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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
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Dose-dependent Anti-inflammatory Effect of Silymarin in Experimental Animal Model of Acute Inflammation
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Silymarin, a flavolignans from seeds of ‘milk thistle’ “Silybum marianum” has been widely used from ancient times because of its excellent hepatoprotective action. It has been used clinically to treat liver disorders including acute and chronic viral hepatitis, toxin/drug-induced hepatitis and cirrhosis and alcoholic liver disease. The efficacy and dose-response effect of silymarin (125, 250 and 500 mg/kg) were assessed using egg albumin-induced paw edema in rats as a model of acute inflammation. In this model, 56 rats were used and allocated into 7 subgroups each containing 8 rats. All treatments were given intraperitonealy 30 minutes before induction of inflammation by egg albumin and then the increase

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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
NUMERICAL INVESTIGATION OF STATIC AND DYNAMIC STRESSES IN SPUR GEAR MADE OF COMPOSITE MATERIAL
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In this current work, Purpose; to clearly the fundamental idea for constructing a design and
investigation of spur gear made of composite material its comes from the combination of (high
speeds, low noise, oil-les running, light weight, high strength, and more load capability)
encountered in modern engineering applications of the gear drives, when the usual metallic gear
cannot too overwhelming these combinations.
An analyzing of stresses and deformation under static and dynamic loading for spur gear tooth
by finite element method with isoparametric eight-nodded in total of 200 brick element with 340
nods in three degree of freedom per node was selected for this analysis. This is responsible for the
catastropic fa

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Publication Date
Fri Jan 01 2016
Journal Name
Iraqi Journal Of Agricultural Sciences
Influence of cytokinins and sucrose concentrations on bulblet characters of In Vitro Hippeastrum Hybridum
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Publication Date
Thu Nov 22 2018
Journal Name
International Journal Of Applied Pharmaceutics
PREPARATION AND IN VITRO EVALUATION OF CYCLODEXTRIN BASED EFFERVESCENT AND DISPERSIBLE GRANULES OF CARBAMAZEPINE
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Objective: Carbamazepine is typically used for the treatment of seizure disorders and neuropathic pain. One of the major problems with this drug is its low solubility in water; therefore the objective of this study was to enhance the solubility of carbamazepine by complexation with cyclodextrin to be formulated as effervescent and dispersible granules.Methods: Solvent evaporation method was used to prepare, binary (Carbamazepine/β-cyclodextrin) complex and ternary (Carbamazepine/β-cyclodextrin/hydroxypropyl methyl cellulose (HPMC E5). The more soluble complex will be further formulated as unit dose effervescent and dispersible granules. The complexes were evaluated for their solubility, drug content, percentage practical yield and

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Development of Green Method for Trace Determination of Bendiocarb in Real Samples Using Emerson
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In this study, cloud point extraction combined with molecular spectrometry as an eco-friendly method is used for extraction, enrichment and determination of bendiocarb (BC) insecticide in different complex matrices. The method involved an alkaline hydrolysis of BC followed Emerson reaction in which the resultant phenol is reacted with 4-aminoantipyrene(4-AAP) in the presence of an alkaline oxidant of potassium ferric cyanide to form red colored product which then extracted into micelles of Triton X-114 as a mediated extractant at room temperature. The extracted product in cloud point layer is separated from the aqueous layer by centrifugation for 20 min and dissolved in a minimum amount of a mixture ethanol: water (1:1) followed

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Publication Date
Wed Apr 01 2020
Journal Name
Brazilian Dental Journal
In Vitro Homeostasis of Rat Oral Epithelial Cell Cultures Following Withdrawal of Periodontal Pathogens
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Abstract Inflammation of periodontal tissues is the consequence of interaction between periodontal pathogens and immune system. This is associated with increased expression of inflammatory cytokines, which may exert destructive effect to the periodontal tissues when released over long period. The aim of this study was to chronologically track the homeostasis of oral keratinocytes following removal of periodontal pathogens. This was done by investigating expression of selected inflammatory markers and integrity of epithelial monolayers in vitro. Rat oral keratinocytes were stimulated with heat-killed Fusobacterium nucleatum and Porphyromonas gingivalis over 7-days then bacteria were washed away and epithelial cells re-cultured for 3-

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Possible protective effects of two different doses of cyanocobalamin against methotrexate nephrotoxicity in rats
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Abstract

   Nephrotoxicity is defined as rapid deterioration in kidney functions. It arises from direct exposure to drugs or their metabolites. Methotrexate is a famous chemotherapeutic drug with anti-inflammatory and immunosuppressive properties. A high-dose methotrexate-induced renal dysfunction can be life threatening. Cyanocobalamin, one of the forms of vitamin B12, acts as a coenzyme in the conversion of homocysteine to methionine in the cytosol, and the conversion of methylmalonyl-CoA to succinyl-CoA in the mitochondrion. This study is designed to examine the effect of cyanocobalamin in two different doses each co-administered with methotrexate at 20 mg/kg induced nephrotoxicity in rat

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Publication Date
Fri Dec 03 2021
Journal Name
Rawal Medical Journal
Functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures
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Objective: To assess prospectively functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Methodology: This prospective study included 134 patients with closed shaft tibia fractures with age 18-60 years and isolated closed fracture of shaft of tibia. The fractures were fixed by interlocking intramedullary nail. At follow-up after 12 months postoperatively, the functional outcome was assessed radiographically for the sign of union and clinically according to Klemm-Borner criteria. Results: The mean age was 38.55 years. Out of 134 patients, 55.2% were male. The cause was road traffic accident in 44.8%, majority of the fracture occur in the mid-shaft (41.8%), and oblique fracture was th

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Publication Date
Fri Jan 01 2021
Journal Name
Family Medicine & Primary Care Review
Assessment of depressive symptoms among students at Al-Kindy College of Medicine in Baghdad
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Background Depression is one of the most common medical illnesses worldwide. Medical students during their training will be subjected to many stressors, both mentally and emotionally. Objectives Assess the prevalence of depressive symptoms among medical students and to identify any association between depressive symptoms and some socio-demographic factors.

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preventive Effects of Different Doses of Pentoxyfilline Against CCl4-Induced Liver Toxicity in Rats
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The liver protective effects of pentoxifylline were studied through pre-treatment of rats with various intraperitoneal (IP) doses (25, 50 and 100mg/kg/day) 14 days before induction of liver toxicity by carbon tetrachloride (CCl4). The parameters of oxidative stress, malondialdehyde (MDA) and reduced glutathione (GSH) were measured in liver homogenate in addition to histopathological examinations.  Analysis of data revealed significant amelioration of oxidative stress in groups of animals pre-treated with different doses of pentoxifylline (PTX) compared to group of animals intoxicated by CCl4 as evidenced by lowering MDA contents and elevation of GSH levels in liver tissue homogenate but the levels still signifi

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