thepharmacywatch …everything pharmacy,everything drugs

I personally want to appreciate you for the wonderful work you are doing with this wonderful series, since I started following it, I must confess, I have learnt a whole lot. Ensure you keep it.
I went to the hospital to visit a friends wife who was delivered of a baby through a Caesarian, on our arrival, we met with the doctor, in his office ( it was a private hospital), while he was congratulating my friend for a successful surgery and explaining how difficult it was…but in all, we thank God it was successful. We now decided to go see our wife, when we got to her private ward, the nurse told the doctor their pharmacist said the diclofenac which was part of her take home drug should be changed to Celecoxib, the doctor said, if the pharmacist said give celecoxib, then give that.
The question I want to ask now is, what was going on in the pharmacist’s mind
Pharmacist Audu wrote in from Jos, plateau state Nigeria.

Join us every Monday for can you deliver series,and Fridays for here comes the answer series,we expect your replies to the questions and your criticisms to our answers. If you have any experience as a pharmacist, a medical doctor,a nurse, scientist,physiotherapist etc that you think will help improve learning ,you can email them to us at ugwulekecc@gmail.com for publication
Do not forget to like our page on facebook,
follow on twitter @futurerxdream or @ugwuleke
BBM channel C002D3B6D
NOTE; Every first and last fridays of the month would be interns focused questions. read more

As pharmacists, our primary aim would be to look at the drugs. Recall the lady has conceived before, therefore something went wrong along the line, and it is the NSAIDs.Let’s look at this holistically.
Ovulation, the release of matured ovum from the ovary into the Fallopian tube, constitutes a central event in the ovarian cycle and a woman’s ability to conceive.Ovulatory disfunction is a relevant cause of female infertility.
Non-steroidal anti-inflammatory drugs (NSAIDs), widely used due to their analgesic and anti-inflammatory properties, consistently inhibit ovulation in all mammalian species. The pharmacological target of NSAIDs is cyclo-oxygenase (COX), which catalyses the first rate-limiting step in the production of prostaglandins. COX-2, one of two isoenzymes, is active in the ovaries during follicular development. Its inhibition by NSAIDs is thought to cause luteinised unruptured follicle (LUF) syndrome, an anovulatory condition characterised by clinical signs of ovulation but in the absence of follicular rupture and ovum release. COX-2 inhibition has major effects on ovulation, fertilization and implantation, and NSAID therapy is likely implicated in human infertility and could be an important, frequently overlooked, cause of ovulatory disfunction in women.
If you look at this case, you will realise that the lady has been on NSAIDs for the past six months, this further emphasises the that the pharmacist is an important link in patient care.
We are of the opinion that if a woman who presents with infertility is found to be taking a NSAID, the role of the drug should be considered before launching costly, invasive investigations or starting medically assisted reproduction.
If you missed the question click the infertility read more