Papers by Titilayo Fakeye
Expert review of clinical pharmacology, Jan 8, 2017
There is a lack of information on CYP2D6, a major metabolizing enzyme, in Africa ethnic nationali... more There is a lack of information on CYP2D6, a major metabolizing enzyme, in Africa ethnic nationalities. The objective was to determine CYP2D6 phenotype in Yoruba Nigerians using dextromethorphan (DEX). A total of 89 healthy volunteers received 30 mg of DEX orally followed by blood and urine sample collection at 3-hour and over 8 hours post-dose, respectively. DEX and dextrorphan (DOR) concentrations were determined using High Performance Liquid Chromatography (HPLC). The metabolic ratio (MR, DEX/DOR) were plotted for the phenotype determination. The log MR that separated poor (PMs) from normal metabolizers (NMs) was 0.28 and 0.75 for urine and plasma, respectively. Two subjects (2.3%) identified as PMs had a mean MR of 17 and 3.2 in plasma and urine, significantly higher than that of NMs (p<0.0001). A positive correlation between urine and plasma MR was noted. The prevalence of PMs in the Yoruba Nigerians was similar to that reported among blacks.
Ghana Medical Journal, 2016
To evaluate management approach and outcome in two endocrinologist-managed clinics using data on ... more To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes-specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about diabetes were also explored. A cross-sectional prospective study using semi-structured interview among consented patients for eightweek, and a review of participants&amp;amp;#39; case notes at 3-month post-interactive contact for details of diabetes-specific parameters and antidiabetes medications. The University College Hospital (UCH) and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in southwestern Nigeria. Adult patients with type 2 diabetes, on therapies for &amp;amp;gt;3-month and who had average fasting blood glucose (FBG)&amp;amp;gt;6.0mmol/L were enrolled. All patients with type 1 diabetes, and type 2 diabetes who decline participation were excluded. Out of 185 participants who were approached, 176(95.1%) consented and completed the study including 113(64.2%) from UCH and 63(35.8%) in OAUTHC. Mean FBG for patients were 9.6mmol/L in UCH and 11.0mmol/L in OAUTHC (p=0.03). Medication adherence among patients was 47(46.5%) in UCH and 31(52.5%) in OAUTHC (p=0.46). Prescribed antidiabetes medications between the clinics significantly differ. Practice of self-monitoring of blood glucose among participants was 26(23.0%) in UCH and 13(20.6%) in OAUTHC (p=0.72). Thirty-two participants (29.4%) in UCH and 33(43.4%) from OAUTHC (p=0.02) mentioned complications as perceived fear about type 2 diabetes. There are differences and similarities between the diabetes-specialty clinics with respect to diabetes management and outcome. This underscores the necessity for a protocol-driven treatment approach in ensuring improved diabetes care and outcome. None declared.
African Health Sciences, 2016
Inappropriate prescribing negatively impacts on health and economy of individual and the society.... more Inappropriate prescribing negatively impacts on health and economy of individual and the society. To evaluate the prescribing patterns and patients&amp;amp;#39; opinions on healthcare practices in selected primary healthcare centres (PHC) in Ibadan, South-Western Nigeria. A prospective cross-sectional study was carried out among patients and healthcare workers in selected PHCs using semi-structured questionnaires. Also, patients&amp;amp;#39; prescription records were reviewed using the WHO-prescribing indicators. About one-half (210; 52.5%) were very satisfied with convenience of obtaining prescribed medicines in the PHCs, accessibility of PHC to abode (158;39.5%) and affordable medications (136;34.0%). Patients were dissatisfied with follow-up of care (191; 47.8%), courtesy of workers (184; 46.3%) and non-availability of medicines (138;34.5%). Number of drugs per encounter was 5.8±2.3 and % encounter with an antibiotic was &amp;amp;gt;26.8% in each facility. Hematinics accounted for (814; 35.0%), analgesics (544; 23.4%), antimicrobials (303;13.0%) and antihypertensives (5; 0.2%). Primary healthcare attendees were satisfied with medication costs affordability and accessibility of PHC to abode but expressed dissatisfaction with follow-up of care and courtesy of workers. Also, inappropriate prescriptions characterized by polypharmacy and overuse of antibiotics were common underscoring the need for regular training of PHC workers on rational drug use and instituting appropriate measures for improvement.
African Journal of Traditional Complementary and Alternative Medicines Ajtcam African Networks on Ethnomedicines, 2008
This study evaluated immunomodulatory properties and the sub-acute toxicity profile of two fracti... more This study evaluated immunomodulatory properties and the sub-acute toxicity profile of two fractions of the aqueous alcoholic extract of the dried calyx of Hibiscus sabdariffa in experimental animals. Immunomodulatory activity was evaluated using red blood cell-induced immunostimulation. The fractions were not found to be toxic after 7-day administration, though there was severe weight loss with the residual water-soluble fraction (RWSF) and weight gain with the ethyl acetate soluble fraction (EAC). The EAC exhibited a significant dose-dependent immunostimulation (p&amp;amp;amp;amp;lt;0.05) higher than that observed for levamisole (positive control). The residual water-soluble fraction exhibited immunostimulatory activity at 100 mg/kg body weight. The two fractions caused a significant reduction in production of tissue necrosis factor-alpha and an increase in interleukin 10 (IL-10).
Pharmacy Practice, 2017
To evaluate perception, extent of involvement and barriers to pharmacy practice-based research am... more To evaluate perception, extent of involvement and barriers to pharmacy practice-based research among community and hospital pharmacists in Ibadan, Oyo state, southwestern Nigeria. A prospective cross-sectional study was carried out among 65 hospital and 86 community pharmacists with at least five-year post-qualification experience, using pre-tested questionnaire. Socio-demographic information, extent of involvement, relevance and scope, as well as barriers to pharmacy practice-based research were explored. Data were summarised using descriptive statistics. Kruskal-Wallis and Mann-Whitney-U tests were used for evaluating ranked variables at p&lt;0.05. Nearly all participants (&gt;95.0%) in each practice category agreed that pharmacy practice-based research is essential to pharmacy profession. Greater than 90.0% agreed that pharmacy practice-based research may help in identifying gaps to improve practice. Thirty-five (40.7%) community and 36(55.4%) hospital pharmacist participants had previously involved in practice-based research. Seventy-seven (89.5%) community and 55(84.3%) hospital pharmacists agreed that acquisition of additional research-oriented training is essential for effective conduct of pharmacy practice-based research. More than one-half in each category agreed that inadequate financial commitment and lack of access to patient&#39;s data are major barriers to pharmacy practice-based research. Community and hospital pharmacists agreed that pharmacy practice based research is essential to pharmacy profession, especially in identifying areas of focus to improve practice. Necessity for acquiring additional training in research, financial constraints and lack of access to patient&#39;s data were identified as barriers to pharmacy practice-based research. Thus, there is a need to continually stimulate pharmacists&#39; interest in research so as to enhance professional competence and promote healthcare development.
Pharmacy Practice, Oct 1, 2010
Practice of self-medication has not been evaluated in hospitalized patients especially in Nigeria... more Practice of self-medication has not been evaluated in hospitalized patients especially in Nigerian hospitals. Objectives: To evaluate the practice of selfmedication among hospitalized patients with an aim to unearth some of the reasons for, and perceptions of benefits of this type of behaviour in secondary health care facilities. Methods: This study was carried out among 197 inpatients admitted in three secondary health facilities in southwestern Nigeria using structured questionnaire. Effects of variables such as age, gender and marital status on the practice of self medication were also evaluated using the Fisher's Exact test at p<0.05 as level of significance. Results: Response rate of the study was 93.8% with 174 respondents (88.3%) perceived that the
Pharmacy Practice, Jul 1, 2013
Adisa R, Fakeye TO. Effect of number and type of antidiabetes medications on adherence and glycem... more Adisa R, Fakeye TO. Effect of number and type of antidiabetes medications on adherence and glycemia of ambulatory type 2 diabetes patients in southwestern Nigeria. Pharmacy Practice 2013 Jul-Sep;11(3):156-165. www.pharmacypractice.org (ISSN: 1886-3655) 156 ABSTRACT * Objective: To determine the influence of number and type of antidiabetes medications on adherence and glycemia of ambulatory type 2 diabetes patients in southwestern Nigeria. Methods: A cross-sectional study using pre-tested structured questionnaire among 176 consented patients recruited from the endocrinology clinics of two teaching hospitals between November, 2010 and January, 2011; and a retrospective review of case notes of the cohort for details of prescribed medications and blood glucose values. Descriptive statistics were used to summarize the data. Tests of proportions were evaluated using Chi-square or Fisher's exact test as appropriate. The differences in mean fasting blood glucose (FBG) between and among categorical variables were compared using student t-test and ANOVA respectively, with p<0.05 considered significant. Results: Mean number of prescribed medications was 4.6±1.4. Almost two thirds 103 (60.6%) were placed on >4 medications. Adherence was better among patients on >4 medications compared to those on ≤4 medications (p=0.05). However, patients on >4 medications were mostly older adults (>60 years of age), and they were in the majority (66.7%) who had tertiary education compared to 33.3% of those on ≤4 medications who had tertiary education (p=0.02). Adherence rates to antidiabetes medications were in the ranking of oral antidiabetes medications (OAM) alone (50.0%) > insulin plus OAM (44.0%) > insulin alone (41.7%) with no significant difference (p=0.77). There was a significant difference in mean FBG among patients on >4 medications (172.1 ±61.1mg/dL) versus (198.8 ±83.8mg/dL) among those on ≤4 medications (p=0.02). Conclusion: Prescribing more than four medications is linked to improved adherence and glycemic outcome. However, age and educational background of patients are important factors that need to be considered when prescribing multiple medications for type 2 diabetes. Adisa R, Fakeye TO. Effect of number and type of antidiabetes medications on adherence and glycemia of ambulatory type 2 diabetes patients in southwestern Nigeria. Pharmacy Practice 2013 Jul-Sep;11(3):156-165.
Pharmacy Practice, Aug 1, 2013
Pharmacy Practice, 2008
Fakeye TO, Onyemadu O. Evaluation of knowledge base of hospital pharmacists and physicians on her... more Fakeye TO, Onyemadu O. Evaluation of knowledge base of hospital pharmacists and physicians on herbal medicines in Southwestern Nigeria. Pharmacy Practice 2008 Apr-Jun;6(2): 88-92. www.pharmacypractice.org 88 ABSTRACT * The use of herbal medicines among Nigerian patients and the tendency to combine this class of medicines with allopathic drugs while on hospital admission have been on the increase. Earlier studies show that community pharmacists from Nigeria believe that they need more training to counsel patients on their use of herbal medications. Objective: To evaluate knowledge base, use, acceptability, attitudes and beliefs of hospital pharmacists and physicians in South-western Nigeria on herbal products / phytopharmaceuticals /dietary supplements (HP/PP/DS). Methods: A 20-odd questionnaire including an 8item herbal medicine question was used to assess the knowledge of the physicians and pharmacists in the area of pharmacology of HP/PP/DS. Effects of demographic information such as age, sex, year post graduation, years of experience and area of specialization on the scores obtained were evaluated using Fisher's exact tests. Level of significance was set at p<0.05. Results: Pharmacists (51.4%) believed that the training they had was not adequate while physicians (44.6%) believed HP/PP/DS are not safe and 18.5% believed they are not effective. Pharmacovigilance centres were not significantly used for adverse reactions reported by patients. Pharmacists (67.6%) and physicians (29.3%) believed phytopharmaceuticals interact with other drugs.
Pharmacy Practice, 2009
Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medica... more Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria.
African journal of medicine and medical sciences
A bioactivity monitored phytochemical examination of the morphological parts of Mallotus oppositi... more A bioactivity monitored phytochemical examination of the morphological parts of Mallotus oppositifolium utilizing the hole-in-plate bioassay procedure against gram-positive, gram-negative bacteria and fungal isolates resulted in the location of significant antimicrobial activity in the acidic fraction (HAF) of the hexane extract of the powdered leaves. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were 32.5 microg/ml and 65 microg/ml against Pseudomonas aeruginosa NCTC 6750 and 25 microg/ml and 50 microg/ml against Staphylococcus aureus NCTC 6571 respectively. These activities were found comparable with standard drugs.
ABSTRACT: Adverse drug reaction (ADR) is poorly reported globally but more in developing countrie... more ABSTRACT: Adverse drug reaction (ADR) is poorly reported globally but more in developing countries with poor participation by health professionals. Currently, there is no known literature on the Nigerian pharmacy students’ knowledge on ADR reporting. Hence the purpose of this study was to find out the level of knowledge of pharmacy students on the concept of pharmacovigilance and adverse drug reaction reporting and also to evaluate their opinions on the National Pharmacovigilance Centre guidelines on adverse drug reaction reporting. A pretested 34-item semi-structured questionnaire was administered among 69 pharmacy undergraduate students in their penultimate and final years that consented to take part in the study, in one of the universities in Nigeria. The study was carried out strictly adhering to the principles outlined in the Helsinki declaration of 1964, which was revised in 1975. The questionnaire used had four sections which included a section on biographical data, a section...
African journal of traditional, complementary, and alternative medicines : AJTCAM / African Networks on Ethnomedicines, Jan 18, 2008
This study evaluated immunomodulatory properties and the sub-acute toxicity profile of two fracti... more This study evaluated immunomodulatory properties and the sub-acute toxicity profile of two fractions of the aqueous alcoholic extract of the dried calyx of Hibiscus sabdariffa in experimental animals. Immunomodulatory activity was evaluated using red blood cell-induced immunostimulation. The fractions were not found to be toxic after 7-day administration, though there was severe weight loss with the residual water-soluble fraction (RWSF) and weight gain with the ethyl acetate soluble fraction (EAC). The EAC exhibited a significant dose-dependent immunostimulation (p<0.05) higher than that observed for levamisole (positive control). The residual water-soluble fraction exhibited immunostimulatory activity at 100 mg/kg body weight. The two fractions caused a significant reduction in production of tissue necrosis factor-alpha and an increase in interleukin 10 (IL-10).
African journal of traditional, complementary, and alternative medicines : AJTCAM / African Networks on Ethnomedicines, 2007
The solvent partitioned purified fractions of the hydro-acetone root bark extract of the African ... more The solvent partitioned purified fractions of the hydro-acetone root bark extract of the African breadfruit (Treculia africana Decne) were evaluated for hypoglycemic activities in normal and diabetic albino rats. Fasting blood glucose levels were estimated by the use of a glucometer at pre-determined intervals after oral administration of the test extracts/fractions. Results revealed that the test fractions have only a slight effect on blood sugar level of normal rats. On short term and chronic administration in diabetic rats however, diethyl ether-soluble (DEF) and the water-soluble (WSF) fractions significantly reduced the fasting blood sugar levels (p<0.05) at differing rates when compared with the control group of animals. The diethyl ether soluble fraction (10 mg kg(-1) dose level) was found to exhibit the highest activity giving 69.4% reduction in blood sugar level (at 240 hours) which was in comparable range with the reference standard glibenclamide (0.5 mg kg(-1)) which r...
African journal of medicine and medical sciences, 2008
Aqueous (A), hydroalcoholic (AE) and ethanolic (E) extracts and fractions of dried calyxes of Hib... more Aqueous (A), hydroalcoholic (AE) and ethanolic (E) extracts and fractions of dried calyxes of Hibiscus sabdariffa were evaluated for anxiolytic property using elevated-plus maze (EPM), and sedative properties using ketamine-induced sleep in animal models. The extracts exhibited a dose-dependent increase in the time spent in the open arm with ethanol extracts having the best anxiolytic activity. The extracts at A 5 mg/kg, AE 5 mg/kg and A 50 mg/kg did not cause an increase in time spent in the open arms (p < 0.05) but other doses significantly did when compared with the vehicle control. The fractions of the hydroalcoholic extracts showed no significant anxiolytic activity. Neither the extracts nor the fractions significantly reduced or increased latency to sleep after a single dose except AE 300 (p < 0.01). There was significant reduction in onset of sleep, and increase in sleeping time with A and AE extracts with multiple doses at A 300, AE 50 and AE 300 mg/kg dose groups (p &...
African Journal of Pharmacy and Pharmacology, 2012
This study evaluated the attitude and opinion of Nigerian community pharmacists on self medicatio... more This study evaluated the attitude and opinion of Nigerian community pharmacists on self medication practices with respect to the definition, advantages and disadvantages of self medication, ailments for which self medication should be allowed, as well as measures that may be instituted to ensure appropriate self medication practices. Pretested structured questionnaires were administered to licensed community pharmacists practicing in Southwestern Nigeria between December, 2009 and July, 2010. Descriptive statistics were used to summarize the data. Mann Whitney U and Kruskal Wallis tests were used to evaluate the respondents' opinions in ordinal variables with p < 0.05 considered statistically significant. Respondents with postgraduate qualification (p < 0.05) believed that self medication solely done by patients without guidance of a health care professional may lead to mismanagement or subtherapeutic management of diseases (66; 91.66%), medication errors and likelihood of disease complications (68; 93.15%). Years of practice had a significant effect on community pharmacists' perception of advantages of self medication (p < 0.05). Rigorous monitoring of drug advertisement in the media might help in controlling the practice of self medication (63, 86.30%). Respondents believed that keeping the identity of the medications (29; 39.73%) and diagnosis details (19; 27.14%) unknown to patients is unethical. Self medication may be acceptable for fever (53; 74.65%), diarrhea (46; 67.65%) and cough (39; 53.62%), but with specific time limits, for patients on chronic medication who have stable clinical conditions, including asthma (46; 66.67%), hypertension (36; 51.43%) and diabetes (37; 52.86%). Community pharmacists in Southwestern Nigeria possess a good understanding of the concept of self medication, believed the practice should not be discouraged in totality, but should be practiced under controlled conditions, and that public enlightenment may help to ensure safe self medication practices.
Pharmacy Practice (Internet), 2009
Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medica... more Adisa R, Alutundu MB, Fakeye TO. Factors contributing to nonadherence to oral hypoglycemic medications among ambulatory type 2 diabetes patients in Southwestern Nigeria.
Tropical Journal of Pharmaceutical Research, 2007
The study was carried out to assess the knowledge of community pharmacists who sell herbal/phytop... more The study was carried out to assess the knowledge of community pharmacists who sell herbal/phytopharmaceutical formulations in pharmacy retail outlets. Method: Questionnaires were administered to the pharmacists to gather information on phytopharmaceuticals regarding their use, side effects, potential drug-herb interactions and contraindications of the phytopharmaceuticals sold in their retail outlets. Opinions on regulation, safety and efficacy of herbal remedies were also obtained. Descriptive statistical tests and median scores were used to evaluate the distribution of responses, opinions and perception of the pharmacists on their level of knowledge of the phytopharmaceuticals, and effects of demographic data on the pharmacists' knowledge of the herbal remedies. Results: The study revealed that 31 (62%) sold imported herbal remedies and nutritional supplements. Seventy-two (72) % had received no postgraduate training on herbal medications. Most of the community pharmacists agreed that they did not possess adequate knowledge of potential interaction profiles and side effects of the herbal remedies sold. The training in pharmacy schools on herbal drugs and sale of phytopharmaceuticals in their outlets also had no influence (p>0.05) on desired knowledge. Community pharmacists with less than 10 years of experience in the practice however possessed better knowledge than pharmacists with more than ten years of professional practice (p=0.05) Conclusions: There was gross inadequacy in the pharmacists' knowledge of the phytopharmaceuticals sold in pharmacies indicating an urgent need for intensive training in order to render better services to their clients.
Phytotherapy Research, 2000
The basic fraction (BF) of the methanol extract of the stem bark of Picralima nitida (family Apoc... more The basic fraction (BF) of the methanol extract of the stem bark of Picralima nitida (family Apocynaceae) exhibited significant antimicrobial activity against a wide range of Gram-positive bacteria and fungi, but limited activity against Gram-negative bacteria. The BF had a similar minimum inhibitory concentration (MIC) for S. aureus to the control drug ampicillin, and lower MIC values against A. flavus and A. niger than those of tiaconazole. Values of the minimum bactericidal concentration (MBC) of the BF against microorganisms tested were generally much higher than those for the control drugs ampicillin and gentamicin. The results suggest that some constituents of the stem bark could be isolated and developed into effective antimicrobial agents.
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Papers by Titilayo Fakeye