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review the role of endothelin (ET) A-receptors (R) on the coronary circulation.
ET-1 maintains the normal coronary artery tone. ET-1 plasma levels are increased
during and after coronary angioplasty and this increase is related to
myocardial ischaemia rather than to mechanical artery injury. ETAR
antagonists inhibit coronary artery vasoconstriction induced by ET release
after coronary angioplasty in humans. ET promotes neointimal formation and ETAR
antagonism has been shown to inhibit restenosis after angioplasty in the
animal model but not in humans. ETAR blockade increases coronary
blood flow, dilates distal coronary arterial segments and decreases coronary
vascular resistance. Coronary collaterals are less sensitive than other
coronary vessels to ET-1. ETAR blockade decreases collateral blood
flow and, consequently, perfusion of the ischemic myocardium.
Correct drug labelling is central for ensuring proper drug dispensing
and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was,
therefore, to assess the effect of labelling on the quality of drug
dispensing and patient knowledge about dispensed drugs in Jimma University model
and specialized hospital outpatient Pharmacies.
Individual packages with prescribed drugs were examined using pretested
questionnaire and observational check lists during the dispensing process.
Patients’ knowledge about drugs dispensed to them was assessed at the exit
interview using a pretested questionnaire. Out of 743 prescribed drugs, 682
(91.8%) were dispensed to 426 patients. The average labelling score (range from
0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI
1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average
labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge
score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35
to 3.64) for model and outpatient pharmacy, respectively, while the overall
average knowledge score was 3.46 (95%
CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose
followed by frequency of administration, duration of treatment, and the reason
for prescription. Literacy status of patients had a significant effect on their
knowledge (p < 0.005) but age had not (p > 0.05). We recommend that
corrective measures targeting both, labelling and patients’ knowledge should be
implemented to improve the patients’ safety
and drug therapy adherence.