluents consisting of Cellactose速 80, Avicel速 PH102, sodium bicarbonate and citric acid. The powder mixture equivalent to AMG 5 mg was compressed to a tablet by direct compression. The physical characteristics and dissolution of AMG- SEDDS tablets were evaluated. The content uniformity, hardness and friability of the AMG-SEDDS tablets were acceptable. The results indicated that the tablets using SEDDS with PVP K30 and PVP K90 disintegrated within 15 and 5 min, respectively. Moreover, the dissolution studies revealed that 68% and 79% of AMG were released from the tablets with PVP K30 and PVP K90 at 60 min, respectively. It was concluded that the release of AMG from tablets could be improved significantly by using SEDDS. Keywords: alpha-mangostin, solid self-emulsifying drug delivery system, solid carrier, tablet, dissolution

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FAPA Congress 2016 | Bangkok, Thailand

S-P-75 LOW DENSITY FLOATING TABLETS PREPARED BY HOT MELT EXTRUSION: IMPACT OF THE DRUG LOADING AND POLYMER BLEND Worawut Kriangkrai1, Satit Puttipipatkhachorn2, Pornsak Sriamornsak3, Florence Siepmann4, Juergen Siepmann4, Srisagul Sungthongjeen1,* 1

Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand 2 Department of Manufacturing Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand 3 Department of Pharmaceutical Technology, and Pharmaceutical Biopolymer Group (PBiG), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand 4 University of Lille, College of Pharmacy, INSERM U1008, 3 Rue du Prof. Laguesse, Lille, France *

Correspondence: sungts2000@yahoo.com

The low density floating matrix tablet based on porous foam powder prepared by hot melt extrusion (HME) was developed in order to prolong the gastric residence time and to increase the overall bioavailability of the drug. The floating tablets consist of riboflavin- 5- phosphate ( model drug) , polyethylene oxide ( PEO, matrix forming polymer) and polypropylene foam powder (low-density substance). Incorporation of foam powder led to increasing porosity and decreasing density of the tablets. The tablets could float immediately and maintained flotation longer than 8 h with the optimized level of foam powder. In this work, impacts of drug loading and polymer blend on properties of the floating tablet were investigated. The pressure during hot melt extrusion process continuously increased with increasing drug loading and caused increasing tablet density. Time to float was observed and increased with increasing drug loading due to the higher density of the system. Moreover, prolonged drug release of the floating tablet occurred. To optimize the drug release, Kollidon速 SR ( polyvinyl acetate and povidone based matrix retarding polymer) was used as a polymer blend ( with PEO) . The increasing ratio of Kollidon速 SR decreased the drug release and did not affect on floating properties of the system. In conclusion, low density floating tablet was successfully prepared by hot melt extrusion. Drug release was affected by drug loading and could be modified by a ratio of PEO and Kollidon速 SR. The tablets exhibited initial floatation and retained buoyancy with the sustained release profile.

Keywords: floating tablets, hot melt extrusion, polypropylene foam powder, polyethylene oxide, Kollidon速 SR

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FAPA Congress 2016 | Bangkok, Thailand

S-P-76 COMPARATIVE IN VITRO EQUIVALENCE STUDIES OF HYDROXYCHLOROQUINE TABLET USING VARIOUS BINDER Ulfi Bahari1, Chitra Fadilla Dzulfia2, Ai Surtiati1 1

Formulation Deveopment, Kimia Farma Research and Development, Bandung 40171 Indonesia 2 Analytical Method Deveopment, Kimia Farma Research and Development, Bandung 40171 Indonesia Many SLE sufferers have problems to finding hydroxychloroquine tablet for their medication; however, in Indonesia there is no pharmaceutical company which produce this tablet. The aim of his study was to develop formulation so the in vitro dissolution result will be similar to Plaquenil in order to assure good result in bioequivalence test. Plaquenil which is the innovator drug has an in vitro dissolution profile in which only 30- 40 % of hydroxychloroquine sulfate is dissolved after 10 minutes, whereas the hydroxychloroquine sulfate itself has an intrinsic dissolution rate of 80- 90% dissolved drug in 10 minutes. Therefore, the dissolution of hydroxychloroquine sulfate has to be retarded in order to match Plaquenilâ&#x20AC;&#x2122;s dissolution profile.

Wet granulation method with different binders was used to retard dissolution of hydroxychloroquine sulfate in tablets. Povidone ( 0. 25 to 3. 0% of Kollidon K- 30) , polymethacrylates (0.5 to 5.0% of Eudragit L100) and hydroxypropyl cellulose (2.0 to 6,0 % of Klucel HxF) were among the binders used in this study. The dissolution profile was determined using USP paddle apparatus at 50 rpm in 900 mL in each of the following media: Hydrochloric acid (pH 1.2), phosphate buffer (pH 4.5) and (pH 6.8). The dissolution tests were performed on 12 tablets with sampling at 0, 10, 15, 20, 30, 45, and 60 minutes. Samples were analyzed by UV spectrophotometry method. The best result was observed from the formulation using 6. 0% of Klucel HxF, it showed similarity with the innovator drug in three dissolution medium and gave values of f1 < 5 and f2 > 60.

Keywords: hydroxychloroquine, in-vitro, bioavailability, dissolution, binder

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Poster presentations II. Hospital and Clinical Pharmacy

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H-P-1 DRUG EFFECTIVENESS ANALYSIS AND DRUG EFFICIENCY ANALYSIS IN THE USE OF TWO KINDS OF CEPHALOSPORIN ANTIBIOTIC FOR CHILDREN WITH PNEUMONIA IN SALAK HOSPITAL BOGOR INDONESIA Masruchin Zuhairi, Ferry Effendy, Delina Mkes Hassan, Masruchin Zuhairi Pancasila University, Jakarta, Indonesia The use of antibiotic in Salak Hospital cover 27 % of total drug Cost in Salak Hospital in 2014Sefotaksim and sefritiakson are 2 kinds of cephalosporin which are used in the treatment of child pneumonia. The research objective The research aim to know the cost effectiveness and the efficiency of cefotaxime and cefriatiaxone in the treatment of child pneumonia in Salak Hospital Bogor The research execution Data are takenretrospectively from patients medical record provided by Salak Hospital Administration The subject of this study are 84 patients with pneumonia which 42 patients recieve cefotaxime therapy and 42 patients recieve ceftriaxone With Chi-square analysis there are signicanf differrence between two regiment therapy and the biggest therapy effectivness occur on the patient who receive cefotaximThe lowest cost of therapy occur to the patient who recieved cefotaxim compare to cost of therapy of ceftriaxoneConclusionIn Salak Hospital , the use of cefotaxime more effective and efficien compare to the use of ceftriaxone for child pneumonia treatment Keywords: cephalosporin, antibiotic, effectiveness analysis

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H-P-2 CLINICAL EFFECTS OF PROBIOTICS ON THE IMMUNE EFFECTS TO INFLUENZA VACCINATION IN PATIENTS: A META-ANALYSIS OF RCTS Jiun-Jie Lin Department of Pharmacy, Feng-Yuan Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C Objective: Probiotic usage is beneficial to patients in preventing infections and could enhance the effects of influenza vaccination. However, these effects have not been fully elucidated in some studies. Materials and methods: Randomized controlled trials ( RCTs) were identified from the electronic databases: the Cochrane Library, MEDLINE, and PubMed web of knowledge. The trials compared the immune effects of probiotics versus placebo to vaccination in patients. Statistical analysis was performed using by RevMan5. 3 software from Cochrane Collaboration. Results: A total of 43 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article in four reports, involving 196 patients, immunoglobulin (IgA, IgG and IgM) and influenza-specific immunoglobulin (sIgA, sIgG and sIgM ) were not significantly affected in patients by either treatment. Conclusion: Our study showed immunoglobulin and influenza- specific immunoglobulin were not significantly affected in patients by either treatment. Treatment with probiotic usage should be attempted to evaluate the onclusions: effectiveness and further investigation is needed for developing influenza infections.

Keywords: probiotic, immunoglobulin, meta-analysis

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H-P-3 META-ANALYSIS OF THE EFFICACY OF CARRAGEENAN NASAL SPRAY IN THE TREATMENT OF COMMON COLD Nalinee Poolsup1, Lalita Poolsup2, Siree Disawat1, Prommin Issarolarn1, Parnpat Na Chiangmai1, Sopaporn Srisuan1 1

2

Faculty of Pharmacy, Silpakorn University, Nakhon-Pathom, Thailand Faculty of Humanities and Social Sciences, Suan Dusit University, Bangkok, Thailand

Common cold is the most widespread infectious disease in humans. It is a benign self-limiting illness. However, it can sometimes be serious and complications may also occur. Carrageenan is sulphated polysaccharides derived from red seaweed. It has been shown to possess antiviral activity. Clinical studies have reported conflicting results of the effect of carrageenan in treating common cold. We undertook a systematic review and meta- analysis to assess the efficacy of carrageenan nasal spray in the treatment of common cold. Clinical trials were systematically searched from PubMed, The Cochrane Library, CINAHL, NCCIH, clinicaltrials.gov, Web of Science and Scopus up until April 2016. The following MeSH terms were used: carrageenan, nasal sprays, common cold, respiratory tract infections, and antiviral agent. The reference lists of retrieved articles were also screened for relevant studies. Language restriction was not imposed. To be included in the meta-analysis, a study had to be randomized double- blind controlled trial comparing carrageenan nasal spray and placebo in patient with common cold and reporting total symptom scores. Treatment effect was estimated with mean difference and adverse event with odds ratio. Three trials involving a total of 380 patients met the inclusion criteria and were included in the meta- analysis. Carrageenan nasal spray was more effective than placebo in reducing total symptom severity (mean difference -0.58; 95%CI -1. 09 to -0. 08, p-value = 0.02). The risk of severe adverse events did not differ between the two groups ( OR 0. 71; 95% CI 0. 22- 2. 31) . In conclusion, carrageenan nasal spray may be effective and safe for treating common cold.

Keywords: carrageenan, common cold, systematic review, meta-analysis

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H-P-4 Pharmaceutical care in warfarin overdose in-patient department in Central Chest Institute of Thailand Yuppadee Innoi, Sirijit Rattanawai Central Chest Institute of Thailand, Pharmacy, 74 Tiwanon road Tambon Bangkrasor Nonthaburi 11000 Thailand This study is a retrospective descriptive to find causes of warfarin overdose and the appropriate solutions to prevent warfarin overdose in patients at the Central Chest Institute of Thailand.

The study reviewed 75 inpatients profiles between January 1st 2012 and December 31st 2014 whose INR are more than 5, regardless of the presenting of bleeding and whose INR are less than 5 with presenting of bleeding. The study showed that cause of warfarin overdose are as following result. First, too high of warfarin dosage was found in 11 patients ( 14. 67% ) .

Prescribing error by increasing dosage of warfarin for 50% from 14 mg/ wk to 21 mg/ wk.

Secondly, a drug- drug interaction between amodarone and warfarin was found in 10 patients (13. 33%). An anti-inflammation drugs- warfarin interaction was found in 9 patients (12%).

Herbal medicine-warfarin interaction was found in 8 patients (10.67%). Thirdly, a drug-disease interaction, a decompensated heart failure was found in 8 patients ( 10. 67% ) . Lastly, noncompliance was found in 7 patients (9.33%) by taking wrong dose from the patients. According to causes mentioned above, these are solutions recommended. Firstly, all patients have to be educated or informed about warfarin application. Secondly, medication reconciliation system has to be improved. To apply a computerized drug interaction program is third solution. Final suggestion is to offer an advice to doctors an appropriated dose adjustment of drug. I would recommend the author to revise his/her article again.

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H-P-5 EFFICACY AND SAFETY OF FEBUXOSTAT IN PATIENT WITH HYPERURICAEMIA AND GOUT Shu-Chao Huang1, Mei-Jung Huang2, Chung-Hsuan Wang3, Fang Yu Wang4 1

Department of Pharmacy, Show Chwan Memorial Hospital, Changhua, Taiwan 2 Department of Pharmacy, Wu Xing Pharmacy, Changhua, Taiwan 3 Department of Medicine, Wu Xing Clinic, Show Chwan Memorial Hospital, Changhua, Taiwan 4 Department of Nursing, Chung Shan Medical University, Taiwan Background： Allopurinol has been widely used for the treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase, has been approved by the US Food and Drug Administration for the treatment of hyperuricemia in patients with gout. This study was to explore the efficacy and safety of new drug febuxostat for the treatment of hyperuricemia and gout. Methods： We conducted a retrospective study data collected between April 2013 to March 2014, the diagnosis code (ICD-9-CM -2740: gouty arthritis, 2749: gout).The patients have hyperuricemia and gout which were treated with febuxostat, tracking of serum uric acid ( SUA) changes and was used SPSS 17. 0 for statistical analysis. Results： The 115 patients ( 74. 8% male) had a mean (SD) age of 61.7 ± 17.1 years. At baseline, the mean serum uric acid (SUA) was 9.5 ± 2.1 mg/dL. Kidney disease was present in 71.2% of the population, hypertension was 47%.The 27 (23.4%) patients with allopurinol therapy hyperuricaemia and 26 (22.6%) with allopurinol plus colchicine. After treatment with febuxostat, with significant decrease in the serum uric acid (SUA) (9.5 ± 2.1 mg/dL vs 6.3 ± 1.8 mg/dL, −3.2 mg/dL, p < 0.001). The most common adverse events in the treatment group were liver-function test abnormalities (6.1%), skin rash ( 2. 6% ) , and nausea ( 1. 7% ) . Conclusions： It is recommended when hyperuricemia were difficult to control, liver and kidney dysfunction in patients with gout, new drug febuxostat provide another option.

Keywords: hyperuricemia, gout, serum uric acid, febuxostat, allopurinol

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H-P-6 EVALUATING BLEEDING RISK FACTORS OF DABIGATRAN AND RIVAROXABAN IN PATIENTS WITH ATRIAL FIBRILLATION- A 2YEAR OBSERVATIONAL STUDY Hsiu Ju Hsu Department of Pharmacy, Tainan Municipal Hospital, Taiwan Objective New oral anticoagulants (NOACs), including dabigatran and rivaroxaban have been developed as alternatives to warfarin in the prevention of stroke for patients with atrial fibrillation. We conducted a 2-year observational study and evaluated the bleeding risk factors of Dabigatran and Rivaroxaban in the treatment of atrial fibrillation. Method All patients with atrial fibrillation who received dabigatran or rivaroxaban and visited our hospital between January 2014 and December 2015 were enrolled. Data which included patient demographics, serum creatinine values, concurrent medications, profile of bleeding complications ( major bleeding, intracranial hemorrhage, minor bleeding) were collected. SPSS software was used for data analysis. Logistic regression analysis was performed to determine the risk factors for bleeding events. Results As a result, the dabigatran group consisted of 89 patients and the rivaroxaban group consisted of 93 patients. Logistic regression analysis revealed that advanced age and deteriorated renal function were risk factors for bleeding in the dabigatran group, while in the rivaroxaban group, there were no independent factors correlating with bleeding.

Keywords: dabigatran, rivaroxaban, novel oral anticoagulants (NOACs), bleeding, atrial fibrillation

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H-P-7 THE OUTCOME OF THE PHARMACEUTICAL CARE IN PATIENTS TAKING WARFARIN IN THE WARFARIN CLINIC, PRACHUAP KHIRI KHAN NETWORK. Sakonwan Pounghom1, Onanong Hongchumpae1, Seerasa Saeneaw2 1

2

Pharmacy Department, Hua-Hin Hospital, Prachuap Khiri Khan 77110 Thailand Chief of Heart Center, Prachuap Khiri Khan Network, Prachuap Khiri Khan 77110 Thailand

Warfarin is a narrow therapeutic index (NI) drug and have to closely monitor the international normalized ratio for preventing of adverse events, especially bleeding and thrombosis.

Prachaupkhirikhan Province have set the warfarin clinic in 8 hospitals in 2015 to promote the target range of INR and increase the effectiveness and safety in patients by the multidisciplinary care team under the guidance of Huahin Hospital. The aim of this study is to determine the outcome of the pharmaceutical care in patients taking anticoagulant at warfarin clinic in the 8 Hospitals of Prachuap Khiri Khan Province. The activities of the pharmaceutical care in patient taking warfarin and pharmacists roles were set in (1) education of warfarin dosage adjustment to general practitioner, (2) academic conference setting, (3) referring or passing on patient data to another hospital, (4) investigating an drug-related problems, and (5) patient education. Among 813 patients-taking warfarin have been recorded between 2014 and 2015. Around half of all (43.5%) are arrhythmia patients. We found that most of patients (82.4%) have a normal target INR range (2.0-3.0). 1,582 drug-related problem were found. The highest DRPs were classified into dosage to high (35.2%) and dosage to low (33.5%). Major bleeding and minor bleeding were found lower in 4 and 65 times, respectively. There are no thromboembolism event. In conclusion, the pharmacists in Warfarin Clinic have a crucial role with the multidisciplinary care team in promoting the INR being in the target range, increasing safety and effectiveness of therapy, and enhancing patient compliance.

Keywords: warfarin, pharmacist, International normalized ratio (INR), Prachuap Khiri Khan Network

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H-P-8 EVALUATED THE EFFICACY AND SAFETY OF DAPAGLIFLOZIN COMBINED WITH HYPOGLYCEMIC DRUGS IN TYPE 2 DIABETES MELLITUS PATIENTS Hui-Chen Lo, Shih Chen Yi, Li Chih Yung Department of Pharmacy, Tainan Municipal Hospital, Taiwan, R.O.C Background: Dapagliflozin is a new class of oral anti- hyperglycemic drugs: sodium- glucose cotransporter 2(SGLT2) inhibitors. Studies of dapagliflozin have demonstrated efficacy both as monotherapy and in combination with oral antihyperglycemic agents and insulin.Objective: This study aimed to evaluate whether dapagliflozin was synergistic with other antidiabetic drugs without lipid abnormality in type 2 diabetes mellitus patient. Materials and methods: This retrospective study was collected the database in one regional teaching hospital from May 2015 to April 2016, and included the type 2 diabetes mellitus patient who took dapagliflozin combined with conventional antidiabetic drugs for at least 6 months. Patients were divided to group A ( HbA1c < 8 % ) , group B ( HbA1c : 8- 9% ) and group C ( HbA1c>9% ) by baseline HbA1c separately. We compared the changes of HbA1c and LDL- cholesterol after treatment with dapagliflozin. Further more, we compared the changes of HbA1c between different groups. Statistical comparisons were by Student t- test or ANOVA as appropriate. Data were given as mean ± standard deviation. Results: 44 patients was included in this study and the baseline characteristics of patients were summarized. After 6 moths of treatment with dapagliflozin, the HbA1c was significantly deceased to 1 mmol/ mol ( 1. 07±1; p= 0. 000) , and there was no statistically differences of LDL level(2±5.802; p=0.647). The changes of HbA1c was significantly different between three groups (p=0.053) and group C deceased more HbA1c than other groups ( 1. 65±1. 0896; p= 0. 008) . Conclusion: We found that dapagliflozin was synergistic with other antidiabetic drugs without lipid abnormality in type 2 diabetes mellitus patient.

Keywords: dapagliflozin, combination therapy in type 2 diabetes mellitus

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H-P-9 ADEQUATE TRAINING IMPROVES THE PRECISE RATE OF INHALATION TECHNIQUE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE Hui-Chi Chang1, Shiuan-Pey Lin2, Chi-Chih Kuo3 1

Department of Pharmacy, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C 2 School of Pharmacy, China Medical University, Taichung, Taiwan, ROC 3 Division of Chest, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C Background：Proper use of inhaler devices is strongly associated with disease control.

Respimat® Soft Mist™ Inhaler is a new type of inhaler devices.We found that outpatients used these inhaler devices could be associated with inadequate inhalation technique and affected disease control in our hospital.Methods：Inhalation educational intervention for patients with COPD trial is an open-label trial, conducted in 5 pharmacists in our hospital, enrolling patients prescribed daily COPD medication. Inhaler technique was evaluated using a standard checklist of recommended steps, with 1 point given for each step performed correctly (maximum score = 8, “correct technique”). Median score was calculated after each session and was compared before and after an educational intervention. Each patient was followed up at the one-month follow-up visit and the re-evaluated the same way. All statistical analyses were performed using SPSS by an academic statistician. Two-sided P values of < 0 .05 were considered significant. Results： From September 2015 to March 2016, there were 32 patients with COPD used Respimat® Inhaler for the first time. No one (0%) of the 32 subjects performed all the steps of inhaler usage correctly, and 17(53.1%) of the 32 subjects after an educational intervention. After a one-month follow-up visit, 27(84.4%) of the 32 subjects (p < 0 .001) performed all the steps of inhaler usage correctly. Conclusions：The intervention improved the precise rate of inhaler use in patients with COPD evaluated using a standard checklist of recommended steps, and inhalation technique at the one-month follow-up visit.

Keywords: respimat inhaler, COPD, inhalation technique, patient education

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H-P-10 BEVACIZUMAB-ASSOCIATED RECTAL PERFORATION IN A PATIENT WITH GLIOBLASTOMA MULTIFORME Hsiu Ju Hsu, Pei Lin Wu Department of Pharmacy, Tainan Municipal Hospital, Taiwan Objective: To report a case of rectal perforation in a patient receiving bevacizumab for glioblastoma multiforme (GBM). Case Summary: A 63-year-old female with GBM who had experienced adverse reactions to temozolomide was treated with bevacizumab (10 mg/kg every other week). After five cycles of chemotherapy, the patient had a fever and severe abdominal pain for 3 days. Abdominal computed tomography showed pneumoperitoneum and multiple diverticula in the sigmoid colon. Under the impression of hollow organ perforation, the patient underwent an emergency operation. The patient was discharged 8 days after the surgery and received only supportive care and nutritional supplements for GBM. Discussion: Gastrointestinal perforation is a rare but a potentially lethal complication of bevacizumab treatment; the risk varies with tumor types. There are few case reports of rectal perforation associated with bevacizumab, particularly of patients with GBM. This case was classified as a possible adverse reaction of bevacizumab according to the Naranjo probability scale.

Conclusions: Although the occurrence of this side effect is rare and the pathophysiology is not yet understood, clinicians should be alert for signs and symptoms of gastrointestinal tract disorders in patients undergoing therapy with bevacizumab.

Keywords: bevacizumab, glioblastoma multiforme, rectal perforation

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H-P-11 DEVELOPMENT OF PRESCRIPTION SCREENING SYSTEM TO DETECT DRUG RELATED PROBLEMS IN IN-PATIENT PHARMACY DEPARTMENT AT PRASAT NEUROLOGICAL INSTITUTION Kwanchai Bunrukchai, Sermsook La-ongsuwan Department of Pharmacy, Prasat Neurological Institute, Bangkok ,10400 Thailand Drug- related problems ( DRPs) are the most common issues that found in the patient which admitted to the hospital, due to the complicated diseases and several types of medicine. DRPs has been detected prior to the patient, it could reduce severity from such problems eventually.

Therefore, the objective of this study was to set up prescription screening system for detection, solving and prevention in DRPs systematically. This study was prospective descriptive study, to detect and monitor DRPs of patients which admitted to Prasat Neurological Institution during January 2015 to September 2015. DRPs were detected by the pharmacist in inpatient pharmacy services who reviewed physicianâ&#x20AC;&#x2122; s medication orders by using Prescription screening criteria which approved by Medication Safety Committee. The result revealed that 64 of DRPs (12.2%) from 525 events of prescription screening. Among detected DRPs, the most frequency type of DRPs was an inappropriate dose of antimicrobial agents in patient with renal insufficiency ( 50% ) , followed by drug- drug interaction ( 21. 9% ) and improper drug selection ( 12. 5% ) , respectively. From result of DRPs, the pharmacist recommended to prescribed physician and found that physician accepted pharmacistâ&#x20AC;&#x2122;s recommendation much more 78.13%, followed by 71. 43% and 87. 5% , respectively. From the result of DRPs above, we specify the policy to prevent the most DRPs and conduct multidisciplinary guideline to monitor adverse drug reaction from antimicrobials usage. This study shows that pharmacist in inpatient pharmacy services play the important role in early detection of DRPs and reduces the severity of adverse drug events by using prescription screening criteria which are standardized by the multidisciplinary team.

Keywords: prescription screening, drug related problems, in-patient pharmacy

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H-P-12 AN ANALYSIS OF EFFECTIVENESS OF PHARMACIST RECOMMENDATION FOR DOSING ADJUSTMENT OF ANTIBIOTICS IN PATIENTS WITH RENAL DYSFUNCTION Wen-Hwang Chen1, Min-Si Li2 1

Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

2 Critical Care Department of Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan Background: Use of inappropriate dosage of antibiotics is common in elderly patients with renal dysfunction. This study is to investigate and analyze the influence of pharmacist before and after their recommendations on the impact of renal function in these patients. Method: This is a retrospective study. Data collection from January 2015 to December 2015. A total of 1340 cases were screened and only 117 were enrolled but only 82 cases were analyzed completely.

Indicators in assessing renal function we used serum creatinine, eGFR and CKD-EPI(The Chronic Kidney Disease Epidemiology collaboration equation glomerular filtration rate). We analyze the changes in the indicators by comparing before and after the antibiotic adjustments.

Result: Mean age is 69.64 ±16.39. Piperacillin / tazobactam, ampicillin / sulbactam and Vancomycin were the top 3 mostly needed to be adjust. After the recommendations, 45.12% there renal function improved, 45.12% no change in their renal function and 9.8% of these patients renal function deteriorated. The average difference before and after the recommendation showed creatinine in the range of 0.556±0.14 mL / dL,95% confidence interval 0.277 ~ 0.835 (p < 0.05), eGFR -9.08±3.27 mL /min, 95% confidence interval -15.58 ~ -2.59(p =0.007), CKD-EPI -9.84±2.15 mL /min ,95% confidence interval -14.11 ~ -5.559(p < 0.05). Discussion: The use of antibiotics without proper renal dose adjustment or change to a non-nephrotoxic antibiotic can further worsen patients of renal function. There are a statistical significance findings in our study and importantly there is a great reduction in renal function deterioration after our recommendation.

Keywords: antibiotic, renal dysfunction, dosing adjustment

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H-P-13 ACUTE KIDNEY INJURY IN THERAPY WITH ENTECAVIR OR TENOFOVIR FOR CHRONIC HEPATITIS B PATIENTS Yi-Chun Hung1, Chen-Fan Wen2, Kee-Ching Jeng1, Pei-Liang Chen1 1

Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taiwan. Taichung County Pharmacist Association, Taiwan.

2 Departments of Medical Research, Tungsâ&#x20AC;&#x2122; Taichung MetroHarbor Hospital, Taiwan

Background information: Long-term therapy with nucleos(t)ide analogues have been reported with the decline of creatinine clearance for chronic hepatitis B patients. Purpose: We are interested to find out the risk of entecavir (ETV)- and tenofovir (TDF)-associated nephrotoxicity in these patients with or without diabetes. Methods: We retrospectively analyzed the data between October 2006 and December 2014 from 691 chronic hepatitis B patients. The cumulative incidences of acute kidney injury (AKI) were calculated by the Kaplan-Meier method with either ETV (N = 580) or TDF (N = 111) treatment. AKI was defined as an increase in serum creatinine (SCr) 0.3 mg/dL from baseline or a decrease in the estimated glomerular filtration rate. Results: The incidences of AKI between non-diabetic ETV and TDF treated patients were not significantly different. However, a significant difference of AKI (P < 0 .001) was found between diabetic and non-diabetic patients treated with ETV or TDF. TDFtreated diabetic patients had more severe AKI than ETV-treated one at 6-, 12-, 18, and 24 months (P < 0 .001). Conclusion: Taken together, these results indicate that both TDF and ETV could damage kidney and raise serum creatinine in certain condition. It suggests that TDF should be used with more caution in patients with diabetes or even a mild renal dysfunction.

Keywords: tenofovir, creatinine, renal dysfunction, chronic hepatitis b

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H-P-14 IMPROVEMENT FOR THE COMPLETENESS OF ANTIBIOTICS PRESCRIPTION REVIEW SYSTEM Yi-Chun Hung, Pei-Liang Chen Department of Pharmacy, Tungs Taichung MetroHarbor Hospital, Taiwan. Taichung County Pharmacist Association, Taiwan.

Background: Antibiotic resistance is a global public health issue and the hospital care system must reduce this threat. Therefore, an antibiotics approval window by infectious physicians is implemented in the computerized physician order entry ( CPOE) . Purpose: We revised the antibiotics approval window of CPOE in the early 2016, because the old version could not provide a complete reasoning of prescribing antibiotics. The conformity rates for the reason to use antibiotics in this window were compared from these two versions. Methods: We studied the conformity of the reason data, one- month before and after revision of the antibiotics approval window of CPOE. The data were then analyzed by chi-square test. Results: Among 2160 cases in the old version, 1554 (71.9%) were in conformity with the reasoning. In contrast, there were 2410 cases with 2371 ( 98. 4% ) of conformity in the new version. The new one provided a more complete information than the old ( p < 0 . 001) . Conclusion: After revision, the new window could show more complete reasoning for antibiotics use by prescribers and provided an easy platform for the approval by infectious physicians and clinical pharmacists.

Keywords: antibiotics, reason of usage, approval

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H-P-15 APPLYING INFORMATION SYSTEM TO REDUCE OUTPATIENT WAITING TIME OF RECEIVING MEDICINES AT HOSPITAL PHARMACIES Yu-Chung Tsai, Hsien-Yu Chen, Hui-Jung Hsu, Chi-Sheng Chang Chi Mei Hospital, Liouying Objective During the process of receiving medical service, “Waiting” is one of the major issues which all hospitals have set out to resolve. Under this circumstances, the intervention of informatization has become extremely crucial. The purpose of our team is using the information technology assistance to maintain the high drug dispensing accuracy and increase patients’ satisfaction. Method Data collected from October 2013 to January 2014 shows the average rate of waiting time longer than 20 minutes of outpatient receiving medicines is about 5.65%. Our cross functional team has addressed 4 solutions: (1) Increase ten drug dispensing counters and 2 drug dispensary windows during the rush hour. ( 2) Develop 78 items of prepacked medicines. (3)Set up traffic-light alert system of drug dispensing process. And (4) Set up cross- unit pharmacist assistance system. The effectiveness of the intervention is then examined six months later. Result After the intervention, the average rate of waiting time longer than 20 minutes of outpatient receiving medicines dropped from 5.65%(Oct 2013 to Jan 2014) to 0% (Nov 2014 to Jan 2015). In conclusion, with the intervention of cross-functional team, we are able to improve the waiting time of outpatient receiving medicines at the hospital pharmacies.

Keywords: outpatient waiting time, traffic-light alert system of drug dispensing process, prepacked medicines

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H-P-16 ASSESSMENT OF PHARMACOTHERAPY IN GERIATRIC INPATIENTS AT A TERTIARY CARE HOSPITAL OF SOUTHEASTERN INDIA: ELUCIDATING THE PROBLEMS AND POSSIBLE SOLUTIONS Sudhakar Babu M.S Akula, Pradeep D Kumar, Lokesh V Reddy, Gopala Krishna CH A.M. Reddy Memorial College of Pharmacy, Narasaraopet, Guntur Dist; Andhra Pradesh, India.

In general, the older adults are more prone to adverse events and morbidity in healthcare management. On this context prescribing inappropriate drugs to the elder inpatients maximizes the significant health problems. There are many scales and criteria are produced to assess the improper pharmacotherapy in geriatric patients. This article objective is to determine the prevalence of inappropriate pharmacotherapy in hospitalized older adults of a tertiary care hospital using modified updated beers criteria 2003& HEDIS criteria. An observational study of 6 months was conducted in all departments of a tertiary care hospital, reviewing prescriptions of 135 elderly patients. The potential inappropriateness was found to be 25.9% by using Modified Updated Beerâ&#x20AC;&#x2122;s Criteria 2003& HEDIS Criteria, i.e. out of 135 patients, 35 patients were found to be receiving at least one inappropriate medication. The prevalence of inappropriate prescribing as shown in this study was significant than the rates reported in different countries. Advanced age, Polypharmacy, Multiple co-morbidities and long-time hospitalisation are the possible etiological factors of inappropriate medication use. In this study, the prevalence of inappropriate medication use was found to be 25.9%.

Keywords: pharmacotherapy, Updated Beerâ&#x20AC;&#x2122;s Criteria, HEDIS Criteria, Multiple comorbidities.

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H-P-17 STRENGTHENING THE EXPERIENTIAL LEARNING IN PHARMA EDUCATION: NEED OF THE HOUR Sriram Shanmugam Department of Pharmacy Practice,College of Pharmacy, SRIPMS, 395,Sarojini Naidu Road, Siddhapudur,Coimbatore-641 044,Tamil Nadu, INDIA The goal of any Pharmacy educational learning program is to provide the tools that are required to design quality experiential learning for the pharmacy student in the practice environment.

Practice experiences help to reinforce didactic learning and build clinical practice skills and knowledge. A special kind of self-directed learning can occur in practice setting and is called experiential learning. Experiential learning is one that occurs when a student is physically engaged in a professional activity with real consequences. Experiential learning in comparison to classroom learning, tends to be much more individualized with regard to what the preceptor can teach and the student can learn. Only in an experiential setting a student can perform a skill over and over until he/she becomes truly proficient. It is in the implementation of the learning objectives that students begin their professional development and gain confidence in providing pharmacy services. Experiential learning integrates knowledge and theory learned in the classroom with practical experience in a professional setting. The role of a preceptor in an experiential setting differs from that of a teacher in a classroom. A classroom teacher is mainly a describer of facts or skill steps. The preceptor is a teacher, a facilitator, and a mentor. In addition to the fact & skill teaching, the preceptor facilitates the learning process for the student by providing a rich environment for the development of the knowledge, skill, attitude and behavior required of competent pharmacy professionals.

Keywords: experiential learning, clinical practice skills, competent

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FAPA Congress 2016 | Bangkok, Thailand

H-P-18 HUMANITY PERSPECTIVES IN MEDICAL EDUCATION OF HOLISTIC PATIENT CARE FOR PHARMACISTS Yuan-Ling Chang, Kee Ching Jeng, Pei-Liang Chen, Ching-Shiang Chi 1

Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Background: The professional training in the hospital has been shifted from educational process to educational outcomes. Patient safety and quality of health care are considered as two important issues in medical practices nowadays. Therefore, integrating humanity into the medical education is necessary for competencies of health professionals. This holistic patient care program was aimed to improve humanity perspectives and safety culture by educating hospital pharmacists. Methods: From June 2014 to October 2015, a protocol of holistic patient care and inter- professional education and learning was implemented, including 4 phases, preconference, conference, post- conference, and learning/ observation feedback, in the pharmacy department. Pre- and post-tests were performed before phase 2 and after phase 4, respectively.

Comparisons between the two tests were analyzed using the t-test. The cutoff significance was a p value of 0.05. Results: Thirty-six pharmacists participated 25 sessions of holistic patient care conferences. The median time of meeting was 94 minutes, ranged from 60 minutes to 180 minutes. All 13 items in the pre- and post- test showed statistical significance, p < 0 . 001.

Importantly, knowledge, attitude, and skill were significantly changed. Perspectives of safety culture, humanity, and quality of pharmacistâ&#x20AC;&#x2122; s service were also improved. Conclusion: Pharmacists may learn from this holistic education program that the patient and family are also belong to the patientâ&#x20AC;&#x2122; s medical care team and provide a better mind- body- spirit care program for the patient with other inter-professional team members.

Keywords: medical education, holistic patient care

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H-P-19 LITHIUM SERUM LEVEL IN CHILDREN; THE TOOL FOR DOSE ADJUSTMENT IS NEEDED : PRELIMINARY DATA AT YUWAPRASART WAITHAYOPATHUM CHILD PSYCHIATRIC HOSPITAL. Karunrat Tewthanom1, Ransom Ongarjsakulman2, Theerarat Tankhum3 1

2

Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Medicine division, Yuwaprasart Waithayopathum Child psychiartric Hospital.Samuth Prakarn, 10270 Thailand 3 Pharmacy division, Yuwaprasart Waithayopath um Child psychiartric Hospital.

Samuthprakarn, 10270, Thailand

The purpose of study is to determine the Lithium serum level and classified the percentage of patients who had Lithium serum level within target range and outside target range. The study was performed with retrospective data collection of Lithium serum level of the children aged less than 18 years who received lithium therapy from Yuwaprasart Waithayopathum Child Psychiatric Hospital since 2013. The trough concentrations of Lithium were collected and then was classified by the recommended target range (06-1.2 mg/L). The mean and standard deviation of trough Lithium concentration were calculated. Twenty nine patients were recruited. The characteristics presented as the following; age (mean+ SD) was 15.79+ 2.64 years, weight (mean+ SD) was 69.75+22.28 kg and the average daily dose of Lithium (mean+ SD) was 858.62 + 274.53 mg. The trough Lithium concentrations (mean+ SD) was 0.56+ 19 mg/L. Although the standard dose of Lithium was used, only 13 patients (44.82%) who had serum Lithium level within targeted range. More than half of patients (55.18%) present out of therapeutic range of Lithium concentrations. Therefore, using more appropriate tool for Lithium dose adjustment is needed, according to the pharmacokinetics variability.

Keywords: lithium serum level, dose adjustment, children, preliminary

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FAPA Congress 2016 | Bangkok, Thailand

H-P-20 AMBULATORY PHARMACEUTICAL INTERVENTIONS FOR TYPE 2 DIABETIC PATIENTS Huei Chung, Ying-Pi Yang Pharmacy, Taipei City Hospital Zhong-xiao Branch, Taipei Taiwan Objective: To investigate the ambulatory pharmaceutical intervention on the improvement of disease control under the diabetic multi- disciplinary medical team, including endocrinologist, cardiologist, nurse, pharmacist and dietitian. Methods: The data was retrospectively collected from the database of pharmacist care project in a regional hospital from September 2015 to May 2016. The type 2 diabetic patients with HbA1C>8. 0 would be transferred to pharmacist clinic. Six months after receiving the pharmaceutical intervention, patients were followed the outcome was to evaluate the indicator of HbA1C. Resultsďź&#x161;A total of 33 patients was included with an average age of 68 years. The average numbers of drugs taken by patients were 8. 9.

42. 4% patients controlled their HbA1C below 7. 0 after receiving ambulatory pharmaceutical interventions. 36.4% patients controlled their HbA1C between 7.0 to 8.0. Conclusion: In our study, we showed ambulatory pharmaceutical interventions could improve HbA1C controlled for type 2 diabetic patients.

Keywords: pharmacists, diabetes care, patient education

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FAPA Congress 2016 | Bangkok, Thailand

H-P-21 THE EFFECT OF PHARMACIST-DELIVERED INDIVIDUAL HEALTH EDUCATION IN OUTPATIENTS: IMPROVED PATIENT CARE Mei Chi Chang1, Kuo Sheng Fan2, Hsin Lin Liang1, Chi Han Chen1 1

Department of Pharmacy, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan 2 Department of Chest Medical, Dalin Tzu Chi General Hospital, Dalin, Taiwan.

The Effect of Pharmacist-delivered Individual Health Education in outpatients: Improved patient care Objectives The aim of this study was to assess drug safety education in new patients. Method A retrospective database analysis was conducted among new patients between February 2014 and February 2015. After completion of education in patients or their primary caregivers, we evaluated the effectiveness of education and satisfaction by questionnaires survey and direct observation of procedural skills. A total of 144 patient satisfaction questionnaires were returned. Evaluation included Patient general information, cognitive function and questionnaires of satisfaction. Questionnaires of cognitive function include drug's effects and administration and common adverse effects and precautions. We used Excel to perform a descriptive analysis. Results Most of the patients were more than 70 years old (40%).

The most respondents by patient (63 %). In education level of largest was primary school (24%).The highest number of medication counseling was inhalation drugs (72%). Before receiving education, 80% patients or their family did not know how to use inhaled medication properly. 37% knows this drug precautions. After education, all patients were able to administer medication properly and aware of the drug effects and precautions. The patient satisfaction questionnaire of medication explain pharmacists' attitudes very satisfied were 90%, satisfied were 10%.All patients recognized the pharmacists' professional expertise, and would request the same assistance whenever necessary in the future. Discussion Pharmacists play an important role in providing counseling services regarding proper, safer, and more effective pharmaceutical care and patient education. Pharmacists were willing to provide this service whenever asked.

Keywords: education, patient care

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H-P-22 THE ANALYSIS OF THE FACTORS AFFECTING SIDE EFFECT DEVELOPMENT OF PATIENT-CONTROLLED-ANALGESIA Rung Wei Zhang, Chia Hung Wang, Hsing Hsien Lin, Su Chen Yen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

Background This study tried to analyze the influential factors of whether PCA may have side effects on the persons taking it. Methods The data were collected from October 2014 to May 2016. We defined the patients who stopped taking PCAs for well-controlled pain as controlled group. Results We enrolled 176 cases, including 75 cases of controlled groups (Male: Female =14:61) and 101 cases of side effect groups (Male: Female= 21:80). In our hospital there were three formulas of PCAs. Among them, we found Formula 2 Group (morphine 20mg + fentanyl 1.1mg) might develop side effects more often. In the second part of our study, we found the elder patients would develop side effects (controlled: side effect group = 49.64 + 18.27: 55.59 + 15.79, p=0.022), and the side effect group might discard more while using PCA (controlled: side effect group = 67.49 + 13.60 %: 76.73 + 13.66%, p=0.000). The doses of morphine and fentanyl received may also influence the development of side effect (p=0.00). Conclusion We found those who develop side effects might stop using PCA, and be injected less morphine and fentanyl. The elder patients might develop side effect when they use PCA. Thus, we should be more careful while using PCAs on elder patients.

Keywords: patient controlled analgesia, PCA, side effect

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FAPA Congress 2016 | Bangkok, Thailand

H-P-23 PHARMACEUTICAL ALTERNATIVES BETWEEN TWO DOSAGE FORMS OF CYTARABINE IN PEDIATRIC LEUKEMIA Noppamas Phutubtim Department of Pharmacy, Queen Sirikit National Institute of Child Health, Bangkok 10400 Thailand The aim of this study was to determine the efficacy of two dosage forms of cytarabine on therapeutic outcomes in pediatric leukemia at Queen Sirikit National Institute of Child Health.

Cytarabine dosage forms that used in this study were lyophilized sterile powder and solution for injection. The manufactory discontinues lyophilized form and turn to a new dosage form; solution for injection. Both dosage forms were provided in vials containing 500 mg from different manufacturers. Retrospective study was conducted to determine leukemia patients who were admitted at Queen Sirikit National Institute of Child Health in fiscal year 2015 that were used cytarabine and divided in two groups by dosage forms. A total 63 patients were included in this study. Majority of patients were female (58.73%). This study compared efficacy of two dosage forms of cytarabine with the number of white blood cells. Based on the white blood cell count, the patients were divided into two groups; low white blood cell count or normal white blood cell count. The results found that number of white blood cells in low white blood cell count group or normal white blood cell count group in two dosage forms did not statistically significant (p=0.38 and 0.35, respectively). These results suggested that two dosage forms of cytarabine on therapeutic outcomes were pharmaceutical alternatives.

However, more study is needed to assess the potential safety of continuing treatment with this new dosage form.

Keywords: cytarabine

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H-P-24 RISK FACTORS OF PATIENT WITH ESBL-PRODUCING ESCHERICHIA COLI Po-I Chen1, Chen-Fan Wen2, Se-Chin Ke3, Chin-Ming Chen3 1

Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

2 Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taiwan.

3 Infection control committee, Tungs' Taichung MetroHarbor Hospital, Taiwan.

Background: The epidemiology of ESBL-producing E. coli infection is changing during the past decade. Therefore, we intend to perform a retrospective epidemiology study to determine the risk of acquisition of ESBL-producing E. coli in our hospital. Methods:We collected 751 E. coli isolates from inpatient and outpatient of our hospital. The data collected included: age, sex, underlying disease, antimicrobial therapy prior to the onset of infection, admission to the ICU, use of immunosuppressive agents, surgical procedures within 1 month. Comparisons of categorical variables were done using the chi-square test or Fisherâ&#x20AC;&#x2122;s exact test. P < 0 .05 was considered statistically significant. Results: Of the 751 patients, 337 patients were infected by ESBL-producing E. coli (ESBL-E. coli), 279 patients were infected by non-ESBL-producing E. coli which was resistant to at least one antibiotic (non-ESBL-E. coli) and 135 patients were infected by E. coli which was susceptible to all antibiotics (non-resistant-E. coli). The difference between percentages of previous surgery within 1 month, admission to the ICU, previous exposure to steroids, beta-lactams/beta-lactamase inhibitors, 1st and 2nd-generation cephalosporin antibiotics and to quinolones among ESBL-E. coli (16.3%, 20.5%, 9.2%, 5.6%, 12.2%, and 6.5%, respectively) and non-resistant-E. coli (5.2%, 6.7%, 3.0%, 0.0%, 2.2% and 0.0%, respectively) was highly significant (P=0.019~0.000). Conclusion: Our data indicate that previous surgery within 1 month, admission to the ICU, previous exposure to steroids, betalactams/beta-lactamase inhibitors, 1st and 2nd-generation cephalosporin antibiotics and to quinolones can predispose individuals to infections with ESBL-E coli.

Keywords: risk factors, ESBL-producing Escherichia coli

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H-P-25 INCIDENCE RATES OF ADVERSE REACTIONS AND ASSOCIATED FACTORS OF GRAFT VERSUS HOST DISEASE (GVHD) IN PATIENTS WITH LEUKEMIA TREATED BY HEMATOPOIETIC STEM CELLS AT RAMATHIBODI HOSPITAL. Chanawee Surachatri, Kwanwiwat Sriwitoon, Wariya Ngamauksornsilp, Akarawit Uanwichit Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Leukemia is a bone marrow dysfunction disease. Nowadays, stem cell transplantation is an alternative treatment that was increasing but it may cause adverse reactions from chemotherapy or stem cell transplant process especially Graft versus host disease(GVHD) is more common and leads to death. This study was aimed to determine the incidence of adverse reactions and factors associated with GVHD by retrieved data from medical records of patients who received stem cell therapy at Ramathibodi Hospital during 2011 to 2013. The results found that 12 leukemia patients were received stem cell transplantation. The most adverse reactions were GVHD (25%), and Mucositis (25%). Due to small number of patients, only gender of recipients (Female: Male), which one of the factors associated GVHD can be calculated as odd ratio that equal to 1.75 (95% CI 0.099 to 30.837, p=1.00). However, further study are needed for determination of more factors which affect GVHD. Keywords: leukemia, hematopoietic stem cells, graft versus host disease

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H-P-26 A COMPARATIVE STUDY BETWEEN NEW FORMULATED AND COMMERCIAL ULTRASOUND GEL AT QUEEN SIRIKIT NATIONAL INSTITUTE OF CHILD HEALTH Manit Lertchaiporn1, Somphan Klandima1, Anchalee Krutrachue1, Thanarat Layangool2 1

Department of Radiology, Queen Sirikit National Institute of Child Health, Bangkok 10400 Thailand 2 Department of Pediatric Cardiology, Queen Sirikit National Institute of Child Health, Bangkok 10400 Thailand

Introduction: Diagnosis by Ultrasound and Echocardiography has to use the ultrasound gel as an intermediary. The Ultrasound gel is used mostly commercial product orders from abroad, which is inconvenient and expensive. Consequently, the pharmacists have developed a new ultrasound gel formulation that a low cost, safety and efficiency acoustic coupling for use.

Objectives: The purpose of this study was to compounding a new formulated ultrasound gel that low cost, safety and efficiency get to replace the more expensive commercial ultrasound gel. Methods: Measure of agreement is the test the reliability of individual doctors diagnosis of each line in the same way or not. To study the properties of new formulated Ultrasound gel was tested by comparing with the commercial gel in performing echocardiogram with 2 groups of 208 pediatric patients that sampling by Block of four experimental design at QSNICH Results: Measure of agreement showed that the doctors diagnostic was aligned with statistical significance by the Kappa value = 0.82, 0.82, 0.806, and 0.806, respectively, and p < 0 .01, indicating that doctors diagnosis corresponds to each line in the same way. It was found that the new formulated gel had more viscosity and difficulty in cleaning than the commercial gel.

It had no odorous and not affect patientsâ&#x20AC;&#x2122; skin. The quality of image from using both gel were well correlated (r=0.833:p < 0 .001). Conclusions: The cardiologist, pharmacist and technologists satisfy with the general properties and cost of this new formulated ultrasound gel which can replace the more expensive commercial ultrasound gel products.

Keywords: ultrasound gel, compounding, new formulated, commercial products

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FAPA Congress 2016 | Bangkok, Thailand

H-P-27 INADEQUACY OF CONVENTIONAL DOSING SCHEDULE OF CEFAZOLIN FOR ABDOMINAL SURGICAL PROPHYLAXIS Su-Chen Yen, Pei-Liang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

The Enterobacteriaceae is one of the most common pathogens isolated from the wound culture of patients with gastrointestinal surgery. The conventional cefazolin dosing schedule of 1 g every 8 hours appears effective for the treatment of Enterobacteriaceae with a cefazolin MIC ≤ 2 μg/mL only. However, unsatisfactory results are reported for the bacterial strain with MICs more than 4 μg/mL. Methods The patients were recruited after abdominal surgery. All of the patients were treatment with cefazolin 1g Q8H for infection prophylaxis post operation and wound classification was determined. Biochemical status, blood, culture data were recorded.

Microbiological culture not belong Enterobacteriaceae was excluded from this study. Results 49 patients were included in this study. Fifty-four percent (27/49) of patients failed for cefazolin treatment and switched to the third generation of cephalosporins or carbapenem.

There were 25 patients with Enterobacteriaceae positive finding in the wound culture and two with no finding in the culture but still had a fever. Mortality rate in those with the positive Enterobacteriaceae culture was obviously higher than those with a negative result, 44% (11 of 25 patients) vs. 8% (2 of 24 patients), respectively. Conclusion The conventional cefazolin dosing regimen of 1 g Q8H did not achieve a satisfactory prophylaxis post abdominal surgery if wound carried a high risk of Enterobacteriaceae infection. It is prudent to apply cefazolin 1g Q8H only when the wound classification is clean. Otherwise, cefazolin dose up to 2g Q8H should be considered.

Keywords: Cefazolin, enterobacteriaceae

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FAPA Congress 2016 | Bangkok, Thailand

H-P-28 BLOOD TRANSFUSION MASKING CHRONIC COLCHICINE INTOXICATION IN A PATIENT ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) Su-Chen Yen, Pei-Liang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

Introduction Colchicine, a liposoluble alkaloid, is a widely prescribed to treat gout arthritis since the 19th century. Colchicine arrests microtubule assembly and inhibits many cellular functions. Preferential accumulation of colchicines in red blood cells and neutrophil was found.

Colchicine has a narrow therapeutic index. Bone marrow suppression has been reported after prolonged administration of colchicines. We report the case who suffered from aplastic anemia after prolonged colchicines administration Case report This 68-year-old female with underlying disease of chronic renal dysfunction, gout and anemia accepted long-term medication regimen including colchicine 0.5mg QD, folic acid, B-Complex QD, Calcium carbonate 500mg TID, sennoside 20mg HS, NovoNorm 2mg TID and Periactin 8mg QD. Due to the rapid deterioration of renal function during colchicine administration since June, 2011, peritoneal dialysis was performed since May, 2013. Meanwhile, the patient accepted blood transfusion to relieve symptomatic anemia. However, this patientâ&#x20AC;&#x2122;s anemia never subsided so that blood transfusion was more and more frequent. Colchicine was discontinued after the patient was transferred to intensive care unit due to multiple organ failure on April 15, 2015.

Unfortunately, even after the treatment, the patient still died of standstill and CV collapse on April 20, 2015. Bone marrow examination revealed hypocellularity, in favor of aplastic anemia. Colchicine induced aplastic anemia cannot be ruled out. Conclusion Colchicine overdose should be considered in cases of multiple system organ failure and bone marrow suppression of unclear cause. For elderly patients and those with kidney or liver disease must be monitored carefully if colchicine is used for long-term therapy.

Keywords: colchicine, aplastic anemia, multiple organ failure

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H-P-29 UTILIZATION ANALYSIS OF COLISTIN FOR TREATMENT OF MULTIDRUG-RESISTANT BACTERIAL INFECTIONS IN A REGIONAL HOSPITAL Sue-Fei Cheng1, Tzuu-Guang Young2, Shin-Ming Chen3, Hui-Ting Huang3 1

2

Department of Pharmacy, Taiwan Adventist Hospital, Taipei, Taiwan Department of Medical Affair , Taiwan Adventist Hospital, Taipei, Taiwan 3 Taiwan Adventist Hospital, Taipei, Taiwan

Objective The purpose of this study was to evaluate the appropriateness of colistin utilization at a regional hospital in Taiwan. While also examine the outcomes for effectiveness and safety of this agent. Methods Patients who received colistimethate sodium (colistin) at least 3 days for the treatment of a multidrug-resistant gram-negative infection from May, 2009 to March, 2016 were eligible in study, charts were reviewed retrospectively. Patients younger than 18 years of age, without culture positive were excluded. The objective was to determine microbiological outcome at day-7 of therapy. Microbiologic success was defined as eradication of the original causative organism from subsequent cultures. The criteria for evaluating appropriateness of utilization was based on package insert. Results 21 cases were analyzed.

The colistin average dose used was 122.5±41.4 mg/day, duration of therapy averaged 9.4±5.1 days. The 66.7% patients were infected from multidrug-resistant Acinetobacter baumannii (MDRAB); 6 patients were infected by multidrug-resistant Pseudomonas aeruginosa. Overall, 38.1% patients achieved microbiological success at day-7 of colistin therapy. We observed mean colistin daily dose was significantly higher in the day-7 microbiological success group (150.3±30.9 mg vs 105.3.±38.2 mg, respective; P < 0 .01). Furthermore, success group patients average age were younger than failure group (72.6±14.5 vs 85.1±10.0, P=0.01). No correlations between dosage of colistin and nephrotoxicity could be made in the case series. Conclusion Colistin may be a useful drug when choices are limited. Patients were given higher colistin doses had better outcome at day-7 of therapy.

Keywords: colistin (colistimethate sodium), mdr bacteria, antibiotic resistance, medication use evaluation

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H-P-30 MEDICATION UTILIZATION EVALUATION OF DABIGATRAN AND RIVAROXABAN AT A COMMUNITY HOSPITAL IN TAIWAN Shin Li, Sue-Fei Cheng Department of Pharmacy, Taiwan Adventist Hospital, Taipei 10554 Taiwan Objectives: The purposes of this study were to describe and to evaluate the appropriateness of dabigatran and rivaroxaban utilization, also to review the outcomes for effectiveness and safety at a community hospital in Taiwan. Methods: A retrospective chart review was performed using electronic medical record for patients received at least one dose of dabigatran or rivaroxaban from September 2014 to March 2016. Data of patientâ&#x20AC;&#x2122;s characteristics, dosage, frequency, indications, index of renal and hepatic function, medication history of oral anticoagulants, co-administered medication and adverse events were collected. The criteria for evaluating appropriateness of medication utilization was based on recommendations and package insert approved by the Taiwan Food and Drug Administration. Results: Of the total of 273 patient encounters included in analysis, 34% of patients received dabigatran and 66% for rivaroxaban. There was no statistically significant difference in baseline characteristics between two groups. Dabigatran was prescribed for appropriate indications in 94.6% of encounters and 93.9% for rivaroxaban. An inappropriate regimen based on dosage, frequency, indication, renal and liver function were used in 17.2% of patients receiving dabigatran and 11.1% for rivaroxaban. Adverse events including documented bleeds occurred in 12.9% of dabigatran and 6.1% of rivaroxaban patients. No strokes or systemic embolism events were reported in both groups. Co-administration of antiplatelet agents was observed in 12.9% of dabigatran and 13.3% of rivaroxaban therapy. Conclusions: Although the use of dabigatran and rivaroxaban were appropriate, the study revealed the inappropriateness of utilization mainly occurred in patients with renal impairment at a community hospital in Taiwan.

Keywords: medication utilization evaluation, dabigatran, rivaroxaban, new oral anticoagulants

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H-P-31 EVALUATION OF COMPUTER PROGRAM FOR TRACKING AND DRUG REIMBURSEMENT AT SURATTHANI HOSPITAL, THAILAND Pramanut Tumthong1, Sayrung Funtaku2 1

Department of Pharmacy, Suratthani Hospital, Suratthani 84000 Thailand 2 Computer Center, Suratthani Hospital, Suratthani 84000 Thailand

This historical controlled design was aimed to evaluate computer program that was performed as a web application and PHP was a tool for system development. The database system and the operation system were Microsoft SQL server 2000 and Microsoft Windows XP respectively.

Time measurement (minute per 25-record) was done by using stopwatch time study technique.

The pre- (during February â&#x20AC;&#x201C; July 2014) and post-developmental (during October 2014 â&#x20AC;&#x201C; March 2015) results were compared and analyzed with descriptive statistics. The results showed that computer program could be shown details of patients correctly without printing the report document. It provided details of prescription of each patient that related with hospital information system. Its ability was completely and directly export data files to Drug System Program of the National Health Security Office (NHSO). It could record a summary and list of authorized reimbursement drugs and report a list of drugs which could not be on schedule delivery. It also supported file attachment of drug utilization document so it was easy to search document for the audit of medical records. The average time of data entry which found in prewas higher than post-developmental phase i.e. 30.25 + 1.28 VS 17.32 + 2.33. In summary, the development of this program for tracking and drug reimbursement could be used instead of conventional methods. It could reduce the cost of report paper and the process of individually patient data entry in the drug program of NHSO. Keywords: drug reimbursement, tracking system, computer software, essential list of drug

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H-P-32 A RETROSPECTIVE ASSESSMENT IN THE TREATMENT OF ONYCHOMYCOSIS Zong-Xian Huang Department of Pharmacy, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang City, Tainan, Taiwan, ROC To collect the patient was diagnosed as " toe onychomycosis" between 1 January 2009 and 31 December 2012, and complete 12 weeks of oral terbinafine or itraconazole therapy. After 24 and 36 months of completing the treatment, to recheck these patients whether come back to the clinic and been diagnosed as " toe onychomycosis" and take the antifungal drug therapy again.

Use the model to assess the relapse rate of terbinafine and itraconazole therapy after 24 and 36 months. Between 1 January 2009 and 31 December 2012, 196 patients was diagnosed as " toe onychomycosis" and complete the 12 weeks of oral terbinafine therapy, 12 and 13 patients came back to the clinic within 24 and 36 months and was diagnosed as " toe onychomycosis" and take the antifungal drug treatment again, so the recurrence rate was 6.12% (12/196) and 6.63%(13/196); On the contrary, 68 patients was diagnosed as " toe onychomycosis" and complete the 12 weeks of oral itraconazole therapy, but 9 and 12 patients came back to the clinic within 24 and 36 months and were diagnosed as " toe onychomycosis" and take the antifungal drug treatment again, so the recurrence rate was 13.24% (9/68) and 17.65%(12/68).

The study result showed that the relapse rate in terbinafine group is obviously lower than the itraconazole group (6.12% vs 13.24%; 6.63% vs 17.65%) and this is correspond with other reported literature.

Keywords: onychomycosis, terbinafine, itraconazole

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H-P-33 MULTI-DIMENSIONAL ASSESSMENT FOR PHARMACIST FACULTY TEACHING PERFORMANCE IN A MEDICAL CENTER HOSPITAL Huang Shu-Fen Department of Pharmacy, Chi Mei Hospital, Tainan, Taiwan Background: Assessment of faculty teaching performance is one of the important strategies to improve the teaching performance, the profession performance and student's learning outcome.

Multi-dimensional assessment had already become the major method. According to the teaching performance, the multi-directions assessment was carried on by faculty himself, senior faculty and students, and then the outcome would be feedback to the faculty assessed. The faculty would not only acquire the multi-directions feedback, but also understand the gap between the others, and the ability needed to be fortified. Method: Multi-dimensional assessment for pharmacist faculty teaching performance was carried on two times in one year; the secretary of teaching apartment listed the teachers assessed, and collected the opinions of different evaluators through the designed questionnaire. The statistical result would be feedback to the faculty assessed, and the faculty needed to fill in the satisfaction questionnaire.

Result: In 2015, total 49 faculties are assessed, 70 apothecaries participated in the assessment process. The score that the faculty been assessed was all rather higher than the threshold, Not any one faculty was needed to be strengthened in teaching. The proportion of feeling satisfied and very satisfied with his or her score was 51% and 41% respectively. The faculty suggested the curriculum added to improve teaching performance were “communication skills” and “stress alleviated”. Conclusion: The data from multi-source could definitely recognize a faculty in the teaching performance on the different level, faculty was willing to change their teaching behavior based on the information from multi-dimensional evaluation.

Keywords: multi-dimensional assessment, faculty, pharmacist

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H-P-34 THE QUESTIONNAIRE TO EVALUATE KNOWLEDGE OF MEDICINE USE AND ATTITUDE AMONG ELEMENTARY SCHOOL STUDENTS Chiu Ku Huang1, Hui-Mei Yu2, Yi-Nong Lin3 1

pharmacyf0088@gmail.com 2 yuhuimei51@gmail.com 3 2f0149@tmh.org.tw

Background: Making sure that children are educated about drugs is important even they don’t take any medicine. Purpose: To investigate the outcome of before/after drug education.

Method: 994 questionnaires were distributed to five elementary schools and the total effective questionnaires were 953. The data were collected from 25-04-2015 till 23-05-2015. The topics of drug education were:(1)concept of medication(2)smoking cessation (3)narcotics. Not only pharmacists but also pharmacy students participated in this survey. Result: The effective questionnaires in each elementary school were 179, 186,179,171 and 238, respectively. The average score of before and after drug education were:(1)School A: from 69.2±13.6 to 78±13.2 (P < 0 .001);(2)School B: from 81.7±12.9 to 91.3± 8.1 (P < 0 .001);(3)School C: from 76.2±14.0 to 86.8± 12.2 (P < 0 .001);(4)School D: from 79.2±14.9 to 89.5± 10.4 (P < 0 .001);(5)School E: from 80.0±14.6 to 88.5± 11.3 (P < 0 .001). Conclusion: The outcome of before/after drug education was improved. Besides, the strong cooperation between community pharmacists, hospital pharmacists and pharmacy students were developed through teaching and learning for drug education.

Keywords: questionnaire, drug education

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H-P-35 TRM TEAM MODE TO REDUCE THE CASE NUMBER OF UNEXPECTED DRUG WATING FOR HOSPITALIZED PATIENTS UNDERGOING CHEMOTHERAPY IN A REGIONAL TEACHING HOSPITAL Lin-Chu Chang, Ben Chen, Hsiu-Chi Chang Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. Background: Cancer has been number one cause of death in Taiwan for consecutive 33 years according to the data published by The Department of Health. Hospitalized patients shall receive chemotherapy. Unexpected drug waiting may delay patient discharge, increase customer complain, and induce problems for both the patients and the hospital. Method: 1.

Expected waiting is defined as: patients arriving in the hospital before 9:30 AM should receive chemotherapy before 1:00 PM, and patients arriving in hospital after 9:30 AM should receive chemotherapy before 6:00 PM. 2. The Improvement Strategy: between 8: 00 and 17 : 00 assistant workers to swap good chemotherapy ward, and pharmacist takes care of delivery after 17:00. 3. Track performance improvement for four months, from July to October, 2013. Result: There were 22 cases (38%) of unexpected waiting out of 58 cases of post-surgery chemotherapy at a regional hospital from January to March of 2013. There were 7 cases (11%) of unexpected waiting out of 61 cases of post-surgery chemotherapy from July to October of 2013. Conclusion: After TRM multidisciplinary team communication, delivery of chemotherapy drugs was improved. The unexpected waiting cases dropped from 22 (38%) to 7 (11%), decreased 71% reduced. To reduction of the patient complain, the communication between nurses and pharmacists was also improved.

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H-P-36 THE ANALYSIS OF SIDE EFFECT PATTERN OF PATIENTCONTROLLED-ANALGESIA AND THE INFLUENTIAL FACTORS OF HYPOTENSION, DIZZINESS OR NAUSEA/VOMITING DEVELOPEMET ON THE PERSONS USING IT Rung Wei Zhang, Chia Hung Wang, Hsing Hsien Lin Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taiwan. Taichung County Pharmacist Association, Taiwan.

Background The most bothersome side effects of patient-controlled-analgesia (PCA) were hypotension, dizziness, and nausea/vomiting. This study tried to analyze the influential factors of these side effects. Methods The data were collected from October 2014 to May 2016, the patients who discarded PCA bags were enrolled. We defined the patients who stopped PCAs for well-controlled pain as controlled group. Results The most common side effects of PCA were hypotension (n=18, 18%), dizziness (n=36, 35%), nausea/vomiting (n=31, 31%) and flatulence (n=7, 7%). When hypotension, dizziness, and nausea/vomiting developed, more PCA bags discarded. We found elder patients and those with inferior renal function would develop hypotension (p=0.00). The hypotension might develop when one received lower doses of morphine or fentanyl, and the hypotension group also stopped taking PCA earlier (p=0.00).

The older age was also a significant influential factor of nausea/vomiting (controlled: N/V = 49.64 + 18.27: 57.87 + 16.46, p=0.034). Besides hypotension, the fentanyl dose one received might influence the development of nausea/vomiting (controlled: N/V = 364.70 + 151.37: 271.32 + 148.38, p=0.004) and the dose of morphine might be the factor of flatulence development (controlled: flatulence = 5766.51 + 3631.04: 1811.59 + 3131.07, p=0.007) Conclusion Patients who developed hypotension, dizziness and nausea/vomiting might stop using PCAs pump earlier. And the elderly patients or had impaired renal function might develop hypotension when they use PCA. We found the dose of morphine was the check point of hypotension and flatulence, and the dose of fentanyl was the influential factor of hypotension and nausea/vomiting.

Keywords: Patient Controlled Analgesia, PCA, hypotension, dizziness, nausea/vomiting, flatulence

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H-P-37 PHARMACISTS' BARRIERS AND ATTITUDES TOWARDS RESEARCH IN SABAH: A QUESTOINNAIRE STUDY Sze Ling Tan, Kristine Sheh Fuen Lee, Izzati Abdul Halim Zaki, Siow Yen Liau Pharmacy Department, Hospital Queen Elizabeth 2, Kota Kinabalu, Sabah, Malaysia Introduction Pharmacists help in improving patientsâ&#x20AC;&#x2122; health care system through the clinical researches. At present, the involvement of pharmacists in research in Sabah is low. Thus, the aim of this research is to study the attitudes, barriers of pharmacists towards research and to identify strategies to overcome barriers and culture research participation. Methodology This is a cross sectional; self-administered questionnaire survey conducted from November 2015 till February 2016 involving all public sector pharmacists whom currently working in Sabah.

Results The response rate was 34.4%. Among the respondents, majority (71.7%) claimed that they have involved in research before but the median of completed research is only 1 (Interquartile Range 1.0). Majority of the respondents think that research is able to find answers to work-related problems (59.4%). However, many respondents were neutral to the interest in doing research (35.5%; n=59). Besides that, many agreed that conducting research is tedious (61.9%). Top three barriers towards research were: research increases daily workload (84.9%), lack of time (80.1%) and lack of access to literature (74.7%). As for strategies to overcome barriers and to culture interests towards research, majority thinks that free access to journal articles (88.6%), guidance from experts (87.3%) and utilisation of impactful outcomes of research (88.3%;n=143) may be useful. Conclusion Despite most of the respondents agree that research will help in overcoming problems in daily practice, the lack of time, guidance and access to literature have become major hurdles for them to conduct research. Strategies suggested may be used in future to culture research participation.

Keywords: barriers, attitudes, research

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H-P-38 IMPROVED RESPIRATORY FUNCTION RESULTING FROM COMMUNITY COOPERATIVE PROGRAM OF INHALATION INSTRUCTIONS Hiroshi Shinonaga, Hiroki Kondo, Norikazu Harada, Tsutomu Kaji, Yasunari Yoshida, Yasufumi Yamaji, Eiji Mukai Department of Pharmaceutical Services, Mitoyo General Hospital, Kagawa 769-1611 Japan Introduction: With an increasingly wide variety of inhalants and inhaler devices, the importance of inhalation instructions has drawn attention globally. We developed a program of inhalation instructions implemented in collaboration with community health insurance pharmacies, and under the initiative of Mitoyo General Hospital, a core hospital located in western Kagawa. We investigated the effectiveness of our program by comparing with results obtained in patients who received usual instructions. Methods: We studied patients who received either our inhalation instruction program (program group; n=97) or usual prescription instructions (control group; n=94) in a community health insurance pharmacy. We retrospectively examined the following respiratory function indexes by reviewing our electronic medical data: VC, %VC, FVC, %FVC, FEV1.0, FEV1.0%, V25/HT, PEF, MMF, R5, R20, R5-R20, X5, Fres, and ALX. Results: As compared with baseline, the program group showed a significant improvement in %VC, %FVC, FEV1.0, PEF, X5, Fres, and ALX, while the control group showed a significant improvement only in Fres. In between-group comparison, %VC and %FVC were improved to a significantly greater extent in the program group than in the control group. A subanalysis of the program group showed that multiple instructions significantly improved %VC, FVC, %FVC, PEF, R20, X5, Fres, and ALX, in contrast to the single instruction group, showing no significant improvement in the respiratory function indexes. Conclusion: Our community cooperative program for inhalation instructions was associated with greater improvement in respiratory function compared with usual prescription instructions. Our study also revealed that multiple instructions are required to achieve the improvement.

Keywords: inhalation instructions, community cooperative program, improved respiratory function

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H-P-39 SUSPECTED TRANSVERSE MYELITIS FOLLOWING H1N1 INFLUENZA VACCINATION: A CASE REPORT Chun Lung Liu, Chingta Chen, Hsien Yu Chen Chi Mei Hospital, Liuying,Tainan,Taiwan A 28-year-old female was on influenza vaccination on October 13, 2015. Eight days after the vaccination she called for help due to neck pain, leg numbness. Nerve conduction velocity test was normal, doctor prescribed Fursultiamine 50mg BID. She went to hospital again because of chest pain and persistent numbness hands on October 29. Neurology clinician arranged her for hospital observation and medicine treatment. According to hospitalization C-spine MRI photography found in T2 and C4-C5 region have high signal strength conditions and Naranjo Score ratings to assess this possible adverse drug reactions fraction genus a high (7 points), she was therefore diagnosed suspect as having transverse myelitis. She was given hydrocortisone 500mg QD 3 days during hospitalization. After hydrocortisone treatment, her symptoms were mitigation. She was discharged in stable condition on November 4, 2015.

Keywords: influenza vaccination, Transverse myelitis

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H-P-40 HYPERTENSION AND PROTEINURIA AS PREDICTIVE FACTORS OF EFFECT OF BEVACIZUMAB IN ADVANCED BREST CANCER IN JAPAN Hiroaki Tanaka, Koichi Takahashi, Kazunori Yamaguchi, Takahiro Motoki, Masato Asakura, Daisaku Mizuoka, Shinji Kosaka, Hitoshi Houchi Department of Pharmacy, Kagawa University Hospital, Japan Background Bevacizumab (BV), an inhibitor of vascular endothelial growth factor (VEGF), is used in combination with paclitaxel (PTX) for the treatment of inoperable, advanced, or recurrent breast cancer. Hypertension and proteinuria are known adverse events characteristic of BV therapy, with an incidence of hypertension of 17.9% and proteinuria of 10.5% in a clinical study. Patients and methods of 17 patients with breast cancer who received BV in combination with PTX, at Kagawa University Hospital within the time period from May 2012 to May 2015, and who had not previously received BV, 13 patients were studied. Four patients who received BV as part of their adjuvant chemotherapy were excluded. Progression free survival (PFS), age, hypertension and proteinuria grades, treatment lines, presence or absence of hormone receptors, and positive or negative HER2 status, were retrospectively assessed by reviewing electric medical records. To assess the potential of the adverse events as a predictive marker, period studied was 8 weeks after the initiation of treatment, i.e, from baseline to the end of the second course of anticancer therapy. Results and Discussion Simple regression analysis revealed a significant association of grades of hypertension and proteinuria with PFS (P>0.05). In patients who experienced hypertension or proteinuria, PFS was significantly prolonged as compared with those without the adverse events (P=0.015). Our study suggests the development of hypertension or proteinuria is associated with improved PFS, perhaps indicating their potential as a biomarker for therapeutic benefit of BV. Keywords: bevacizumab, hypertension, proteinuria

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H-P-41 INFLUENCE OF PILL BURDEN AND COMPLEXITY ON PATIENTS’ MEDICATION ADHERENCE AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH POLYPHARMACY Mei-Wen Wang1, Huang-Tz Ou2, Pheng-Ying Yeh1, Hui-Jen Chang1 1

2

Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Objective: We examined the effects of pill burden and complexity on medication adherence and health-related quality of life (HRQoL) among patients with chronic conditions. Methods: This study was conducted among patients aged ≥ 20 with polypharmacy (medications ≥ 6) between 2015/6/1-2016/5/31. Medication profiles were extracted from PharmaCloud to estimate medication persistence ratio (MPR) and medication regimen complexity index (MRCI). Medication adherence and HRQoL were assessed by the eight-item Morisky Medication Adherence Scale (MMAS-8) and EQ-5D, respectively. The MMAS-8 scores > 6, 6-7, and =8 indicate low, medium, and high adherence, respectively. Results: Sixty-eight patients who took 9.69 (±3.33) medications participated in the study. As compared to those with better HRQoL (EQ-5D descriptive score ≥ 75), patients who had relatively poor HRQoL (EQ-5D < 75) took more pills (pills for two groups: 10.59±3.69 vs. 8.89±32.78, p=0.03) with more medication complexity (MRCI: 25.22±9.96). However, patients taking ≥ 9 pills with high medication complexity (MRCI: 27.66±8.80) had relatively better medication adherence as compared to those with pills < 9 with mean MRCI of 16.24±3.61 (MMAS for two groups: 7.34 vs. 7.03, p=0.25). This may be because high disease susceptibility (reflected by more pills) led to better adherence. Patients who needed caregivers had lower HRQoL (EQ-5D: 70.42±13.82) but had better medication adherence as compared to those without caregivers (MMAS-8 for two groups: 7.67±1.34 vs. 6.97±1.39, p=0.01). Conclusion: Pill burden and complexity appear to be associated with low HRQoL but better medication adherence. Caregivers’ assistance may improve patients’ medication adherence, especially for those with poor HRQoL. Keywords: pill burden, medication complexity, medication adherence, health-related quality of life

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H-P-42 PREVALENCE OF SULT1A1 COPY NUMBERS VARIATIONS IN THAI BREAST CANCER PATIENTS UNDERGOING TAMOXIFEN TREATMENT Wanaporn Charoenchokthavee1, Duangchit Panomvana1, Virote Sriuranpong2, Nutthada Areepium1 1

Department of Pharmacy Practice, Faculty of Pharmaceutical Science, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand 2 Medical Oncology Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, 4th Floor Vongvanich Building, Rama IV Road, Pathumwan, Bangkok 10330, Thailand Background: Tamoxifen (TAM) is an anti-estrogen that used in breast cancer treatment, but the single nucleotide variations of TAM-metabolizing enzymes existed in previous studies which included single nucleotide polymorphisms and gene copy numbers variations. This research aimed to explore the prevalence of SULT1A1 gene copy numbers variations in larger numbers of Thai breast cancer patients undergoing TAM treatment. Patients and Methods: 134 Thai breast cancer patients from Thai Tamoxifen Project were selected to join this research.

Individual DNA was extracted for SULT1A1 gene copy numbers variations and subsequently determined by real-time polymerase chain reaction with TaqManÂŽ Drug Metabolism Copy Number Assay Sets with StepOnePlusÂŽ real-time PCR and Vii7 software (Thermo Fisher Scientific, Waltham, MA, USA). Results: Mean age of this patient group was 51.6 (SD 11.6) years covering from stage 0 to stage IV breast cancer. Most of Thai breast cancer patients (96.3%) in this study were carrying two copies of SULT1A1 gene while the rest of them were carrying one copy (1 patient) and three copies (4 patients) of SULT1A1 gene. Conclusions: The majority of Thai breast cancer patients undergoing TAM treatment were carrying two copies of SULT1A1 gene which corresponded with the prevalence that was reported in Caucasians.

Keywords: SULT1A1, copy number, tamoxifen, breast cancer, prevalence, Thai, pharmacogenetics, pharmacogenomics

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H-P-43 INPATIENT MEDICATION DELIVERY SATISFACTION SURVEY AND STATISTICAL ANALYSIS Shu-Wen Kang, Jing-Yi Huang, Wan-Yu Li, Meng-Chiao Lin St. Joseph’s Hospital, Department of Pharmacy, Yunlin County, Taiwan Aim: To ensure the quality and safety of medication use, an Inpatient Medication Delivery Satisfaction Survey is conducted in hospital every year. This survey is a practical reference index to improve the quality and safety of inpatient medications delivery. Methods: From January 4th to 12th 2016, a survey was conducted in 8 departments. 130 questionnaires were given out, 124 were returned. The response rate was 95.4 %. All questionnaires were assessed by 5-point Likert-scale and analyzed by SPSS 19.0 computer software. Results: The calculation of the Cronbach's α value for this questionnaire was 0.911. The outcome of the statistical analysis shows that the average percentage of “very satisfied”, “satisfied” and “neutral” was 94.75 %, which was higher than 93.72 % in 2015. On the other hand, the average percentage of “unsatisfied”and “very unsatisfied” was 3.80 %, lower than 5.97 % in 2015. Discussion: The dissatisfaction occurs mainly at night when pharmacists on duty are busy supplying medications for outpatients. Hence proper night shift personnel allocation and communication may resolve this problem. Due to the dispensing and dispatching time are the main contributing factors for the delay of drug delivery. Hence, with further enhancement of the barcode system in the future, it would be possible to know when the medication is dispensed and dispatched, therefore to determine the cause of any delay.

Keywords: questionnaire, medication delivery satisfaction survey

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H-P-44 USING HEALTHCARE FAILURE MODE AND EFFECT ANALYSIS TO REDUCE DISPENSING ERRORS BY A SOLE PHARMACIST IN THE HOSPITAL PHARMACY Jinru Chuang, Chengying Hsieh, Peiling Tsai, Yipin Chen Department of Pharmacy, National Taiwan University Hospital Yun-Lin Branch, Taiwan In this study, Healthcare Failure Mode and Effects Analysis (HFMEA) is applied to reduce the incidence of dispensing errors during the dispensing process from a sole pharmacist in the hospital pharmacy. A sole pharmacist has higher risk of dispensing errors compared with two or more pharmacists present at one time. The most common factors affecting the error are to do with being busier than normal or interruptions (telephone interruption, query from member of staff, etc.). We used HFMEA to check the dispensing procedures, graphically describing the process, and conducting a hazard analysis. The results showed that it was a high risk dispensing process by a sole pharmacist. 38 failure modes and 61 potential failure causes are identified. Several strategies were determined for prevent the potential dispensing errors during the sole pharmacist dispensed in the hospital pharmacy, such as the automated drug dispensing machines system, the establishment of the verification process and 4 ways to develop the right attitude towards dispensing prescriptions et al. In the pre– and post–strategic actions implementation periods, the hazard score were decreased from 230 to 199.The overall rates of dispensing errors were decreased from 610.4ppm to 406.1ppm. According to the above study, we would suggest: the automation and computerization of drug dispensing are important tools for reducing dispensing error rates. The dispensing error reports were transformed into teaching materials to educate the sole pharmacist. Moreover, pharmacist s’ attitude should be developed and the new checking procedures practiced by a sole pharmacist should be established.

Keywords: healthcare failure mode and effect analysis, dispensing errors, sole pharmacist

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H-P-45 DRUG UTILIZATION STUDY OF ORAL HYPOGLYCEMIC AGENTS IN AN OUTPATIENT PHARMACY DEPARTMENT OF A TERTIARY HOSPITAL, MALAYSIA Suresh Shanmugham, The Shia Yeng, Nurul Suhaida, Suresh Kumar Faculty of Pharmacy, International Medical University Drug utilization research is an impressive investigative tool to govern the role of medications in healthcare system. It assists any healthcare decision by providing socio-medical and health economic basis. Moreover, it supports healthcare system to know, interpret, advance prescription, management and usage of medications. Internationally, diabetes mellitus is considered as one among the predominant, chronic, non-communicable health conditions distressing humanity. In Malaysia, occurrence of diabetes mellitus in adult population is alarming as per national health and morbidity survey (NHMS) and recent studies. Therefore, this study aimed to determine the prescribing trends, utilization pattern, and its implications of oral hypoglycemic agents (OHA) in a tertiary care hospital setting. In continuation to our previously reported work, this retrospective study randomly collected the prescriptions containing OHAâ&#x20AC;&#x2122;s for 6 months in outpatient pharmacy department of a tertiary care hospital.

Patientâ&#x20AC;&#x2122;s demographic data, pattern of drug use and trends in treatment modality were retrieved and analyzed. The study found that 59.61% patients were male. The mean age of diabetic outpatient visits was between 56 and 58 years old. Metformin (77%) was the most widely used OHA, followed by gliclazide (52.11%). 59.06% of total prescriptions were polytherapy whereas OHA monotherapy constituted 40.94% and was dominated by either metformin or gliclazide. Metformin was indeed the most widely used OHA and followed by gliclazide.

Similarly the prescribing tendencies in managing Type-2 diabetes mellitus had shifted towards combination treatment.

Keywords: oral hypoglycemic agents, drug utilization, pharmacy, prescribing trends

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H-P-46 EFFECTS AND ITS EVALUATION OF PROTOCOL-BASED PHARMACOTHERAPY MANAGEMENT ON THE APPILICABILITY OF INFLUENZA VACCINATION Koji Masuda, Kurimi Kase, Tatsuya Isezaki, Ryohkan Funakoshi Department of Pharmacy services, Kameda Medical Center In 2010, in Japan, the Health Policy Bureau of the Ministry of Health, Labour and Welfare issued a notification on applicable measures under the current laws to promote multidisciplinary activities. One of them is protocol-based pharmacotherapy management (PBPM), in which pharmacists develop protocols in collaboration with physicians and other medical professionals and proactively participate in pharmacotherapy. We introduced PBPM for pharmacist-led decision-making on the applicability of influenza vaccination and evaluated its effects. The results are reported herein. In October 2014, PBPM was introduced for application in patients admitted to receive chemotherapy for blood cancer. Those admitted between October 2013 and February 2014 were included in the pre-PBPM group, and those admitted between October 2014 and February 2015 or between October 2015 and February 2016 were included in the post-PBPM group. The observation measures included vaccination rate, influenza incidence rate, all-cause mortality, and incidence rate of influenza-like illness.

To assess the safety of PBPM, incidence rates of adverse events were compared between patients vaccinated on the basis of decisions made by pharmacists according to PBPM and those are vaccinated by physicians during 2014 and 2015. Although vaccination rate improved after the introduction of PBPM, no clear differences were observed in any other parameter. The introduction of PBPM for vaccination improved the vaccination rate. It was also suggested that PBPM might allow pharmacists to safely decide whether vaccination is applicable or not.

Keywords: influenza, vaccine, pharmacist-led

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H-P-47 THE EFFICACY OF COLOR PRINTING IN REDUCING THE RATIO OF DISPENSING ERROR IN EMERGENCY PHARMACY Chung-Yu Lin, Chiu-Mei Lee, Rung-Wei Zhang, Shih-Lun Shang Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

Background As we know, ER is the first medical environment to provide emergent and intensive care for patients. Besides rapid diagnoses and competent treatments, patients and nurses expect the pharmacists to dispense quickly and accurately. However, our retrospective study indicated the ratio of dispensing error in ER pharmacy was 0.0572% which was higher than our KPI: 0.03%. Therefore, we tried to decrease the ratio by QCC concept. Method On 80/20 principle of the Pareto diagram, we identified the major dispensing error types of emergency prescriptions were look-like/sound-like error, formulation error, dosage error and quantity error. In these four aspects, we illustrated cause-and-effect diagram to find 12 main reasons and verify 6 root causes. Most root causes were dispensing wrong drug, therefore, we intended to redesign the emergency prescription format and print colorfully. Result After redesigning the ER prescription format and printing colorful drug picture on it, the ratio of dispensing error declined from 0.0572% to 0.0188%. The degree of reduction was 67.13%.

Additionally, the major dispensing error type was quantity error instead of dispensing wrong drug error which wasnâ&#x20AC;&#x2122;t made ever after improvement. Discussion In our QCC activity, the colorful drug picture printed on ER prescriptions could let the pharmacist confirm if they dispense correctly and reduced the ratio of dispensing error effectively. In the next step, we will analyze the type of quantity error and design a computer program to prevent making errors.

Keywords: QCC, dispensing error, emergency pharmacy

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H-P-48 AGE ASSOCIATED WITH OVERTHERAPEUTIC RANGE IN ADULT RECEIVING VANCOMYCIN Su-chen yen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital,Taichung, Taiwan.

Taichung County Pharmacist Association, Taiwan.

Purpose: A published guideline by the American Society Health- System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists recommended to achieve clinical efficacy and prevent the emergence of resistance, the maintaining trough concentrations of vancomycin should being above 10 mg/ L and targeting trough concentrations of 15 to 20 mg/L in complicated MRSA infections. However, for elderly patients, vancomycin over the therapeutic range is not uncommon even if creatinine is within normal range. Methods: The dosing schedule of vancomycin was according to actual body weight and renal function. The trough level of vancomycin was evaluated if sampling time within 30min before next dose and in the steady- state. Results: A total of 39 patients were analyzed. No. of all patients older than 65 years is 23, which trough level below 10 mg/ L is zero and above 20mg/L is 13 patients. The percentage of over therapeutics range is 56% (13/23) in this elderly population. Correspondingly, no. of all patients younger than 65 years is 16, which trough level below 10 mg/L is 7 and above 20mg/L is 6 patients. The percentage of over therapeutics range is 37. 5% ( 6/ 16) in this younger population. The risk of vancomycin over therapeutics range for elderly is one and a half than the younger population found in this study.

Conclusion: Monitoring of trough levels is not necessary for all patients, only those at risk of over therapeutics range. If patientâ&#x20AC;&#x2122; s age more than 65 years with long- term vancomycin treatment, trough level should be obtained necessarily.

Keywords: vancomycin, trough level, MRSA

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H-P-49 OUTCOMES OF PHARMACEUTICAL CARE SERVICES INHOSPITALIZED PATIENTS AT HRH PRINCESS MAHA CHAKRISIRINDHORN MEDICAL CERTER: A PILOT STUDY Kamonphat Wongtaweepkij Faculty of Pharmacy, Srinakarinwirot University, Nakhon Nayok 26120 Thailand Background: There are a high number of drug- related problems ( DRPs) , particularly in teaching hospitals. They commonly result from errors in the process of physicianâ&#x20AC;&#x2122; s order, dispensing, or administration. The aim of this study was to assess outcomes of pharmaceutical care service by a clinical pharmacist. Methods: This prospective study was conducted from December 2015 to April 2016. One pharmacist collaborated with other health care professionals on a medical ward at HRH Princess MahaChakriSirindhorn Medical Center, Thailand. The pharmacist provided pharmaceutical care as follows; (1) detecting and solving DRPs ; ( 2) performing inpatient medication reconciliations; ( 3) monitoring adverse drug reactions; ( 4) providing drug information service; and ( 5) discharge counseling. Results: Eighty- seven potential DRPs were found. Seventy- seven percent ( n= 67) of the DRPs were prevented and resolved. Seven adverse drug reactions out of 27 ( 26% ) were serious drug reactions and required treatments. OtherDRPs were need for additional drug therapy (n=16),drug-interaction (n=11), and dosage too high (n=8). There were 51 drug information services. Common drug queries were dosages and administrations, adverse effects, and drug compatibility. Other tasks were extemporaneous medicines, etc. Doctors disagreed with pharmacistâ&#x20AC;&#x2122;s suggestion among 23% of DRPs. Conclusion: This study illustrates that a clinical pharmacist on the ward could prevent and solve DRPs in a teaching hospital. This would improve the quality of care and save both direct and indirect costs. Regarding a high number of encountered DRPs, the process of pharmacy service on the ward is required to develop in the future to improve efficacy and safety of care in patients.

Keywords: pharmaceutical care service, drug-related problems, clinical pharmacist

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H-P-50 COMPARISON OF CALCIUM ACETATE, CALCIUM CARBONATE AND ALUMINIUM HYDROXIDE, AS PHOSPHATE BINDER IN PATIENTS ON HEMODIALYSIS Hui-Chia Chuang, Li-Jen Hsu, Su-Yu Chien Pharmacy department, Changhua Christian Hospital, Changhua, Taiwan Background: Hyperphosphatemia is common in dialysis patients, which can be treated by oral phosphate binders. The aim of this study is to compare the efficacy of calcium acetate, calcium carbonate and aluminium hydroxide as phosphate binder in chronic kidney disease patients on hemodialysis. Method: We performed a retrospective study of patients received calcium acetate, calcium carbonate or aluminium hydroxide on hemodialysis from Jan. 2015 to Dec. 2015 in our hospital. The effect was assessed by serum phosphate, serum calcium and adverse events. Results: A total of 236 patients with mean age 58.47Âą 14.05 years old were identified, which 46.6% used calcium acetate, 26.3% used calcium carbonate, and 27.1% used aluminium hydroxide. There was a similar decrease in serum phosphate level with calcium acetate (-1.14 mg/dL), calcium carbonate (-1.17 mg/dL) and aluminium hydroxide (-1.2 mg/dL). All p were greater than 0. 05 between each group. Six patients ( 5. 45 % ) who received calcium acetate developed serum calcium greater than 10.3 mg/dL while 4.69% in aluminium hydroxide group and 1.61% in calcium carbonate group. Tolerances to the three drugs were similar. The most common side effects were gastrointestinal disturbance, with 7. 27% in calcium acetate group, 3.22% in calcium carbonate group and 4.69% in aluminium hydroxide group. Conclusion: In this study, all the drugs has similar effect on lowering serum phosphate and were well tolerated.

Keywords: phosphate binder, calcium acetate, calcium carbonate, aluminium hydroxide, efficacy, hemodialysis, chronic kidney disease

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H-P-51 IMPACT OF COMPUTERIZED PHYSICIAN ORDER ENTRY WARNING SYSTEM ON PRESCRIBING PATTERNS IN ELDERLY Chih-Yuan Wu1, Li-Chun Chen, Shu-Jen Hwang2, Sue-Fei Cheng 1Faculty

2

of Pharmacy, Taiwan Adventist Hospital, Taipei, Taiwan.

Faculty of Information Technology, Taiwan Adventist Hospital, Taipei, Taiwan.

Background: Potentially inappropriate medication ( PIM) use is a major healthcare issue especially in aging society. To improve prescribing among elderly, we instituted a medicationspecific warning system within CPOE, which can provide real- time alerts to prescribers.

Objective: Our study aimed to the impact of these alerts in CPOE on ordering changing pattern.

Methods: 16 PIMs due to drug- disease interaction were integrated into CPOE, based on our study finding the most common PIMs in our hospital 2013, using Beers, STOPP, PIMTAIWAN criteria. We compared rates of ordering before the alerts (January 2014 to June 2014) and after the alerts were implemented in July 2014 through December 2015. Pharmacist assess and record prescribersâ&#x20AC;&#x2122; responses to the warning individually. Results: During the 18- month intervention period, 1794 warnings for 14 different drugs were triggered by PIM prescribing in 65 years and older. Among these not recommended drugs, 56.7% (1013/1794) were dropped and change to suggestion drugs. In pre- post comparisons, the rate of prescribing not recommended drugs weaning by 7.4% (from 50.7% to 43.3%). Conclusions: Specific alerts embedded into a CPOE system in elderly can be effectively avoided PIM prescribing.

Keywords: computerized physician order entry (CPOE), potentially inappropriate medication, elderly

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H-P-52 EFFECTIVENESS OF A COMPUTERIZED DRUG PROGRAM TO IMPROVE PATIENT MEDICATION SAFETY Chun Ta Huang1, Ching-Ying Liao1, Chien-Hsiang Ni2, Kuang-Liang Cheng2 1

2

Department of Pharmacy, Taiwan Adventist Hospital, Taipei, Taiwan Department of Information Technology, Taiwan Adventist Hospital, Taipei, Taiwan

Objective: We intend to improve patient safety by implementing information technology system to assist pharmacist daily practice. Methods: (1) Integrated drug warning system within computerized physician order entry ( CPOE) that alert physicians to drug duplications, interactions, maximum dosage and drug allergy history. ( 2) Using the barcode- assisted medication recognition system combined with drug delivery can provide pharmacists complete information and minimize dispensing errors. ( 3) To implement Taiwan's National Health Insurance PharmaCloud system, physicians and pharmacists can online check patientsâ&#x20AC;&#x2122; medication history. Results: From December 2015 to May 2016, among 213163 prescriptions, 24348 interceptions of the duplicate use of medication, 3128 interceptions of class- one drug interactions, 1273 interceptions of maximum dosage limits, and 486 interceptions of drug allergy using the computer alert system. Barcode-assisted system can provide promptly data to expect the flow of work to share the heavy workload and to assist pharmacists in reducing workplace stress, and, therefore, reduce medication errors. Managers can also use the statistical analysis of each function records of information effectively. Conclusion: Prevention of medication errors is a highly priority worldwide. The computerized drug program is a multifaceted strategy to prevent medication errors and improve patient safety. Standardization and certification of the design and implementation of this program should keep improvement.

Keywords: computerized physician order entry, CPOE, medication safety, PharmaCloud system

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FAPA Congress 2016 | Bangkok, Thailand

H-P-53 DISPENSING NEAR MISS REDUCTION BY THE APPLICATION OF QUALITY MANAGEMENT â&#x20AC;&#x201C; AN EXAMPLE OF A REGIONAL TEACHING HOSPITAL Jinru Chuang, Yingchun Chen, Linchu Liao, Shuchen Lin Department of Pharmacy, National Taiwan University Hospital Yun-Lin Branch, Taiwan In this study, a quality management procedure is applied to reduce the medication error. The medication error is defined as an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. It may appears in the medication-use process, such as dispensing. In this research, the dispensing process of the pharmacy department of a regional teaching hospital is investigated. The quality control circle (QCC) is formed to identify the root causes of the dispensing near misses, and solve them. The data from January 2013 to March 2014 is collected. The fishbone chart is made. The root cause verification survey is designed for Pareto diagram analysis. The root cause are identified by Kawakita Jiro method as follows: 1. Look- Alike Sound- Alike ( LASA) drugs. 2. Disobey standard operation procedure (SOP). 3. Inadequate training. The solutions including the enhancement of LASA drug management, the establishment of the drug information system, and the establishment of the verification process. The target dispensing near miss rate reduction is 50% below average.

The data from April 2014 to Jun 2015 are collected. It shows the dispensing near miss rate is reduced from 504.37ppm to 464.29ppm. The fulfillment rate is 25.98%. The improvement rate is 7. 95% . The LASA drug related dispensing near miss rate is reduced from 183. 98ppm to 159.28 ppm (13.43%). In this project, the QCC is formed, and the improvements are made. As the dispensing near miss rate is reduced, the health- care quality is improved and the patient safety is secured.

Keywords: dispensing near miss, Look-Alike Sound-Alike (LASA), medication error, patient safety, quality control circle(QCC)

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FAPA Congress 2016 | Bangkok, Thailand

H-P-54 STEP BY STEP CHANGE OF THE COMPLETENESS OF POTASSIUM CHLORIDE INJECTION PRESCRIPTION Ya-Lun Lee, Yi-Chun Hung, Pei-Liang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taiwan. Taichung County Pharmacists Association, Taiwan.

Objectives: Potassium chloride ( KCl) injection was prepared by pharmacist since 2011 under hospital accreditation requirement. Since KCl prescription module was incorporated in the physician’ s order system, the incompleteness and error of KCl prescriptions were increased tremendously. Therefore the prescription module was revised and we assessed the completeness of KCl prescriptions. Methods: A retrospective review was conducted on the completeness of KCl prescriptions in Tungs’ Taichung MetroHarbor Hospital from 2014 to 2015. Data were collected including the KCl dosage, route, frequency, content, prescription start and end. According to our prescription regulation, it must be noted with the KCl dosage and volume of infusion solution for adding KCl to the infusion, irrigation, or total nutrition routes; and the diluting solution and administration rate for the IV bag route. Results: There were 1622 and 2091 KCl prescriptions, respectively to 2014 and 2015. The infusions were simplified to 7 types. The completeness of KCl prescriptions was achieved by the revised module. Conclusion: With regard to the completeness of KCl prescriptions, it is necessary to consider the physician’s habit of prescribing for designing KCl prescription module. Although it takes more time to select the columns, the completeness of KCl prescriptions would prevent the unnecessary errors.

Keywords: KCl injection, prescription module, prescription errors

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FAPA Congress 2016 | Bangkok, Thailand

H-P-55 THE COMPARATION EFFECTIVENESS OF AMITRIPTYLINE VERSUS GABAPENTIN AND EVALUATION THEIR SIDE EFFECT AS NEUROPHATIC PAIN THERAPY IN ELDERLY WITH TYPE II DIABETES MELLITUS Made Krisna Adi Jaya1, Tuty T. Kuswardhani2, Fauna F. Herawati1, Ida Bagus N Maharjana3 1

Department of Clinical Pharmacy, Pharmacy Faculty, Surabaya University 2 Geriatric Department, Sanglah General Hospital, Denpasar-Bali 3 Department of Clinical Pharmacy, Udayana University Hospital

Objective: Neuropathy in diabetes mellitus is a disorder that occurs in the peripheral nervous system. The incidence of diabetic neuropathy was found more prevalent in elderly ( 44% ) compared to adult ( 24% ) . Amitriptyline and Gabapentin are widely used on treatment of neuropathic pain. Variations in the results of research related to effectiveness and safety of both drugs, causes the need further research to determine the best and safest therapy to treat the pain of diabetic neuropathy, especially in geriatrics. Methods: A prospective cohort study involving 70 elderly patients who treated with Amitriptyline or Gabapentin were observed during 4 weeks, with the target outcome were neuropathy pain reduction â&#x2030;Ľ 2 unit and incidence of adverse events. Result: The whole subject in this research who got Amitriptyline or Gabapentin decreased pain scale â&#x2030;Ľ 2 units compared to baseline. Comparison head to head at low and therapeutic doses, Amitriptyline showed reduce pain intensity greater than Gabapentin ( p < 0. 05) , while on therapeutic doses show there was no difference in efficacy between two drugs ( p > 0. 05) . The adverse events on low and therapeutic doses showed Amitriptyline ( 91. 43% ) has significantly greater ( p < 0. 05) of adverse event compared into Gabapentin ( 51. 43% ) , but there was no statisticaly difference on therapeutic doses in both groups ( p > 0.05). Conclusion: Amitriptyline was found relatively better in reducing diabetic neuropathic pain intensity compared to Gabapentin, but the adverse events was higer than Gabapentin.

Keywords: diabetes neuropatic pain, geriatric, effectiveness, side effect, amitrptyline, gabapentin.

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FAPA Congress 2016 | Bangkok, Thailand

H-P-56 IMPROVING THE DISCONTINUED INJECTION MEDICATIONS RETURN RATE IN NURSING STATIONS Guan-Yu Lu1, Szu-Hsu Tseng2, Hua-Sin Chen3 1

Department of Pharmacy, Kuang Tien General Hospital, Taichung Taiwan 2 Taichung County Pharmacist Association, Taichung Taiwan 3 Research Institute of Biotechnology, HungKuang University, Taichung Taiwan Object: Medications that are discontinued can become part of "secret stashes", so returning the medications to inpatient pharmacy correctly helps prevent illicit hoarding of drugs by staff.

Quality control (QC) pharmacists utilized Deming's cycle quality improvement techniques and builded computerized control system to improve the returned injectable medications rate in nursing stations. Methods: The study period was from January 2014 to December 2014. QC pharmacists designed questionnaires, and then distributed and visited the nursing stations to collect the questionnaires. Following the quality control steps of Deming's cycle ( Plan, Do, Check, Action) to improve the discontinued injectable medications return rate. Results: The total of 183 questionnaires collected. After brainstorm and discussion, we identified 4 major factors which included " Discontinued prescription approaching the time of administrationďź? medication had been used before discontinuation", "Discontinued prescription after the time of administration" , " Nursing station have no real- time prescription information" , and " Do not follow the institutional procedure to return the discontinuedmedication" . Based on these four factors, we developed some automatic control strategies between the computerized physician order entry system and the computerized nursing cart to overcome these failures. The system was established in Q4 2014. After intervention, the discontinued injection medications return rate was improved from 97.41% in Q3 2014 to 99.18% in Q4 2014.Conclusions: We utilized the Deming's cycle to build the computerized control system, and efficiently enhanced the discontinued injection medications return rate. Other factors which may affect the nursing stations unable to return the discontinued medications need to continue follow up.

Keywords: discontinued medications, Deming's cycle, nursing station

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FAPA Congress 2016 | Bangkok, Thailand

H-P-57 THE EFFICACY AND SAFETY USING RITODRINE FOR LONGTERM TOCOLYSIS -THE EFFECTS OF PROVIDING DRUG INFORMATION BY PHARMASIST Aika Suemitsu1, Masanori Suzuki1, Makoto Suzuki2, Ryohkan Funakoshi1 1

2

Department of Pharmacy Services, Kameda Medical Center, Japan Department of Obsterics and Gynecology, Kameda Medical Center, Japan

Introduction: Ritodrine is a uterine tocolytic agent as beta agonist for preterm labor. In 2013, European Medicines Agency (EMA) recommended the short acting beta agonists must be use in short- term, maximum 48 hours. However, in Japan long- term, over 48 hours, treatment is widely used. The EMA recommendation was informed to physicians by pharmacist. Purpose: The efficacy and safety of ritodrine by comparing with before and after Drug Information (DI) provision were evaluated retrospectively. Methods: Women who treated with ritodorine for preterm labor from November 2012 to December 2014 were included in this single- centered retrospective study. It was divided into two group before ( B, from November 2012 to November 2013) and after ( A, from December 2013 to December 2014) DI provision.

Frequency of side effects as a primary endpoint, and the rate of use in long-term as a secondary endpoint were compared with two groups. The statistical analysis was used chi- squared test and set p < 0 . 05 to be significantly different. Results: 55 patients, 27 in B and 28 in A given ritodrine for preterm labor were included in this study. Frequency of side effects were 48. 1% and 35.7% in B and A (p=0.35). The rate of use in long-term was 81.5% and 46.4% in B and A( p= 0. 0069) . Conclusions: Providing DI by pharmacist made physicians conscious about using ritodrine, and it may make a contribution to the efficacy and safety of using ritodrine. It suggested that provision of DI by pharmacist lead to the patient safety by encouraging behavior change of physicians.

Keywords: ritodrine, uterine tocolytic agent, short acting beta agonists, long-term tocolysis, drug Information

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H-P-58 THE DEVELOPMENT OF WARFARIN CLINIC AND NETWORK IN PATTANI PROVINCE Jenjira Tantiviyavanit Department of Pharmacy, Pattani hospital, Maung, Pattani 94000 Thailand There are 1 general hospital and 11 primary hospitals in Pattani Province. Patients easily access to healthcare services such as a general hospital, primary hospital and health promoting hospital. However, the patients might have a risk of drug related problems (DRPs), especially in drug interaction which leads to bleeding or thrombosis in patients taking warfarin. Therefore, Warfarin Clinic has been established in Pattani hospital and also developed between healthcare units to give a counseling and provide the same standard service. The objective is to develop the effective warfarin network by training. The target group is the pharmacists working at the primary hospital. The pharmacists have been given the warfarin information, checked the past history and address, and send the information to each District where the patients are living.

After that, the primary hospital will send that information to health promoting hospital. Finally, the process will be assessed in term of percent warfarin clinic has been opened, percent of INR in target and major bleeding. The result showed that 100% of warfarin clinic has been opened; 6 one stop services and 6 co- operation with other clinics. There are 52. 4% for INR on target and 5 major bleeding. In conclusion, the development of warfarin clinic network can prevent the risks of warfarin bleeding. The healthcare units should be served the same service standard to prevent the occurrence of drug interaction, and give the information about precaution. And patients can access to the service at the primary hospitals.

Keywords: warfarin clinic, warfarin network

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FAPA Congress 2016 | Bangkok, Thailand

H-P-59 INFLUENTIAL FACTORS OF OXALIPLATIN-INDUCED NEUROPATHY Ping Yu Hsu, Hui Chen Su Background Chemotherapy- induced peripheral neuropathy ( CIPN) is a common treatmentrelated side effect and affects long- term quality of life. Chemotherapy combinations with higher incidences include those that involve platinum drugs and taxanes. Purpose Because there is no relevant guideline for the prevention from oxaliplatin-induced neuropathy, this study aims to investigate influential factors of oxaliplatin- induced neuropathy in order to provide information on clinical treatment and post-treatment care. Methods This retrospective study is conducted among those patients who receive oxaliplatin for treatment of colorectal cancer from January to May 2015 in a medical center in southern Taiwan. The data are processed and analyzed by SPSS 22.0 and explained with descriptive statistics as well as inferential statistics of Chi- Square Test, T- Test, Logistic Regression. Results There were 536 patients receiving oxaliplatin infusions from January to May in 2015. One hundred ninty patients suffered from neuropathy (35.4%).The proportion of those who suffer from oxaliplatin-induced neuropathy doesn’t show statistically significant difference (χ2=0.015,p=0.901) between male and female.

By the t- test, the result indicates the average age between those who suffer from neuropathy and who don’t is significantly different(p=0.028). Furthermore, through the logistic regression, this study finds the significant predictor for neuropathy was age (OR=1.019; 95% CI: 1.0031. 035;p= 0. 018) . Conclusions This study reveals that there is no statistically significant correlation between oxaliplatin- induced neuropathy and gender. However, age may increase the incidence of oxaliplatin- induced neuropathy. The findings provide information that we should pay more attention to the elderly patients who receive oxaliplatin and give them some drugs to stabilize nervous system if necessary.

Keywords: oxaliplatin, neuropathy, Influential factor

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FAPA Congress 2016 | Bangkok, Thailand

H-P-60 CLINICAL PHARMACIST’S CONTRIBUTION TO OPTIMIZE DRUG THERAPY AT AN ACADEMIC HOSPITAL Agil Mus, Desye Tanan Department of Pharmacy, Cipto Mangunkusumo Hospital, Jakarta, Indonesia Backgrounds: The goal of drug therapy is to achieve defined therapeutic outcomes that improve a patient’s quality of life while minimizing patient risk. The strategy of clinical pharmacist to optimize drug therapy is by identifying drug- related problems. Clinical pharmacist plays an important role in drug therapy and collaborate with other healthcare members to improve patient’s quality of life. Purpose:The study was intended to describe the contribution of clinical pharmacists at an academic hospital to optimize drug therapy by identifiying and resolving DRP.Methods: Documentation of clinical pharmacists’ intervention over period of January to December 2015 was collected. All actual and potential DRP during prescribing, dispensing and administration process were analyzed. Each case was classified according to the Hepler and Strand definition.

Recommendation initiated by clinical pharmacists was also evaluated. Results: The number of DRP identified was 2892. Most of the problems occurred during prescribing and were identified by clinical pharmacists when they performed medication review prior to dispensing, meaning that most of the problems were prevented to reach the patients. The patients were prescribed higher doses than they needed in 45. 2% of cases, followed by subtherapeutic dose 17.5%, improper drug selection 12.7%, untreated indications 10.9%, drug use without indication 7.7%, failure to receive drugs 4.6%, and drug interactions 2.0%. Most of the recommendation (98.5%) was accepted by other healthcare team members.

Conclusions: Clinical pharmacists at an academic hospital have shown their contribution to optimize drug therapy by identifiying DRP, preventing and resolving DRP. Their contribution was well accepted by other healthcare team members.

Keywords: Clinical pharmacist, contribution, drug related problem

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FAPA Congress 2016 | Bangkok, Thailand

H-P-61 INTERACTION BETWEEN SUPPLEMENT AND WARFARIN: CASE REPORT CHLOROPHYLL EXTRACTED JUICE Parnrada Nulsopapon1, Pornwalai Boonmuang2, Wichai Santhimaleeworakul2 1

2

Deparment of Pharmacy, Phramongkutklao hospital, Bangkok 10400 Thailand Department of pharmacy, Falculty of Pharmacy, Silpakorn University, Sanamchandra Palace, Nakhon Pathom 73000 Thailand

The purpose of this study was to evaluate and report a case of elevated international normalized ratio ( INR) in a patient taking chlorophyll extracted juice. Drug- Supplement interactions between warfarin and chlorophyll extracted juice have been reported but there was no clear evidence-supporting such interactions. The case study could be used as one of the fundamental practice guidelines to show the effect of interaction. The case summary, 58- year-old Thai man taking warfarin for prophylaxis blood clots after heart valve replacement. He took warfarin 17. 5 mg total weekly dose and controlled INR into therapeutic range. This regular visit, he came to the warfarin clinic for followed up INR. The INR changed from 2.99 to 1.30. He forgot to took warfarin one time for last week and some chlorophyll extracted juice about 50 millimeters for one months that no other factors affect to INR. This visit the patient confirmed to continue drinking chollophyll extract. So, physician increased warfarin doses to 21 milligrams per week. One month later, he came to hospital for checked up INR and INR value were 1. 68. The mechanism of interaction showed that vitamin K1 ( phylloquinone) from chlorophyll extracted juice is an antidote for warfarin, resulting in a decrease in INR. However, other factors such as patient compliance and/ or drug- drug interactions can change the INR. Therefore, pharmacists have to take into consideration and continuously monitor the INR in patients who receive warfarin.

Keywords: warfarin, chlorophyll, interaction

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FAPA Congress 2016 | Bangkok, Thailand

H-P-62 EFFECT OF POLICY AND FACTORS ASSOCIATED WITH ANNUAL HbA1C TEST FOR TYPE 2 DIABETES MELLITUS PATIENTS: A LONGITUDINAL STUDY Sawaeng Watcharathanakij1, Aporn Jaturapattarawong2 1

Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, 34190, Thailand Department of Pharmacy and Consumer Protection, Warinchamrap Hospital, Ubon Ratchathani, 34190, Thailand

2

Introduction: In 2011, annual HbA1C test policy was implemented to monitor disease progression in type 2 diabetes mellitus ( T2DM) patients. However, disparity in accessing to this test may exist among patients with different health insurance schemes. The objectives of this study were to identify factors associated with receiving annual HbA1C test and assess the effect of this policy. Methods: T2DM patients who received out-patient care during 2009-2011 were identified with ICD10 code ( E11X) and HbA1C test results were also retrieved from hospital database. Multilevel logistic regression was used to identify factors associated with annual HbA1C test provided and assess the effect of annual HbA1C test policy. Results: Of 4,289 T2DM patients identified, 42. 53% , 43. 44% and 46. 21% of patients received annual HbA1C test from 2009 through 2011 respectively. Female patients, patients with civil servant benefit scheme, and patients with comorbidities were more likely to receive HbA1C test than male patients, those with other insurance schemes, and those without comorbidity, respectively (95% CI of OR = 1.07-1.62, p < 0 .01, 95% CI of OR = 1.56-2.69, and 95% CI of OR = 2.864.87, respectively, all p < 0 .001). After annual HbA1C test policy was implemented, T2DM patients were 1.52 times likely to receive HbA1C test than before (95% CI of OR=1.31-1.76, p < 0 .001). Conclusion: T2DM patients were more likely to receive annual HbA1C test after the policy was implemented. However, different access to this test among gender, health insurance schemes and comorbidities still exists. Healthcare professional should be reminded to assure that all T2DM patients receive an annual HbA1C test.

Keywords: annual hba1c test policy, disparity, longitudinal study

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FAPA Congress 2016 | Bangkok, Thailand

H-P-63 THE IMPACT OF UNIVERSAL HEALTH COVERAGE IN INDONESIA ON CLINICAL OUTCOMES AMONG TYPE 2 DIABETES MELLITUS PATIENTS Mita Restinia1, Yusi Anggriani1, Agus Purwanggana1, Aries Meryta1, Jenny Pontoan1, Tri Kusumaeni2, Yuli Asnanik3 1

Faculty of Pharmacy, Pancasila University, Jakarta 12640 2 Persahabatan Hospital, Jakarta 3 Marinir Cilandak Hospital, Jakarta

Objective: This study was carried out to determine the impact of universal health coverage in Indonesia, known as Jaminan Kesehatan Nasional (JKN) on frecuency of fasting blood glucose ( FBG) tests each hospital visit and clinical outcomes ( CO) in type 2 diabetes mellitus ( DM) patients. Methods: A longitudinal study before and after JKN was conducted using retrospective sampling method. The subjects were taken from all type 2 DM in outpatients services using ASKES (insurance for civil servant and pensioner before the implementation of JKN) at 3 hospitals in Jakarta Province between July 2013 and December 2014.Results: Total samples were 296 patients divided to predominance female with 166 ( 56% ) and male 125 (44%). The data showed that not all patients did FBG tests. There were only 50% of patients who got that test before JKN. Meanwhile, the percentage decreased mainly at the start of year implementation of JKN to about 34% . Number of visit and number of patiens fell in era of JKN. Based on FBG level, 17(9.19%) patients had better CO and this number increased slightly after JKN to 22( 11. 89% ) . In contrast, patients with worse FBG level decreased about 9% .

More patients had bad stable and less patients had good stable FBG level. It was assumed that CO before and after JKN were statistically similar (P=0.524). Conclusion: Implementation of JKN had impact to decrease percentage of patients who did FBG tests, declined number of visit and number of patients. There were no significant difference in CO between before and after JKN. Keywords: universal health coverage, type 2 DM, clinical outcome

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FAPA Congress 2016 | Bangkok, Thailand

H-P-64 A CASE SERIES ANALYSIS OF HYBRID THERAPY FOR HELICOBACTER PYLORI INFECTION Pei-Ying Chen, Hsu-Huei Lai, Chun-Yen Wang Pharmacist of Show Chwan Memorial Hospital Helicobacter pylori ( HP) infection is a very common gastric infection which is significantly increases the risk of developing gastric or duodenal ulcers, gastric adenocarcinoma, and mucosa â&#x20AC;&#x201C; associated lymphoid tissue lymphoma. Several standard regimens have been published to achieve eradication rate, these regimens include triple therapy ( proton pump inhibitor (PPI) + clarithromycin + amoxicillin or metrodinazole ) and Quadruple therapy (PPI + clarithromycin + amoxicillin + metronidazole) . Triple eradication rate is 75% , while quadruple therapy eradication rate can reached >90% . The quadruple therapy includes sequential, hybrid and concomitant regimen. We conducted a two year case series analysis to assess the completeness of the hybrid regimen as the first line therapy for HP infections in our hospital. The result of our analysis showed in 2014 there are 194 patients received hybrid therapy, the complete eradication is 61% , failure eradication 39% , in 2015 363 patients who were treated with hybrid and the complete eradication is only 51%, failure eradication is 49%.

In both two years, the assessment of HP finding was detected with CLO test and or histology, the eradication confirmation and follow up was performed with 13C-UBT. Adverse events of hybrid regimens are very low, such as bitter taste, nausea, vomiting, and diarrhea.

Keywords: Helicobacter pylori, hybrid therapy, eradication rate

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FAPA Congress 2016 | Bangkok, Thailand

H-P-65 UTILIZING HFMEA TO IMPROVE THE SAFETY OF CHEMOTHERAPEUTIC PROCESS Guan-Yu Lu, Chai-Hsing Wu, Szu-Hsu Tseng, Hua-Sin Chen Department of Pharmacy, Kuang Tien General Hospital, Taichung Taiwan; 2.Taichung County Pharmacist Association, Taichung Taiwan; 3.Research Institute of Biotechnology, HungKuang University, Taichung Taiwan Object: Chemotherapeutic medications are cytotoxic drugs, any error may cause serious effect.

We utilized healthcare failure mode and effect analysis ( HFMEA) to improve the safety of chemotherapic process. Methods: The study period was from Jan 1, 2014 to Dec 31, 2014.

HFMEA which includes five steps. Step 1: Define the HFMEA topic. Step 2: Assemble a multidisciplinary team. Step 3: Graphically describe the process. Step 4: Conduct a hazard analysis - hazard scores (HS). Step 5: Actions and outcome measures. Results: In this study, we identified 29 failure modes and 41 potential causes. After conducting a hazard analysis, we determined 2 failure modes and 3 potential causes warranted further actions. The actions included connecting the computerized physician order entry system to the pharmacy compounding system and nursing care system. Besides, we used bar- code technique to recognize prescriptions, medications, and patients. These actions were started from 2014/4/1, the chemotherapeutic process near miss events were significantly descending. The percentages of the prescription error and the completion rate of intravenous chemotherapy were 0. 04% (down from 0.12 in 2013) and 100% (up from 96% in 2013), respectively. Conclusions: Our study showed that HFMEA technique could effectively improve the chemotherapeutic processes and could significantly increase the oncology patient safety.

Keywords: healthcare failure mode and effect analysis, chemotherapy, patient safety

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FAPA Congress 2016 | Bangkok, Thailand

H-P-66 IMPROVING PRESCRIPTION REFILLED RATE AND MEDICINE ADHERENCE Hui Chu Lee1, Chiao Hui Huang1, Tzu Cheng Tsai2, Shin Tarng Deng2 1

Pharmacy, Taoyuan Chang Gung Memorial Hospital 2 Pharmacy, Linkou Chang Gung Memorial Hospital

According to the population data, Taiwan has become an aging society. Incidences of chronic and degenerative diseases are increased in elders, and as a result, the adherence of medicine is very important for these patients. In order to increase the speed and convenience of refill prescription, we provide prepared medicine service for patients to refill their prescriptions.

However, we found out 19. 24% of those who had reserved didnâ&#x20AC;&#x2122; t come back to refill their prescription in March 2015, thus they may suffer from inadequate treatment. We applied problem- solving Quality Control Circle ( QCC) to improve refilling rate in 2015. 3- 2015. 10.

Through brainstorming and discussion, we found out the problems and solved them. First, we established a counter for people who had reserved prepared medicine service. According to the questionnaire, some pharmacists and nurses of out-patient department didnâ&#x20AC;&#x2122;t know how to refill prescription. To improve this situation, we established an operation manual and educated them.

Simultaneously, we created a poster to introduce the reserved service of refillable prescription and steps to refill medicine in the waiting area in the pharmacy. Then, we conducted a health seminar to teach people the safety of medication and how to refill prescription. After activity, we gave them a 7 days pill-box to help them take their medicine on time. After our effort, the non- refill rate was decreased by 14. 23% ( 2015. 10) and 12. 42% ( 2016. 04) by continuous improvement. As a result, the application of QCC activity can decrease the non-refill rate and further improve the safety of medicine.

Keywords: refillable prescription, quality control circle

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H-P-67 COMPARATIVE EFFECTIVENESS OF DIFFERENT PRODUCTS OF HYALURONIC ACID IN THE TREATMENT OF KNEE OSTEOARTHRITIS. .

Pei-Ying Chen, Ya-Ling Yeh, Chun-Yen Wang Show Chwan Memorial Hospital Knee osteoarthritis ( OA) is a common and progressive joint disease affecting people in their old age. Intra-articular treatment with Hyaluronic acid (HA) has been widely used clinically to reduce patient knee function movement and subside the use of pain killers. These agents are formulated in different molecular weight, we ran a meta- analysis review to determine which kind of molecular weight give a better effectiveness. Our result revealed that there is no significant differences of effectiveness between different molecular HA. HA versus placebo showed mean pain reduction 30% , versus physiotherapy is 33% , versus no treatment is only 20%.

Keywords: hyaluronic acid, knee osteoarthritis

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H-P-68 THE OUTCOME OF PHARMACISTS' INTERVENTIONS ON DOSE ADJUSTMENT IN HOSPITALIZED PATIENTS WITH RENAL IMPAIRMENT ON COST SAVING AND COST AVOIDANCE Rachanont Hiranwong, Thanapon Jantarangsri, Kanchana Bunsoot, Phutthimon Howattanapun Pharmacy department, Banglamung Hospital, Chonburi 20150 Thailand This study aims to evaluate the cost saving and cost avoidance from Adverse Drug Reaction Prevention by providing appropriate information on drug dosage adjustment for hospitalized patients with renal impairment by the pharmacists. The study was descriptive design using one group one measurement, and was prospectively conducted in hospitalized patients with renal impairment and creatinine clearance < 60 ml/ min who admitted between July and October 2014.All 106 renal impairment patients with 127 prescribings require 74 time for pharmacistsâ&#x20AC;&#x2122; interventions on proper drug dose adjustment; 66 (89%) times doctor accepting. For 16,721.34 baht (522.54 USD) on drug cost saving and 49,354.80 baht (1,542.34 USD) on adverse drug reaction cost avoidance. Totally cost saving are 66,076. 14 baht ( 2,064. 88) ; 1,001. 15 baht ( 31. 29 USD) per intervention. It was concluded that pharmacists could provide appropriate information on drug dosage adjustment for hospitalized patient with renal impairment and save drug cost.

Keywords: renal impairment, dose adjustment, cost saving, cost avoidance

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H-P-69 MEDICATION RECONCILIATION BY PHARMACLOUD TECHNOLOGY TO IMPROVE PATIENT SAFETY Chieh-yu Liao, Ming-Fen Wu, Ying-Mei Liu, Wen-Shyong Liou, Chieh-yu Liao Department of Pharmacy, Taichung Veteran General Hospital, Taichung, Taiwan The significant number of people receiving multiple medications and the complexity of managing make medication reconciliation an important safety issue. However, the most difficulty is the lack of a reliable source to gather patient’s complete and accurate medication.

Recently in Taiwan, the National Health Insurance promotes a system provides the patient’ s recent medication usage data for past three months electronically through cloud technology with health insurance card ( PharmaCloud) . Medication information was collected easily and assessed with the system. A 1514- bed hospital, located in the central part of Taiwan, applies PharmaCloud technology to develop comprehensively approaches includes novel information technology: timeline system and screening medication omission program, pharmacists and patient consultation before admission and medication reconciliation after admission. From September 2014 to May 2016, pharmacists used the PharmaCloud technology system to interview 10480 newly admitted patients to reconcile their medications, an average of 499 patients per month. Pre-admission adverse drug events (ADEs) documented during pharmacist consultation is mainly duplicate medication ( 1. 9% of total patients) . After admission pharmacists performed 356 patients’ medication reconciliation in average per month. About 8. 3% of patient had ADEs documented and the most common reported was the medication omission ( 5. 1% ) , followed by inappropriate dose ( 0. 9% ) , duplicate medication ( 0. 6% ) , inappropriate frequency (0.6%), inappropriate use (0.5%), inappropriate dosage form (0.1%) and others (0.4%). The physician acceptance rate for pharmacist ADEs recommendation was 74. 9% in average. The implementation of PharmaCloud technology and medication reconciliation conducted by pharmacist may detect ADEs early and reduce the risk of harm to improve patient-centered safety.

Keywords: pharmacloud, medication reconciliation, adverse drug events

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H-P-70 A PROSPECTIVE STUDY ON ADVERSE DRUG REACTIONS IN HOSPITALIZED PATIENTS. ADR MANAGEMENT - AN EMERGING ROLE FOR A CLINICAL PHARMACIST Anusha Bompelli, Jayapal Reddy Thumma, Swathi Yerram St. Peter's Institute of Pharmaceutical Sciences, Vidyanagar, Hanamkonda, Warangal 506001, Telangana, India Adverse drug reactions ( ADRs) in an individual can be the reason for hospitalization or can occur during a hospital stay. The ADRs are usually dose related, due to allergy or idiosyncratic in nature and the mechanism leading to an ADR can be either pharmacokinetic or pharmacodynamic or mixed. Patients admitted in the hospital were assessed and followed for ADRs. 313 ADRs were identified in a period of 10 months and the ADRs were analyzed for avoidability. Out of 313 ADRs, 62. 6% of ADRs were seen in female patients and 37. 4% in male patients. 36-44 yearsâ&#x20AC;&#x2122; age group were found to develop 17.9% ADRs followed by 18-26 yearsâ&#x20AC;&#x2122;, 54-62 years with 14.7%. The ADRs in general medicine department were found to be of 33.5% followed by cardiology (12.9%) and Psychiatry (12.5%). The fate of suspected drug was found to be withdrawn in 57. 8% patients, no change in 30% and dose altered in 12. 1% .

The treatment given was symptomatic in 43. 5% , Nil in 33. 5% and specific in 23% patients.

Majority of the ADRs are pharmacodynamic in nature. Over a half percent of the ADRs are definitely avoidable or preventable. The major strategy in reducing the burden of ADRs would be through therapy management, ADR avoidability, identification, and management by a clinical pharmacist thus improving the therapeutic outcome and quality of life in patients.

Keywords: adverse drug reactions, therapy management, clinical pharmacist

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H-P-71 THE SURVEY OF HOSPITAL PHARMACY PRACTICE IN ASIA Mei-Yu Chen, Chia-Lin Chou, Yuh-Lih Chang, Yueh-Ching Chou Pharmacist, Taipei Vetarans General Hospital Background and purpose: The core value of hospital pharmacist is to ensure safe and effective medication therapy. However, hospital pharmacy services may vary among different countries because of the government policies, hospital organization and resources, and expectation from the society. The Clinical and Hospital Pharmacy Section of the Federation of Asian Pharmaceutical Association (FAPA) aims to explore and establish the best hospital practice for Asian hospitals. Therefore, we conducted a survey of Asian hospital pharmacy services to understand the structure and diversities in hospital pharmacy services among Asian countries.

Methods: The questionnaire included seven aspects regarding the services and structure in hospital pharmacies. The invitation for participation was sent by FAPA Secretariat and by the experts in 6 Asian countries recommended by FAPA. Data collection was from 1st March to 7th May, 2016. Results: Thirty- four respondents were from Australia, Taiwan, Japan, Philippines and Pakistan. Hospital size and outpatient service volume varied among respondents. In medication distribution model, Taiwan and Philippines mainly applied unit dose system while Japan and Australia mainly applied mixed models. The most popular information technologies applied in pharmacies were inventory management system and barcode assistant system. In clinical service, all respondents provided patient education and adverse drug reaction report, and most hospitals provided therapeutic drug monitoring.

Conclusion: This was the first survey of hospital pharmacy service conducted by FAPA. The results provide meaningful information for the Hospital and Clinical Pharmacy Section of FAPA to plan future programs for FAPA members.

Keywords: hospital pharmacy, pharmacy practice, Asia

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H-P-72 DRUG RELATED PROBLEMS IN HEMODIALYSIS PATIENTS: SINGLE CENTER EXPERIENCE Kanokrat Rungtivasuwan1, Sutthirat Inmuanghiranchot1, Montira Assanatham2, Patcharin Supapsophon1 1

Pharmacy Services, Somdech Phra Debaratana Medical Center (SDMC) Bangkok Thailand 2 Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital

Introduction: Hemodialysis patients are at risk of complicated comorbidities. They frequently have medical issues that should be addressed to provide an appropriate treatment immediately.

Pharmacist is one of the important members of patient care team in determining and resolving drug related problems ( DRPs) . Methods: A cross- sectional study was performed at SDMC Hemodialysis Unit from January to December 2015. Every 6 week, pharmacists reviewed patients’ current medication records and laboratory results. Feedbacks and suggestions were given to physicians and patients to optimize the pharmaceutical therapies. Results: A total of 48 hemodialysis patients were included. About 58. 3% were women with the average age of 71. 6 ± 12. 0 years. Average medicine usage per patient was 16. 2 ± 4. 5 items ( range 8- 29) .

Among 315 encounters, 206 DRPs were detected. The average (median) number of DRPs for each patient was 3 (range 0-19). The common DRPs founded were noncompliance (43.2%), dosage too high (18.9%) and need for additional drug therapy (15.5%). The top 3 drugs that contributed to DRPs were calcium carbonate ( 14. 1% ) , sodium bicarbonate ( 12. 6% ) and erythropoietin (8. 7%). The acceptance for modification was 96.1%. Interestingly, we found that 2 patients took an expired medicine and 1 patient stored medicine under inappropriate condition which may decrease efficacy and increase toxicity of the drugs. Conclusions: DRPs can be found commonly among hemodialysis patients. Pharmacist as one of the multidisciplinary team members should be a key person involving in DRPs management to improve medication usage and treatment outcomes.

Keywords: drug related problems, hemodialysis patients, SDMC

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H-P-73 ELEVATED SERUM TRANSAMINASE AND TOTAL BILIRUBIN IN PEDIATRIC PATIENTS DURING THE INTENSIVE PHASE OF TUBERCULOSIS TREATMENT Fajri Gafar1, Helmi Arifin1, Yusri Dianne Jurnalis2, Finny Fitry Yani2 1

Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Andalas University, Padang, Indonesia.

2 Department of Child Health, Medical School, Andalas University, M. Djamil Hospital, Padang Indonesia.

Background: Elevated liver enzymes during tuberculosis treatment may develop into hepatotoxicity which lead to increase in patient morbidity and mortality and also diminishes treatment effectiveness. Objective: To determine the elevation of serum transaminase and total bilirubin in pediatric patients during the intensive phase of tuberculosis treatment. Methods: We performed a prospective observational study in M. Djamil Hospital, Padang, Indonesia from September 2015 to April 2016. The diagnosis of tuberculosis based on Indonesian pediatric tuberculosis scoring system. Liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin were performed before initiation of tuberculosis treatment, after two weeks, and subsequently after 4, 6 and 8 weeks if the initial 2- week measurement was abnormal. Elevations of transaminase and total bilirubin on pretreatment levels versus peak levels during tuberculosis treatment, were analyzed by Wilcoxon sign-rank test. Result: Among 41 patients, 26 (63.4%) were boys and 15 (36.6%) girls, with mean Âą SD age was 5. 89 Âą 4. 11 years. A total of 19 ( 46. 4% ) patients had pulmonary tuberculosis and 22 ( 53. 6% ) had extra- pulmonary tuberculosis. Wilcoxon sign- rank test showed that administration of anti- tuberculosis drugs, statistically significant in increased of ALT (Z= -2.000; P= 0.045) and AST (Z= -2.675; P= 0.007) between pre-treatment levels compare to peak levels during tuberculosis treatment, but did not significantly difference on total bilirubin (Z= -1.257; P= 0.209). Conclusion: Administration of anti-tuberculosis drugs increased ALT and AST levels in patients during the intensive phase of tuberculosis treatment.

Regularly monitoring of liver function tests are needed to prevent hepatotoxicity.

Keywords: anti-tuberculosis drugs, hepatotoxicity, serum transaminase, total bilirubin, pediatric

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H-P-74 RETROSPECTIVE EVALUATION OF DORIPENEM AT THE TEACHING HOSPITAL IN THE CENTRAL TAIWAN Hsu-Chic Lin1, Chun Yi Chuang2, Hao Ting Gao1, Hsiu Fang Chang1 1

Department of Pharmacy, Dajia Lees General Hospital, Lees Medical Corporation, Taichung 437, Taiwan (R.O.C.) 2 Department of Pharmacy, Yuanli Lees General Hospital, Lees Medical Corporation, Miaoli 358, Taiwan (R.O.C.) Background: Doripenem is the most recently introduced antibiotics of carbapenem class, it is using to treat Gram ( - ) bacteria infections. As antibiotics resistance getting increasing, effectively choosing antibiotics is a major challenge for clinicians. The aim of this study is to investigate the efficacy and safety of doripenem in clinical use, and to develop guidelines.

Method: This is a retrospective study. Data was reviewed from the patients’ notes, 71 adults who infections which were treated with doripenem more than three days at the teaching hospital in the central Taiwan from October 2015 to March 2016. Result: Of 71 patients with a mean age of 70. 9 ± 12. 1 years, the average number of days of medication was 10. 3 ± 5. 9 days, 24 people (33.8%) infection with the urinary tract infections (uncomplicated type, complex type), 20 people (28.2%) with pneumonia, bacterial eradication rate was 45.8%, the survival rate was 56. 3% . The survival and death groups for comparison, the site of infection and bacteria can affect mortality, p values were ( 0. 0001; 0. 0023) , urinary tract infection cure rate was 75% , 50% cure rate of pneumonia. The failure to eradicate bacteria mainly MDRAB, followed by Klebsiella pneumoniae ( ESBL) . There was rarely observed side effects, 2 cases decreased in valproic acid blood levels caused sizure incidents. Conclusion: This study revealed that, use of doripenem in the urinary tract infection treatment has better cure rate of, although in the treatment of pneumonia have’nt a higher mortality rate, it is recommended to comply with the FDA's drug alerts.

Keywords: doripenem, Gram (-) bacteria, urinary tract infection, pneumonia

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H-P-75 POTENTIALLY INAPPROPRIATE PRESCRIBING ACCORDING TO THE STOPP/START CRITERIA FOR ORDER ADULTS IN RESIDENTIAL CARE SETTING IN THE CENTRAL TAIWAN Hsu-Chic Lin1, Chun Yi Chuang2, Hao Ting Gao1, Hsiu Fang Chang1 1

Department of Pharmacy, Dajia Lees General Hospital, Lees Medical Corporation, Taichung 437, Taiwan (R.O.C.) 2 Department of Pharmacy, Yuanli Lees General Hospital, Lees Medical Corporation, Miaoli 358, Taiwan (R.O.C.) Objective: Potentially inappropriate prescriptions ( PIP) and potential prescribing omissions ( PPO) are the major issue in pharmaceutical therapy for older adults, because it can increase the risk of adverse drug events. The aim of this study was to evaluate the prescription of PIP and PPO in older adults. Method: The STOPP/ START criteria was used to identify PIP and PPO. The data collected from the medical records of people older then 65 years living in residential care setting in the central Taiwan. Result: The number of older adults in this study was 93 (mean age was 79.3±7.2 years), the mean number of medicines prescribed was 6.8±1.6 and coexisting disorders was 4. 1±1. 3. We found that, 90 PIPs among 53 ( 57. 0% ) residents were identified. Most common PIPs were calcium channel blockers in patients with constipation ( 17. 8% ) and proton pump inhibitors for peptic ulcer disease at full therapeutic dosage for longer than 8 weeks ( 11. 1% ) . There were 28 ( 31. 1% ) residents had at least one PPO. Most common PPOs were statin (32.3%) and antiplatelet (21.4%) therapies in diabetes mellitus (DM) with cardiovascular risk factors. PIP was independently associated with number of medications. PPO was independently associated with disease. Conclusion: This study revealed that, a highly prevalent of PIPs in older adults in residential care. The STOPP/START criteria provide a useful tool for detecting inappropriate drug to help improve the medicine therapy in older adults living in the residential care setting.

Keywords: STOPP/START criteria, potentially inappropriate prescription (PIP), potential prescribing omission (PPO)

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H-P-76 LABEL INSTRUCTIONS THAT MEET THE NEEDS OF PATIENTS WHO ARE AT HIGH RISK OF MISUNDERSTANDING Mei Ju Chien, Tina Yun-Ting Pan, Yi Zu Wang Department of Pharmacy, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.) Purpose: To help patients understand dosage instructions, the medication label at our medical center contains enlarged traditional Chinese letters of 14 points and pictorial icons. The aim of this study is to evaluate the current dosage instructions, collate information on patient preferences and develop the patient centered optimum service. Methods: Patients who are at high risk of misunderstanding prescription label ( the elderly, limited literacy or those with vision impairment) were eligible to participate. If patients cannot correctly interpret the prescription label and pictorial icons, one of the pharmacists discussed with patients on their individual preferences. Patients’ interpretation of the new modified label instructions were then checked by another independent pharmacist. If label modifications allowed patients to understand how to take their medications, this data were collected. Results: 74 patients were recruited. Of these patients, 52.9% needed the label written in larger font ; 41.2% wanted label to be modified based on patient preferences; 5.9% can understand the pictorial icons. In these three methods, elderly patients have no particular preference (p=0.269). Patients with limited literacy preferred instructions to be written in a simple and clear format using arabic numerals.

Patients with vision impairment preferred to be written in larger font: approximately 36 points( r= + 0. 677，p= 0. 0001) . Conclusion: This study does not support the use of pictorial icons. Efforts to improve label format include the use of larger font and numeric presentation.

Pharmacist should be proactive to evaluate patients’ preferences for the medication label, individualize the label according to their needs and provide a friendly environment for patient counseling.

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H-P-77 EVALUATE THE EFFECTIVENESS OF PHARMACY INTERN TRANING PROGRAM WITH OBJECTIVE STRUCTURED CLINICAL EXAMINATION Mei-Chu Huang, Yu-Chieh Chen, Yih-Dih Cheng, Yow-Wen Hsieh Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan Objectives: In order to enhance professional skills and learning attitude of pharmacy interns, we established a practical and feasible training program with Objective Structured Clinical Examination (OSCE) in a medical center to evaluate the pharmacy internâ&#x20AC;&#x2122;s overall professional competencies in clinical pharmacy skills. Methods: There were 18 pharmacy interns enrolled in the program in a medical center from September, 2015 to January, 2016. A total of 640hours courses were required to complete the internship program. To develop the OSCE, we designed four clinical scenarios with the help of eight pharmacists and eight standardized patients to assess the learning outcomes. A 5- point Likert scale survey instrument was developed to evaluate all participants (interns, instructors & standardized patients) satisfaction about the OSCE. Descriptive statistics were calculated by using with Microsoft Excel 2007.

Results: All participants completed the survey (n=34). Nearly 95% of pharmacy interns were satisfied or very satisfied with the OSCE. Surprisingly, all pharmacists and standardized were satisfied or very satisfied with the OSCE (100%). The overall satisfaction rate is 94.45%, and average score is 3. 88 points ( out of 5. 0) . Conclusion: The OSCE not only successfully evaluated professional and communication skills for pharmacy interns, but also generated high satisfaction for all participants involving in the training program. We should keep this training design in the future, so as to continuously enhance the quality of pharmacy practice experience in the hospital.

Keywords: objective structured clinical examination, pharmacy intern education

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H-P-78 MULTIFACETED APPROACH TO ENHANCE THE ACCURACY OF DISPENSING AT A MEDICAL CENTER WITH HIGH PRESCRIPTION VOLUME Tzu-Hui Yeh, Tina Yun-Ting Pan Department of Pharmacy Far Eastern Memorial Hospital. No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan (R.O.C.) Objective: At our medical center, the outpatient pharmacy has a high prescription volume (50 prescriptions / hr / person) . “ Tall man letters” are used on the medication labels as recommended by the Institute of Safe Medication Practices to prevent dispensing errors.

However, this approach is unsuccessful with medications with multiple strengths as they have the same generic/trade name and similar packaging. Other interventions are required to ensure easier verification of medications in a busy setting for pharmacists from a non-English speaking background. Methods: The dispensing quality control team implemented several strategies to promote accurate dispensing. For medications with multiple strengths produced by the same manufacturer, the color of the packaging is emphasized on the label in Chinese. For medications with multiple strengths or formulations, ancillary labels are used to identify medications. Brightly colored stickers with the strength of the medication are affixed onto the blisters. Results: Newly designed medication label were implemented for many of the medications on the formulary: 23 items emphasized the color of the packaging for medications with multiple strengths in Chinese, 109 items with reminders for formulation, 47 items are labeled using “ tall- man letters” . The new approach reduced the overall outpatient drug dispensing errors from 0.012% from 2012 to 0.006% in 2015. Conclusion: The novel strategies were highly successful in preventing dispensing error. In the future for medications added to the hospital formulary, these strategies will be applied and advocated at the monthly department meetings.

Keywords: dispensing error, high prescription volume

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H-P-79 BORTEZOMIB-BASED THERAPY COMBINED WITH HIGH CUTOFF HEMODIALYSIS FOR A PATIENT NEWLY DIAGNOSED WITH MULTIPLE MYELOMA: A CASE REPORT Tzu Hsuan Ko, Tzu-Hui Yeh, Ming-Shya Wang, Shu-Hui Sun Department of pharmacy, Far Eastern Memorial Hospital No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan Background: Multiple myeloma (MM) is associated with excessive production of lambda light chains ( FLCs) that infiltrates kidney tubules, leads to renal insufficiency and adversely influences patient prognosis. Traditional hemodialysis is minimally effective to remove FLCs. However, high cut-off hemodialysis (HCO-HD) is a novel technology which is now available to remove FLCs. Past literature also demonstrated that bortezomib- based therapy can also improve renal function. The aim of this study was to evaluate whether HCO- HD combined with lenalidomide, bortezomib and dexamethasone (RVD) therapy was effective to minimize renal injury in a patient with MM. Case Report: This is a case of a 70 year- old male newly diagnosed with lambda FLC type of MM who presented with acute renal failure. Patient received 3-week cycles of standard RVD chemotherapy: bortezomib 1.3 mg/m 2 (days 1, 4, 8, 11) , lenalidomide 5 mg ( days 1- 14) , and dexamethasone 20 mg ( days 1, 2, 4, 5, 8,9, 11, 12) .

This is combined with nine HCO-HD sessions to remove lamda FLC. The dose of lenalidomide was adjusted similar to hemodialysis patients. The combination of RVD treatment and HCOHD led to his lambda FLC serum level was decreased from 4129 to 27. 14 mg/ L and serum creatinine levels decreased from 13. 5 mg/ dL to 8. 93 mg/ dL. Conclusion: This study demonstrates that the combination of HCO- HD with RVD therapy is highly effective in the removal of FLC, which in turn improve renal function and patient outcomes in patients newly diagnosed with MM. Keywords: multiple myeloma, high cut-off hemodialysis, lambda light chains, lenalidomide

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H-P-80 PHARMACISTâ&#x20AC;&#x2122;S ROLE IN A COLLABORATIVE ANTIBIOTIC STEWARDSHIP PROGRAM Tiao-Yang Hsieh1, ChenHsu Lo2 1

2

Department of Pharmacy, Show Chwan Memorial Hospital, Changhua County, Taiwan Department of Pharmacy, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan

The optimization of antibiotic use to combat infectious disease and to reduce antibiotic resistance is a global issue. Evidence has shown that antibiotic stewardship programs ( ASPs) can improve patient outcome, in addition to reduce healthcare- associated infections. We described the preliminary outcome of a collaborative ASP with pharmacist intervention at a community teaching hospital. We developed an ASP in 2014 led by a collaborative multidisciplinary team consisting of infectious disease specialists, clinical pharmacists, clinical microbiologists, infection control nurses and pharmacy informatics. The clinical pharmacists are responsible of auditing antibiotic therapy concurrently beginning in July 2014, using a computer- generated patient list. To measure the utilization of antibiotics, defined daily doses per 1,000 patient days are calculated monthly. A total of 9,069 antibiotic prescriptions were reviewed. Among these prescriptions, 71. 3% ( 6,492 prescriptions) were reviewed within 24 hours. 673 prescriptions were considered inappropriate ( 10. 2% ) and interventions were recommended by clinical pharmacists. The most common interventions were dose optimization (35.9%), discontinuation/change antibiotic class due to unclear indication and/or violation of guideline of empirical therapy (28.1%), de-escalation/discontinuation (10.7%). Glycopeptides utilization decreased by 16. 7% ( glycopeptide DDD mean 8. 4 vs 7. 0) . Pharmacists play an important role in ASP, which has a positive effect on antibiotic prescribing, reducing utilization of antibiotics. Creation of a system- supported prescribing guideline may be important to prospectively optimize antibiotic use.

Keywords: antibiotics, pharmacist, infectious disease

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H-P-81 THROMBOCYTOPENIA INDUCED BY THE COMBINATION THERAPY OF VALPROATE AND LAMOTRIGINE Chi-Hua Chen1, Hui-Hsia Hsieh1, Tien-Yuan Wu2 1

Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation 2 Department of Pharmacology, Tzu Chi University; Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Background: The possibility of drug- induced thrombocytopenia ( DITP) is considered as an unexpected problem, especially in- hospital- patient. DITP may be caused by several mechanisms such as direct bone marrow suppression or indirect organ toxicities. Valproate and lamotrigine are commonly used anticonvulsants combination with known hematological and liver toxicities, which are doses or plasma concentration dependent. Case:A 57-year-old male was diagnosed as an acute ischemic stroke treated on April 3, 2016. Valproate 800mg was given by orally three times a day. However, he developed thrombocytopenia when lamotrigine 50mg orally was added to become a combination regime. Initial blood and biochemistry survey showed hemoglobin 9.6 g/dl, platelet count 45,000/uL, and serum creatinine 0.8 mg/dl. Plasma valproate level was 87. 7 ug/ ml. Valproate which was withdrawal was considered as the drug induced thrombocytopenia. The platelet count increased ( 172,000 / uL) after valproate discharged. Discussion:Thrombocytopenia is one of the most common side effects associated with valproate therapy.

However, the exact mechanism of valproate- associated thrombocytopenia is still unclear. Kishi et al have shown that a high serum concentration of valproate is associated with bone marrow suppression. After withdrawal of valproate, the platelet count was return to normal levels immediately. Lamotrigine may have synegestic effects with valproate, enhanced thrombocytopenia. Conclusion: A precise pathophysiologic understanding of valproate and lamotrigine induced thrombocytopenia is still lacking, and further studies are required. Monitoring of platelet counts regularly is necessary in such combination therapy to prevent drug-drug interactions.

Keywords: thrombocytopenia; valproate, lamotrigine

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H-P-82 REFILL MEDICINES BOX REDUCE THE PROCESS OF SERVICES Apinan Khampetdee, Chalit Phankittikul Pharmacy department Ramathibodi hospital Rama VI Rd. Ratchathewi Bangkok 10400 Background: Falls are common in elderly patients and are often serious. Many steps of services that patients have to walk have been associated with an increased risk of fall. Objective: The project aimed to reduce the process of services that patients have to walk in order to reduce incidence of falls. Methods: The process of services was reduced by after patients receive medicines at hospital pharmacy they did not have to contact the orthopedics out- patient department again. Injection medicines were kept in refill medicines box then pharmacy staff brought it to orthopedics out- patient department on the following day instead of patients. Descriptive statistic was used for data analysis. Results: The findings revealed that the percentage of process of services that patients have to bring medicines to the out- patient department was reduced to 0 per cent and the incidence of fall was 0 per cent. Conclusion: The refill medicines box played more roles to reduce the risk of fall. It was recommended that in the treatment of elderly patients, medical staff should try to reduce the process of services that patients have to walk.

Keywords: fall, reduce the process of services, refill medicines box

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H-P-83 FACTORS ASSOCIATED WITH HYPERKALEMIA IN THE COMMUNITY HOSPITAL OF THAILAND Thiyapha Verayachankul, Phacharabongkoch Sukmee, Suwantida Isarowong, Oraphan Chamroen Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131 Thailand Potassium is an essential mineral in human body. A slightly change of serum potassium from normal range ( 3. 5- 5. 0 mEq/ L) lead to muscle and heart work abnormality and death. The objective of this study is to determine the potential risk factor for Hyperkalemia in the inpatient of Laemchabang Community Hospital, Chonburi, Thailand. The retrospective investigated data during 1 January 2014 to 31 December 2014. One hundred and forty nine patients who have been diagnosed with hyperkalemia ( potassium level â&#x2030;Ľ 5 mEq/ L) were totally recruited from the total population 10,487. The age was between 1-87 years old (mean 61 years old). Female were higher than male ( 55. 0% and 47% , respectively) . Most of all ( 61. 7% ) have mild hyperkalemia (K+ 5-5.9 mEq/L). There were three factors; age, diseases, and drugs, associated with hyperkalemia. Patient age â&#x2030;Ľ 60 years have a risk of hyperkalemia significantly (p < 0.001).

Diabetes mellitus ( 30. 2% ) , kidney disease ( 12. 1% ) , and heart failure ( 4. 69 % . ) could be induced hyperkalemia. Potassium chloride supplement elevated serum potassium and induced hyperkalemia ( 55. 17% ) . In conclusion, Pharmacist should be closely monitored serum potassium in the elderly, diabetes mellitus, kidney disease, and heart failure taking potassium supplement, for preventing hyperkalemia.

Keywords: hyperkalemia, elderly, diabetis mellitus, heart failure, potassium supplement

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H-P-84 KHMAER LABEL Apinan Khampetdee, Pannita Polthawichai, Tawanrat Satthaporn, Kiaporn Sutthanapan Pharmacy department Ramathibodi hospital Rama VI Rd. Ratchathewi Bangkok 10400 Background: Burden of language between Thai pharmacists and Cambodian patients affected to long time for dispensing time and patients satisfaction. Objective: The purposes of this project were to decrease dispensing time per patients and increase patient’ s satisfaction.

Methods: Khmer label was created in order to communicate with patients while dispensing at out- patient pharmacy. Questionnaires were used to evaluate patient’ s satisfaction and dispensing time was recorded. Descriptive statistics was obtained for analyzed the data.

Results: The findings revealed that patient’s satisfaction increased to 73.48% and dispensing time per patients was decreased from 8. 4 minutes to 4. 5 minutes conclusion: Khmer label facilitated Thai pharmacist to communicate with Cambodian patients. The labels also decreased dispensing time per patients and increased patient’s satisfaction. Based on the major findings, it was recommended that the label should create for more Keywords: Khmaer label, dispensing time, satisfaction

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H-P-85 ANALYSIS OF ADJUVANT CHEMOTHERAPY IN NON-SMALLCELL LUNG CANCER IN A HOSPITAL Pei-yi Lin1, Yi-Ping Hsiang1, Yu-Feng Wei2, Wang-Chun Chen1 1

2

Department of Pharmacy, E-DA Cancer hospital,Kaohsiung Taiwan Department of chest medicine, E-Da Hospital, Kaohsiung,Kaohsiung Taiwan

This is a retrospective study of cancer therapy prescriptions in a regional teaching hospital.

Through a survey of computer database, prescriptions of cancer therapy were analysed between January 2010 and December 2012 in a regional teaching hospital. The total medical utilization was evaluated using descriptive statistics which incorporates sex, age and medical therapy.

There were 98 newly diagnosed lung cancer patients and the treatment plan that includes surgery plus chemotherapy during 2010-2012. Among them, 48 NSCLC patients were treated by surgery and adjuvant chemotherapy in a regional teaching hospital. There were 22 (45.8%) males and, 26 (54.2%) females. Median age was 57 years (range, 35years to 79 years). Of 48 patients, 37 of 48(77.1%) were stage I-II; 11 of 48(22.9%), stage III-IV. Comprised 48 patients, 19 assigned to adjuvant chemotherapy regimen were Cisplatin combined with paclitaxel, 13 assigned to Cisplatin combined with vinorelbine, 15 assigned to Cisplatin combined with etoposide and one patients choice oral-UFUR. The most common toxicities were neutropenia (17.6% for paclitaxel; 18.1% for vinorelbine; 16.4% for etoposide). Conclusions: Based on this study result, there are high toxicities and low compliance by former chemotherapeutic regimens. They fail to provide survival benefit compared with observation. Cisplatin combined with vinorelbine is well tolerated third generation chemotherapeutic agents. The information on quality of life and cost should enable Patients and their clinicians to make more informed treatment choices.

Keywords: early stage non-small cell lung cancer, medical therapy, chemotherapy

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H-P-86 COLD CHAIN MANAGEMENT Arpar Ngampanya, Nantiya Ritdech Department of pharmacy, Ramathibodi Hospital. 270 Rama VI Road, Ratchatewi, Bangkok, Thailand 10400 Background: Sensitive refrigerated pharmaceutical products, if handle improperly, risk of quality and damage can be raised. Thus, products must be stored and dispensed in appropriate way to ensure the required temperatures are maintained throughout period of dispensing.

Objective: The study aimed to reduce incident of pharmaceutical damages caused by nonadequate cold chain management which result in hospital financial risk. Methods: While waiting customer process financial activities, refrigerated pharmaceutical products must be store into medical fridge, located near dispensing counter with ice box, by first pharmacist checking. The pack of product will tag with queue number. This tag will assist second pharmacist to packed ice pack together with product in picking process. Ice packs are added to maintain appropriate temperatures throughout. Descriptive statistic was used for data analysis.

Results: The finding revealed that after apply new process in cold chain management no pharmaceutical damage was found. Conclusion: Modifying cold chain management can perceive refrigerated pharmaceutical products quality and stability. Also, this process can ensure that refrigerated pharmaceutical products will properly dispensed to the customer.

Keywords: non-adequate cold chain, hospital financial risk

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H-P-87 ASSESSMENT OF DRUG-DRUG INTERACTIONS IN TREATMENT CHARTS OF HOSPITALIZED PATIENTS Mary Prasanna Kumari, Mahendra kumar Jayappa Bettur, Venkata Narayana T, Suma Latha G Faculty of Pharmacy, Vikas Institute of Pharmaceutical Sciences,Rajahmundry 533103, India Introduction: DDI’ s is related to the possibility of a drug to alter the effect of another drug administers simultaneously. There are three possible outcomes when DDI’ s occur, one drug may intensify the effects of the other, one drug may reduce the effects of the other and the combination may produce a new response which is not seen when either of the drug is given alone. DDI’s are widely predictable and thus avoidable and managed. Objective: The objective of the present prospective study is to evaluate DDI’ s in the medication charts of inpatients of Super Speciality Hospital, Rajahmundry, Andhra Pradesh, India. Methodology: This study was conducted at Super Speciality Hospital, Rajahmundry. Between April and September 2015 patients admitted in the Super Speciality Hospital were included in the study. Nearly data of 195 patients were collected which include case history, past medical history, laboratory values ,and drugs prescribed with their doses and frequency of administration were collected and subjected to DDI’ s analysis by using CIMS, ( central information of medical speciality) , Medscape, Micromedex, Drugs. com. Results and Discussion: During the six months study period a total of 195 patients were enrolled out of which 130 DDI” s were identified. Among 130 DDI”s identified, 73 were major (56.30%) and 43 were moderate one were minor (33.07%) and 14 were contraindicated drugs ( 10. 60% ) . Conclusion: Hence there is a need of clinical pharmacist role in the management of DDI’ s; thereby one can prevent the adverse effects due to DDI’s to the patients.

Keywords: drug interactions, screening, clinical pharmacist

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H-P-88 A TRANSPLANT PATIENT WITH CRYPTOCOCCAL PULMONARY INFECTION- CASE REPORT Li-Ching Chien Department of pharmacy, E-DA Hospital, Kaohsiung city, Taiwan Transplant patients need to take large doses of immunosuppressive drugs, resulting in higher infection rates. The case suffered from acute kidney injury and received renal transplantation in 2014. The case used Tacrolimus, Mycophenolate mofetil and other immunosuppressant after surgery. FK level over the past year is about 7. 4, creatinine level is around 1. 1. Chest X- ray examination revealed a patch lesion over right upper lobe on 2016/ 04/ 08. CT scan favored granulomatous infection. Laboratory reports showed positive cryptococcal Ag ( 2X) . The recommended regimen for cryptococcal infection are amphotericin B, fluconazole, or flucytosine; the patient received fluconazole 400mg once daily. The interaction between the drugs raises concern for transplant patients using tacrolimus and fluconazole. After starting with fluconazole, although tacrolimus dose is tapered by one-third (6mg to 4mg), FK level still increased by 2- 3 times. Creatinine level increased to 1. 6. According to weekly dose adjustments and intensive monitoring of drug concentration, Tacrolimus was adjusted to 1. 5mg once daily currently, and the target concentration was maintained between 4- 8. Renal function already returned within normal ranges.

Keywords: renal transplantation, drug-drug interaction, cryptococcal pulmonary infection

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H-P-89 PHARMACIST INTERVENTION IN PREVENTING PRESCRIBING ERRORS â&#x20AC;&#x201C;A SURVEY Mary Prasanna Kumari, Mahendra kumar Jayappa Bettur, Venkata Narayana T, Suma Latha G Faculty of Pharmacy, Vikas Institute of Pharmaceutical Sciences, Rajahmundry 533103, India Background: A prescription is a health- care program implemented by a physician or other qualified practitioner in the form of instructions that govern the plan of care for an individual patient. Formerly, prescriptions often included detailed instructions regarding compounding of medications but as medications have increasingly become pre- packaged manufactured products, the term "prescription" now usually refers to an order that a pharmacist dispense and that a patient take certain medication. Aim and objective: To study non- compliance with Prescription writing requirements, Prescription errors and Pharmacist Intervention Methodology: The study was conducted in the community pharmacies for over a period of two months. The new Prescriptions were screened prospectively to assess non-compliance for one or more of the legal or the procedural requirements of prescription writing and was recorded in a standard data collection form and analysed for pharmacist intervention. Result: Of the 1200 prescriptions screened during the study, 90% had one or more of the legal or procedural requirements missing. These errors of omission are patientâ&#x20AC;&#x2122; s age, gender, weight, dose, frequency, course prescribed. Errors of commission involved related to dosage form 5.8% and Polypharmacy 45% . Conclusion: The study shows a low compliance to the legal and procedural requirements for prescription writing and denotes significant scope to educate and emphasize the importance of writing clear and complete prescriptions to avoid medication related injuries, thus evidencing the need of constant evaluation of these events in order to prevent them and assure greater safety and success in the therapy.

Keywords: prescription writing requirements, prescription errors, pharmacist intervention.

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H-P-90 COMPARATIVE CLINICAL OUTCOMES BETWEEN EMPIRICAL THERAPY AND DOCUMENTED THERAPY OF IMIPENEM/CILASTATIN IN WARINCHAMRAB HOSPITAL. Watcharodom Supaluk, Aporn Jaturapatarawong Department of Pharmacy, Warinchamrab Hospital, Warinchamrab district, Ubonratchathani 34190 Thailand Background: Appropriate treatment of infectious disease is an essential element of clinical practice management. Therefore, the objective of this study to compare clinical outcomes between empirical therapy and documented therapy of imipenem/ cilastatin in Warinchamrab hospital. Methods: In a prospective study, analytical statistic performed between 1st July 2014 to 31st May 2016. We evaluated clinical outcomes of an empirical therapy and documented therapy of imipenem/cilastatin in Warinchamrab hospital. Result: Among 209 patients received imipenem/ cilastatin 31. 10% ( 65) were Documented Therapy( DT) and 68. 90% ( 144) were Empirical Therapy(ET). Clinical outcomes of Documented Therapy(DT) group, 76.92%(50) were improved, 1.54%(1) were failed, 6.15%(4) were dead and 15.38%(10) were referred to the Tertiary hospital. Clinical outcomes of Empirical Therapy(ET) group, 61.11%(88) were improved, 7.64%(11) were failed, 4.17%(6) were dead and 27.08%(39) were referred to the Tertiary hospital. Patients in DT group were statistically significant improved 1. 26 times compare with ET group. (RR 1.26; 95%CI 1.04-1.52; P=0.029) Drug related problems were found 7.66%(16) form patient safety evaluation. There are too low dose 0. 48%(1), too high dose 5. 74% ( 12) , and adverse drug reaction( i. e. rashes) 1. 44% ( 3) . Conclusion: Imipenem/ cilastatin should be prescribed regarding to indication of Thai national drug list.

This study showed the improvement of patient clinical outcomes and lower rate of antibiotic resistance. Otherwise, promoting rational drug use need strengthen multidisciplinary cooperation.

Keywords: Imipenem/Cilastatin, DUE, clinical outcome, antibiotic, Empirical therapy, Documented therapy

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H-P-91 PHARMACEUTICAL CARE IN ACUTE MYOCARDIAL INFARCTION PATIENTS Chen Chien-Ming, Su H Chen Department of Pharmacy, Chi Mei Medical Center, No.901, Zhonghua Rd., Yongkang Dist., Tainan City 710, Taiwan (R.O.C.) Background: With the Living and economic progress, heart disease is ranked second leading cause of death in Taiwan. Among heart disease, acute myocardial infarction is more dangerous than other type of heart disease. After percutaneous coronary intervention (PCI), Patients with Coronary artery disease ( CAD) receiving percutaneous coronary intervention ( PCI) need to take medicine such as antiplatelet agent, beta blocker, and angiotensin- converting- enzyme inhibitor ( ACEI) or angiotensin receptor blocker ( ARB) regularly to reduce thrombus formation and to prevent second event. Method: 612 patients were included during January 2014 to December 2014 performing PCI. 291 patients received customized care with medicine, exercise, diet, smoking cessation after PCI were performed, while 321 patients using regular care with similar topics and documents. Laboratory data was obtained during January 1, 2014 to June 20, 2016. Data were compared after receiving pharmaceutical care or regular care for over 1 year. Result: Comparing with regular care group, patients receiving pharmaceutical care show better control in HbA1c ( 6. 698 ± 1. 428 v. s. 7. 098 ± 1. 626, p < 0 . 05) , Low- density lipoprotein (90 ± 32 v.s. 100 ± 35, p < 0 .05) and uric acid (6.04 ± 1.56 v.s. 6.49 ± 1.82, p < 0 .05). With pharmacist customized education, patients have more willing to learn about disease they are dealing with and pay more attention to their condition.

Keywords: pharmaceutical care, PCI, AMI

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H-P-92 THE USE OF TICAGRELOR IN PATIENTS WITH CORONARY ARTERY DISEASE. Pattaraphon Tangsucharit1, Siriluk Jaisue2, Ketsaraporn Kiatsathitkul2, Natika Panodpagkapat2 1

Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University Faculty of Pharmacuetical sciences, Khon Kaen University, Khon Kaen 40002 Thailand

2

Introduction: Ticagrelor is a potent, reversibly binding, P2Y12 platelet inhibitor. AHA/ ACC has recommended ticagrelor to use in patients with unstable angina ( UA) / non ST elevation myocardial infarction ( NSTEMI) , ST elevation myocardial infarction ( STEMI) and post percutaneous coronary intervention ( PCI) . Ticagrelor has been proven to gain benefits in the patients and it has used at Queen Sirikit Heart Center since June 2012. Objective: To evaluate the use of ticagrelor in patients with coronary artery disease (CAD). Method: This study was to evaluate the use of ticagrelor at Queen Sirikit Heart Center, Thailand, between January 1, 2014 to December 31, 2015, by reviewing the patientâ&#x20AC;&#x2122; s medical record. Result: Among 290 CAD patients were male ( 70. 3% ) and age over 60 years old ( 72. 1% ) . The indications of ticagrelor were NSTEMI (29.3%), STEMI (14.5%), Unstable angina (8.3%) and unspecified type of CAD (43. 8%). Five patients received the medication because they did not respond to clopidogrel. Ninety-nine point seven percent of patients received ticagrelor 90 mg twice daily and 0. 3% received ticagrelor 90 mg once daily. There were 106 ( 36. 5% ) and 94 patients ( 32. 4% ) used ticagrelor less than one year and more than one year, respectively. Adverse events of ticagrelor were found in dyspnea ( 0. 7% ) and minor bleeding ( 2. 1% ) . Conclusion: The use of ticagrelor in patients with CAD at Queen Sirikit Heart Center was mostly appropriate in both effectiveness and safety. Ticagrelor was offered to use in combination with aspirin and other standard medication for patients with CAD and complied with the established practice guideline.

Keywords: Ticagrelor, P2Y12 platelet inhibitor, coronary artery disease

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H-P-93 ATROPINE EYEDROP FOR REMISSION DEATH RATTLE IN TERMINAL PATIENT Chen Yu-Chi, Chen C Ming, Su H Chen Department of Pharmacy, Chi Mei Medical Center, No.901, Zhonghua Rd., Yongkang Dist., Tainan City 710, Taiwan (R.O.C.) Background Death rattle ( or terminal bubbling ) refers to noising causing by mucus secretion retaine in respiratory tract. Airway screction may accumulate due to mucociliary clearance decrection and Increaseion od production. It often shows in terminal phase and some scholars consider an indicator of death predictor[ 1] . Subcutaneous Atropine, scopolamine or glycopyrrolate may helpful in ease this situation but needs injection technice to perform.

Sublingular atropine eyedrop maybe is an alternative way to releaf this situation. Method We searched terminal patients during Jan, 2014 to Dec, 2016 using Atropine eyedrop to ease death rattle. Result 6 patients using sublingular atropine eyedrop are all effective in remission death rattle compared to oral form and Subcutaneous route. The benefits using Atropine eyedrop formulation are easy to obtain, easy to use, and effective. Death rattle usually cause much pressure in family care unit. By using atropine eyedrop can decrease burden on both patient and their family members.

Keywords: death rattle, atropine, sublingular, terminal patient

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H-P-94 PHARMACIST INTERVENTION IN USELESS PRESCRIBING OF ANTIBIOTICS FOR COMMON COLD: ANTI-MICROBIAL RESISTANCE Mary Prasanna Kumari, Mahendra kumar Jayappa Bettur, Venkata Narayana T, Suma Latha G Faculty of Pharmacy, Vikas Institute of Pharmaceutical Sciences, Rajahmundry 533103, India Introduction : The common cold is caused by viruses which cannot be helped by antibiotics and it has long been believed that antibiotics have no role in the treatment of common colds yet they are often prescribed in the belief that they may prevent secondary bacterial infections.

Objective : The objective was to evaluate the antibiotics prescribed and assess the effects of antibiotics for the common cold Methodology: it was prospective, observational study conducted for a period a 9 months ( September to May 2016) in the general medicine department of the super speciality hospital, Rajahmundry . Andhra Pradesh, India Results and Discussion: Out of 600 prescriptions evaluated, 349 were of male and 251 were of female patients. Out of 600 prescriptions screened 600 ( 100% ) prescriptions were prescribed with Antibiotics along with symptomatic medications. The most common antibiotics prescribed were amoxicillin (39%), erythromycin (32%) azithromycin (19%). Antibiotics are medicines used to treat infections caused by bacteria. So thereâ&#x20AC;&#x2122;s no point taking antibiotics to treat a cold or flu. It can also mean that they wonâ&#x20AC;&#x2122; t work when you really need them. This is called antibiotic resistance and it happens when bacteria are exposed to antibiotics and learn to resist them. Conclusion: This analysis of prescriptions, suggests that pre- scribing of symptomatic medications was to be frequent and that reduces antibiotic prescribing for patients with common cold . Hence there is a need of clinical pharmacist role in reducing Antimicrobial resistance.

Keywords: screening, prescription, antibiotic drugs, ntimicrobial resistance

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H-P-95 A CORRELATION STUDY OF ANTIHYPERTENSIVE MEDICATION AND INFLUENCE FACTORS TO CONTROL BLOOD PRESSURE Nuttinee Teerakulkittipong, Pallapach Rangsikitpho, Phakdee Sukpornsawan, Nampratai Pawasan Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131 Thailand High blood pressure is a chronic disease that requires ongoing treatment for reducing disease progression and preventing complications. The goal of the study is to study a correlation of factors that influence the effectiveness of antihypertensive drugs in essential hypertensive patients. 31 out of 954 patients who are currently treated at Burapha University Hospital, Chonburi during 2014-2015 were randomly sampling for home visit. We found 10 uncontrolled blood pressure patients and 21 controlled blood pressure ( < 1 40/ 90) patients. All of uncontrolled group patients treatment are monotherapy and the relationship between type of treatment and the average of the systolic and diastolic blood pressure among uncontrolled group patients with monotherapy are a significantly different from the controlled group with monotherapy (p = 0.002) and combination therapy (2 drugs, p < 0.01 and 3 drugs, p = 0.025) respectively. Salty food is a factor that showed the significantly difference of systolic blood pressure in controlled and uncontrolled of monotherapy group ( p = 0. 036) . Geographic information showed that patients with uncontrolled group are residential area around University Hospital which is urban society. Furthermore, Comparison average of disease onset between two groups who are having high blood pressure family history and patients who are not having family history showed the significantly difference ( p = 0. 006) . In summary, our research shows that patients with family history of hypertension have a tendency to be a disease earlier and uncontrolled patients require a repeat visit including changing monotherapy medication and eating less salt or using combination therapy.

Keywords: antihypertensive drugs, efficacy of drugs, essential hypertension

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H-P-96 RATIONAL DRUG USE AND ELDERLY-PATIENT CARE Inthira Kanchanaphibool Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Background: Aging society is a challenge in global and Asian healthcare systems including in Thailand. Risks of frequent preventable medication- related problems in elderly patients, therefore, are needed to be accomplished. Objective: To investigate potential medicationrelated problems highly relevant to elderly patients. Methods: The cross- sectional survey of drug utilization among elderly patients ( age >= 65 year) in a community hospital was performed with a prescription database in 2015. The criteria and indicators for rational drug use among elderly patients from The Rational Drug Use Hospital Manual developed by the Sub-Committee on Promotion of Rational Drug Use under the National Drug Policy A.D.2011 were used to screen for potential medication- related problems. Results: Of all 7,799 elderly outpatients, only 76 outpatients (0.97%) used long-acting benzodiazepines that met the criteria of the Manual ( â&#x2030;¤ 5% ) . Drugs that should be avoided in the elderly, including tricyclic antidepressant, glibenclamide, pethidine, and phenobarbital were used in 1,554, 29, 14, and 2 elderly outpatients respectively. Drugs that should be used with precautions, including anticholinergic drugs, flunarizine, drugs with narrow therapeutic index, and anticoagulants were used in 1,698, 377, 225, and 40 elderly outpatients. These groups of patients were at risk of potential medication-related problems that pharmacists should focus on taking care of them.

The preventable problems were needed to be carefully addressed and resolved. Conclusions: The criteria and indicators suggested by the Manual seem to be useful for screening of the elderly patient groups that need pharmacistsâ&#x20AC;&#x2122; interventions to improve quality of care. Implications: Standard of pharmacy practice guidelines for these Keywords: rational drug use, elderly patients, preventable medication related problems, indicators, community hospital

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H-P-97 THE EFFECTIVENESS OF SALMETEROL-FLUTICASON FIXEDDOSE COMBINATION (FDC) AND INFLUENCE OF SALMETEROLFLUTICASON PLUS TIOTROPIUM INHALER ON EXACERBATION PATIENT WITH COPD IN PRIVATE HOSPITAL YOGYAKARTA Chynthia Pradiftha Sari, Rizka A. Alvianty Faculty of Pharmacy, Universitas Islam Indonesia, 55584, Indonesia Introduction:Long-acting anticholinergic (tiotropium bromide), a combination corticosteroids inhaled and β-2 agonist long action, is a combination of budesonide-formoterol and salmeterolfluticasone which is a therapy used to treat exacerbations. More patients with COPD use inhaled salmeterol- fluticasone than budesonide- formoterol inhalation. The purpose of this study is to describe the effectiveness of salmeterol- fluticason FDC and the influence of single salmeterol- fluticason with salmeterol- fluticason + tiotropium inhaler on exacerbations patient with COPD. Methods: This study involves a cross sectional retrospective of ≥ 40 year- old patients with medical history of COPD at private hospitals in Yogyakarta between 2014 and 2015. Patients with COPD without asthma, tuberculosis, lung cancer use salmeterol-fluticasone with or without tiotropium combination at least 3 times in 6 months regularly. Effectiveness was measured from the frequency of exacerbations of the patients’ use of oral corticosteroids, short- acting β- 2 agonists, and antibiotics. Results: The four hundred patients involved are prescribed the dose of 250 ug discus ( salmeterol 50 mcg+ fluticasone 250 mcg) , 2 puffs a day for six months, with or without tiotropium. 230 patients with COPD who used salmeterol fluticasone with no added tiotropium shows 65. 2% effective results ( no exacerbations) and 34. 8% ineffective ( exacerbation) . On the other hand, 170 patients with COPD who used salmeterol-fluticasone FDC plus tiotropium shows 41.2% effective results (no exacerbations) and 58.8% ineffective (with exacerbation). There is no significant relationship between the use of single salmeterol- fluticasone FDC compared to the combination salmeterolfluticasone+tiotropium inhaler analyzed using nonparametric Chi-Square test, which obtained a significance value of 0.680 (p > 0.05).

Keywords: COPD, salmeterol-fluticasone FDC, tiotropium bromide, exacerbations

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H-P-97 USE INFORMATION SYSTEM TO SUPPORT ANTIBIOTIC STEWARDSHIP PROGRAMS IN A REGIONAL HOSPITAL Chia-Ling Tsai1, Huan-Sheng Chen2, Jye-Daa Chen1, Shin-Chang Hsu1 1

2

Division of Pharmacy, Landseed Hospital,Taiwan Division of Infectious Diseases, Landseed Hospital,Taiwan

Objective: As antibiotic resistance has increased and antibiotic development has lagged, antibiotic stewardship programs(ASPs) have become important to improve clinical outcomes, prevent resistance, and decrease adverse events such as Clostridium difficile infections. How to choose the most advisable antibiotics and used correct dosage in shortest time are problems Information system may assist to recheck the antibiotic prescription for infectious disease doctors and clinical pharmacists. Method: Develope Antibiotics auditing system. Patients information includes physician order ,medication ,biochemistry data, microbiology data (including antimicrobialresistance) could be presented on the same system. Infectious disease doctors and clinical pharmacists could make a suggestion to clinical doctors when they need to discuss with the antibiotic prescription. Results: (1) The percentage of prescriptions reviewed by pharmacists is increased 2.76 times (26.7% increased to73.5%) , and its retrospective reviewing rate with 24 hours was over 70%. (2) The percentage of prescriptions reviewed by infectious disease doctors is increased and its retrospective reviewing rate with 48 hours was over 85%. (3) Inappropriate prescription, among which 70% were changed in prescription according to pharmacist recommendation and 90% were changed in prescription according to infectious disease doctors recommendation Conclusion: Based on the above results, the information system could increase antibiotic prescription retrospective reviewing rate then enhance the appropriateness of the use of antibiotics.

Keywords: antibiotic stewardship programs, retrospective reviewing rate

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H-P-98 INVESTIGATION OF IRREGULAR DOSAGE AND FREQUENCY ORDER SYSTEM USAGE IN OUTPATIENT SETTING Yen-Lin Chang, Hsiu-Chu Chen, Shuw-Chuan Wang Wen-Shyong Liou Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. Irregular dosage and frequency order (IDF) is necessary in some clinical cases, for instance, take 2 tablets on odd days and 1 on even days. Physicians usually prescribe total amount in Health Information System (HIS) and free texting in the comment section (so called special comment) to inform pharmacist to educate the patients. It takes pharmacists more time to check the orderâ&#x20AC;&#x2122;s accuracy. In 2014, we developed an IDF order system and built a module for QD, QW, BIW, TIW, QIW frequencies. With the system, physicians can choose the module, enter the different dosage and show the correct comment on prescriptions. Pharmacists can save time since the special comment is the same as printout prescription dosage and frequency. We collected the outpatient settingâ&#x20AC;&#x2122;s IDF order records in October and December 2014. Among those, the highest usage rate (57%) is nephrology department and the lowest one is cardiovascular surgery department. The results indicated that our system usage rate dropped by a relative 13.8% from 282 to 243 per 1,000 special order records. The abstract title should be in capital letter. The paper is qualified for poster presentation. We further investigated the reasons that the system did not use by all the physicians. The major reason is too many patients in our hospital while the physicians may not want to spend much time to rewrite the prescription. However, this system could not only properly deal with IDF situations, but also improve the accuracy of prescriptions. Promotion of the system to physicians will be the next major strategy. It might be useful for other health institutes to manage the IDF prescriptions in Asia.

Keywords: irregular dosage and frequency (IDF), usage rate, order system

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H-P-99 THE IMPLEMENTATION OF PHARMACOVIGILANCE PROGRAM IN HOSPITAL SETTING. Wan-Jen Tseng, Guan-Ling Lin, Ya-Wei Tsou Department of Pharmacy, Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Pharmacovigilance was defined by WHO as the science and activities relating to detection, assessment, understanding and prevention of adverse drug effects or any other possible drugrelated problems. In order to reduce the patients’ risks for exposing adverse drug reactions, we implemented a pharmacovigilance program followed by WHO’s definition for drugs using in our hospital. Any drug safety-related alerts announced by health departments in advanced countries or Taiwan Food and Drug Administration (TFDA) should be collected. Those alerts are forwarded to medical departments by email system in our hospital. After analyzing individual alerts, different interventions such as integrating as block pop-up alerts to clinical decision support system (CDSS) in computerized physician order enter (CPOE) system were implemented. The effectiveness of all interventions should be compared within 3 months before and after implementation. During Jan 2012 to Jan 2016, total 113 alerts, most announced

by TFDA (88 items, 77.9%), have been evaluated and 226 interventions have been implemented after analyzing. Besides forwarding alerts, the majority of interventions belong to “labeling warnings and precautions on medication bags” and “making alert pop-up boxes for prescribers”. After implementation of alert pop-up boxes, inappropriate prescriptions regarding to drugs (1) have cross-reactivity with other drugs known to cause allergy, (2) higher than age restriction, (3) above maximum dose, (4) with categories D, X in pregnancy have not been found and amount of prescriptions associated with all alerts decreased 8.55%. Pharmacists play an important role in harm prevention by implementing different interventions depending on analyzing alerts in advance.

Keywords: pharmacovigilance, drug safety-related alerts

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Poster presentations III. Community Pharmacy

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C-P-1 DEVELOPMENT PROGRAMS OF INTERNATIONAL MEETING PARTICIPATION FOR COMMUNITY PHARMACIES OF TAIPEI PHARMACISTS ASSOCIATION Ming-Sheng Hong1, Ben Chen1, Hsiu-Chi Chang2 1

International Affairs Committee, Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

Background: More than one-fifth of member pharmacists of Taipei Pharmacists Association (TPA) are from community pharmacies. However, very few of them have experiences of participating international meetings while participants are mostly from hospitals or academy.

It might be one of the reasons they are not familiar with the international pharmacy meetings.

Aims: In order to enhance quality of community pharmacies, expand viewpoint of community pharmacists and encourage participation of international meetings, a series of workshops were sponsored by the International Affairs Committee of TPA. Methods: Four lecturers from pharmacy schools, hospital pharmacy and community pharmacy were invited to introduce their experience of participating FIP and FAPA, how to write an abstract and prepare a poster at international meetings. Pharmacists of TPA member joined the workshops and practiced writing an abstract with individual counsel from lecturers at class. In addition, two classes of Etiquette and table manners were given by another lecturer. An exercise dinner was also held at an elegant restaurant after the classes for practicing Etiquette and table manners. Results: Eighty-one member pharmacists of TPA had joined and accomplished the workshops since 2013. Every participant completes his/her own assay and would love to submit their abstract.

A total of seventeen abstracts were accepted by FIP and FAPA in 2014 and 2015. Conclusions: The workshops are well accepted and welcomed. Participants learned about the international meetings and how to write an assay at limit period of time. Outstanding participants will be identified to assist at future workshops.

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C-P-2 COLLABORATION BETWEEN THE GOVERNMENT AND THE CIVIL IMPROVES THE “PHARMACLOUD SYSTEM” Mandy Fan1, Bluce Huang2, Ben Chen1 1

Taipei Pharmacists Association, Taipei, Taiwan 2 Protect Pharmacy, Taipei, Taiwan

In Taiwan, National Health Insurance Administration (NHIA) data shows there are 47 thousands people having the behavior of “doctor shopping”. In order to improve drug use safety and rationality and reduce the unnecessary healthcare expenses, NHIA started a series of program modifying patient’s behavior, setting up the patient-centered “PharmaCloud System” since 2013. On the other hand, NHIA takes steps to deduct expenses of duplicate prescription and duplicate medication from 2015. The overall implementation is scheduled to kick off in July this year. However, the program of “PharmaCloud System” is not yet well established. If the Government immediately implements the deduct program, it will bring huge impact to 6,000 community pharmacies in Taiwan. Mr. Wayne Chiang, legislator, after receiving the statement from Taipei Pharmacists Association (TPA), held a communication conference between NHIA and Pharmacist Associations to solve the problem. In this conference, the participants reached a consensus – postponing the deduct program to January 2017. It gives us more time to inspect the unreasonable legal aspects of health information management and technical issues on PharmaCloud System. A successful policy implementation is based on consideration of both system infrastructure and operating procedures. In this case, Mr. Wayne Chiang plays a role as the bridge between the government and the civil. We are happy to see the progress of communication improvement. We do believe that will be a win-win policy for both people and the government.

Keywords: PharmaCloud System, deduct expenses, duplicate prescription, duplicate medication, health insurance

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C-P-3 TAKING LUTEIN TO PREVENT EYE DISEASES: A COMPARISON STUDY OF EMPLOYED AND UNEMPLOYED BASED ON HEALTH BELIEF MODEL Feng Chuan Pan, Jieh-Horng Hwang, Ching-Chang Fan Faculty of Pharmacy, Tajen University, Pingtung County 90741, Taiwan Equity in access to medicines had become one of the major concerned in the medication. This issue had prevailed in the marriage, sex, job opportunity, education, medication and many societal disciplines and practices to prevent the minorities from being unfairly treated.

However, few, if any, research had looked into the research model for the minority may differ from the main stream. Based on Health Belief Model (HBM), the current research compared the applicability of HBM both in the population of the employed and the unemployed, in particular when expose to the threats of eye diseases. Purpose of this research was to identify how a research on the minority may differ from the main stream under the same theoretical background. 1075 valid samples were conveniently taken from general adult population around the island of Taiwan. The sample was divided into two groups based on the respondent’s selfadministered questionnaires, 356 unemployed and 719 employed. The survey showed that the unemployed respondents relied most the TV program and the healthcare institutes as the source of healthcare information, whereas the employed group relied on the internet-web and the TV programs the most. Two groups regression analysis indicated that HBM as a theory had a better explanation for the unemployed (R2=25.4%) than the employed (R2=21.0%), however, the main predictor was the perceived benefit of taking lutein for eye disease prevention. It was the same for both unemployed (β=0 .491, p=0 .000) and employed (β=0 .408, p=0 .000).

Keywords: unemployed, lutein, eye diseases, health belief model, health care information

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C-P-4 LUTEIN INTAKE INTENTION AND EYE DISEASES PREVENTION AMONG THE POPULATION OF CHRONIC PATIENTS Feng Chuan Pan, Jieh-Horng Hwang, Chung-Te Hsieh Faculty of Pharmacy, Tajen University, Pingtung County 90741, Taiwan Macula is the most sensitive part of the retina, sick of macula will seriously damage the retina, and accordingly eyesight. Chronic patients, in particular, those suffered from diabetic mellitus, were exposed to a much higher risk of macular degeneration. This is the main reason for vision loss and blindness for people. Literature had suggested that Lutein and Zeaxanthin can help eyes absorbing ultraviolet light and contains more radical radiation source to prevent cells from harm. Lutein cannot be synthesized by the human body; it should be supplied through intake of either dark green vegetables and fruits or lutein supplements (nutraceuticals) continuously.

We may conclude that lutein supplement is a modern, essential nutrient to maintain health of human eyes. In the other hand, Levels of lutein were found positively correlated with levels of physical activity. Based on the theory of planned behavior, the current research explored the effects of a personâ&#x20AC;&#x2122;s attitude, subjective norms, and self-confidence can affect oneâ&#x20AC;&#x2122;s behavioral intention in taking lutein supplements along with physical exercise. 363 cases with chronic diseases were collected from pharmacies around the island, and analyzed with SPSS for Windows 20.0. Test results indicated that the conventional independent variables of attitude, subjective norms, and perceived behavior control can explain 58.4% of variance of lutein taking intention. The model can be improved to a higher level of 61.2% of variance by adding physical exercise level as an extra variable.

Keywords: chronic ill, exercise habit, lutein, theory of planned behavior

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C-P-5 HAVE PHARMACISTS CONTRIBUTED TO THE HEALTH AND WELL-BEING OF THE PEOPLE? Masako Hashimoto, Keiji Nakamori, Masato Nakamura Ishikawa Pharmaceutical Association Background: In Japan, people 65 and older account for 25.2% of the population and we expect that number to rise year after year from now on. We hope people who need long-term care in their old age will be able to live a quality life in their local communities. Purpose: Efforts are underway to build â&#x20AC;&#x153;community-based integrated care" in which an environment is put in place to provide medical care, long-term care, preventative approach long-term care, housing, and living support services â&#x20AC;&#x201C; all in an integrated format. The goal of this approach is to enable seniors to continue living in the region and the manner in which they are accustomed, maintaining respect for themselves and ensuring support for independent lifestyles, if possible, at every stage of their life. Methods: 432 pharmacies in the Ishikawa Pharmaceutical Association participated in this program. This took place between November, 2015 and February, 2016. Our methods are as follows. 1. Tests of vital signs and blood were done.2.

Pamphlets were given to local residents to explain health information. 3. Seminars were held in pharmacies.4. Some people were urged to see a local specialist. Results: A total of 716 reports were collected from pharmacies detailing their findings. 22659 health information pamphlets were distributed. 2389 blood pressure tests were done. 295 blood sugar tests were done. 358 people were encouraged to get a follow up consultation. Conclusions: Pharmacists try to encourage and educate residents to prevent and detect disease early by going to the hospital regularly. This has proved pharmacists have contributed to well-being of the people.

Keywords: community pharmacy, community-based integrated care, educate prevent detect disease

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C-P-6 TOPICAL ANTI-BACTERIAL’S AND THE ROLE OF PHARMACISTS IN THE COMMUNITY PHARMACY SETTINGS IN PERAK, MALAYSIA. Sathish Amirthalingam1, Wong Peng Peng2, Jamuna Rani A1, Ankur Barua3 1

Department of pharmacy practice, school of pharmacy, international medical university, 19 jalal jalil perkasa, bukit jalil, kualalumpur, 57000 malaysia 2 School of pharmacy, international medical university, 19 jalal jalil perkasa, bukit jalil, kualalumpur, 57000 malaysia 3 Department of community medicine, international medical university, 19 jalal jalil perkasa, bukit jalil, kualalumpur, 57000 malaysia

Topical antibacterial drugs are commonly used to treat superficial bacterial infections. Topical antibacterial drugs can be dispensed by a registered community pharmacist. This study sought to explore the perceptions and experiences of CPs towards current practice of dispensing topical antibacterial drugs as well as its resistance issue in community pharmacy setting of Perak, Malaysia. A descriptive and cross-sectional survey involving 124 community pharmacists in Perak, Malaysia was conducted using a validated questionnaire, from June to August 2015. Descriptive statistics and Spearman’s Correlation coefficient was used for data description and comparison respectively. A 60.5% of the CPs perceived that topical antibacterial is not necessary for every topical infection. More than 70% of the CPs recognized the importance of WWHAM approaches and patients’ counselling for the safe use of topical preparation. 85% of the CPs were aware of the existence of drug resistance issue. However, only 1.6% claimed that they had reported ADRs, even 25% had encountered the resistance cases. CPs in Perak, Malaysia had the positive attitude towards dispensing of topical antibacterial drugs. However, majority of CPs had never reported ADRs even they have positive awareness towards resistance issues. CPs should remain vigilant to detect bacterial resistance as they are one of the most important healthcare profession for ADRs reporting.

Need of more training and educational programmes to promote rational antibiotic use and improve CPs’ vigilances on antibacterial resistance issues.

Keywords: topical antibacterial drugs, community pharmacist, pharmacist perceptions, pharmacist experience, drug resistance

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C-P-7 THE ROLE OF THE PHARMACIST DRUG INFORMATION SERVICES TO MOTIVATE THE PATIENT HEALING PROCESS AND TO HANDLE THE DRUG RELATED PROBLEM IN PHARMACIES, GOVERNMENT COMMUNITY HEALTH CENTRE, HOSPITALS IN NORTH KALIMANTAN PROVINCE INDONESIA Ully Widya R Ulla, Masruchin Zuhairi Pharmacy Post Graduate Programme, Pancasila University, Jakarta, Indonesia Backgound: The problem of the medication usage not only caused by the health providers but related to the habit of all parties who involve to the process. According to Green et all 1980, there are three factors involve the habit: predispositon factor, enabling factor, reinforcing factor. This study focused on predisposisiton factor to analyse the effect of the pharmacist knowledge, skill to the practices of the drug information and the impact to motivate patient healing and to handle Drug Related Problem in pharmacies, government community health centre, hospitals. Methodology: The sample of the study is 31 pharmacist who work in pharmacies, government community health services and hospitals in Bulungan District, North Kalimantan Province Indonesia. They fill the questionnair cover their perception concerning knowledge, skill, the practices of the drug information, motivation to heal the patients and the handling of the DRP. The Analysis tool in this study is SPSS 19. The finding: Pharmacist knowledge, skill influence significantly to the practices of the drug information. The practices of the drug information influence significantly to the motivation of the patient healing. The practices of the drug information does not influence the handling of the Drug Related Problem.

The handling of the drug related problem does not influence the motivation of the patient healing.

Keywords: pharmacy role, drug information, motivation to heal, DRP handling

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C-P-8 PROMOTING COMMUNITY PHARMACY’S OPERATING PERFORMANCE OF CHINESE MEDICINE BUSINESS IN TAICHUNG CITY Wei-Chou Lee1, Wei-Wen Liu1, Feng-Chuan Pan2 1

Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan 2 Faculty of Pharmacy, Tajen University, Taiwan

The aim of this study was to reveal how the member pharmacists were empowered and encouraged by the Chinese Medicine promotion program of that was conducted by the Taichung City Pharmacists Association, and to foster the medication safety on both of the Western and Chinese Medicines. The study surveyed into the entire membership of the targeted association via a structured questionnaire in the early 2016. 503 or 77.03% of valid responses out of 784 solicits were gathered for analyses. This survey results showed that the perceived satisfaction on measures associated with Chinese medicine had an average of 3.77±0.57, training and guiding services at 3.81±0.63, both were significantly higher than those prior to the campaign. However the respondents’ satisfaction on future expectation descended to the lower level at 2.45±0.51, non-significant. The authors suggested that the certain goals of the instructive and incentive campaigns had been reached. The organization should continuously and effectively encourage the community pharmacy conducting Chinese medicine business.

Taken the community pharmacies lacking confidence, the government should take proper actions to make the western and Chinese medicine complete to escort the nationals medication safety.

Keywords: community pharmacy, Chinese medicine business, operation performance

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C-P-9 STORAGE AND DISPOSAL OF PHARMACEUTICALS AMONG HOUSEHOLDS IN POBLACION, BUHI, CAMARINES SUR Mae Pauline F. Siocson1, Paula Angelica T. Ramos1, Christine Aileen M. Ching2 1

2

College of Pharmacy, University of the Philippines-Manila, Philippines Department of Pharmacy, College of Pharmacy, University of the Philippines-Manila, Philippines

Objectives: To describe the actual storage and disposal practices of pharmaceuticals among households in Poblacion, Buhi, Camarines Sur, to assess the respondents’ correct knowledge on the health and environmental effects of improper disposal and to determine association of the possible factors influencing their practice. Methodology: A survey was conducted among 335 respondents from 6 the barangays using a validated self-administered survey questionnaire.

Results: The types of medicines mostly stored in households include drugs indicated for the following: common colds (78.2%), cough (81.62%) and fever headache or body pain (87.2%).

Respondents mainly store them in cabinets or drawers. Majority of the respondents (84.9%) disposed their unused or expired medications by mixing them with other household garbage before disposal to the garbage can. Assessment of their knowledge scores showed that while most of the respondents are aware of the health effects of expired medication (78.2%) and improper medicine storage (84.8%), only less than half of the respondents were aware that disposal of unused medicines in garbage (19.7%) and sink (37.6%) poses significant environmental risks. The residents’ knowledge and practices are based primarily from their self-perception while pharmacists were not the identified primary source of knowledge among healthcare professionals. Differences of overall knowledge scores (p=0.019) among respondents with various information sources were found to be significant. Conclusion: Respondents’ correct knowledge on proper storage disposal reflects their correct storage practices. However, their information regarding the proper disposal practices is insufficient thus reflecting their improper practices. The knowledge imparted by medication knowledge providers significantly impacts residents’ perception on the health and environmental effects of improper drug storage and disposal practices Keywords: storage, disposal, pharmaceuticals, households

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C-P-10 EXPLORE THE IMPORTANCE OF NUTRITION SUPPLEMENT KNOWLEDGE UPDATE FOR COMMUNITY PHARMACISTS Yen-Yu Chang1, Ben Chen2, Hsiu-Ying Yu2 1

Community Pharmacy Committee, Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

Background: As a practicing community pharmacist for years, I found out that nutraceutical products, either single or multiple ingredients, are widely used. The initiative of taking nutraceutical might be from doctorâ&#x20AC;&#x2122;s recommendation or consumerâ&#x20AC;&#x2122;s own decision. There are interactions between drugs and certain food, so are nutraceuticals. Community pharmacists need to increase and update knowledge of nutrition supplement so as to provide service or consultation to patients. Method: As observed at community pharmacy, most people do not follow the dietary guidance published by the National Health Bureau. It is not the problem of insufficient nutrition but the balance of nutrition or over-intake. As inquired by the patients at the community pharmacy, there are so many different nutraceuticals used. Most of them are compound formula with varied brands. In daily practice at community pharmacy, besides ordinary drug safety assessment, patients are asked if any nutraceuticals are taken. The ingredients and dose of nutraceuticals are checked and whether or not there is interaction between those ingredients and prescribed medicines. For example, Monascus products may reinforce effects of lipid lowering agents, and liver function might be affected. Community pharmacists may provide correct health education to patients including right concept of using nutraceuticals. Results and discussion: Nutrition supplement knowledge and update is provided at some Pharmacist Continuing Education programs. Furthermore, it is recommended to make nutriology curriculum available at the pharmacy college in the future.

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C-P-11 COMMUNITY PHARMACIST HOME HEALTH CARE FOR STROKE PATIENTS IN BANGKOK METROPOLITANT Sirirat Tunpichart1, Wilailuck Tuntayothin2, Pongsiwa Kunok2 1

Community Pharmacy Association (Thailand) 40 Soi Suntisul Rd., Klongtaey, Bangkok, 10110 Thailand 2 Kanok Pharma Chain 1209 Soi Latphrao 94, Latphrao rd., Plab Pla, Wngthronglang, Bangkok, 10310 Thailand

Background: In Thailand, the burdens of health is stroke that is the long term disability and cause of death. Stroke have impact on the family members that provide care for ailing patients.

The stroke patients with the drug related problems (DRPs) frequently occur, side effect and drug interactions, leading to problems on disease controlled. The objective of this study was implied the community pharmacist home health care services for identified the drug related problems and medication management for stroke patients by patient centred care model.

Methods: An action research was conducted during 2011-2015 in Bangkok. The stroke patients was purposively selective by neurologist and nurse from Taksin Hospital. The community pharmacist provided the home health care visiting in 3 to 6 times as intensive service design.

This service template included the medication management (MTM), empowering caregivers, and environment health concern. Results: Data were gathered for 33 stroke patients that discharge from hospital. The pharmacist identified the problems and improved in safety issues (adverse drug reactions, drug interaction and over used), adherences and effectiveness issue.

The side effects of warfarin and mistaken administration were prompt detected and collected data to physician and nurse team. The caregiver improved the food and drug management for stroke patients. The self- management issue was attainable to caregiver and stroke patients as appropriate way to support them with long-term conditions. Conclusion: The stroke patients was delivering effective care by the multidisciplinary teams. This study established that community pharmacist home health care could alleviated patientsâ&#x20AC;&#x2122; medication utilization.

Keywords: drug related problems (DRPs), home health care, medication therapy management, multidisciplinary teams

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C-P-12 RELIABILITY AND FEASIBILITY TESTING OF QUALITY INDICATORS DEVELOPED BY THE COMMUNITY PHARMACY ASSOCIATION (THAILAND) Apichaya Wongpratat1, Sunee Lertsinudom1, Sirirat Tunpichart2, Wiwat Arkaravichien1 1

Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.

2 The Community Pharmacy Association (Thailand)

Background: The Community Pharmacy Association (Thailand) has developed quality indicators as a tool for quality assessment. This tool has not been tested for the reliability and feasibility yet. Objective: To conduct the reliability and the feasibility testing for the quality indicators. Methods: Quality scores were assessed by observation and interviewing the responsible pharmacists in 30 accredited and 30 non-accredited pharmacies using the 40 items, 5 domains quality indicators. Conbrach’s alpha was calculated to determine the internal consistency of the quality tool to reflect the reliability. Feasibility testing was by comparing the domain’s assessable scores with the domain’s possible maximum scores. The study was conducted in 34 accredited independent and 24 accredited chain pharmacies. Spider chart was plotted to compare the measured quality scores between the two settings. Results: Conbrach’s alpha coefficient was 0.87 which meant that the quality tool was highly reliable. Domain’s assessable scores were close to domain’s possible maximum scores which meant that most indicators could be assessed in most pharmacies. The spider chart could reveal gaps between measured scores of accredited independent and accredited chain pharmacies. The measured scores in accredited chain pharmacies were significantly higher than measured scores in accredited independent pharmacies in three out of five domains. This meant the quality indicators could differentiate the quality scores of two different routine settings. Conclusion: Quality indicators developed by the Community Pharmacy Association (Thailand) passed the reliability and feasibility test and could be used in genuinely routine settings.

Keywords: quality indicator, reliability, feasibility, accredited pharmacy

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C-P-13 PROBLEMS CONCERNING COMMUNITY PHARMACIES PARTICIPATING AMBULATORY CANCER THERAPY IN JAPAN ďź?

IMPORTANCE OF MULTIDISCIPLINARY COOPERATION IN COMMUNITY HEALTH SERVICE Yuko Kanazawa, Nobuo Yamamoto Hoseido Pharmacy, Tokyo JAPAN Recently, the number of prescriptions for outpatients suffered from cancer has been increased, and there arose strong demands for community pharmacists to provide safer and more effective pharmaceutical care for cancer patients. In this study, we conducted a survey concerning the problems to respond to these demands especially focus on the availability of information. We classified the information which are difficult to obtain for community pharmacists into two categories; those are information relating patient and information concerning anti-cancer drug itself (i.e. knowledge concerning the latest regimen or treatments procedure). These difficulties seems to result from the remarkable increase in complexities of cancer chemotherapy caused by the recent developments in cancer treatment, and the recent increase in the number of ambulatory cancer chemotherapy. The lack of these critical information may cause an inadequate confirmation of prescriptions and management of adverse effects by community pharmacists, which is essential to provide the safe and effective cancer chemotherapy for patients. These situation can increase the risk of adverse effects becoming serious, and disruption of chemotherapy due to adverse effects. To solve these problems, it is effectual to construct a multidisciplinary cooperation in community health services to promote the information sharing. An extensive and cooperative patient support by hospitals and community healthcare providers such as pharmacies is desirable for the best pharmaceutical care for patients receiving ambulatory cancer therapy. We believe that to consolidate the support systems is necessary to realize such cooperation.

Keywords: a faculty of community pharmacy, ambulatory cancer therapy, multidisciplinary cooperation

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C-P-14 A STUDY ON PHARMACY CUSTOMERS' BEHAVIOR IN PURCHASING ELDERLY HEALTH PRODUCTS Kuo-Hua Li1, Wei-Wen Liu2, Shorong-Shii Liou1 1

2

Department of Pharmacy Master and Program, Tajen University,Taiwan Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan

The elderly population has increased steadily in Taiwan, health and longevity less illness is the focus of concern of the elderly daily life. How to let elderly person to use safe health products, is a pressing issue.This cross-sectional study used a structural questionnaire as an instrument to explore the level of understanding and purchasing behavior in elderly health products, and data were collected from pharmacy customers in central Taiwan.The study found the first two highest agreement for purchasing behavior in elderly health products are: “approved by the Ministry of Health and Welfare”(4.26±0.58)”and“can not replace drugs”(4.22±0.63), and the first two lowest agreement are: “high price, high effect”(2.41±0.65) and “may influence the effect of taking drugs”(2.89±0.83). There are 93.3% will go to the pharmacy to purchase elderly health products, which improve gastrointestinal function 43.5%, 58.7% with osteoporosis improve. Pharmacists should teach customer that health products are nutritional supplements, not completely replace the drugs, but also to use clearly marked, have permission from the Ministry of Health Welfare , improve cognition of health products for elderly consumer, in order to achieve effective and safe use of health products.

Keywords: elderly health products, purchasing behavior, pharmacy customers

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C-P-15 A STUDY ON PHARMACY CUSTOMERS' BEHAVIOR IN PURCHASING ANTICOLD SOLUTION Chun-Chih Chan1, Wei-Wen Liu2, Ming-Chi Hung1 1

2

Department of Pharmacy and Master Program, Tajen University, Taiwan Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan

Many people have a headache, flu symptoms, will purchase directly to a pharmacy to take an anticold solution, some will buy several bottles at once, or even on the spot to drink a whole bottle directly , although this phenomenon has brought considerable crowds, but it should be noted that the use of the safety of anticold solution.This cross-sectional study used a structural questionnaire as an instrument to explore the level of understanding and purchasing behavior in anticold solution, and data were collected from pharmacy customers in central Taiwan.The study found one of the highest agreement for purchasing behavior in anticold solution is: “purchase anticold solution in pharmacy ”(4.13±0.65) , and one of the lowest agreement is: “long-term use anticold solution will not cause bodily harm”(2.56±1.34). There are 82.1% will go to the pharmacy to purchase an anticold solution, which own use 58.6%, 24.1% with family.A considerable number of people, especially older persons, with cold symptoms will go to pharmacy to purchase anticold solution . Pharmacists should teach the customer the right amount of taking anticold solution, but also to remind customers when to let doctors diagnose, prevent long-term overdose, causing bodily harm.

Keywords: anticold solution, purchasing behavior, pharmacy customers

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C-P-16 DRUG PRESCRIBING PATTERN OBSERVED IN ONE DAY HEALTH CAMP AT DHORPHIRDI VILLAGE DEVELOPMENT COMMITTEE OF WESTERN NEPAL Parbati Thapa, Raj Kumar Thapa, Kalpana Parajuli, Gulam Muhammad Khan Pharmacy Program, School of Health and Allied Sciences, Pokhara University, Lekhnath, Kaski Background: Health camps are organized to provide health care service to people with specific disease or to people deprived with health care facilities. Methods: A case study was performed from the one day health camp organized by School of Health and Allied Sciences, Pokhara University. Information regarding the demographic details, drug prescribed and disease diagnosed was collected from the logbook maintaiend by registered pharmacist. The WHO prescribing indicators were used to assess the appropriateness of prescribing pattern. Data were analysed using SPSS version 16. Result: A total of 317 patientâ&#x20AC;&#x2122;s prescriptions were assessed in a health camp. Majority of the patients were of age group 41â&#x20AC;&#x201C;50 years. Brahmins and Chettris were found to be predominant ethnic groups with gastrointestinal disorders as the major disease. A total of 510 medications were prescribed, Non Steroidal Antiinflammatory Drugs (NSAIDs) (29.41 %) were most commonly prescribed medication which was followed by antipeptic ulcer drugs (19.41 %) and vitamins and supplements (15.88 %). The average number of drugs per prescription was 1.6, the percentage of antibiotics prescribed was 21.4 % and 96.8 % of prescription was by generic names. Similary 100 % of prescription included drugs from essential drug list which indicates that compliance of the prescription as per WHO prescribing indicator. Conclusion: Majority of the patients participated in health camp were of working age group with higher number of females. NSAIDs were the most common prescribed drug and precribing pattern was found to be within the standard range of WHO precribing indicatior.

Keywords: case study, health camp, Nepal, prescribing pattern

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C-P-17 FOSTERING COMMUNITY PHARMACY PRACTICE: MAHARASHTRA STATE PHARMACY COUNCIL INITIATIVES Pooja A Chougale1, Vijay P Patil2, Namdeo R Jadhav3 1

Drug information center, Maharashtra state Pharmacy Council 2 Maharashtra state Pharmacy Council 3 Bhartividyapeet college of Pharmacy Kolhapur, Maharashtra

The aim of present work was to critically review and assess activities of Maharashtra State Pharmacy Council (MSPC) in the view of radical reforms likely to be brought about by implementation of Pharmacy Practice Regulation 2015 (PPR) in India. It has been observed that, apart from prime function to grant registration to the eligible pharmacists possessing requisite qualification, Drug Information Centre (DIC) set up by MSPC offers Continuing Education Programmes (CEP) to all registered pharmacists, especially, hospital and community Pharmacists. DICs started in state have been effective in counselling patients on appropriate use of medicines, dosing, side effects and adverse effects. MSPC's Patient counselling centre of KEM hospital Mumbai is a mile stone counselling station for diabetics and patients suffering from nervous disorders. Training sessions organised by MSPC on knowledge, attitude, good pharmacy practice, along with patient counselling on meal and medicine, hypertension, diabetes, asthama, anti-tubercular drugs, antibiotics has proved effective in shaping pharmacists professionally. Exceptionally, sensitisation programmes arranged by MSPC in Pharmacy colleges have created manifold aspirations in budding pharmacists. As an attempt to enhance medication adherence, patient communication and follow up through SMS, facebook, WhatsApp, Linkedin etc. has been found to be effective.

Conclusively, involvement of MSPC, doctors, pharma-academicians, community pharmacists in training to community/hospital pharmacists has been a effective model, which has given birth to family pharmacist. Such model may be needed for every Indian State to revolutionise pharmacy profession in post PPR era.

Keywords: MSPC, DIC, CEP, patient counselling, family pharmacist

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C-P-18 PRIMARY HEALTH CARE SERVICES BY PHARMACIST OF ACCREDITED DRUG STORE IN NATIONAL HEALTH SECURITY OFFICE (NHSO) SONGKHLA BRANCH AREA: HYPERTENSION AND DIABETES SCREENING Theerapong Teptawee, Sompong Apiromrak, Supapan Kangkasuwan Songkhla Community Pharmacist Club, Hat Yai, Songkhla 90110 Thailand This cross sectional study projects was adaption of hypertension and diabetes screening to drug store customers, by practiced community pharmacist in 22 quality accredited drug store, located in NHSO, Songkhla branch area, from March to September 2015. Thai subjects, over 15 years old without a previous hypertension or diabetes diagnosed were invited in each drug store. Screening written form and web based data compilation obtained from community pharmacy association (Thailand) were used together with automatic blood pressure (BP) device and portable figure blood glucose meter. The criteria was 140/90 mmHg for BP, 126 and 200 mg dL-1 for fasting and random blood sugar, respectively. Subjects with over criteria were asked and written referred for further assessment by physician. Total of 1,881 customers were screened and found that 364 and 79 subjects were have over criteria of BP and blood sugar, respectively, 16 of 364 and 9 of 79 subjects were newly hypertension and diabetes diagnosed.

For the whole participants, 745 person were have high and very high risk scores to diabetes and 439 risk subjects were able to be contacted by telephone, the 145 contacted person were voluntary visited to physician for more assessment. Verbal data from contacted person was shown 55 person for new diagnosed disease from physician and 6 main reason was given from non-physician visiting person. The study was shown a chance for newly diagnosed hypertension and diabetes by both community pharmacist and physician.

Keywords: primary health care, drug store, screening, hypertension, diabetes

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C-P-19 IDENTIFICATION OF NONADHERENCE BEHAVIOR AMONG ELDERLY DIABETIC PATIENTS USING PILL COUNT METHOD IN PRIMARY HEALTH CARE SURABAYA-INDONESIA Hanny Cahyadi1, Adji Prayitno2, Eko Setiawan2 1

Magister of Pharmacy in Clinical Pharmacy, Faculty of Pharmacy, University of Surabaya, Indonesia and Department of Pharmacy, National Hospital, Surabaya, Indonesia 2 Center for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, University of Surabaya, Surabaya, Indonesia and Department of Clinical and Community Pharmacy, Faculty of Pharmacy, University of Surabaya, Surabaya, Indonesia

Background and Objectives: Non-adherence in elderly diabetic patients is a threat for the effectivity and cost-effectiveness of diabetic treatment. In National Health Insurance Era, identification of non-adherence behavior is very important to provide a cost-effective treatment. The aim of this study was to identify non-adherence behavior among elderly diabetic patients using pill count method. Methods: 58 elderly diabetic patients (> 55 years old) from three primary health care center in Surabaya, East Java, Indonesia, during SeptemberOktober 2014 was included this study. Each patient had one or more than one medication. Pill count was performed by two times measurement home visitation for each elderly patients with one month interval of time. The pill count result was expressed in percentage. The formula of the pill count which was used in this study = (the actual amount drugs used by the patient / the amount drugs supposed to be use in that period of time) x 100%. Patients was classified to nonadherence if mean percentage of pill count from two times measurement for each medication was less than 80%. Result: 47 elderly diabetic patients (81.03%) demonstrated pill count percentage less than 80%, while 11 elderly diabetic patients (18.97%) demonstrated pill count percentage more than 80%. Conclusion: Pill count percentage indicated a high non-adherence level in elderly diabetic patients from three primary health care center in Surabaya, East Java, Indonesia. So, it was important to increase the adherence level to provide a cost-effective treatment for elderly diabetic patient in National Health Insurance Era. Keywords: non-adherence, elderly, diabetes, primary health care, pill count

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C-P-20 SMOKING CESSATION SERVICE IN HEALTH PROMOTION IN BANGKOK METROPOLITAN BY COMMUNITY PHARMACY Pongsiwa Kunok1, Sirirat Tunpichart2, Wilailuck Tuntayothin3 1

Kanok Pharma Chain , Bangkok 10310 Thailand Community Pharmacy Association (Thailand), Bangkok 10110 Thailand 3 Faculty of Pharmacy, Chulalongkorn University, Bangkok 10310 Thailand 2

Background: Smoking is among the leading causes of many diseases such as lung cancer, heart attacks, chronic obstructive pulmonary disease (COPD). For instance, in Thailand, mortality rate of COPD was 9.22 per 100,000 people in 2015. Community pharmacists perform smoking cessation service as a strategy in health promotion. Methods: A cross-sectional descriptive study was conducted during 2014-2015 in five pharmacies. Community pharmacists used the 5 A's pharmacist checklists to collect 18 participantsâ&#x20AC;&#x2122; data. The 5 Aâ&#x20AC;&#x2122;s of interventions were performed by Ask-Advice-Assess (A1-A3) and Assist-Arrange for follow up (A4-A5) in 6 months. In pharmacotherapy, heavy smokers used nicotine gum 2 mg, Vernonia cinerea tea, and nicotine patch 21mg/24 hours and 14mg/24 hours, while moderate and heavy smokers changed their lifestyles in non-pharmacotherapy. Pharmacists followed up smokers via telephone and Line application. Result: Data were gathered for 18 participants for smoking. At the end, there were 2 smokers (11%) who quit smoking. Two months later, the non-smoking participants still quit smoking. In pharmacotherapy, participants used supportive quit-smoking items such as gum (6 smokers), patch (2 smokers), and tea (16 smokers). The numbers of smokers were 12 participants that denied intervention in arranging steps (A5) after 2 weeks.

The reasons for rejecting intervention were irritability, constipation, and nausea. Conclusion: The pharmacies were the accessibility for smoking cessation. The community pharmacists have the role of health promotions in smoking cessation.

Keywords: smoking cessation, community pharmacies, The 5 A's pharmacist checklists, Ask(A1)-Advice(A2)-Assess(A3)-Assist(A4)-Arrange(A5)

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C-P-21 INCIDENCE OF VIRAL PHARYNGITIS VS BACTERIAL PHARYNGITIS IN NUKKEELA VILLAGE COMMUNITY, BANGKOK,THAILAND Chanakit Imbumrung Phonprasit Pharmacy, Bangkok, Thailand Background: Antibiotics are over-prescribed for Upper Respiratory tract Infection (URI).

Unclear procedure to differentiate bacterial infection and viral infection is the key issue in community pharmacy practice. Community pharmacists have been encouraged by Community Pharmacy Association of Thailand (CPA) to use McIsaac score for differentiate diagnosis.

More evidence is required to encourage the use of Mclsaac score and the appropriate use of antibiotics for URI treatment. Methods: A prospective study was conducted in adult patients with URI at Phonprasit Pharmacy, Bangkok, Thailand from January to December 2015.

Patients presented with pharyngitis were assessed by McIssac score and were managed according to the Infectious Diseases Society of America (IDSA) 2015 guideline. Clinical outcomes were evaluated by telephone interviews. Results: A total of 263 enrolled patients, 257 (97.7%) and 6 (2.3%) were diagnosed viral pharyngitis and bacterial pharyngitis respectively. A total of 257 patients with viral pharyngitis, 222 (86.4%) completely recovered, 18 (7%) unrecovered and 17(6.6%) lost follow-up. After 3-5 days followed-up, 16.7% and 83.3% of 18 unrecovered patients developed bacterial pharyngitis and worsening symptoms respectively. Conclusion: The findings in this study encouraged community pharmacists to apply McIsaac score as a tool to differentiate viral infection and bacterial infection in routine pharmacy practice. The appropriate use of antibiotics could help reduce antimicrobial resistance outbreak and healthcare cost.

Keywords: viral pharyngitis, bacterial pharyngitis

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C-P-22 THE ROLE OF COMMUNITY PHARMACY IN HEALTH PREVENTION ON THE RISKS OF CARDIO-METABOLIC SYNDROME Chanakit Imbumrung Phonprasit Pharmacy, Bangkok, Thailand The Role of Community Pharmacy in Health Prevention on The Risks of Cardio-metabolic Syndrome ChanakitImbumrung, B.Pharm PhonprasitPharmacy, Bangkok, Thailand Background: Community pharmacists are well position for screening service due to the large proportion of client visits. Medication Therapy Management (MTM) has been initiated to optimize the benefit of medication and to prevent drug related problem (DRP). Methods: A prospective study was conducted at PhonprasitPharmacy, Bangkok, Thailand during Jan-Dec 2015. Healthy adults were screened for cardio-metabolic syndrome. Screening guideline from community pharmacy handbook 2015 was followed. Clients with blood pressure (BP)>160/100 or fasting blood sugar (FBS)>126mg/dl and/or postprandial >200 mg/dl were referred to the hospital at first visit. Lifestyle modification and the assessment of this intervention were performed at the second assessment. Patients with FBG>126 mg/dl or BP>140/90 mmHg were referred to the physician at the third assessment. Patients diagnosed with hypertension and/or diabetes based on the screening protocol were enrolled to MTM at the forth follow-up. Results: During 12 months period, a total of 671 healthy adults were screened. Adults with normal blood pressure, normal postprandial blood sugar, prehypertension, pre-diabetes, hypertension and diabetes were 23%, 31%, 29%, 4%, 10% and 3% respectively. After 1-month lifestyle modification, 99% of adultswith pre-hypertension, returned to normal, 4% of adults with pre-diabetes returned to non-diabetes, and 44% of adults with diabetes returned to non-diabetes. Approximately 2% of adults with hypertension referred to the hospital and hypertension was diagnosed. Conclusion: These observations highlight the positive impact of pharmacistsâ&#x20AC;&#x2122; intervention in promoting health prevention.

Implementing such activities would contribute positively.

Keywords: cardio-metabolic, hypertension, diabetes, medication therapy management

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C-P-23 THE COMPARISON ON THE RETAIL PRICES OF 10 COMMON GENERIC DRUGS OF THAILAND BETWEEN GOVERNMENT HOSPITALS, PRIVATE HOSPITALS AND COMMUNITY PHARMACIES IN SAMUTPRAKARN PROVINCE, THAILAND Wirat Tongrod1,2, Jatarin Trenate2, Anukul Pankaew2 The Pharmaceutical Association of Thailand under Royal Patronage (PAT) Faculty of Pharmaceutical Sciences, Huachiew Chalermprakiet University, Samutprakarn, 10540 Thailand.

1

2

Nowadays Thai people can access to health care services from public hospitals, private hospitals, or community pharmacies as they want when they get sick. However, the prices of their services and medications are varied and very high especially in private sector. This issue is interested and criticized by the publics because it is a barrier to access health care services.

This research aims to investigate the retail prices of top 10 most common generic drugs in Thailand and compare the prices from public hospitals, private hospital, and community pharmacies in Samutprakarn province. The data were obtained from 247 community pharmacies, 6 public hospitals and 3 private hospitals. Results show that the average retail prices of 10 generic medicines from public hospitals, private hospitals and community pharmacies are 9.12, 75.23, and 22.44 bahts respectively. When comparing the average retail prices of 10 generic drugs between public hospitals, private hospitals and community pharmacies, the prices of public hospitals are 0.41 times of community pharmacies and private hospitals are 3.35 times of community pharmacies. Thus the average retail prices from private hospitals are 8.25 times of public hospitals. In conclusion, the average retail prices of generic medicines in public hospitals are cheaper than community pharmacies, and community pharmacies are cheaper than private hospitals in Samutprakarn. However, there were 3 from 18 private hospitals in Samutprakarn or 16.7% only that provided these data.

Keywords: price comparison, generic drugs, government hospitals, private hospitals, community pharmacies, Thailand

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C-P-24 ESTABLISHING FAMILY PHARMACIST SYSTEM – MAKING ONE FAMILY PHARMACIST AVAILABLE FOR EACH FAMILY Yen-Yu Chang1, Ben Chen2 1

Community Pharmacy Committee, Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

The population is getting into “aged society” from “aging society” in Taiwan. There is a huge demand of pharmacist proficiency to take care of the drug use safety and health issues for the seniors. When patients look for proficiency consultation at community pharmacy, it may not be simply drug use issue. Often, there might be issues of taking nutraceuticals or comorbidities behind the existing diseases and medicine. Is it a better solution for the patients to go to see a doctor or to take self-medication? In order to solve the problem, Department of Health of Taipei City Government works along with Taipei Municipal Hospital and Taipei Pharmacists Association to implement the first ever “Family Pharmacist System” in Taiwan, aiming one pharmacist available for each family in Taipei. Family Pharmacist will provide three major services: 1. Individual healthcare service 2. Disease prevention and healthcare education 3.

Self-medication and medical referral system consultation. There are 100 community pharmacy pharmacists voluntarily joining this project so far. They will provide convenient and accessible Family Pharmacist services for their community. Furthermore, community pharmacists will be able to play a key role in medical resources allocation integration through reinforcing medical referral system for the community residents in the future.

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C-P-25 CONTINUING PHARMACY EDUCATION NEED AND PRECEPTOR PERSPECTIVE SURVEY AMONG COMMUNITYPHARMACISTS Nittayawan Kulnawan Community Pharmacy Association, Thailand Background and objective: Starting from 2015, all registered pharmacists must obtain 100 compulsory continuing pharmacy education (CPE) credits for every 5 year interval from the CPE providers granted by Thai pharmacy council to sustain their licenses. The community pharmacy association Thailand (CPA), one of CPE providers, has been responsible for their members in this area. The objective of this study is to survey CPE needs and preceptor perspective among CPA members. Method: The data were gathered from all participants during the 2015 annual CPA meeting held on 28 February 2016. The self-administered questionnaires were composed of demographic characteristics and theirs needs including the preferences of CPE delivery formats and knowledge topics, and preceptor perspective. The preferences were measured by means of 5 score Likert scale. Descriptive statistics were employed for data analysis. Result: There were 325 respondents included 232 community pharmacists (71.4%).

The most age range was 31-40 years (39 %), and graduation of 5 year curriculum was majority (70.6 %). The highest preference formats of CPE delivery were journal review articles (score 4.32). Ranking the preference among 37 CPE topics, the highest preferences were drug use in special populations (pediatrics, pregnancy, and elderly) and common disease in pediatrics.

32.1% of the respondents were interested in developing to be preceptors. Conclusion: The findings would be useful for CPA to delivery CPE to meet the membersâ&#x20AC;&#x2122; needs and to collaborate with pharmacy academic institutes to develop membersâ&#x20AC;&#x2122; pharmacies to be pharmacy preceptors.

Keywords: community pharmacy Thailand, continuing pharmacy education, pharmacy preceptor

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C-P-26 RESEARCH OF COMMUNITY PHARMACY ATTRIBUTION FOR FAMILY PHARMACY Yoko Nanaumi1, Mitsuko Onda2, Hitohisa Imai3 1

2

Advance Pharma Research Office Osaka University of Pharmaceutical Sciences 3 National Institute of Public Health

Aim: In 2016, it started that the family pharmacist system in Japan. To be family pharmacist, community pharmacy be the family pharmacy. To be family pharmacist, it is required that the pharmacist has experience in home care service. But the number of pharmacies which do home care service is not many. Therefore, we researched the pharmacy attribution which do home care already. Methods: Research term was January- Feburary2013. Target was community pharmacist in whole of Japan. The questionarrier form was sent to the 3321 pharmacies which had a experience of home care service and corrected by mail to the whole Japan. Result: Result of one thousand three hundreds twenty seven community pharmacies showed the middle of attribution was the number of pharmacists: 2.5 person, the average of prescription filled in one day/ one pharmacist (work load): 20 prescriptions, the number of patients for home-visiting service 3 patients/ month, the number of cooperated medical facility (positivity): 1. The group of work load: 20 prescriptions and cooperated medical facility > 1 visited more frequency than others and the groups of cooperated medical facility>1 worked longer than others. The group of work load: 20 prescriptions and cooperated medical facility>1 did mainly works of pharmacist in home-visiting service more frequency than other groups. Therefore, it is revealed that the actual situation of pharmacistâ&#x20AC;&#x2122;s home-visiting service was involved not the number of pharmacist or scale of community pharmacy but work load, positivity based on effort to cooperate with medical facility.

Keywords: community pharmacy, family pharmacy, attribute, home care

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C-P-27 IMPACT OF PHARMACISTS INTERVENTION ON DISPENSING PRACTICE IN THE RETAIL PHARMACIES OF KATHMANDU METROPOLITAN-NEPAL Badri K.C, Himal Paudel Chhetri Faculty of Pharmacy, Kathmandu University, Dhulikhel, Nepal The objectives of the research with pre-post intervention (one day training) were to evaluate the dispensers knowledge through structured questionnaire, calculate the average dispensing time, assess the content of labeling parameter and evaluate the effectiveness of pharmacist intervention. Methods: A base line survey (n=104) with semi-structured questionnaire was done. Twenty pharmacies were randomly chosen for interventional study. Outcome measures consisted of percentage of right answer, observation of dispensing time, percentage of drugs adequately labeled and labeling content. Result: A pre-post evaluation of answers to selfadministered questionnaire showed improvement in knowledge from 70.71% to 91.42%. The average number of retail pharmacies outside the hospital was 5, with more number outside the hospitals which have their own hospital pharmacy. The average dispensing time was 97.26 seconds. Label was present in 94.5% of encounters but only 3.3% had envelop use. 21% increment in average dispensing time was seen in intervention group. Association between educational status and dispensing time has been observed (Pearson Chi-Square value : 57.708, d. f = 20). The average dispensing time for illiterate and literate is 109.31 (n=294) and 100.74 seconds (n = 906) respectively. This shows that dispensers give more time to illiterate than literate (d. f = 905, p<0.1, t = -4.031). Average number of medicine per prescription was 2.08.

15% of medicines dispensed were antibiotics, 12.5% analgesics, antipyretic and antiinflammatory, 11.93% antihypertensive, 10.16% anti-secretory and antacids, vitamin and minerals 7.96%, 4.58% oral hypoglycemic agents, 3.54% cough and cold medications.

Conclusion: The result of the intervention has shown that improvement in dispensing practice can occur even with a short training of one day.

Keywords: dispensing practice, average dispensing time, retail pharmacy, pharmacist intervention, Nepal

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C-P-28 NEW MODEL OF COLLABORATION OF DRUGSTORE AND OTHER TYPES OF BUSINESS Michiko Obara Faculty of Pharmaceutical Science, Josai International University, Chiba 1020094 Japan Purpose: Japan is in the super aged society as the ratio of the population aged 65 and older to the total population has exceeded 20% and will be increasing. Drugstores are expected to be healthcare providers for prevention, treatment and care in community. We have played an active role to support healthy and frailty people in community. In this report, we introduce our activities in collaboration with other types of business. Activities: 1. Oral care (bad breath prevention and aspiration prevention) in elderly people with tongue plaque using candies in collaboration with a candy manufacturer (UHA Mikakuto Co. Ltd.) 2. Support of sufficient protein intake in patient with inadequate nutrition using protein rich drinks in collaboration with food manufacturer. (Wakodo Co. Ltd) Results: A candy containing substance for oral care is found to have effect not only to improve oral condition of elderly people but also to decrease unpleasant smell in a room. A tongue plaque in more than 70 % of patients was solved within a few weeks after suck on a candy. The candy manufacturer now develops a suitable candy form and formulation for safety use of candy for elderly people. The protein rich drinks would be a tool to support frailty patients to improve nutrition condition. Conclusion: Collaboration of drugstores with other types of business can expand activities of pharmacist in the community.

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C-P-29 STEROID ABUSE SURVEY IN COMMUNITY BASED AREA IN BANGKOK METROPOLITAN BY COMMUNITY PHARMACISTS Sirirat Tunpichart1, Wilailuck Tuntayothin2, Pongsiwa Kunok3, Varavoot Sermsinsiri4 1

Community Pharmacist Association, Thailand Faculty of Pharmaceutical Science, Chulalongkorn University 3 Kanok Pharma Chain 4 Food and Drug Administration, Ministry of Public Health, Thailand 2

Background: The use of steroid can cause diseases and induce chronic kidney disease, heart attacks, and stroke. In Thailand, steroid abuse has been a massive problem in community areas. The steroid was found in herbal products, mixed cosmetic products and medicines. The objective of this study was to explore steroid abuse in community areas and develop the community network between community pharmacists with Bangkok public health centers.

Methods: The cross-sectional descriptive study was explored by community pharmacists in 8 communities in Bangkok Metropolitan in 2015. The duration of this study was 3 months. Data were collected in a proactive case finding, interview and observation based on the assessment questionnaires. The suspected samples would be corrected and were tested by the steroid test kits. Results: Data were gathered from 201 people with 312 households within 8 communities.

There were 26 steroid found contaminated from 243 suspected samples. Furthermore, the steroid was contaminated within 40.7 % of herbal products and 26.7% of packed medicine. The distribution channel of contaminated steroid products were found in 21.95% from neighbours, 21.9% from drugstores, and 12.2% from clinics. The feedback results were informed directly to people, community, voluntary health village, and Bangkok public health centers. The steroid abuse prevention was obtained by the knowledge sharing together with people, voluntary health village, and Bangkok public health center staffs such as physicians, pharmacists, and nurses.

Conclusion: The community pharmacists could provide the steroid awareness in the community. The steroid abuse protection was achieved by the multidisciplinary team in community.

Keywords: community pharmacist, steroid abuse, steroid awareness

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C-P-30 CHRONIC DISEASE SCREENING SERVICE PACKAGE BY COMMUNITY PHARMACISTS IN THAILAND Pentipa Kaewketthong, Sirirat Tunpichart, Kitravee Sombatthanyapong Community Pharmacy Association (Thailand) Background: The Non-Communicable Diseases (NCDs) are the grated factors contributing to mortality and overall disease burden in emerging economics in Thailand. The NCDs like cardiovascular disease, cancer, diabetes, chronic respiratory disease and injury were increased in every year. The high risk groups have the modifiable risk factors such as smoking, alcohol drinking, and uncontrolled diet. The objective of this study was to develop the screening service package for people who had risk of chronic diseases by community pharmacists. Methods: The cross-sectional descriptive study was provided the screening service package by 368 community pharmacies in 2015. Data were collected from the risk assessment questionnaires.

The diabetes and hypertension screenings were services for risk groups by community pharmacists in pharmacy. This package services were educated the knowledge of food for diabetes and hypertension disease in educational individual program. The diabetes screening was by fasting capillary blood glucose in community pharmacy. Results: Data were gathered for 8,082 cases in community pharmacy. The screening found that 2,979 cases (36.85%) had very high risk of diabetes (score â&#x2030;Ľ 9) and 1,349 cases (16.69%) had high risk in hypertension.

The 48 cases from the very high risk diabetes and 124 cases of high risk hypertension were diagnosis to be diabetes and hypertension from health care units. Conclusion: The community pharmacy can help to detect individuals with undiagnosed Type 2 diabetes and hypertension.

The new service program should include the screening service package by community pharmacy in the universal coverage package from Nation Health Security Office.

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C-P-31 CORRELATION OF HOME PHARMACY CARE AND CLINICAL OUTCOME FOR HYPERTENSION PATIENT Endang S. Ningsih, Mutiara Herawati, Rahma Fitriyani Department Pharmacy, Universitas Islam Indonesia, Jalan Kaliurang km 14,5 Yogyakarta Background: Hypertension is one of the five most cardiovascular disease in Indonesia. It caused many complications such as renal failure, heart disease, stroke and retinopathy if the blood pressure uncontrolled to achieved the target. Home pharmacy care had proposed to improve the therapeutic outcome in some chronic diseases by participing directly to optimize medication management. Objective: Aim of this paper were to evaluate home pharmacy care and the impact of clinical outcome for hypertension patient by measuring blood pressure (BP) and to test hypothesis that home pharmacy care correlated with clinical outcome for hypertension patients. Methods : Quasi experimental study design with non equivalent control group from two primary healthcare in West district of Yogyakarta. Participant were hypertension patients without compelling indication with uncontrolled BP from medical record information. The main clinical outcome were BP measure that achieve target less than 140 /90 mmHg for patients < 60 years old and 150/90 mmHg for patients â&#x2030;Ľ 60 years old. Result: The study enrolled 61 patients consist of 30 control and 31 intervension group. It showed that there were 37 patients achieved BP target (11 control and 26 intervension group) and 24 patients didnâ&#x20AC;&#x2122;t achieve BP target (19 control and 5 intervention group). It showed that home pharmacy care impact the clinical outcome to achieve BP target better than control groups and there were correlation between home pharmacy care and clinical outcome (p = 0.02). Conclusion: Home pharmacy care had correlation with clinical outcome for hypertension patient by improved BP target.

Keywords: home pharmacy care, clinical outcome, hypertension

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C-P-32 HS-CRP LEVEL OF GENERAL AND CENTRAL OBESITY AMONG WOMEN IN RURAL AREA OF YOGYAKARTA, INDONESIA Fenty, Grace Shelia Pramitha Putri, Risanuri Mardiyana Pharmacy Faculty of Sanata Dharma University, Yogyakarta, Indonesia General or Central obesity is a risk factor of cardiovascular disease. Obesity is associated with level of high sensitivity C-reactive protein (hs-CRP) in the blood, which is a marker of systemic inflammation in cardiovascular disease. Anthropometric is a method that indicates general or central obesity. It can be used as a simple, easy, and fast method, which can indicate the nutritional status and health of a person, especially against the risk of cardiovascular disease.

The aim of this study was to know the differentiation of general and central obesity index for hs-CRP levels in the blood of adult women in rural area of Yogyakarta. This cross-sectional study was conducted in Cangkringan, Yogyakarta. Personal interviews, anthropometric (Body Mass Index; BMI and Waist circumference; WC) and blood Hs-CRP level measurement were accomplished in 48 women subjects. This study showed that the women with higher BMI (general obesity) have increased level of blood Hs-CRP (p=0.002). The women with central obesity also have increased level of blood Hs-CRP compared to the women who were without central obesity, but the difference was not statistically significant (p=0,073). In conclusion, the general or central obesity is associated with level of blood Hs-CRP, as a risk factor of cardiovascular disease among women in rural area, Yogyakarta, Indonesia.

Keywords: Hs-CRP, obesity, woman, rural area

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C-P-33 CORRELATION BETWEEN FASTING PLASMA GLUCOSE, CASTELLI’S RISK INDEX-1 AND HEALTH RELATED QUALITY OF LIFE (HRQoL) AMONG HYPERTENSION SUBJECTS IN DISTRICT SEMBIR AND SOMORAI, YOGYAKARTA, INDONESIA Dita M. Virginia, Christianus H. Setiawan, Yunita Linawati, Rita Suhadi Faculty of Pharmacy, Sanata Dharma University, Yogyakarta, Indonesia Hypertension is the major factor contributing stroke and other cardiovascular diseases. High levels of cholesterol and blood glucose could increase cardiovascular risk significantly in hypertensive subjects. The total/high density lipoprotein (HDL) cholesterol ratio, known as Castelli’s risk index-1 (CRI-1), is an indicator of cardiovascular risk. The recent study showed that the hypertension subjects had lower health related quality of life (HRQoL) than the healthy subjects. The aim of this study was to determine the relationship between fasting plasma glucose (FPG) and CRI-1 as cardiovascular risk indicator and HRQoL among the hypertension subjects in District Sembir and Somorai, Yogyakarta, Indonesia. An observational-cross sectional study was conducted, considering any hypertension subject that was identified in the previous study. Total hypertension subjects were 86 which 9 subjects were excluded because of not fasted. This study used the Short-Form Health Survey (SF) to collect HRQoL data.

HRQoL has 8 dimensions which are physical function (PF), role physical (RP), bodily pain (BP), general health (GH), social function (SF), vitality (V), mental health (MH), and emotional role (ER). The following laboratory tests were performed on all participants: FPG, total cholesterol (TC), and HDL-cholesterol (HDL-C), CRI-1 were calculated. Data were analyzed using Spearman. Seventy seven hypertension subjects were included. Mean age of the subjects 51.81 (range 31 – 67) years old and 76.62% were females. There was a significant correlation between age and HRQoL on vitality (p=0.007, r=0,304) and mental health (p=0,010, r=0,294). There was no significant difference between FPG and HRQoL in all dimensions: PF (p=0.511), RP (p=0.158), BP (p=0.523), GH (p=0.548), SF (p=0.855), V (p=0.761), MH (p=0.638).

Keywords: fasting plasma glucose, Castelli’s risk index-1, health related quality of life, hypertension subjects

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C-P-34 HOME PHARMACEUTICAL CARE FOR SOLITARY ELDER AND SOCIAL DISADVANTAGED GROUPS IN TAICHUNG CITY Chen Sheng Chen1, Jen-Chieh Wang1, Hung-Yi Chen2, Pei-Wen Yu1 1

2

Taichung City Pharmacists Association China Medical University School of Pharmacy

Background/Purpose: The elderly population in Taichung is about 8.7%. Elders were always the primary group of medical resources user, especially the solitary elders. They have multiple chronic diseases and medical needs and lack of self-care concept. Above lead to polypharmacy, and came to drug overdose, contraindications, side effects and drug interactions. The aim of this study was to improve the adherence and concepts about medications in elders by pharmaceutical care. Including reduce hospital/clinic visits, pill counts, the frequency of adverse drug events, medication duplications. There is a significant improvement of medication compliance, drug storage and medication knowledge. Method: We held a training program for the pharmacists, whom should pass the exam at the end of the course, and got the certificate for home pharmaceutical care. The certified pharmacists need to do case reports and discussions in monthly meeting. pharmacist provided medication counselling, medication use instructions, and individual health education at cases’ home, improving citizens’ health knowledge about medication safety. Results: There were 590 registered elders. Before home pharmaceutical care was 1597 medical visits totally, and the average medical visits were 2.71 per person-month. After the intervention of pharmacists, the average medical visits were 1.99 per person-month, reduced 36%. Otherwise, the pill counts were reduced from 7.12 to 6.73 in the study population. Conclusion: Home pharmaceutical care corrected elders’ concepts about medical visits, and reduced medication usage. promoted using health resources efficiently, and reduced the waste at the same time.

Keywords: pharmaceutical care

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C-P-35 A PHARMACIST BASED INTERVENTION TO IMPROVE THE CARE OF PATIENTS WITH RENAL INSUFFICIENCY IN NURSING HOME RESIDENTS Lo Hui Chen1, Chang Pao Yu1, Tasi Yu Lin2 1

Department of Pharmacy, Tainan Municipal Hospital, Taiwan, R.O.C 2 Department of Nursing, Tainan Municipal Hospital, Taiwan, R.O.C

Background: Nursing home residents often have being accompanied by chronic diseases, and take many different drugs. A lot of drugs are eliminated via the kidneys and then require dose adjustment in patients with renal insufficiency. The aim of this study is to investigate the occurrence of incorrectly dosed or contraindicated with renal dysfunction in this population.

Method: This observational study involved 45 residents with multiple diseases and some residents needed catheter care from March 2015 to May 2016. The estimated glomerular filtration rate (eGFR) was calculated with Modification of diet in renal disease equation (MDRD). Result: 45 residents were included in the study, eGFR level were received 33（73.3 ％） of them （average 65.8 years ,66.7％ male. 30.3％ of these patients had moderate renal dysfunction （eGFR 59-30 ml/min, and 6.06％ had severe renal dysfunction（eGFR ＜30 ml/min. 15.5％ were taking at least one medication that was contraindication or incorrectly dosed according to renal dysfunction. These drugs that were inappropriately used were ranitidine, metformin, and valsartan. Conclusion: The study indentifies future areas of research for enhancing impact of renal dysfunction interventions in nursing home. Pharmacists were effective in resolving medication dose adjustment and potential preventing drug-related problems. It may result in reduced hospitalized rates.

Keywords: pharmacists based intervention, renal dysfunction

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Poster presentations IV. Industrial Pharmacy and Marketing

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IM-P-1 TAKING LUTEIN TO PREVENT MACULAR DEGENERATION: AN APPLICATION STUDY OF HEALTH BELIEF MODEL WITH A FOCUS ON CHANNEL PREFERENCE

Chiung-Hui Chu1, Jhy-Yih Chen2, Feng- Chuan Pan2 1

Graduate Student of Pharmacy School, Tajen University 2 Faculty of Pharmacy, Tajen University, Taiwan

Research background: Residents in Taiwan exposed to an extreme high risk of eye diseases because of extensive use of image applications. Since lutein had been proofed to be helpful to strengthen the eyes function and help prevent macular degeneration, it had become a star product in the pharmacies and drug stores. In the other hand, consumers were easily confused with a wide variety of brands and sales channels when shop for a proper lutein supplement.

Theory and Literature Review: This research took the health belief model as the theoretical basis and hypothesized that the levels of consumer’ s threat perception on eye diseases affect their lutein consuming behaviors. In addition, such consuming behaviors would be affected by some other demographic factors. Research design: This was a survey research with a structured questionnaire. 823 samples were taken from major distribution channels of nutritional supplements across Taiwan. Data were analyzed with statistical techniques such as independent t-test, one-way ANOVA, Pearson correlation, cross-tabulation with X2 testing, and regression analysis. Results: The current study revealed that the perceived benefit (r=.489) significantly had the strongest correlation with lutein consumer behavior, followed by the susceptibility (r=.146) and severity (r=.137) of eye diseases, and ended with a negative effect of perceived barrier of lutein supplement (r=-.100), all test results were significant at a level of Cronbach’s α=0.05. The current survey indicated as well the most complicated customer profile was found in the drug stores. More than 61% of respondents reported that mid-aged woman was the main decision maker for healthcare Keywords: distribution channel, lutein supplement, health belief mode, eye care

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IM-P-2 APPLYING HEALTH BELIEF MODEL TO INVESTIGATE THE PREVENTIVE INTENTION OF AGE RELATED MACULAR DEGENERATION BY LUTEIN INTAKE: A STUDY IN THE POPULATION OF DIABETES MELLITUS PATIENTS Feng Chuan Pan, Jhy-Yih Chen, Chang-Da Hsieh, Jieh-Horng Hwang Faculty of Pharmacy, Tajen University Research background: As the disease expansion theory predicted, chronic diseases prevailed along with the continuous innovativeness of medical and pharmaceutical technology. Longer life expectancy may not promise a better quality of life. Literature general suggested that chronic patients were eligible to enjoy quality life by obeying physician order. One of the major drawbacks of quality life was the macular degeneration, which jeopardize the patient’s vision.

Theory and Literature Review: Diabetic retinopathy was the major threat to blindness. Diabetes retinopathy means significant impacts on the patient’s quality of life. Literature also suggested that sufficient lutein supply in a continuous manner will effectively protect eyes and eyesight.

Based on the health belief model, this research explored how the perceived threats of eye diseases alone can affect the chronic patient’ s lutein consuming behavior, and how the effects change after adding perceived benefit and barrier as additional variables. Research design: This study collected 452 responses with a structured questionnaire. Results: Four independent variables of susceptibility (β=.056, t=.952), severity (β=-.006, t=-.104), perceived benefit ( β= . 419, t= 7. 303) , and perceived barrier ( β= . 056, t= - . 410) of the health belief model can explained 18.1% of variance of chronic patients’ lutein consuming behavior. Noteworthy the perceived benefit was the only variable that significant in predicting consuming behavior. This implied that the perceived benefit of lutein supplement should be particularly stressed when designing a health promotion program. In the other hand, communication contains horrifying message of eye diseases may not be viable.

Keywords: chronic patients, health belief model, consumer behavior, lutein supplement

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IM-P-3 A STUDY ON PHARMACY CUSTOMERS’ BEHAVIOR IN PURCHASING LIQUID DIETARY SUPPLEMENTS Ya- Hui Yen1, Wei-Wen Liu2, Ming-Chi Hung3 No.269, Sec. 2, Tianxin Rd., Fengyuan Dist., Taichung City, Taiwan (R.O.C) Department of Healthcare Administration,Central Taiwan University of Science and Technology,Taiwan 3 Department of Pharmacy and Master Program,Tajen university,Taiwan 1

2

Most people persist in taking dietary supplements such as vitamin and mineral nutrients.

However, the absorption rate of both traditional tablets and capsules are low. As a result, the best way to improve the absorption rate of dietary supplements is to turn them into liquid which includes all kinds of required ingredients. It is also important that how to make the customers have high quality liquid dietary supplements and bring healthy benefits. This cross- sectional study used a structural questionnair as an instrument to explore the level of understanding and purchasing behavior in liquid dietary supplements, and data were collected from pharmacy customers in central Taiwan. The study found the first two highest agreement for purchasing behavior in liquid dietary supplements are: “ingredients clearly labeled”(3.98±0.78) and “have confidece on advertising products”(3.08±0.91), and the first two lowest agreement are: “liquid dietary supplements have side effects” ( 2. 55±1. 04) and “ internet purchases are helpful” ( 2. 67±0. 93) . The purchase rate both ENSURE®( Abbott) and COMPLETE NUTRITION FOOD®(QUAKER) are more than 50%. The customers purchase liquid dietary supplements mainly used for back to health during and after the illness ( 62. 2% ) and the maintenance of good health ( 45. 9% ) , due to the pharmacist professional ( 47. 2% ) and reasonable prices (38.9%). The brand awareness, take convenience and fair price of this kind of product deeply affect the purchase intention of the customers. For taking good care of the resident, community pharmacists should recommend the liquid dietary supplements which is the most appropriate in nursing body and keeping health.

Keywords: liquid dietary supplements, purchasing behavior, pharmacy customers

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IM-P-4 A STUDY ON PHARMACY CUSTOMERS’ BEHAVIOR IN PURCHASING PAIN RELIEVING PATCH Ming-Ching Chen1, Wei-Wen Liu2, Shorong-Shii Liou3 1

2

Department of Pharmacy and Master Program, Tajen University, Taiwan Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan 3 Department of Pharmacy and Master Program, Tajen University, Taiwan

Nowadays, because of work and often a lack of regular exercise, people often feel pain, and therefore to a pharmacy to purchase pain relieving patch, every pharmacy has also provided a wide range of pain relieving patch for customers’ choice. This cross- sectional study used a structural questionnair as an instrument to explore the level of understanding and purchasing behavior in pain relieving patch, and data were collected from pharmacy customers in central Taiwan. The study found the first two highest agreement for purchasing behavior in pain relieving patch are: “ approved by the Ministry of Health and Welfare” ( 4. 05±0. 85) , and “ pharmacists provide relevant information” ( 4. 05±0. 74) , and one of the lowest agreement is: “due to spokesperson ad to purchase pain relieving patch”(2.58±1.15). There are 89.5% will go to the pharmacy to purchase cool feeling(53.4%) and aqueous(44.8%) pain relieving patch, which own use 58. 6% , 24. 1% with parents. Pain relieving patch must be approved by the Ministry of Health and Welfare. For various pain relieving patch, pharmacists should explain in detail, allow customers to purchase the most appropriate. Pharmacy pharmacist should teach customer to understand the cause of pain, clearly to describe the ingredient and use precaution, so that customers can correct and safe use of pain relieving patch to enhance satisfaction and loyalty, let pharmacy to achieve sustainable development goals.

Keywords: pain relieving patch, purchasing behavior, pharmacy customers

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IM-P-5 A STUDY ON PHARMACY CUSTOMERS’ BEHAVIOR IN PURCHASING POWDERED INFANT FORMULA MILK Jen-Chang Chien1, Wei-Wen Liu2, Ming-Chi Hung3 1

2

Department of Pharmacy and Master Program,Tajen university,Taiwan Department of Healthcare Administration,Central Taiwan University of Science and Technology,Taiwan 3 Department of Pharmacy and Master Program,Tajen university,Taiwan

Breast milk is one of the best nutrient source for babies such that breast feeding is always the first priority. Nevertheless, some mothers also have to feed their babies with powdered infant formula milk because of the insufficient of their breast milk. Consequently, the choice of powdered infant formula milk for babies has been an important issue. This cross- sectional study used a structural questionnair as an instrument to explore the level of understanding and purchasing behavior in powdered infant formula milk, and data were collected from pharmacy customers in central Taiwan. The study found one of the highest agreement of purchasing behavior in powdered infant formula milk is: “ingredient labeling” (4.26±0.53), and one of the lowest agreement is: “ purchase because of inexpensive” ( 2. 20±0. 76) . Almost always to a pharmacy to purchase ( 98. 8% ) , because of trusted pharmacist professionals ( 61. 7% ) and introduced by friends and relatives (53.2%), the initial purchase considerations were nutrition (66.7%) and brand awareness (52.1 %). The price of powdered infant formula milk is not the primary consideration for customers. In contrast, customers attach more weight to the brand awareness and the nutrient source of powdered infant formula milk. The government encourage breast feeding such that the advertisement of milk powder for 0 to 1-year-old baby is forbidden.

As a result, customers can only choose the most suitable powdered infant formula milk by seeking professional advice from the community pharmacists.

Keywords: powdered infant formular milk, purchasing behavior, pharmacy customers

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IM-P-6 THE STUDIES OF PHARMACEUTICAL QUALITY & RISK MANAGEMENT BY FAILURE MODE AND EFFECT ANALYSIS (FMEA) METHOD Kuei-Kang Chen1, Wei-Wen Liu2, I-Min Liu3 1

2

Department of Pharmacy and Master Program,Tajen University, Taiwan Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan, R.O.C 3 Department of Pharmacy and Master Program,Tajen University, Taiwan, R.O.C

ICH ( International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use) published the guidance documents "ICH Q9: Quality Risk Management" has been adopted by the United States, Japan and European countries. ICH Q9 reports that quality risk means that the entire pharmaceutical lifecycle, the occurrence of any adverse events, which led to the possibility of patient losses. Failure Mode and Effects Analysis (FMEA) is the inductive system or process analysis method to assess the potential for error or implicit, and a method where the error occurred to determine the impact of each failure mode of the quality system. The main purpose of this study was to investigate the use of FMEA methods to assess the quality of medicines in connotation and applicability of risk management,in order to provide the potential failure of evaluations, the quality of the drug to reduce the risk of errors. Our results show that FMEA can be used to prioritize and schedule risk monitoring and risk control activities. It also can be used to analyze the effect of its manufacturing operations or the impact on our manufacturing process. FMEA can strengthen CAPA measures by FMEA score estimated methods. It can be effective drugs have reached the quality of risk control. Drug quality assessment of the seriousness of a hazard, the risk profile of the drug and found that the frequency of occurrence rate risk profile of the quality score.

Keywords: failure mode and effects analysis, quality risk management, CAPA

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IM-P-7 EFFECT OF VARIOUS POLYMERS ON IN VITRO CHARACTERISTICS OF DOXYFYLLINE SUSTAINED RELEASE TABLETS Ajay Babu Ch1, Prasada Rao M2 1

Department Of Pharmaceutics, MAM College Of Pharmacy, Narasaraopeta, 522601 India 2 Department Of Pharmaceutical Analysis, MAM College Of Pharmacy, Narasaraopeta, 522601 India

The objective of work is to envisage the applicability of various polymers, Hydroxypropyl methylcellulose ( HPMC) and sodium carboxy methylcellulose ( NaCMC) on enhancing the dissolution rate of doxyfylline and to formulate into sustained release tablets. Doxyfylline belongs to the xanthenes derivative used for treatment of asthma which exhibits low aqueous solubility and poor bioavailability by first pass metabolism. Biological half- life of the drug is 2-4 hrs and hence, to obviate the demerit of multiple dose of administration and also to improve the bioavailability of drug, various polymers are used in different ratios to prepare dosage form which delivers the drug for prolonged period of time. Twelve formulations of doxyfylline sustained release tablets were prepared by employing the polymers, HPMC K15M, K100M and NaCMC, using polyvinyl pyrolidone (PVP) K30 as a binding agent using wet granulation technique. The prepared tablets were evaluated for various physiochemical parameters by official procedures and found everything was within the limit. The results show that, type of polymer and drug: polymer ratio in the tablets influences the physiochemical and in vitro characteristics of drug. The release rate of the drug from all formulations increased in the following order HPMCK15 >HPMC K100M> NaCMC. It can be concluded that the in- vitro drug release of formulation F8 containing HPMC K100 of 11% and 19% NaCMC, exhibited better drug release profile of 99.42 % at the end of 24 hours compared to marketed formulation so, that drug retains in GIT for longer periods which meets the Keywords: doxyfylline, sustained release tablets, hydroxypropyl methylcelluose, sodium carboxy methylcellulose

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IM-P-8 FORMULATION OF GRAPE SEED OIL IN WATER NANOEMULSION; A COMPARISON OF LOW ENERGY AND HIGH ENERGY PREPARATION METHODS Siti Z. Munawiroh1, Pratiwi Andriani1, Bambang Hernawan Nugroho2 1

Department of Pharmacy, Faculty of Mathematics and Sciences, Universitas Islam Indonesia, Jl. Kaliurang Km. 14.5, Sleman, Yogyakarta 55584 Indonesia 2 Nanopharmacy Research Center, Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta 55584, Indomesia Nanoemulsion can be prepared by low energy and high energy methods which each have advantages and also limitations. This study compared an optimal formulation and the characteristics of grape seed oil in water nanoemulsion which prepared by low energy method ( phase inversion composition) with by high energy method ( ultrasounic homogenizer) . Doptimal mixture design and Box Behnken design were used to optimize the formulation using low energy and high energy method, respectively. No significant difference was observed in particle size (p>0.05) by each method but the value of polydispersity index and zeta potential between two methods was found to be significant (p < 0 .05). The low energy method required high amount of surfactant but could produce smaller particle size nd significantly lower polydispersity index (PI) than high energy method.

Keywords: grape seed oil, nanoemulsion, low energy, high energy

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IM-P-9 MARKETING INNOVATION LEADING TO BETTER HEALTHCARE Imelda M. Tesalona Philippine Pharmacist Association, Fine Nutrition Trading International Human brain is the depository of wisdom and can bring breakthrough in global health. As a Pharmacist marketing and promoting health supplements and medicines, I ensure product safely, effectivity and quality. Marketing is building relationship. It is not the product itself, it is creating a story about the product. In these modern times where marketing innovation is the trend, we need to focus on what the product can do for the consumer. Communicate on different media like digital and social and use visuals to keep them engaged. It should capture their hearts. People are never satisfied, they buy not because they need but because they want. When people want something, they need it. That is why in marketing we need to uncover the want and sell to the emotions. Whether we adapt the transnational or global marketing strategy, we need to clarify the promise, actualize, relationalize and level up the promise. There are many things we need to know before we market to millenials. The comprise huge part in key generation. They think differently. Marketing to these segment should be distinctive. Putting together our tacit knowledge will bring change which will move us forward to better time.

Keywords: marketing, health supplements

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IM-P-10 DESIGN AND EVALUATION OF SELF MICROEMULSIFYING DRUG DELIVERY SYSTEMS OF FINASTERIDE Hyma Ponnaganti St.Pauls college of pharmacy, Hyderabad, Telangana The aim of the study was to develop self- microemulsifying drug delivery system ( SMEDDS) of a poorly water soluble drug Finasteride. Hydrophobic drugs can often be dissolved in microemulsion allowing them to be encapsulated in the form of fine globules, so that drug remains undissolved in the gut avoiding the dissolution step, which frequently limit the rate of absorption of hydrophobic drugs. Phase solubility studies were conducted for the maximum solubility of Finasteride. Ternary phase diagrams were constructed to evaluate microemulsion regions. FTIR analysis was done for investigating the drugâ&#x20AC;&#x201C; excipient interactions. The mean globule size of SMEDDS was observed to be below 200 nm for the optimized formulations and the zeta potential was negative. The dissolution of emulsion formulations was compared with commercial tablets; the results indicated that the rate of dissolution of developed formulations containing Finasteride was 2 to 3 folds increased compared with that of commercial tablets. SEM and TEM studies were done for the shape and morphology of the globules. A 3 month stability studies at accelerated conditions (400C & 75% RH) showed no change in physical appearance, droplet size and dissolution rate of the drug. Thus SMEDDS formulation was found to be instrumental in improving oral bioavailabily and can be regarded as novel and commercially feasible alternative to the current Finasteride formulation.

Keywords: finasteride, SMEDDS, phase diagram, bioavailability

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IM-P-11 EFFECTS OF SOLVENTS ON PROPERTIES OF ZEIN MICROPARTICLES PREPARED BY SPRAY DRYING TECHNIQUE Duangratana Shuwisitkul, Witchaya Kosawang, Supapitch Eamsherangkoon, Sujimon Tunvichien Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand The study aimed to compare solvents of zein solution for preparing zein microparticles by spray drying technique. Morphology and particle size of the microparticles were investigated. 40% v/ v isopropyl alcohol ( IPA) and 2% w/ v sodium lauryl sulfate ( SDS) were compared.

Concentrations of zein solution were varied from 2- 5% w/ v. Zein microparticles from the solution in 40% v/ v IPA showed better morphology in comparison to the microparticles from the solution in 2% w/ v SDS. The increase in zein concentrations in IPA solution enhanced morphology, whereas the increase in zein concentration in SDS solution had no effect. The best morphology of zein micropaticles was achieved using 5% w/ v zein solution in 40% v/ v IPA. The larger particle size was obtained when prepare the microparticles by IPA. The resulting morphology and particle size were explained by viscosity and stages of zein in solution. At the low concentration of SDS, zein was dissolved and stayed in the form of globular stage. In the case of 40% v/v IPA, zein was totally unfolded, thus the higher viscosity and slower solvent evaporation during spray drying process. In summary, 40% v/ v IPA as a solvent provided better morphology and larger particle size size of zein microparticles.

Keywords: zein, microparticles, solvent, spray drying technique

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IM-P-12 ENHANCED CURCUMIN BIOAVAILABILITY OF STANDARDIZED CURCUMA LONGA EXTRACT LOADED IN PVP K30 BASED SOLID DISPERSION Dewi Setyaningsih1, Yosi Murti2, Sitarina Widyariini3, Triana Hertiani4, Achmad Fudholi2, Sudibyo Martono2, Wouter Hinrichs5 1

Faculty of Pharmacy, Sanata Dharma University, Indonesia Faculty of Pharmacy Universitas Gadjah Mada, Indonesia 3 Faculty of Veteriner, Universitas Gadjah Mada, Indonesia 4 Department of Pharmaceutical Biology, Faculty of Pharmacy, Gadjah Mada University, Indonesia 5 Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, The Netherlands 2

Curcuminoids are the active compound of Curcuma longa L with superior antioxidant and antiinflammatory activities. However, clinical application of this compound is limited due to its low bioavailability following oral administration. Solid dispersions have been used to improve solubility and bioavailability of several lipophilic compounds. This study was aimed to developing a suitable solid dispersion system for the improvement of curcumin dissolution and curcumin bioavailability. The study was initiated by preparation of solid dispersion of curcumin with PVP K30 using 2 different methods including spray drying ( SD) , and vacuum drying using rotary evaporator (VD). The solid dispersion products were characterized by DSC, XRPD, SEM and dissolution behavior. An in vivo study in rats was carried out to evaluate whether dissolution enhancement as observed in vitro resulted in an improved bioavalaibility.

Curcumin plasma concentrataions were determined using a validated Reversed Phase High Performance Chromatography Analysis method. A high dissolution rate of curcumin were obtained from the solid dispersions prepared by spray drying with 100% dissolution was obtained within 50 minutes. Investigation on the molecular embedment of the solid dispersions

by FTIR, DSC, and SEM demonstrated the formation of amorphous state of curcumin in PVP K30 matrix. The in vivo study demonstrated bioavailability relative of curcumin in plasma more than 2000% for the solid dispersion of C. longa extract in PVP K30 based solid dispersions.

Keywords: curcumin, bioavailability, solid dispersions, amorphous, Curcuma longa

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IM-P-13 HOW PERCEIVED THREATS OF EYE DISEASES AND PERCEIVED BENEFITS AND BARRIERS OF LUTEIN PREDICT LUTEIN CONSUMPTION? Shun Lung Chao1, Jieh-Horng Hwang2, Jhy-yih Chen2, Feng-Chuan F Pan2 Department of Pharmacy, Tajen University and Puu Deng Pharmaceutial Co.,Ltd. 2 Faculty of Pharmacy, Tajen University, Pingtung 907 Taiwan Literature generally suggests that the macular pigment can only be obtained from the diet. AgeRelated Eye Disease Study 2 Protocol had also suggested that lutein help prevent Age- related Macular Degeneration (AMD) by increasing macular pigment optical density (MPOD). Given the daily diet may not be able to provide sufficient Lutein and Zeaxanthin to protect eyes, to intake nutrient such as Lutein and Zeaxanthin from nutritional supplements will be a wise alternative to prevent eye diseases. Based on the health believe model, this research explored into the respondentsâ&#x20AC;&#x2122; perceive threats toward the threats of eye diseases, and the perceived benefits toward lutein as a preventive measure. Independent variables of susceptibility, severity, benefits, and barriers as a whole can explain 25% of variance with the perceived benefit ( . 49) as the major predictor of lutein intake, and followed by perceived barrier ( - . 19) and susceptibility ( . 08) . Findings from the current research were consistent to the previous research, thus confirmed that the Health Belief Model as a theory was applicable in the research of the behavior of taking lutein as a preventive measure of eye diseases. The current research suggested to promote the benefits of lutein intake may help strengthen peopleâ&#x20AC;&#x2122;s willingness to gain these specific nutrients from daily diet. Research results can be a useful reference for the lutein suppliers as well as the public health agencies while conducting preventive campaigns on eyes and eye-sight.

Keywords: lutein, zeaxanthin, age-related macular degeneration (AMD), macular pigment optical density (MPOD), Age-related eye disease study 2 protocol (AREDS II)

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IM-P-14 CURRENT PHARMACEUTICAL PRODUCT GDP IMPLEMENTATION STATUS IN TAIWAN Lian-Kwun Lin1, Ben Chen2 1

Pharmaceutical Industry Marketing Committee, Taipei Pharmacists Association,, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

Pharmaceutical Products GDP is an international trend to ensure that pharmaceutical supply chain process can maintain product quality, integrity and security. World Health Organization presented the draft of Good Distribution Practices for Pharmaceutical Products in 2004, after the 2005 revision amended as No. 957 technical report in 2010, Annex 5 of the pharmaceutical specification file. The EU also announced Good Distribution Practice of medicinal products for human use in 2011, which was amended in 2013. Countries in the world have been conducting pharmaceutical products GDP including most EU countries in Europe; Canada, United States, Brazil, Argentina in America; China, India, Taiwan, Malaysia, Singapore in Asia; and Australia in Oceania. TFDA announced pharmaceutical Good Manufacturing Practices in May 2015 as the draft guidelines of pharmaceutical products good distribution practice. In July 17, 2015, it was announced that pharmaceutical product good manufacturing Practices (Part III: distribution) with immediate effect. Taiwan Food and Drug Administration initiated the first consultation visit from 2012 to 2015 for total 4 years. In result, there are total 145 manufacturer- ( site) visits, in which total of 107 was awarded with excellent marketing practice as merit pharmaceutical manufacturers. In 2016, the consultation visit expands to total 300 manufacturing sites. The first phase includes medical gas plant, re-packaging and labeling plant and apply debut Licensed Pharmacy Evidence to medicine trafficking industry must implement GDP from July 1, 2016. From January 1, 2019, all drug manufacturers with pharmaceutical drug licenses must implement GDP.

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Poster presentations V. Pharmaceutical Education

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PE-P-1 STUDENT PERCEPTIONS ON FACTORS AFFECTING ACADEMIC PERFORMANCE IN A TERTIARY INSTITUTION IN MANILA, PHILIPPINES Vina Rose A. Dahilig1, Dr. Ma. Lourdes Santos Balatbat2 1 2

School of Pharmacy Emilio Aguinaldo College 1113-1117 San Marcelino St., Paco, Manila Department of Psychology College of Liberal Arts De La Salle University 2401 Taft Avenue, 1004 Manila

Evaluation of how the students perceive the factors that affect their own academic performance is important to ensure that the learning goals of any college program are met. Such selfperceptions may guide educators in choosing interventions that need to be implemented to ensure academic success. This study was conducted to identify students’ perceptions on the factors affecting academic performance. The study utilized a survey instrument administered to all 108 students enrolled in the BS Pharmacy program in a tertiary institution in Manila, Philippines. The mean age of the respondents was 19.82±0.18. Majority were female (78.07%).

The students ranked highest on academic competence ( 4. 11±0. 49) and strategic studying 3. 93±0. 94. The lowest scores were on the test anxiety ( 3. 11 ±0. 51) and test competence ( 3. 125±0. 25) domains. The results indicate that while the students use strategic studying techniques and can, to some degree, manage the Pharmacy course load, their academic success is hampered by poor test-taking skills. Educators may explore test counselling to help improve students' academic performance.

Keywords: academic performance, factors affecting academic performance, test anxiety, academic competence

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PE-P-2 FACTUAL INVESTIGATION OF UNDERGRADUATE EDUCATION IN PALLIATIVE CARE AT PHARMACEUTICAL COLLEGES AND PHARMACEUTICAL DEPARTMENTS AROUND THE COUNTRY IN JAPAN Yoshiaki Okamoto1, Midori Hirai2, Tsutomu Suzuki3, Hajime Kagaya4 1

Ashiya Municipal Hospital Kobe University Hospital 3 Hoshi University, Graduate School of Pharmaceutical Sciences 4 Meiji Pharmaceutical University 2

Background: Pharmaceutical undergraduate education in Japanese universities changed from a four-year course to a six-year course from 2006, and from 2012 graduates who have received the new education have been clinically active. In Japan, each university individually sets curriculum in compliance with the Pharmaceutics Model Core Curriculum. In recent years, the number of lectures in clinical fields has drastically increased, and the contents are also becoming richer, but it is known that there are large differences between the universities.

Method: We sent questionnaires to university presidents, deans, and concerned teaching staff at 72 of universities around the country and collected the answers via e- mail. The questionnaires consisted of 14 items including " Is palliative care necessary in pharmaceutical education?", "State of implementation of palliative care education", "Influence on pharmacists' duties", and "Sense of satisfaction in lectures". Results: The response rate to the questionnaire was 71.6%, or 53 of the 74 schools. 96% responded "Yes" to "Is palliative care necessary in pharmaceutical education?" 86. 5% responded " Yes" to " Do you conduct lectures regarding palliative care?" As for the number of classes of the lectures, 58.7% responded 2-7, which was the highest, and 6.5% of universities had 17 classes or more. Considerations: This investigation showed that the necessity of palliative care was recognized at most universities and that lectures devised at each university are being conducted. However, because about half of the Universities feel that it is currently insufficient, we can expect that education in this field will be further enriched in the future.

Keywords: palliative care, undergraduate education

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PE-P-3 ADVICES OF CAREER FOR YOUNG PHARMACISTS IN TAIWAN: THE EXPERIENCES FROM TAIWAN YOUNG PHARMACISTS’ GROUP Hung-Chang Chou1, Yen-Lin Chang2, Yi-Hsuan Chen3 1

2

School of Pharmacy, Taipei Medical University, Taipei 11031 Taiwan Department of Pharmacy, Taichung Veterans General Hospital, Taichung 40705 Taiwan 3 Taiwan Young Pharmacists’ Group, Taipei 10641 Taiwan

Backgrounds: Taiwan Young Pharmacists’ Group ( TYPG) aims to facilitate pharmacy students’ transition to practice and to help young pharmacists develop their career pathways.

Although pharmacy students are well trained as pharmacists, there is lack of advices that specifically emphasizes the needs in career of young pharmacists. Purpose: TYPG organized a series of career- related courses for young pharmacists that help them acquire the ability to develop their careers. Methods: The course consisted of three aspects: working attitude, law and time management. The course was delivered in workshops where the pharmacists who were representative to specific fields and setting were invited to share their career experiences.

A survey on participants’ satisfaction with the course was delivered in the end. On this fivepoint scale, young pharmacist who rate their satisfaction level more than 4 showed high satisfactory. Results: A total of 65 young pharmacists participated in the course and reflected their needs and concerns regarding career planning. About 90% of participants showed high satisfactory. Many participants reported that experiential sharing was useful and the content designed specific to field and practice setting was in particular valuable. Detail career development course and satisfaction responses from the participants will be presented in the Congress. Conclusions: The course on career development for young pharmacists is needed.

The content of career planning organized into age and practice setting is helpful for pharmacists’ transitions in their career.

Keywords: career, young pharmacists

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PE-P-4 TEACHING MODEL: THE EFFECT AND EXPERIENCE OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) Yung-Jun Hung, Be-Ling Chiou, Yi-Ping Hsiang Pharmacy Department of E-DA Hospital, Kaohsiung city 82445 Taiwan (R.O.C) Research Objective: Recently in Taiwan, Objective Structured Clinical Examination ( OSCE) has been included in the criteria of the evaluation for medical doctors in the teaching hospital accreditation. Although the evaluation for pharmacists hasn’ t been strictly formulated in the accreditation yet, most hospitals have already considered OSCE a method of multiple assessment. The effect and our experience of OSCE were summarized in this study. Method: Before evaluation: (1) Setting of the teaching plans (2) Composition of the teaching plans (3) Practice and consensus- building between assessors and standardized patients ( 4) Exam orientation for the candidates. During evaluation: (1) The length of each station was defined to be 12 minutes (including evaluation feedback for each candidate) (2) Comprehensive feedback and discussion after OSCE. After evaluation: (1) Set pass-fail decisions by using angoff method (2) Assess the results. Result: We have been implementing OSCE once a year since 2011. 51 post-graduate year (PGY) pharmacists, 14 under-graduate year (UGY) pharmacists and several visitors were included in the evaluation. We totally designed 25 teaching plans containing 9 professional knowledge, 9 operation techniques and 7 communication skills. On average, we set 9. 4 OSCE stations and there were 1. 6 stations that the candidates failed to complete. The overall satisfaction rating of the candidates, the assessors, the standardized patients and the visitors were 4.69±0.20, 4.70±0.30, 4.71±0.36,5.00±0.0(five points Likert scale). Discussion and Conclusion: We carried out OSCE not only to examine the learning effect but to re-educate our candidates. For those who didn’ t not pass the test, they would get a feedback from the assessors, and receive more aids and information from their preceptor pharmacist to provide the patients with a better pharmaceutical care.

Keywords: teaching model, experience of Objective Structured Clinical Examination (OSCE), effect

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PE-P-5 THE TRANSITION OF PHARMACY PRACTICE IN TRADITIONAL CHINESE MEDICINE IN TAIWAN Chien-Yi Hsu1, Kun-Cheng Lin1, Tsung-Ying Hsieh1, Tzu-Hua Wu2 1

Chinese Herb Development Committee,Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

Traditional Chinese Medicine ( TCM) currently has become more modernized and scientific under the endeavor of the relevant department and industries even though it seem to be conventional and conservative. For example, to ensure the quality and safety of TCM for public health, implementations of Good Manufacturing Practice, crude drug origin identification, manufacturing process and quality control, barcode system in TCM origin traceability management platform, QR-code labeling on the package and so forth were rigorously promoted for controlling of product quality and safety. The committee of Taipei Pharmacist Association aims to encourage practicing pharmacists in Taiwan to keep playing a key role in such transition of TCM with their well- trained pharmaceutical knowledge. Those areas of knowledge include developing new dosage forms for TCM, studying TCM pharmacokinetics and drug interactions. The clinical efficacy of new drugs from TCM was also followed the guideline of Good Clinical Practice to provide its evidence-based medicine. Therefore, efforts in creating platforms for pharmacists to involve in controlling of product quality, safety and efficacy include one series of lectures for professional practices and two visiting activities ( Botanical Garden or Pharmaceutical manufacture for Chinese herbal medicines) . Total 225 pharmacists joined those training programs. In Taiwan, TCM is no longer traditional, but present a completely brand-new modern face and spirits in health care. The pharmacy practices in TCM are not only focused on patient care, but also contribute to its transition during pluralistic development of TCM.

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PE-P-6 DAWN OF THE NEW ERA OF THE POST-GRADUATION EDUCATION IN JAPAN: SHOWA UNIVERSITY PHARMACY RESIDENCY PROGRAM. Kanayuki Kitahara, Isao Saito, Yasuha Ogawa, Yuki Naito, Airi Takahashi, Hiroko Yamada, Masahiro Usuda, Shuhta Ujiie, Kaoru Murakami, Tomiko Sunaga, Kazuki Tomura, Daisuke Ichikura, Nagisa Miyamoto, Akitoshi Takuma, Moeka Fukai, Kosuke Sakurai, Toru Watanabe, Mari Kogo, Astuko Minemura, Katsumi Tanaka, Tadanori Sasaki School of Pharmacy, Showa Univeristy, Tokyo142-8555, Japan As the role of the pharmacists has shifted to more clinical in Japan, residency program as a post- graduation education has very important meanings to raise pharmacy clinician. Showa University Pharmacy Residency Program was started in 2010 and more than 70 residents graduated from the program. In this session, we present some results of our investigation regarding efficacy and efficiency from aspects of subjective and objective evaluation of the program. From the fiscal year 2010 to 2014, paper based examinations and observational structured clinical examinations (OSCE) were conducted. The exams were done three and six months after the start of the program. The OSCE was consisted of the central pharmacy practice techniques and team-medicine practice skills. At the end of the program case presentation was carried out and evaluations were fed back to the residents. In the year 2015, as a new step, residents accumulated case summaries and portfolios, and preceptors gave feedback repeatedly and frequently. Interprofessional evaluation and case based discussion were also taken place.

Residents were able to set goals for the next step by knowing the results of the exams and it facilitated them to learn more to be a better clinical pharmacist. The case based discussion revealed an insufficient area of each resident and made preceptors possible to support residents' growth in a timely manner. Next action assignments are clarifying the final goal of the program and generalizing the level that residents reach by the end of the program.

Keywords: residency, observational structured clinical examinations, case based discussion, interprofessional evaluation

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PE-P-7 ASSESSMENT OF PROBLEM-BASED LEARNING FOR UNDERGRADUATE PHARMACY STUDENTS IN A MIDDLE TAIWAN HOSPITAL Min-Ling Tsai, Yung-Rung Lai Department of Pharmacy, Chung Shan Medical University Hospital Background and Objective: Problem- based learning（PBL）has been reported to learn problem solving skills and acquire knowledge about clinical science. The aim of this study is to evaluate the effectiveness of PBL approach which was designed to hospital pharmacy training program for undergraduate year（UGY） in our department from 2st semester 2010 to 2014. Methods: 36 UGYs were enrolled and 5~6 of them were divided into a group with a tutor assigned. All of them participated in 12 workshops in which they had to solve problems and discuss pharmacokinetic concepts for 1~3 hours. Every student and the tutor had to fill a questionnaire when each workshop was finished. 51 questions covering 4 item domains were included in the questionnaire. Results: Tutors and students assess of two- way feedback after class: Student self-assessment and peer assessment score is 4.62±0.11 points and 100% of the students think PBL is superior to the traditional subject- based learning. Students assess the teaching effectiveness score for 4. 73±0. 23 points; teachers assess student learning outcomes scores for 4. 28±0. 15. Students and teachers are up to 93. 76% and 85. 34% to the whole satisfaction of course. Conclusion: Most UGYs and tutors thought that PBL provided more self- directed learning capability, interactive learning experiences and practical teaching materials comparing with traditional subject-based learning. However, some of them indicated the insufficiencies of teaching equipment and time of workshop for full discussion. Overall, most UGYs and tutors believed PBL was a good learning approach and should be applied in the future teaching.

Keywords: problem-based learning, PBL, UGY

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PE-P-8 AN EXAMPLE OF EDUCATION OF DRUG-INTERACTION USING CASE STUDIES TO PHARMACY STUDENTS Hiroshi Moriuchi Laboratory of Pharmacy Practice, Daiichi University of pharmacy, Fukuoka, Japan Background: In Japan, there is an increase in the occasion for pharmacists to go to the bedside of inpatients. They may find something wrong with biomarkers of patient. This may happen because of drug-interaction. However, Japanese pharmacy students do not seem to be familiar with drug interaction well. Although the subject is taught in a part of pharmacology and biopharmaceutics, many students seem to think that the subject is important but is hard to remember the miscellaneous information about drug-interactions. Objective: If they can notice that predicting and preventing drug interaction is very important, their motivation to learn the subject would be improved. Therefore, by using case studies, they can understand 1) how important the knowledge of drug interaction, 2) how to apply their pharmacological and/ or biopharmaceutical knowledge to clinical area. Method: Therefore, showing pharmacy students examples of drug-interaction by using simulated clinical case reports can be an interesting way of teaching. Possible results and discussion: By referring to pathophysiology of the case, students may be interested not only in drug- interaction but also the alteration of biomarkers.

Besides, they would improve their ability to think over causes of alteration and how to solve problems. Meanwhile students could review physiology and possibly anatomy. To make a class of drug-interaction more attractive, this type of teaching would be a proper way.

Keywords: drug-interaction case-study

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PE-P-9 DEVELOPMENT OF PHARMACIST TO PREPARE FOR DISASTER ACTION OF HYOGO PHARMACIST SOCIETY Atsushi Ueda Hyogo Pharmaceutical Society In 2016, Kumamoto earthquake hit. Now we pharmacist is demanded more wide range of medical skill of the sub- immediate nature period as specialist of medicine in disaster area.

Hyogo pharmacist society have developed pharmacist who can active practically. We acted with the skill in Kumamoto.

Keywords: Kumamoto earthquake, disaster relief, education

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PE-P-10 TEACHING MODEL: THE EFFECT AND EXPERIENCE OF “INTERNATIONAL PHARMACY TEACHING PROJECT” (IPTP) Yu-Chen Pan, Yung-Jun Hung, Yi-Ping Hsiang, Li-Ching Chien Pharmacy Department of E-DA Hospital, Kaohsiung city 82445 Taiwan (R.O.C) Research Objective: To coordinate with the government project of cultivating medical talents from friendly nations, our hospital cooperates with I- Shou University and provides abundant academic and medical resources of 4- year medical education. We aim to solve medical insufficiency in our friendly nations by raising outstanding and enthusiastic talents. To further advance the teaching abilities and extend the worldview of the junior pharmacists, our pharmacy department encourages them to join the “ International Pharmacy Teaching Project”(IPTP). The effect and our experience were summarized in this study. Method: In this study, the qualification of teachers are needed to be junior pharmacists within three years working experiences who are English proficiency tests qualified. Besides, we also arranged senior pharmacists to be the instructors during the whole project. The teaching effect evaluation includes: (1) The overall satisfaction rating of the international students (2) The assessments of the instructors ( 3) The self appraisals of the teachers. Result: We have been giving 12 lectures by 10 junior pharmacists instructed by 3 senior pharmacists since 2015. The overall satisfaction rating of the teachers, the instructors and the international students were 4.27±0.56, 4. 00±0. 49, 4. 54±0. 57. ( five- point Likert scale: very satisified- 5, very dissatisified- 1 ) Discussion and conclusion: The purpose of IPTP is to train the teaching and English ability as well as develop the global perspective of the junior pharmacists. “ Teaching is learning” , we expect to promote the importance and status of pharmacists in medical education by IndustryAcademy Cooperation. Furthermore, we provide senior pharmacists as instructors during the whole project. In conclusion, we aim to foster well English-instructed clinical teachers through IPTP. Keywords: teaching model, experience of “international pharmacy teaching project” (IPTP), effect

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PE-P-11 SELF-DIRECTED LEARNING AND TWENTY-FIRST CENTURY SKILLS IN PHARMACEUTICAL ANALYSIS CLASSROOM: NIR AND RAMAN SPECTROSCOPY Lawan Sriphong Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand Self-directed learning (SDL) was designed to construct the 21st century skills in pharmaceutical analysis course. The students were assigned a case study to learn something more in NIR and Raman spectroscopy from their own experiences independently and as a teamwork. Certainly, they showed their ability to gather information for decision making to procure the instruments for quality control and quality assurance of raw material and medicinal products in pharmaceutical industry and present their knowledge in term of a proposal for chosen instrument. Compared to the pretest, the improvement in posttest results was significant ( p < 0. 001) demonstrating that students gained basic knowledge of NIR and Raman spectroscopy during the process of SDL. High scores of final examination ( 82. 5% ± 6. 7) indicated the retention of knowledge. Moreover, the performance of students’ presentation and results from students’ self-assessments showed that being self-directed learners in pharmaceutical analysis classroom could develop 21st century skills including computing and ICT fluency, critical thinking and problem solving, collaboration and teamwork, communication and lifelong learning. Students’ satisfaction was very high (93.3% ± 10.3) for the opportunity to study by their own interests and instructor’s support for self-direction study.

Keywords: self-directed learning, 21st century skills, pharmaceutical analysis

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PE-P-12 CYTOTOXICITY ASSAY AND ACUTE TOXICITY ETHYL ACETATE FRACTION OF ANTS NEST (MYEMECODIA ERINACEAE BECC) Sri T Rahayu1, Yahdiana Harahap2, Noorwaty Soetandyo3, Abdul Mun'im2 1

Faculty of Health Science, Esa Unggul University, Indonesia 2 Faculty of Pharmacy, Indonesia University,Indonesia 3 Dharmais Cancer Hospital, Jakarta, Indonesia

Plants anthill (Myrmecodia erinaceae Becc.) Is native to Papua. Undiscovered scientific data about the plant is that this research carried out observations of activity against vero cells and toxicity properties to mice (Mus musculus) of selected fractions. Maceration is done with 80% ethanol and then fractionated with hexane, ethyl acetate, and butanol. Characterization of the extract obtained and calculated total phenols and flavonoids of extracts and fractions, and the ethyl acetate fraction has a value of total phenols and flavonoids greatest. Using MTT method, tested the inhibitory activity against vero cells at a concentration of test fractions 750, 500, 250, 125, 62. 5, and 32. 25 ppm. Doxorubicin as a positive control and 0. 1% DMSO as a negative control. This test gives the IC 50 value of 803. 41 ppm. Acute toxicity test on 50 male and female mice, with concentrations of 413, 826, 1,653 and 3,307 mg / kg with a negative control corn oil provide value LD 50> 3307 mg / kb weight and based on the table Toxicity Classes: Hodge and Sterner Scale The faction ethyl acetate including category 4 with slighly toxicity.

Keywords: Myrmecodia erinaceae Becc, ethyl acetate fraction, IC50, vero cells, MTT

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PE-P-13 APPLYING AN ONLINE DRUG INFORMATION SERVICE MODEL TO A HEALTH INFORMATICS COURSE FOR THE 3RD YEAR PHARMACY STUDENTS Perayot Pamonsinlapatham1, Samart jamrat2, Lawan Sratthaphut1, Suang Rungpragayphan1 1

Health-related informatics department, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand 2 Drug information service "Prachanath", Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000 Thailand

Drug information service ( DIS) , one of major tasks in pharmacy practice, requires not only clinical skills, but also good informatics skills to be executed efficiently. At the Faculty of Pharmacy, Silpakorn University ( Thailand) , we have developed a core course named Health Informatics aiming to train our 3rd year pharmacy students the informatics knowledge and skills. In the course, a topic of DIS with informatics and information technology perspective was established. To carry out the DIS lesson, an online DIS model was developed based on 3 concepts: 1) Drug information service providing, 2) Electronically working (paper less), and 3) Available through the internet. After a lecture of DIS principle, the model was applied in the DIS practicing class and was evaluated by all students. Results are shown as mean± SD in 5- scale rating. Structure and concept, usefulness to DIS, availability of searching tools, and storage of questions and answers of the online model were graded at 4. 200 ± 0. 621, 4. 153 ± 0. 565, 3. 988 ± 0. 713, and 4. 224 ± 0. 613, respectively. In terms of benefit to the class, understanding improvement and interestingness were rated at 4.212 ± 0.557 and 4.218 ± 0.601, respectively. In conclusion, application of the online DIS model to the DIS lesson was interesting and beneficial to student understanding. It could expand learning experience of students.

Keywords: drug information service, class, informatics, pharmacy student

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PE-P-14 CURRENT SCENARIO, CHALLENGES AND FUTURE TRENDS OF PHARMACY EDUCATION IN INDIA Ashokkumar Durairaj1, Narayana Venkata Tanniru2 Pratishta Institute of Pharmaceutical Sciences, Durajpally (V), Chivmla (M), Nalgonda District, Telangana-508214, India 2 Vikas Institute Pharmaceutical Sciences, Nidigutla (V), Near Airport, Rajahmundry, EG District, Andhrapradesh-533103, India 1

Pharmacy is the health profession that links health sciences with chemical sciences and charged with ensuring the safe and effective use of pharmaceutical drugs. India, a developing nation that occupies the greater part of South Asia, is a sovereign, secular republic consisting of 29 states and 7 union territories. Pharmacy education in India traditionally has been industry and product oriented. In contrast to the situation in developed nations, graduate pharmacists prefer placements in the pharmaceutical industry. To practice as a pharmacist in India, one needs at least a diploma in pharmacy, which is awarded after only 2 years and 3 months of pharmacy studies. These diploma- trained pharmacists are the mainstay of pharmacy practice. In India, there has been a surge in the number of institutions offering pharmacy degrees at various levels and practice- based doctor of pharmacy ( Pharm D) program was started in some private institutions in 2008. However, relatively little information has been published describing the current status of complex pharmacy education of India. In this, description of Pharmacy education in India and highlight major issues in pharmacy practice including deficiencies in curriculum. The changing face of the profession is discussed, including the establishment of the Pharm D program. The information presented may stimulate the discussion, critical analysis and planning, and will be value in further adaptation of the pharmacy education to desired educational outcomes. These are times of enormous change in healthcare and pharmacy profession and pharmaceutical education must prepare students to enter into the practice of pharmacy.

Keywords: current status, future trends, pharmacy education

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PE-P-15 FACTORS INFLUENCING CAREER CHOICES AMONG PHARMACY STUDENTS IN A PRIVATE UNIVERSITY Pravinkumar V. Ingle1, Kirthana Kanagaraj2, Tamilarasi Krishna Murthi2, Raynugah Gunasagaram2, Lavinyaa Thiruchelvam2, Mari Kannan Maharajan1, Kingston Rajjah2 1

Faculty of Pharmacy, Department of Pharmacy Practice, School of Pharmacy, International Medical University, IMU Main Campus, Bukit Jalil, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

2 School of Pharmacy, International Medical University, IMU Main Campus, Bukit Jalil, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Background: Choosing a career is a crucial decision in oneâ&#x20AC;&#x2122;s life. Many undergraduate students face difficulties when it comes to making decisions about their career choices. Objective: This study was done to investigate the career choices and preferences of undergraduate students and to determine what factors the students consider when deciding upon their career and to what extent each factors influences their decision. Method: A validated self- administered questionnaire was used in this cross sectional study to collect data from first year, semester 2, Bachelor of Pharmacy students in International Medical University (IMU). Statistical Package for Social Science (SPSS) was used to generate reports of descriptive statistics and independent sample T- test, for the data analysis. Result: The most influential factor when deciding upon their career choice as a pharmacist was due to a good career opportunities with a mean score of 3.52 for male and a mean score of 3.59 for female. For the section of career image, majority of students were strongly committed and have a positive attitude towards pharmacy as a profession. Majority students chose the statement intent to travel during working holidays with 75% chosen by males and 65% chosen by females when asked about their career intention for future working life. Conclusion: It was found that the most influential factor when deciding upon their career choice as a pharmacist was due to good career opportunities followed by their interest in science based course.

Keywords: career choice, pharmacy students, influencing factor

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Poster presentations VI. Administrative, Social Pharmacy and Ethics

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A-P-1 INFORMATION BUILDING DEVELOPMENT IN TAIPEI PHARMACISTS ASSOCIATION Yu-Chung Sun1,2, Mandy Fan1 1

2

Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. Division of Pharmacy, Cheng Hsin Rehabilitation Medical Center, Taipei, Taiwan

Introduction: Taipei Pharmacists Association ROC was established in June 1, 1946, which has 13 committees and related work team to execute business promotion. One of the CommitteeIT Committee ‘duty is e-business to publish Issues of Metropolitan Pharmacists and eNewsletter, and builds up World Wide Web. Methods & Results: In World Wide Web page, to strengthen the channels of communication and efficiency with TPA members, we provide a wide range of services to improve the quality. In 2012’TPA planned building new page in which it is made an integrated information platform and imported “Drug Delivery System for Pharmacy Dispensing”, “Drug Information Management System” and “Pharmacy Care Service System” three levels of operational mechanisms and reference, to improve professional performance of pharmacists practicing. This system began on-line in 2013. In addition, due to modern people using mobile-phone to enter APP very common, in response to the trend, TPA plans building web site in this year and makes APP in order that TPA members can inquire website announcement, register Continuing Education Course and accept push message from TPA in any time. Conclusion: The purpose of information is to get the message more quickly and conveniently, and new message can be used correctly by people in order to enhance mankind’s life. So to enhance mankind’s health we hope to provide TPA members more complete information and more convenient using style so that they can gain the correct information quickly.

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A-P-2 A STUDY ON THE MEDICATION 0F LONG-TERM CARE FACILITY RESIDENTS Ming-Chih Chiang1, Chi-Tsung Huang2, Wei-Wen Liu3, Shorong-Shii Liou1 1

Department of Pharmacy and Master Program,Tajen University, Taiwan 2 Wen-Xiang Nursing Home, Changhua County, Taiwan (R.O.C.) 3 Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taiwan In the last decades, there are major changes in Chinese peopleâ&#x20AC;&#x2122;s lifestyle and eating habits due to the advent of hypertension, hyperglycemia and hyperlipidemia. It is a fact that most residents in long-term care facilities are afflicted with one or more of those three aforementioned diseases. Another fact is that drug therapy is used more than it is needed in those cases; thus, requiring extra time and energy from the nursing staff to manage the drugs. This paper aims to acquaint residents and their families with: 1) the basic knowledge on the pathogenesis of the chronic diseases and the necessity of drug therapy, 2) the significance of a healthy diet on such chronic conditions, 3) the vital mission to control blood pressure, blood sugar, blood lipoid and weight, and 4) the potential benefit that a released dosage could bring. This research is based on chronic-disease-remedy-drug consumption conditions including disease category, dosage and consumption in five long-term care facilities. We find that more than 90% of the medicines taken by facility residents come as chronic disease remedy and the average dosage is 5-8 pills.

This leads us to reconsider the significance of a healthy diet, a healthy lifestyle, responsible disease education and quality of care when combating with chronic diseases. In addition, it is the responsibility of the care facility to practice quality care against chronic diseases and gradually reduce unnecessary drug dosage.

Keywords: long-term care facility, chronic disease, medication

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A-P-3 PHARMACEUTICAL ETHNOBOTANY OF THE MOST COMMONLY USED MEDICINAL PLANTS OF THE AGTA INDIGENOUS GROUP SITUATED AT IRAYA, BUHI, CAMARINES SUR, PHILIPPINES Genaliza L. Laynesa, Aleth Therese L. Dacanay, Carol Geraldine C. Pablo Faculty of Pharmacy, University of Santo Tomas, Espana Manila Philippines An ethnobotanical study was conducted on the Agta tribe situated at Iraya, Buhi Camarines Sur, Republic of the Philippines with an objective to document indigenous knowledge of the Agta Tribe on the use of medicinal plants and investigate plant species that are used as medicines for the treatment of encountered health problems. Plant and ethnobotanical information were collected through the use of a semi-structured questionnaire. A total of 103 informants were involved in providing information on the 108 plant species documented as medicinal plants and utilized by the tribe members to treat different kinds of diseases and ailments. The most frequently used plant part in terms of percentage of the total number of species was the leaves (50.0%), root (11.2%), fruit (10.6%), bark (9.6%), stem (6.2%), rhizome (5.1%), whole plant (3.4%), clove and hair (1.7%), seeds (1.1%), and flower (1.1%). The methods applied in the preparation of the herbal medicine were expression, decoction, poultice, heat application, infusion, direct application and fresh consumption. Most the medication were administered orally. The most common illnesses were musculo-skeletal pain & inflammation, respiratory disorders and gastrointestinal disorders. Ethnobotanical valuations of medicinal plant species are important for the conservation and protection of indigenous knowledge of medicinal plant. Such information is vital for pre-clinical studies of drug development. Hence, there is a need to utilize and coarsen the ethnobotanical information to continually encourage indigenous people to preserve biological and cultural diversities.

Keywords: ethnobotany, Agta tribe, Buhi, Camarines Sur

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A-P-4 TOTAL COST OF INSULIN THERAPY FOR DIABETIC OUTPATIENT IN SANGLAH HOSPITAL BALI Luh P.F Larasanty, I Gusti N.A Dewantara Department of Pharmacy, Faculty of Mathematics and Basic Science, Udayana University, Bali, Indonesia Insulin is one of the antidiabetic drug therapy for diabetic patients. There are 4 types of insulin based on the onset of action, each type has it own cost and effectiveness. Has been a lot research about insulin effectiveness, however there is just few research reviewing about the total cost required for the insulin therapy. The purposes of this study is to determine of the total cost incurred for prescribed insulin therapy in Sanglah Hospital Bali. This study was conducted in March to June 2016 in Sanglah Hospital Bali. Research subject of this study was diabetic type 2 outpatient. Data of insulin therapy regimens and its costs obtained from patients' medical records, prescription data, administration sheet, patient therapy reports at the pharmacy as well as the social history of the patient. The total cost is calculated based on direct medical costs (physician services, lab tests, drugs and preparation cost of medicines and equipment), direct non-medical costs (administration fees and transport) and indirect non-medical costs (loss of salary / wages because they do not come to work). There are 8 types of insulin are prescribed at the internal disease division at Sanglah Hospital with it each percentage of use as follows: Apidra Solostar (12.66%), Humalog Mix (4.37%), Humalog Quickpen (3.78%), Humulin N (2.40%), Lantus Solostar (28.68%), Levemir (12.01%), Novomix (0.15%) and Novorapid (35.95%). Lowest total cost of prescribed insulin are Lantus Solostar (USD 42.28), while the highest are Humalog Mix (USD 54.81). The average total cost of insulin therapy is 45.24 USD. Keywords: diabetic, insulin, therapy, total cost

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Poster presentations VII. Pharmacoepidemiology and Pharmacoeconomics

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PP-P-1 EVALUATION OF TREATMENT ALTERNATIVES AND OUTCONES TO SECOND LINE ANTI-TUBERCULOSIS AMONG PATIENTS WITH PULMONARY TUBERCULOSIS IN CENTRAL TAIWAN Chieh-Ying Chen1, Yi-Wen Huang2, Meng-Yu Liou1, Sheng-Kang Huang1 1 2

Department of Pharmacy, Changhua Hospital, Ministry of Health and Welfare, Taiwan Pulmonary and Critical Care Unit, Changhua Hospital, Ministry of Health and Welfare, Taiwan

Background: In 2011, the treatment success rate for new tuberculosis (TB) cases was 72.5% in central Taiwan. Second line anti-TB drugs are much more toxic and expensive than first line drugs. Thus, prescription of second line anti-TB drugs is verified and monitored by Taiwan CDC since 2006 and all patients received DOT aim to prevent second line drug resistance. The objective of this study was to evaluate the treatment alternatives and outcomes of second line anti-TB drug users in central Taiwan. Methods: Initial second line anti-TB applications between January 2010 and December 2014 in central Taiwan were selected for this study.

Medical records were followed from the date of initial use of second line agents to the end of study (November 30, 2015). The treatment success was defined as cured or completed treatment. Results: There were 11,292 TB patients in central Taiwan during 2010-2014. 789 patients were included in this study. The mean age of the subjects was 66 and 74% were males.

619 patients (78%) were prescribed one alternative second line agent. 78% of patients received oral fluoroquinolones, 34% of patients received injectable agents and 8% received oral bacteriostatic second line agents. The fluoroquinolones resistant rate was 0.08% in 2010 and 0.1% in 2014. The treatment success rate among all participants was 75%. Conclusion: Oral form fluroquinone was prescribed most often by physicians. Under Taiwan CDC policy and DOT, the fluoroquinolones resistant rate didnâ&#x20AC;&#x2122;t increase and the treatment success rate of second line anti-TB patients was similar with general TB cases in Taiwan.

Keywords: alternative second line anti-tuberculosis drug, injectable agents, fluoroquinolones

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PP-P-2 EPIDEMIOLOGY OF INFECTIONS CAUSED BY CARBAPENEMRESISTANT ACINETOBACTER BAUMANNII(CRAB) Po-I Chen1, Pei-Liang Chen2, Se-Chin Ke3, Chin-Ming Chen3 1

Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan Taichung County Pharmacist Association, Taichung, Taiwan 2 Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan 3 Infection control committee, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan Background: In developed countries, infection of Acinetobacter baumannii is difficult to both control and treat because of its propensity to accumulate mechanisms of antimicrobial resistance that lead to pan-drug resistance. We, therefore, performed a study to identify the risk factors for carbapenems-resistant Acinetobacter baumannii (CRAB) infections. Methods: During the study period, 376 A. baumannii isolates were separated into three groups: 41 isolates were sensitive to all antibiotics (CSAB-S), 56 isolates were resistant to at least one antibiotic but not to carbapenems (CSAB-R) and 279 isolates were resistant to carbapenems (CRAB).

Comparisons were made between the three groups. Risk factors analyzed included demographic variables, the antibiotics used and comorbid conditions. Results: As compared with CSAB-S, the patients who stay in intensive care unit (ICU) or respiratory care ward (RCW) (OR, 5.16; 95% CI, 2.30 to 11.56; p = 0.000), underlying pulmonary disease (OR, 8.84; 95% CI, 4.03 to 19.36; p = 0.000) and CNS disease (p = 0.033) were associated with CRAB infection. ICU or RCW stay (OR, 3.84; 95% CI, 1.51 to 9.77; p = 0.005), underlying pulmonary disease (OR, 5.10; 95% CI, 2.05 to 12.69; p = 0.000) and CNS disease (p = 0.020) were also associated with CSAB-R infection. Conclusion: The results in our study suggest that the nosocomial occurrence of CSAB-R or CRAB is strongly related to an ICU or RCW stay, pulmonary disease and CNS disease.

Keywords: epidemiology, carbapenem-resistant Acinetobacter baumannii

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PP-P-3 THE HAZARD OF VASCULAR RISK IN PATIENTS WITH DIALYSIS TREATED WITH ANGIOTENSIN-CONVERTING ENZYME INHIBITION OR ANGIOTENSIN II RECEPTOR BLOCKERS Chung-Yu Chen School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807 Taiwan Aim: From previous evidences, hemodialysis have higher risk of vascular diseases than general population. However, current evidences indicated vascular safety is a matter of debate in patients with dialysis using angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin type 1 receptor blockers (ARBs). Our study sought to examine whether ACEI/ARBs could reduce the hazards of vascular events in hemodialysis patients.

Methods: This is a retrospective cohort study. We identified new cases of ESRD with dialysis from the National Health Insurance Research Database between 2004 and 2010, and used Coxregression with medication possession ratio (MPR) to evaluate risk of vascular outcomes.

ACEIs or ARBs was prescribed within 90 days and over 90 cumulative DDDs before or after first-time dialysis.Vascular outcomes, including mortality, first-time admission for stroke (ischemic or hemorrhagic), acute myocardial infraction, aortic aneurysm/dissection, arrhythmia and heart failure, were examined. Result: The overall risk of mortality was 0.92fold (95% C.I. 0.86-0.96) less than in patients treated with ACEIs than those non-user group and 0.98-fold (95% C.I. 0.88-1.12) less than in patients treated with ARBs than those non-user group after adjusting for confounding factors and MPR. The mortality was 0.23-fold lower in ACEIs group than in ARBs. Furthermore, compared with non-users, the risk of other vascular outcome 1.36-fold (95% C.I. 1.06-1.96) significantly increased in ACEIs/ARBs group (including MPR < 8 0% or MPR >= 80%) in long-term follow-up. Conclusion: ESRD patients with dialysis, particularly those treated with ACEIs/ARBs, are at decreased risks for mortality. However, patients on hemodialysis may not experience the same vascular benefits from ACEIs/ARBs use. Further studies are required to determine the benefit of ACEIs/ARBs on dialysis patients.

Keywords: ESRD, clinical effectiveness, safety

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PP-P-4 INADEQUATE CARDIOVASCULAR THERAPY AND LIFE-STYLE MODIFICATION: CROSS-SECTIONAL STUDY AMONG SUBJECTS IN RURAL AREA OF SLEMAN DISTRICT OF YOGYAKARTA Rita Suhadi, Yunita Linawati, Dita Maria Virginia, Christianus Heru Setiawan Faculty of Pharmacy, Sanata Dharma University, Yogyakarta 55284, Indonesia Background: Hypertension, diabetes mellitus (DM), and hypercholesterolemia were attributed as the highest health burden in Indonesia. Failure to reach therapy target in long-term duration will cause advanced adverse cardiovascular outcome. Aims: to describe the therapy and lifestyle modification based on cardiovascular related variables. Methods: It was a cross-sectional study done in rural community. Participants were invited with a cluster-random sampling within Sleman District of Yogyakarta. Subjects were purposively selected within 1027 participants with criteria received the therapy of hypertension, DM, and/or hypercholesterolemia. The subjects were measured for blood pressure, random blood sugar and cholesterol. Data were analyzed descriptive statistics based on types of disease; persistence of therapy; and control of disease. Results: The eligible subjects (n=113) comprised hypertension at 50.4%; DM 19.5%; hypercholesterolemia 7.1%; and combined-cardiovascular diseases 23.0%. The most frequently used medicines were captopril 23.0%; amlodipine 15.0%; and glibenclamide 9.7%. The subjects were known at 16.8% not-routinely treated; 44.2% passive/active smokers; 61.9% less-regular exercise; 66.4% no-healthy diet; and not recognize the name of medicine, i.e. 33 of 78 (42.3%); 16 of 37 (43.2%); 18 of 19 (94.7%) for hypertension, DM, or hypercholesterolemia medicine respectively. The subjects failed to reach therapy target 78.2%; 59.5%; 63.2% for hypertension, DM, and hypercholesterolemia; and persistence to the therapy was the most likely problem to cause the failure. Conclusion: The subjectsâ&#x20AC;&#x2122; therapy was inadequate based on the low rate of hypertension, DM, and hypercholesterolemia control; and the poor healthy-life style.

Keywords: hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, healthy diet

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PP-P-5 THE CHALLENGES OF MULTI-ANTIMALARIAL DRUG RESISTANT IN PAILIN PROVINCE, CAMBODIA Sopheap Un1, Boravann Mam2 1

School of Public Health, National Institute of Public Health (NIPH), Cambodia 2 Cambodia National Malaria Center, Cambodia

Background of the problem: Malaria is a complex and priority public health problem for Cambodia. Recent studies have shown that Plasmodium falciparum malaria parasites in Pailin province, along the border between Thailand and Cambodia, have become resistant to Artemisinin derivatives. According to CNM in 2015, there are 51,262 malaria cases (incidence rate 2.26 cases among 1000 population) and death is 10 cases (mortality rate 0.06 case among 100 populations). Aims: To reduce the inappropriate drug prescription from private sectors/local pharmacies, To reduce the inappropriate diagnosis and treatment, To reduce the length of seeking health facilities, To strengthen public health facilities providing 24 H services for malaria (1 RH & 6 HCs), To establish the health education for the specific high risk area, To promote private sector engagement in malaria control (Private & Public Mixed). Study Design: Demographic data including gender age district and village of Pailin, Location and type of private sectors/local pharmacies, Information given by private sectors/local pharmacies, Advice given by private sectors/local pharmacies, Private & Public doctorâ&#x20AC;&#x2122;s diagnosis & treatment, Dose prescribed & the guideline of treatment. Outcome measures: Demographic data, Percentage of non-hospital drug sellers, Percentage of correct partially correct and incorrect prescriptions and advice, Percentage of drugs given at above the recommended dose, Most common drugs prescribed, Most common errors. Discussion: There was a paucity of epidemiological information on which to base the planning of additional interventions and a lack of operational experience in Cambodia and elsewhere in implementing potential new tools for elimination.

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PP-P-6 RETROSPECTIVE STUDY OF CHEMOTHERAPY IN PATIENTS WITH UNRESECTABLE LUNG CANCER Pei-yi Lin1, Yi-Ping Hsiang1, Jing-wen Zheng1, Yi-Hsin Yang2 1

2

Department of Pharmacy, E-DA Cancer hospital, Kaohsiung, Taiwan College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan

Majority of lung cancer death is mainly due to being diagnosed at in unresectable advanced stage, and cannot apply effective treatment to improve the survival rate of patients. The preferred treatment approach for unresectable advanced stage lung cancer patients is a single chemotherapy drugs. The study adopts a retrospective cohort study design based on the National Health Insurance Research Database (NHIRD) from 2002 to 2011. Medical records of newly diagnosed lung cancer (ICD-9-CM 162.0-162.9) patients from 2003-2011 were extracted. Demographic characteristics, comorbidities, treatment patterns, and pattern of chemotherapy were analyzed. The total medical utilization was evaluated using descriptive statistics which incorporates sex, age and single agent therapy. There were 55,136 newly diagnosed lung cancer patients during 2003-2010 identified from NHIRD. Divided into two groups, one is no treatment group were 13,615 patients, another was 41,521 people in treatment group; among them, 1,964 patients were treated by single therapy. There were 1,419 (72.3%) males and, 545 (27.7%) females. The average age was 71.1years old. Treatment patterns are received chemotherapy only based. Chemotherapy prescriptions were divided into three groups, 375 patients in docetaxel, 1253 patients in gemcitabine, and 336 patients in vinorelbine group. Using vinorelbine group has higher average of survival time 31.4 (23.6-39.1) weeks than other groups. Elderly patients had a longer survival time than younger patients. Median and 1-year survival were 16.8 weeks and 34% in docetaxel group, 21.1 weeks and 31% in gemcitabine group, and 31.4 weeks and 37% in vinorelbine group.

Keywords: chemotherapy, unresectable, lung cancer, survival analysis

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PP-P-7 COMPARISON OF COSTS OF FACTOR VIII AND RECEIVED COMPENSATION FROM THE NATION HEALTH SECURITY OFFICE OF PEDIATRIC WITH THE UNIVERSAL HEALTH COVERAGE PROGRAM AT SRINAGARIND HOSPITAL, FACULTY OFMEDICINE, KHONKAEN UNIVERSITY Theera Rittirod1, Patcharee Komvilaisak2, Paiporn Sripraya2, Arunee Meesri2 1

Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand 2 Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

Hemophilia is a hereditary bleeding disorder with life-long treatment needed. The patients must be treated with factor concentrate consistently. Cost of factor concentrate is high. The purpose of this study is to compare the cost of factor VIII concentrate used with the cost of compensation from the universal health coverage program (UHCP) of Srinakarind Hospital, Faculty of Medicine, Khon Kaen University, 2012-2013. Retrospective study is obtained from secondary data. The analyzed medical cost is compared with the compensation received from the National Health Security Office (NHSO). The data of 8 and 9 hemophiliac patients who younger than 10 years in 2012 and 2013 respectively is obtained, with severe 3-4 patients and mild 5 patients. The total cost of factor concentrate for severe and mild hemophiliac patients is 748,720 Baht and 347,828 Baht respectively. The NSHO support for severe and mild hemophiliac patients is 1,035,000 Baht and 132,000 Baht respectively. The NSHO support for severe hemophiliac patients is 286,280 Baht lower than cost of Factor VIII used and its for mild hemophiliac patients is 215,828 Baht higher than cost of Factor VIII used. Ten patient age â&#x2030;Ľ 10 years in 2012 and 2013, with severe 6 patients and moderate 4 patients. The cost of Factor VIII used for severe hemophiliac patients and moderate hemophiliac patients is 1,369,722 Baht and 1,218,104 Baht, whereas NSHO support for severe and moderate hemophiliac patients in 2012, and 2013 is 1,368,000 Baht and 732,000 Baht. The cost of Factor VIII used for severe hemophiliac.

Keywords: Factor VIII, hemophilia, compensation from NHSO

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Poster presentations VIII. Pharmaceutical Legislation, Regulatory Science and Pharmacopeia

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LP-P-1 EVALUATION OF A NEWLY DEVELOPED POST-MARKETING SURVEILLANCE METHOD TO VERIFY THE EFFICACY AND SAFETY OF A SWITCH-OTC DRUG Rie Nakajima School of Pharmacy, Nihon University, 7-7-1 Narashinodai Funabashi-shi Chiba Japan Purpose: We aimed at developing a post-marketing surveillance (PMS) method to implement after the release of a new switch- OTC drug. For this, we developed a health check sheet for assessing and estimating possible side effects of the drug to reach a conclusion on consumer complaints. We compared the results of the PMS, which uses our health check sheet, and a traditional PMS ( special inquiry) , and assessed the effectiveness of the health check sheet.

Methods: This study focused on the drug Loxonin®S. We compared the results of the health check sheet survey and the special inquiry in regard to efficacy, safety, and compliance.

Results: The efficacy rate was 46.5% with the health check sheet survey and 93.5% with the special inquiry. Main side effects reported in both surveys included “ frequent sleepiness” (“drowsiness” in the special inquiry), “increase in fatigue” (“fatigue” in the special inquiry), and “ noticing recent swelling in the body” ( “ edema” in the special inquiry) . The results revealed that 0.7% of the cases in the health check sheet survey and 0.5% in the special inquiry had poor compliance. Conclusion: Although the health check sheet survey was used in a small number of cases and over a short period, we could obtain results similar to the special inquiry in the categories of drug regimen compliance and detected side effects. These results suggest that the health check sheet survey is an effective method with lower cost and workload in comparison with the traditional PMS method.

Keywords: post-marketing surveillance, switch-OTC drug

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LP-P-2 THE ROLE OF PHARMACISTS IN INDUCED PLURIPOTENT STEMCELL THERAPY Leo Tsui1,2, Li Yu Tsui2 1

2

Taipei Pharmacists Association

Master of Public Health degree Program, National Taiwan University

Induced pluripotent stem- cell ( iPSC) therapy is a novel technique to generate human pluripotent stem cells from somatic cells via induction of specific gene expression ( Oct- 4, SOX2, KLF4, and Myc) , also known as reprogramming. Using episomal vectors and feederfree system could respectively avoid tumorigenesis and reduce adventitious agents in clinical application. Recently, it is reported that 2 patients had received transplantation of retinal pigment epithelium derived from iPSC in Japan. However, the role of pharmacists in reprogramming, stem cell culture and cell differentiation were not mentioned in Taiwan good tissue practice (GTP). Pharmacists have more experience of manufacture, storage, distribution and validation than general operators. It is suggested that involvement of pharmacists in iPSC therapy should be established in GTP, especially preparation of iPSC and validation of differentiated cells or tissue.

Keywords: induced pluripotent stem cells, reprogramming, episomal vectors, good tissue practice

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LP-P-3 REVIEWING THE PHARMACEUTICAL INDUSTRY HAS SUFFERED A MAJOR INTELLECTUAL PROPERTY LITIGATION Chung-Fu Wu, Hsiu-Chi Chang Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. Background: Itâ&#x20AC;&#x2122;ll be importantly effect in pharmaceutical manufactures when the patent linkage

system (PLS) will be proceed in Taiwan. Example, economy, law sue that may be rising or down to hell. Only US and Canada have PLS, and Korea following recently that we look on the developing in the future. Method: We search for Google, use keyword to get information in Taiwan about medicine litigation. In last decade, we review and collected the medicine verdicts of intelligence property (IP) that search from JROCLRR System. Results: We found. There are including copyright, trademark and patent infringement of verdict. It almost suffer a defeated are Plaintiffs. Such as MSD v. Novartis (alendronate), MSD v. Covax (alendronate), Pfizer v.

NangKuang (sildenafil), Aventis v. TTY (docetaxel), SanofiAventis v. Pharmastar (clopidogrel), AstraZeneca v. Genovate (rosuvastatin) and Takeda v. CCPC (pioglitazone). Conclusion: In according, the results we found in the system that it might remind people respective IP right and medicine using right. In fact, PLS will be proceed in Taiwan, predictable both of original and generic manufactures has benefits and risks. Original manufacturesâ&#x20AC;&#x2122; products had protected from patent right, but they almost had been defeated on litigation because many reasons.

Studied the causes maybe, successful design around, mistake and miss judgment that original manufactures loss the benefits. If it was without professional people assistant, pharmaceutical manufacture could search relative IP website by itself, such as Orange Book, EspaceNet and TIPO. It following problems must be avoided when you found out the patent could be infringement.

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RE-IV-6 CURRENT HEALTHCARE TRENDS IN THE UNITED STATES: ROLE OF THE PHARMACIST Andrew J. Donnelly University of Illinois at Chicago College of Pharmacy, Chicago, Illinois USA Healthcare continues to evolve in the United States, with changes in patient care models and reimbursement for services provided being areas of major focus. The federal government continues to penalize hospitals for excessive readmission rates and has recently expanded its program to include several new conditions. Reducing readmissions is a major initiative of all hospitals in the US today. Payment for services provided in the inpatient setting continues to transition to an episode of care or bundled payment model. This requires the care provided patients to be as cost effective as possible. Emphasis today is placed on keeping patients out of the hospital by focusing on disease prevention and management of patients’ chronic conditions in the ambulatory setting. This will continue to grow in importance. With the increasing use of telehealth, patients will not have to travel to a physician’ s office for care.

More and more institutions are starting to take advantage of this technology. Pay for performance models are increasingly being used by payers in the ambulatory setting. Patients must meet certain treatment goals in order for the provider to receive full payment and/ or incentive payments for services provided. This presentation will provide specific examples of programs implemented by the pharmacy department at the University of Illinois Hospital and Clinics in response to these trends. These include a pharmacy run transitions of care program, meds to bed program, value analysis program, genomics program, and telemedicine program as well as development of a managed care clinical pharmacist position.

Participants attending this session will be able to:  Describe a pharmacist driven transitions of care program  List three initiatives that can be undertaken by a Pharmacy Value Analysis Committee  List three benefits of a pharmacy run telemedicine program  Describe the role of a managed care clinical pharmacist Keywords: transitions of care, meds to bed program, value analysis, genomics, telemedicine

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IM-O-7 SYNTHESIS, CHARACTERIZATION AND FORMULATION OF SECOND GENERATION SUPER POROUS HYDROGELS COMPOSITES AS CONTROLLED RELEASE RETARDANTS Varun Dasari1, Narayana TV2, Sumalatha Gindi3, Sambasiva Rao Ambati1 1

Sri Indu Institute of Pharmacy, Sheriguda(V), Ibrahimpatnam(M), R.R. Dist, Hyderabad 2 Educational Division, Indian Pharmaceutical Association, Mumbai, India 3 Vikas Institute of Pharmacy, Nidigatla Road, Opp. Airport, Rajahmundry

Formulation of potent drug molecules as dosage form still draws continuous interest and challenges against its optimization towards pharmacokinetics parameters like absorption, bioavailability, onset of action, duration of action. The present research work aims to design and evaluate hydrodynamically balanced buoyant formulations of Pregabalin based on Second generation Superporous hydrogels Composites. SPHâ&#x20AC;&#x2122;s synthesized employing various composite agents viz., Chitosan, Ac-Di-Sol, Carbopol were subjected various characterizations. SPH-Ac-Di-Sol with best results was optimized for further characterization.

By water retention studies it was observed that Gelation kinetics gives good information to determine addition time of blowing agent. Density found to be decreased and swelling characteristics were improved by changing drying condition upon dehydration of gel. The results of invitro dissolution studies shows the dry gel coating of SPH Ac-Di-Sol composite was found to be effective in retarding release rate of Pregabalin at rate controlled fashion. By fitting the dissolution data into popular regression and exponential models, all formulations were found to be accepting zero order kinetics with diffusion mechanism. By conducting invivo clinical study, overall assessment of Pregabalin Pharmacokinetic data had revealed that Cmax, Tmax, AUC-0t, KE and T1/2 parameters were totally varied between reference and test formulations.

Keywords: superporous hydrogels, pregabalin, composites, invitro, in-vivo

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PE-O-7 FACTORS AFFECTING THE EMPATHY LEVELS OF THE STUDENTS OF THE UNIVERSITY OF THE PHILIPPINES COLLEGE OF PHARMACY Joshua Elijah M. Chavez, Genmar Cyrus S. Pasion, James Louie D.R. Tronco College of Pharmacy, University of the Philippines Manila, Philippines Empathy is known to be an important attribute for health care professionals, as this has been associated with positive clinical outcomes for patients. As such, it is considered as the center of the patient-health care professional relationship. Several studies report that empathy can be developed, even at the level of students. In this study, empathy levels of students of the University of the Philippines College of Pharmacy were measured. Likewise, effects of the different demographic, psychosocial, and academic factors on empathy were explored. A total of 225 students were randomly selected to participate in this study. The Interpersonal Reactivity Index, which consists of four subscales, was used to generate scores that correspond to the respondentsâ&#x20AC;&#x2122; empathy. The results revealed that five factors were significantly associated with any of the subscales of empathy. Females significantly scored higher than men in the Fantasy and Personal Distress scale. Higher subjective well-being, measured as satisfaction with life, corresponds to an increase in Empathic Concern. Furthermore, extracurricular participation and time spent on organizational work were both shown to be negatively correlated with Personal Distress (p < 0 .001 and p=0.008 respectively) but positively correlated with Perspective-Taking (p=0.008 and p=0.024 respectively). Significant differences were likewise observed between the Fantasy and Empathic Concern scores across the grade weighted average groups. The study confirmed that empathy possesses a multifactorial nature, opening the possibility of its deliberate enhancement in the academic setting.

Keywords: empathy; interpersonal reactivity index; pharmacy

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S-P-77 FLAVONOIDAL CONTENT AND ANTINEOPLASTIC ACTIVITY OF DIFFERENT ARATILES (MUNTINGIA CALABURA, ELEOCARPACEAE) LEAF EXTRACTS Mark Ryan D. Langit, Kahren Yvonne Salbino, Jelly Rhio Nuarin, Irwin Posadas Department of Pharmacy, Saint Louis University, Baguio City, Philippines Cancer remains to be the most frequent cause of morbidity and mortality. However, treatment advances that fight the complex mix of cells in each individual cancer, including traditional therapy and newer forms of treatment, pose limitations and disadvantages on their use due to their accompanying costs and side effects. The demands for potential complementary and alternative phytochemotherapeutic agents that exert antineoplastic activity through its antioxidant property that inhibit the formation of free radicals targeting stable cells continue to arise. This study evaluated flavonoid extract of Aratiles (Muntingia calabura, Eleocarpaceae) leaves for their antineoplastic activity. Methanol was proven to contain the highest flavonoid concentration as compared to three other solvents (ethanol, chloroform and water) that was confirmed using the Aluminum Chloride Assay in comparison with the Quercetin standard.

Methanol extract was used for the micronucleus assay. Antineoplastic activity of the sample was determined through the occurrence of induced micronuclei and was compared with the positive control, Cyclophosphamide. Results showed that the different concentrations of the extract had a direct relationship with their ability to induce micronuclei formation. The Independent Sample t-test was used to compare the micronucleus indices of the Aratiles extracts, the positive control, Cyclophosphamide and negative control, Plain Normal Saline Solution to help in the conclusion of the potential similar effects of Cyclophosphamide and the Aratiles extracts. The flavonoid extract of the Aratiles plant possesses a dose-dependent antineoplastic activity since an increasing concentration was observed to have an increasing micronucleus induction.

Keywords: aratiles extract, flavonoids, micronucleus assay, antineoplastic activity

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H-P-100 CASE REPORT: PROLONGED DEXMEDETOMIDINE INFUSION FOR SEDATION IN A CRITICALLY ILL BURN PATIENT Tair Shin Wang, Tzu-Hui Yeh, Ming-Shya Wang, Shu-Hui Sun Department of Pharmacy, Far Eastern Memorial Hospital, New Taipei City, Taiwan Maintaining appropriate sedation and analgesia is challenging in critically ill burn patients. In the critical care setting, dexmedetomidine may be a superior alternative compared to traditional sedatives used in mechanical ventilations because of less risk of complications. It is currently approved by the FDA for sedation of mechanically ventilated patients for short term sedation.

In Taiwan, there is limited experience on the off label use dexmedetomidine for sustained sedation in critically ill burn patients. We present a case in which dexmedetomidine was used for prolonged sedation and analgesia of a critically ill burn patient.

Case report: A 19-year-old male presented with second to third degree burn to 79% of his total body surface.

He was on mechanical ventilation and received prolonged dexmedetomidine infusion (0.4 mcg/kg/hr) for 16 days. During dexmedetomidine infusion, an improved quality of sedation was observed (Ramsay scale of 3 out of 6) and the patient demonstrated acceptable pain control (Numeric Rating Scale of 6 out of 10). Cardiovascular status and other adverse effects was closely monitored during treatment. There were no evidence of hypotension, bradycardia, or respiratory depression. Rebound hypertension and tachycardia were absent on discontinuation.

Conclusion: Dexmedetomidine is a safe and effective long-term sedation for critically ill burn patients on mechanical ventilation with close cardiovascular monitoring.

Keywords: dexmedetomidine, critically ill burn patients

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H-P-101 INTEGRATING THE TAIWAN NHI-PHARMACLOUD TO OPTIMIZE MEDICATION RECONCILIATION IN ICU Yi-Ching Yang, Hsi-Hui Chen, Yu-Ying Chu Yi-Ching Chen Department of Pharmacy, Kuang-Tien General Hospital, Taichung, Taiwan Taichung County Pharmacist Association, Taiwan Background：Taiwan National Health Insurance (NHI) PharmaCloud has been launched in 2014. With consent of the insured, physicians and pharmacists can acquire prescription information from different institutions over the preceding 3 months. Objective：To evaluate the impact of integrating the PharmaCloud to medication reconciliation in our intensive care unit (ICU). Method：This was a prospective study. New ICU patients admitted from September 2015 to May 2016 were included. Pharmacists reviewed the PharmaCloud in addition to domestic records to identify medication discontinuity upon ICU admission as well as ICU discharge. When discontinuity was found, pharmacists proposed to consider prescription modification. Results：Medication continuity was reviewed in 1,947 ICU patients. PharmaCloud data was accessible in 77.6%. Among them, 47.1% was taking medications prescribed from different institutions. Discontinuation of long-term medication was found in 407 patients. Forty of them were unintentional while 14 of them were identified from PharmaCloud. The most frequent unintentionally discontinued category of medication was “cardiovascular system” (n=13). Proposal to consider prescription modification were accepted in 90% cases. 75% of unintentional discontinuation occurred upon ICU admission while the most common reason was “medication omission” (50%, n=15). Upon ICU discharge, the most common reason for unintentional discontinuation was “inappropriate medications” (50%,n=5). For intentional discontinuation, the most common reason was “prioritized treatment for other diseases” (n=235). Conclusion：Additional information from the Taiwan NHI-PharmaCloud provided inter-institutional pharmacological information, reduced unnecessary medication discontinuity. With the PharmaCloud, medication safety would be improved by optimizing the continuity of medication.

Keywords: Taiwan NHI-PharmaCloud, medication reconciliation, intensive care unit

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H-P-102 THE DIFFERENCE IN RISK FACTORS BETWEEN CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE AND CARBAPENEM-SUSCEPTIBLE KLEBSIELLA PNEUMONIAE PRODUCING EXTENDED SPECTRUM BETA-LACTAMASE INFECTION Shu-Chuan Hsu1, Po-I Chen1, Se-Chin Ke2, Chin-Ming Chen2 Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan .

Infection control committee, Tungs' Taichung MetroHarbor Hospital, Taichung,Taiwan.

1 2

Background :Carbapenem-resistant Klebsiella pneumoniae) CRKP (is an emerging threat for the healthcare system .The objective of our study was to determine the difference in risk factors between infection due to carbapenem-resistant Klebsiella pneumoniae) CRKP (and carbapenem-susceptible K .pneumoniae producing extended spectrum beta-lactamase )ESBLCSKP .(Methods :A total of 348 KP isolates were collected from patients, 108 patients with CRKP infection, 88 patients with ESBL-CSKP infection, and 152 patients with infection caused by KP which was susceptible to all antibiotics )Non-resistant-KP .(We compared the demographic characteristics, use of antibiotic, and comorbidities of all patients between the three groups .Results :As compared with Non-resistant-KP, the risk factors for acquiring CRKP infection were age)p=0.000(, admitted to the ICU or RCW )p=0.000(, previous surgery )p=0.000(, comorbidities )CNS disease, pulmonary disease, etc) (.p=0.015~0.000(, and ever used antibiotics )cephalosporins and carbapenems) (p=0.005~0.000 .(Also compared with Non-resistant-KP, the risk factors for acquiring ESBL-CSKP infection were age )p=0.001(, admitted to the ICU or RCW )p=0.019(, surgery )p=0.002(, comorbidities )CNS disease , pulmonary disease, etc) (.p=0.010~0.000(, and ever used antibiotics )cephalosporins and carbapenems) (p=0.026~0.000 .(When patients admitted to the ICU or RCW, the probability of acquisition of CRKP was significantly higher than acquisition of ESBL-CSKP )OR=3.66; 95 %CI=2.00-6.69; p=0.000 .(Conclusion :In our study, the risk factors for acquiring CRKP infection were similar to ESBL-CSKP infection .The patients who admitted to the ICU or RCW would have more chance to acquire CRKP infections.

Keywords: Klebsiella pneumoniae

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H-P-103 PERFORMANCE ANALYSIS OF AN ESTABLISHED PHARMACEUTICAL INFORMATION SYSTEM FOR INTERDISCIPLINARY CORONARY CARE TEAM Chia-Hung Wan, Po-I Chen, Wen-Hwang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Backgroundďź&#x161;Pharmacists as one of the members in interdisciplinary coronary care team through the establishment of pharmaceutical information systems hoping to assist them to upgrade the quality of drug safety, their work- related assessments, and care in order to have complete and accurate records . This study is to investigate the appropriateness, contents and related impacts of pharmaceutical information systems .Method:This is a retrospective study .

The information system was newly established in 2015 and started to collect data in order to provide the team the necessary information, guidelines, and responsibilities . Result : The system has 5 major elements : Medication assessment 2 . drug history records 3 . Health education 4.Track records 5 .Prescriptions inquiry .There is an 11 %decrease in cost of supplies and another 23. 5 % in work burden after the system was established . A 77. 4 % significant improvement incompleteness of data collection and 13 %increase in patientâ&#x20AC;&#x2122;s health education from 83.1 %to 96.1) %p =0.009 .(Accuracy in pharmaceutical workflow process also up from 85 %to 95 .%Discussion :Each discipline has different areas of expertise and their technical terms or words used are different which may cause misunderstanding or misinterpretation .The need of a formidable system can integrate and analyze information more effectively . A comprehensive pharmacy care information systems can assist pharmacists in their professional field, shorten the time in data collection and easy access to information .Another advantage is to provide a more complete and accurate information, bring individual care benefits for patients.

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H-P-104 FUNCTION OF PHARMACISTS IN JOINT COMMISSION INTERNATIONAL CLINICAL CARE PROGRAM CERTIFICATION FOR ACUTE MYOCARDIAL INFARCTION Hsing-Hsiem Lin1, Min-Si Li2, Wen-Hwang Chen1 Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan .

Critical Care Department of Tungs ’Taichung MetroHarbor Hospital, Taichung, Taiwan

1 2

Background :By participating in a disease-specific care certification organized by the Joint Commission can help the hospital enhance their internal department operations and disease treatment processes .Besides, we were already accredited by the commission which we provide the highest quality for patient .This study is to investigate the function and responsibility of pharmacist during the certification process .Method :This is a retrospective study .Data were collected from January to December 2015 in accordance to the key elements and requirements set by the Joint Commission .Performance analysis to data collected related to pharmacists .

Result :Pharmacists found prescription problems and not meeting the treatment guidelines from AMI patients in 2015, a total of 92 cases .Patient received appropriate guidance on medication reached 96.7 .%In the medication management system it covers the following :periodic checking to monitor the temperature of the different drug storeroom .In 2015 our high-alert medications reach an overall compliance of 98 .%Restriction use of “highly concentrated ” medication intravenous solution with the hospital policy had reached the required status to 100 .%Dispensing of potassium chloride solution by pharmacists increased by 12.2) %p< 0.01 ( compared to last year .Discussion :In the certification of a clinical program, pharmacists have multiple responsibilities in team care .Beside assessing drug prescriptions they also need to do medication regulations .In caring patient with myocardial infarction, constant and effective communication between team members and patient, gain patient trust and drug compliance .

Pharmacists can also exert their function in caring, decision making, communication, management, education and leadership capabilities.

Keywords: pharmacist; acute international infarction; joint commission; clinical care program

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H-P-105 THE STUDY OF RELATION BETWEEN OUT PATIENT’S SATISFACTION AND WAITING TIME FOR GETTING MEDICINE Shih-Lun Shang, Yuan-Ling Chang, Ya-Lun Lee, Pei-Liang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan .

Taichung County Pharmacist Association, Taiwan.

Background Patient satisfaction is the extent to which the patients feel that their needs and expectations are being met by the service provided .According to the prior studies, the score of waiting time for getting medicine was often worse and had great influence on patient’s satisfaction .A pharmacy redesign project that more closely aligned stuff work patterns within the physical setting was shown to improve workflow and reduce waiting time for patients, as well as increase patient’s satisfaction levels .Method We used Likert scale in the survey .The questionnaire include four sections :interior design, dispensing operation, pharmacy service, and information provided .150 patients were inquired pre/-post -QCC improvement .In QCC activity, we divided dispensing workflow into five sections and illustrated cause-and-effect diagram respectively to seek 19 main reasons and verify 12 root causes .Then, we formulated the strategies against the root causes .Result After improvement, pharmacy operation was rerouted from the patient’s clinical flow path .The waiting time for getting medicine declined from 14.17 min to 9.21 min) p < 0 .005 .(The score of the waiting time for getting drugs was raised from 3.88±0.71 to 4.25±0.72 )p < 0 .005 .(The patient’s satisfaction levels was raised from 3.98±0.42 to 4.33±0.55 )p < 0 .005 .(Discussion In the QCC activity, we reorganizing pharmacy workflow to decline patient’s waiting time for getting medicine, as well as increase patient’s satisfaction levels .However, the waiting time for the chronic disease repeated prescription wasn’t decreased .We had set up the on-line prescription booking system and will popularize it further.

Keywords: QCC; patient’s satisfaction; waiting time

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H-P-106 STUDY OF DRUG RETURN AND DRUG SAFETY UNDER THE UNIT DOSE DISPENSING SYSTEM Pei-Liang Chen1, Yuan-Ling Chang1, Chen-Fan Wen2, Shu-Chuan Hsu1 1Department of Pharmacy,Tungs' Taichung MetroHarbor Hospital, Taichung,Taiwan .

2 Department of Medical Research, Tungs ’Taichung MetroHarbor Hospital, Taichung, Taiwan.

Background :Unit dose dispensing system has been established in Taiwan by requirements of Taiwan Joint Commission on Hospital Accreditation and National Health Insurance policy .

This provides a better drug distribution system, inpatient’s drug quality and safety, and development for clinical pharmacy since last decades .Purpose :To evaluate the current conditions of inpatient’s drug return and drug safety under the unit dose dispensing system .

Methods :We studied the records of inpatient’s drug return from January 2013 to December 2014 .The causes and drug safety were further analyzed .Results :There were 362,750 records of drug return consisted with 775 drug items were registered .The main reason of drug return in the ward was due to the patients ’discharge )42.2 (%that consisted of 83.3 %oral drugs .The next reason was discontinued the drugs by physician order )34.4 (%with oral and injection drugs, 50.5 %and 46.1%, respectively .The total number of drug return reached to 698,687 and the lost, 22,755,799 NT dollars in these two years .Conclusion :The patients ’discharge and discontinued the drugs by physician order were two major reasons of drug return which consisted 72.9 %of all causes .About 1,000 drug return items remained in the ward daily .These drugs might be misused by nurses and could harm inpatients as pointed out by a 2014 data from Taiwan Patient-safety Report System that reported a 27.8 %of medication error in the ward .

Therefore, drug return by the ward must be correctly returned to the pharmacy and before the return, stored in the assigned Keywords :drug return evaluation, patient’s safety

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H-P-107 SOCIAL PARTICIPATION FOR THE PREVENTION OF DEMENTIA :EVIDENCEBASED PRACTICE Shia-Chin Chen1, Ya-Fang Ke1, Hui-Wen Lin2, Hui-Chi Chang 1 1

Department of Pharmacy, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C 2 Department of Family Medicine, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C Background According to the national statistics, Taiwan's elderly population is expected to reach 20 %in 2025 .With global aging, cognitive dysfunction and dementia gradually become a social burden .Many studies showed deferring cognitive degeneration can reduce the morbidities, as well as the expenditure of medical resources and social costs .As we know, social participation can promote the external stimulation and the people interaction .As the result, we wonder if social participation can prevent the occurrence of dementia .Methods We designed a search filter restricted to articles relevant to the PICO question within PubMed, EMBASE, Cochrane Library .The search used a combination of search terms using relevant synonyms for the domain" :dementia," "Alzheimerâ&#x20AC;&#x2122;s disease,""cognitive impairment,""social involvement,"and "social participation ".The search was limited to randomized controlled trial and systematic reviews .The quality of studies and evidence were evaluated using CASP Systematic Review Checklist and GRADE profiler .Results 25 eligible studies were retrieved and 1 latest article of systematic review were reported in 2015 .The number needed to treat from social participation and frequency of social contact with risk of incident dementia were 30 and 22 .According to GRADE profiler, the level of evidence was moderate for social participation with dementia and the strength of recommendation was strong .Conclusions Based on this systematic review about social relationships in dementia, the quality of evidence was moderate but strong for intervention .Therefore, for those people who lack of contact with society, we recommended and encouraged to participate in community activities for the prevention of dementia.

Keywords: social participation, dementia

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H-P-108 OUTCOME OF INTER-PROFESSIONAL EDUCATION IN THE PHARMACIST PROGRAM â&#x20AC;&#x201C;A REGIONAL HOSPITAL EXPERIENCE Li-Ting Hsu1, Chiu-Ku Huang2 1

2

2f0153@tmh.org.tw pharmacyf0088@gmail.com

Background :To improve the competence of health professionals to work more effectively as a part of medical team, "inter-professional education)IPE "(should be the initial step , cultivate the core ability of "collaborative practice "and carry out effectively by the IPE program, then reached the best outcome of patient-centered care .In the training schedule of PGY )PostGraduated Year (pharmacist and pharmacy students, they need to take part in speciallyassigned inter-disciplinary teaching meetings; we would periodically evaluate the outcome of learning .Method :The PGY pharmacist must take part in three types of inter-disciplinary meeting, pharmacy students should only take part in one; The assigned teacher lead the students used TRM skill-brief, huddle, debrief to carry on the IPE teaching, the students need to fill in satisfaction questionnaire and report after teaching meeting .Result :In the holistic-care meeting, there were 30 participants in 2015, 14 participants till May 2016; the proportions of feeling very satisfied were 46.7 %and 45.5 %respectively .In the home-care case conference, there were 6 participants in 2015, 5 participants till May 2016; the proportions of feeling very satisfied were 0 %and 80 %respectively .In the intensive-care-unit )ICU (case conference, there were 7 participants in 2015, 4 participants till May 2016; the proportions of feeling very satisfied were 42.9 %and 50 %respectively .Conclusion :Inter-professional collaborative patient-centered care is intuitively essential for optimal healthcare outcomes .The interprofessional education in the pharmacist program offers an opportunity for PGY pharmacist and pharmacy students to understand and practice the â&#x20AC;&#x153;collaborative team-care."

Keywords: inter-professional education; PGY )Post-Graduated Year (pharmacist

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H-P-109 TO ENHANCE THE UNDERSTANDING OF LEGITIMATE ENVIRONMENT OF THE CLINIC PHARMACISTS Chen-Hsiu Shih1, Ben Chen2, Hsiu-Chi Chang2 1

Clinic Pharmacist Committee, Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. 2 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. Background: The clinic pharmacists are practicing in a closed, busy, and less informative environment. Pharmacists should pay attention to the details of the legal trap in practice, and avoid violating the Pharmaceutical Affairs Law or Law pharmacists so that guarantee job security. Methods: By organizing "Clinic Pharmacists Forum" to explore (a) regulations (Pharmacists Law, Pharmaceutical Affairs Law). for example, a pharmacist should not leave his/her chop for the prescription seal by others. It is the pharmacist’s responsibility to fill the prescription. (b) Labor Standards Act (labor hours and hours in disguise). for example, there is a problem of paid leave. Pharmacists don’t get pay fo leave for the time being. The rights and obligations of the clinic pharmacist workplace are explored and clarified. Results: A series of seven forums were held and there were more than 400 clinic pharmacists participated, satisfaction more than 92%. Clinic pharmacists receive a better understanding of maintaining a legitimate environment. (1) The pharmacist shall always carry personal chop. (2) Filing of prescriptions. (3) Understanding the provisions of labor hours, and get the right pay for pharmacists. Discussion: The forum is organized by Taipei Pharmacists Association in its good way, but it might have attracted pharmacist’s attendance for Continuing Education credit.

Hopefully, pharmacists will participate such a forum and learn about his/her job environment.

However, as the forum is held, we expect more pharmacists will join the clinic pharmacists team due to the better understanding of Clinic Pharmacist practicing environment.

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H-P-110 THE EFFECT OF INTERACTION BETWEEN VALPROATE AND CARBAPENEM ANTIBIOTICS IN A REGIONAL HOSPITAL IN TAIWAN Tsai-Hsuan Lei1,3, Chi-Ting Tseng1, Hsiu-Chi Chang2, Lih-Chi Chen1 1

Department of Pharmacy, Taipei City Hospital Yangming Branch, Taipei, Taiwan 2 Taipei Pharmacists Association 3 Institute of Clinical Medicine, National Yang-Ming University

Objective: To evaluate a population of hospitalized patients who were simultaneously treated with valproate and carbapenem antibiotics and assess the effect on the plasma concentration of valproate. Methods: A retrospective study was conducted to examine the potential drug–drug interaction in patients receiving carbapenem antibiotics and valproate in a regional hospital.

The study was screened the hospital system for concomitant prescription of carbapenem antibiotics and valproate during 24 month period from Jan. 1st 2014 to Dec. 25th 2015.

Descriptive statistics were used to analyze baseline characteristics, and all p- values were calculated using paired T-test. Results: The carbapenem antibiotics are including meropenem (Mepem®), ertapenem (Invanz®), and imipenem (Tienam®). A total of 516 patients were studied but only 6 patients met the inclusion criteria. During concomitant therapy with carbapenem antibiotics, valproate plasma concentration significantly decreased from 48.25 ± 22.89 mg/L (mean ± SD) to 21.3± 15.79 mg/L ( p=0.009) following carbapenem administration. Conclusions: The coadministration of valproate and carbapenems resulted in decreased trough concentrations of valproate with statistically significant. Clinicians should be aware of this potential interaction and closely monitor serum valproate levels and possible failure to control seizures with the concomitant use of carbapenems.

Keywords: drug drug interaction; valproate; carbapenem antibiotics

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C-P-36 APPLICATION OF PHARMACY-INITIATED CHECKING STRATEGY IN COMMUNITY PHARMACY TO IMPROVE PATIENTS’ SATISFACTION Jen- Mu Liao1, Shih-Feng Chiu2, Chieh-Hsi Wu2, Tzu-Hua Wu1 1

Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan 2 College of Pharmacy, Taipei Medical University, Taipei, Taiwan

In Taiwan, PharmaCloud System of the National Health Insurance (NHI) was constructed to integrate patients’ prescribed medications in order to improve patients’ medication safety especially for “Refillable prescriptions for patients with chronic illnesses”. However, community pharmacists encounter certain difficulties. Here, we aimed to identify the impact of this compulsive action of Checking NHI-PharmaCloud System (CPS) with or without using Pharmacy-initiated checking strategy (PICS) on patients’ satisfaction in a community pharmacy. Time and motion technique was used to collect events when patient came for refilling prescriptions in an independent pharmacy in Wenshan district, Taipei city, Taiwan.

Before pharmacist starting dispensing, time spent on “checking the NHI-CPS/calculating the remainder of drugs by day (CPS/CRD)”, and “results explanation including communication (EC)” were determined. Average time spent on CPS/CRD plus EC was significantly increased to 143.0 secs with regular NHI-CPS checking (n=13; p < 0 .01) in comparison to the baseline EC= 7.3 secs (n=34). Six patients (46.2%) cannot understand why they cannot have their prescription refilled as prescription said. After pharmacists utilized PICS to screen dates indicated on prescriptions (n=11) before CPS/CRD process, the time spent on EC was reduced from 82.9 seconds to 22.9 (p < 0 .01) without complaints from patients. Application of PICS before evaluating medication utilization via NHI-CPS improves patients’ satisfaction regardless whether they can refill their prescriptions at the day of visiting pharmacy. Efforts to avoid inconsistency between the dates for refills showed on prescriptions institutes and approvals by NHI-CPS are warranted.

Keywords :pharmacy-initiated checking strategy; evaluating medication utilization; NHIPharma Cloud System; patients ’satisfaction

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C-P-37 ADULTERATION OF THE TRADITIONAL CHINESE MEDICINES IN TAIPEI CITY Pei-fen Chen Department of Health, Taipei City Government To protect the medication safety and health rights of the publicďź&#x152;the Department of Health of Taipei City Government held annual inspections to products of Chinese herbal, tradition formulas, and original Chinese medicine materials providing by the Chinese medicine clinics and Chinese medicine pharmacies (stores) in Taipei City. In this studyďź&#x152;we inspected the adulteration prevalence of samples which were collected from the Chinese medicine clinics and Chinese medicine pharmacies (stores) in Taipei City from 2011 to 2015. Samples were analyzed mainly according to their sources, components and types of assays. The results of 409 traditional Chinese medicines showed that 2.44% of the samples were adulterated. The sources of samples were classified into two groups, one was obtained from the regular inspections of Department of Health randomly and the other came from the general public. There were 322 samples from regular inspections of Department of Health randomly and showed the adulteration rate was 0.93%. The 87 samples came from the general public showed the adulteration rate was 8.04%. Among 10 adulterated samples, 4 samples were collected from the Chinese medicine clinics, 4 samples were collected from the Chinese medicine stores, and 2 samples were collected from illegal suppliers. It is concluded that undeclared drugs in traditional Chinese medicines could cause potential health and safety issues to consumers. Means of minimizing the issues must be found and implemented. The results of study showed the approximate status of adulteration of Chinese medicines in Taipei City and would be considered as the reference for future inspections.

Keywords: adulteration, Chinese herbal products, Chinese medicine materials

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PE-P-16 STUDY OF DRUG OF CASE-BASED DISCUSSION FOR THE CRITICAL CARE PHARMACY PRACTICE COURSE IN PGY PROGRAM Hsiang-Yi Tseng, Yi-Chun Hung, Yuan-Ling Chang, Pei-Liang Chen Department of Pharmacy, Tungs' Taichung MetroHarbor Hospital, Taiwan. Taichung County Pharmacist Association, Taiwan.

The Hospital PGY Pharmacy Residency program is designed to develop the skills and confidence required for providing contemporary pharmaceutical care. The Case-based Discussion (CbD) has been implemented since 2014 in our PGY program for Critical Care Pharmacy Practice. We investigated whether this structured discussion would enhance the learning effect in critical care for the trainees. Methods: Pre- and post-tests were performed for the PGY program. Five aspects of learning effect were evaluated. The control group was the trainees during 2012-2013 and the CbD group was the trainees during 2014-2015. Comparisons between the two groups were analyzed using the t-test. The cutoff significance was a p value of 0.05. Results: A total of 14 PGY pharmacists took the Critical Care Pharmacy Practice course in the PGY program during 2012-2015. The CbD group had a CbD session after the course and the control group turn-in reports only. A statistical significance was found between the pre- and post-test in both groups. The score of “pharmaceutical care monitoring and communication skills” was significantly different between the CbD and the control groups, difference between means 2.17±2.84 (95% CI 0.25, 4.09). Discussion: CbD is a structured, non-judgmental review of decision-making and clinical reasoning. A case presented by the trainee is thought to enhance the effectiveness of the assessment process by the trainer and allows more active involvement in the learning. The CbD helps our PGY participants improve their pharmaceutical care monitoring and communication skills. We will try to apply this experience to similar PGY programs.

Keywords: case-based discussion; PGY program

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PE-P-17 EFFORTS TO PROMOTE SUPPORTING SYSTEMS FOR CLINIC PHARMACISTS BY CLINIC PHARMACIST COMMITTEE OF TAIPEI PHARMACIST ASSOCIATION I-Mei Tang1, Tzu-Hua Wu2, Hsiu-Chi Chang3 1

2

Clinic Pharmacist Committee, Taipei Pharmacists Association, Taipei, Taiwan, R.O.C. Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical Unviersity, Taiwan, R.O.C. 3 Taipei Pharmacists Association, Taipei, Taiwan, R.O.C.

It is the committeeâ&#x20AC;&#x2122;s mission of the Taipei Pharmacist Association (TPA) to promote supporting systems for pharmacists who work at the pharmacy affiliated with the community clinics. There are several issues that might interfere with the performance of the practicing pharmacists in patient care. Therefore, the committee scheduled a series of events in order to assist clinic pharmacists if they confront problems. Those events include holding a forum to discuss the legal issues encountered during practices, implementing continued education courses focusing on Traditional Chinese Medicines (TCM) and organizing recreational activities including vising western pharmaceutical companies or parties for singles. The results are: 1) 63 pharmacists attended the forum lectured by registered lawyers to discuss the possible legal issues confronted by the clinical pharmacists and so fewer problems were reported to TPA. 2) 140 pharmacists attended Traditional Chinese medicine courses. 3) Total 41 pharmacists attended pharmaceutical visits and were expected to enhance their capability of choosing better quality of medications for patients. 4) Total 45 pharmacists attended parties for singles. Single recreational activities were held continuously for six years. In summary, more than 97% attended pharmacists approved contents of continued education lectures and quality of programs provided by this committee of TPA. TCM education was suggested to be enforced to fulfill the expectation of those practicing pharmacists due to their practicing needs.

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