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The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical Care Network Europe classification, an interventional phase to increase the awareness of patients and the nephrologists about those problems and proposing a proper solution for each one.  The main drug related problems was related to the effect of drug treatment being not optimal in 58.7%, followed by no effect in 17.8%, and least for unrelated symptoms or indications in 4.8%; causes were inappropriate combination and patients taking less drug than prescribed (both 17.4%), followed by no/or incomplete drug treatment in spite of existing indication in 12.2%, drug without indication in 10.4%. Erythropoietin and calcium were the most frequently drugs with problems. Acceptance and full implementation were observed in 34.3%, while half of the drug related problems had unknown implementation (51.3%). There were significant numbers of drug related problems among Iraqi patients on hemodialysis, the use of erythropoietin, calcium carbonate and sevelamer  was responsible for most of inappropriate combinations. Physicians and clinical pharmacist cooperation was excellent.

Keywords: Drug related problems, Hemodialysis, Clinical pharmacist.

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Publication Date
Sun Jan 12 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Validity of computed tomographic in assessment of genial tubercle and anterior mandible as a reference guide to locate osteotomy in genioglossus advancement
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Background: Genioglossus advancement is a surgical procedure to advance the tongue in some patients with obstructive sleep apnea syndrome.The important step in this procedure is that of accurately capturing the bone segment attached to the genioglossus muscle to avoid complications such as mandibular fracture, devitalization of the inferior incisor roots, and incomplete incorporation of the genioglossus Materials and Method: Computed tomography scans were taken for 53 Iraqi adult patients (28 male and 25 female) range from (18-35) years with skeletal class I classification and intact anterior mandible dentition included in this study using sagittal and axial sections. The measurements were done for genial tubercle and anterior mandibular re

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Over expression of Her- 2 neu in ovarian surface epithelial carcinoma in a sample of Iraqi patient at Al-kindy Teaching Hospital.
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Background: Although expression of the HER-
2/neuoncogene may be of some prognostic importance
in advanced ovarian cancer, its role in early-stage
disease has not been established. The current study
examined the prevalence and significance of HER-
2/neu expression in different grades of different types
of surface epithelial ovarian carcinoma.
Methods: Thirty eight female patients with surface
epithelial ovarian cancer were included in this study.
The blocks of corresponding formalin fixed, paraffinembedded
ovarian biopsies were retrieved from the
archives and hematoxylin-eosin slides of each ovarian
biopsy were reviewed and marked their grades of
differentiation , then a new sections from each sampl

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Publication Date
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
In vivo study of cherry stick effect on concentration of serum total cholesterol, triglyceride and total protein in white albino male mice
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Background: Cherry extract has a wide range of biological activity. In the present investigation, two oral doses 0.04&0.08 mg/kg/day of cherry stick (ethanol extract) in albino male mice resulted in a significant decrease in concentration of serum total cholesterol concentration, triglyceride and total protein, albumin and globulin.
Objective: we investigated the impact of biological activities of cherry stick extract on serum cholesterol, triglyceride, total protein, albumin and globulin in white albino male mice.
Design: This study include three groups of white albino male mice. The first group (G1) was a control group comprised of 5 animals. The second group (G2) consisted of 5 animals treated with 1

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Publication Date
Sun Jul 30 2023
Journal Name
Iraqi Journal Of Science
Integration of Sunflower and Sorghum Water Extracts Applied Alone or in Combination With Reduced Doses of Chevalier for Weed Control in Wheat
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      Field trial was conducted with the aim of utilizing extract of allelopathic crop to reduce the use of synthetic herbicides in wheat fields. Sorghum extract at 12 L /ha, sunflower extract at 12 L /ha, combination of sorghum and sunflower extracts at 12 L /ha and chevalier at 25, 50 and 100% of recommended dose were applied alone or in combination with each other. Weed free and weedy check treatments were included for comparison. The experiment was conducted in a randomized complete block design with three replications. The results showed that the recommended  dose of chevalier  treatment recorded lowest means of weed density 15.7, 23.7, 25.3 and 27.9 weeds m-2and weeds dry weight 13.4, 16.4, 23.3 and 29.2 g m-

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Publication Date
Tue Nov 01 2022
Journal Name
Standards
Observation of a Signal Suppressing Effect in a Binary Mixture of Glycol-Water Contamination in Engine Oil with Fourier-Transform Infrared Spectroscopy
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An in-depth experimental study of the matrix effect of antifreeze (ethylene glycol) and water contamination of engine oil through FT-IR spectroscopy. With a comparison of the percent by volume concentration of contaminated fresh 15W-40 engine oil, there appeared to be a noticeable reduction in the O–H stretching signal in the infrared spectrum when ethylene glycol based antifreeze was included as a contaminant. The contaminants of distilled water, a 50/50 mixture of water and commercial ethylene glycol antifreeze, and straight ethylene glycol antifreeze were compared and a signal reduction in the O–H stretch was clearly evident when glycol was present. Doubling the volume of the 50/50 mixture as compared to water alone still res

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Publication Date
Wed Jul 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Enteral intake of Aluminum Sulphate in acidic medium enhances absorption and alters tissue content of other trace elements in male albino rats
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Background: Aluminium (Al) intoxication was recognised as a causal agent in p a t i ent s undergoing haemodialysis and then was linked to Alzheimer's disease. Nevertheless, environmental pollution with Al is mainly v i a drinking water, particularly when acidic rain falls on Al containing soil and bedrock. In addition, aluminium utens i l s are widely used for cooking. Therefore, an increasing concern is emerging for the role of pH in the absorption of aluminium from ingested food.
Materials and methods: The objective of this study was to establish the effect of acidification with1 ml/dL of concentrated acetic acid on the absorption of aluminium from a 5 mM a l u mi n i u m sulphate\ solution taken orally

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Publication Date
Wed Jun 29 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF USE MICROWAVE RADIATION IN SOM FOODS AND IABORATORY APPLICATIONS.: EFFECT OF USE MICROWAVE RADIATION IN SOM FOODS AND IABORATORY APPLICATIONS.
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study the effect of radiation microwave (MW) in inhibition the growth of some types of bacteria in a minced meat and barker were exposed to MW for different times included (0, 10, 20, 30 and 40) sec.The results showed a high inhibition rate for 40 sec, reached to 100%. It is the other side studied the effect of microwave radiation against four types of bacteria included (Staphylococcus aureus, Escherichia coli, Proteus mirabilis and Klebsiella spp), when were exposed to for (0, 5, 10, 20, 30 and 40) sec the inhibition ratio reached to 100% in each of the Proteus mirabilis and Klebsiella spp at 30 sec and Staphylococcus aureus and Escherichia coli at 40sec. using MW in the sterilization media, such as Nutrient agar, Macconkey agar and Man

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Publication Date
Wed Nov 01 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessment of ellagic acid action in 5-fluorouracil induced intestinal mucositis: Assessment of ellagic acid action in 5-fluorouracil induced intestinal mucositis
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The intestinal mucositis define as inflammation and ulceration in the gastrointestinal tract wall and in some case in the oral cavity these cause by treatment with antineoplastic drug like 5-fluorouracil and Irinotecan and other types of chemotherapeutics drugs , 5-Fluorouracil-induced intestinal mucositis (IM) is consider as one of the more common tumor issue .it cause series of undesirables symptoms like severe diarrhea ,abdominal pain , stomach uncomfortable and other. The aim of this current study to see how ellagic acid act to  Attenuates 5-FU-Induced Intestinal Mucositis and  Diarrhea in Mice . we induced the intestinal mucositis by injected the mice intraperitoneally in 5-fluorouracil about 50mg per kg daily for

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Publication Date
Sun Jan 12 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical expression of MMP9, as a marker of local invasion in Hodgkin’s and Non-Hodgkin’s lymphoma of the head and neck region
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Background: Malignant lymphoma is the generic term given to tumors of the lymphoid system and specifically of lymphocytes and their precursor cells, While all lymphomas are malignant neoplasms, there is a wide spectrum of clinical behavior, with some following an indolent clinical course and others behaving in an aggressive manner (will causing death in a short time frame if left untreated). The metastatic process involves intravasation and extravasation of tumor cells, followed by reimplantation of tumor cells, formation of a new tumor stoma, Degradation of the extracellular matrix and components of the basement membrane by proteases facilitates the detachment of tumor cells, their crossing of tissue boundaries, and invasion into adjacent

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Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Provisional diagnosis of clinically significant hemoglobinopathies and decision on suitability for marriage as part of the premarital screening program in Iraq: Iraqi Society of Hematology Guidelines
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