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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
Tue Jan 08 2019
Journal Name
Iraqi Journal Of Physics
Preparation of Ag nanoparticles via pulsed laser ablation in liquid for biological applications
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Ag nanoparticles were prepared using Nd:YAG laser from Ag matel in distilled water using different energies laser (100 and 600) mJ using 200 pulses, and study the effect of the preparation conditions on the structural characteristics of and then study the effect of nanoparticles on the rate of killing the two types of bacteria particles (Staph and E.coli). The goal is to prepare the nanoparticle effectively used to kill bacteria.

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Possible Protective Effects of Lutein against Ciprofloxacin Induced Bone Marrow Toxicity in Rats
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Ciprofloxacin, which is a second generation of fluoroquinolone and one of the most effective and widely used drugs within fluoroquinolone. Unfamiliar adverse effects of ciprofloxacin such as bone marrow (BM) suppression, thrombocytopenia, anemia, agranulocytosis, renal failure, and others observed. Lutein, is a xanthophyll (an oxygenated carotenoid), was focused by most studies as it has a strong antioxidant activity in vitro; and also, it has been associated with reducing the risk of the age-related disorders. The current study was designed to describe the role of apoptosis through the measurement of Bcl-2 associated X protein (Bax) marker, as mechanisms of bone marrow toxicity induced by ciprofloxacin and to find whether lutei

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Publication Date
Sat Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Development of novel paracetamol/naproxen co-crystals with an improvement in naproxen solubility.
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Co-crystals are new solid forms of drugs that could resolve more than one problem associated with drugs formulations like solubility, stability, bioavailability, mechanical and tableting properties. A preliminary theoretical study for estimating the possible bonding between the co-crystal components (paracetamol and naproxen) was performed using the ChemOffice program. The results revealed a high possibility for bonding between paracetamol and naproxen and indicated the ability of molecular mechanics study to predict the co-crystal design.

       In this work, four different methods were used for the preparation of three different ratios 1:1, 2:1, and 1:2 of paracetamol:naproxen co-crystals. The four

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Publication Date
Sat Aug 01 2015
Journal Name
Materials Science And Engineering: C
Antibacterial activity of magnetic iron oxide nanoparticles synthesized by laser ablation in liquid
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In this study, (50–110 nm) magnetic iron oxide (α-Fe2O3) nanoparticles were synthesized by pulsed laser ablation of iron target in dimethylformamide (DMF) and sodium dodecyl sulfate (SDS) solutions. The structural properties of the synthesized nanoparticles were investigated by using Fourier Transform Infrared (FT-IR) spectroscopy, UV–VIS absorption, scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray diffraction (XRD). The effect of laser fluence on the characteristics of these nanoparticles was studied. Antibacterial activities of iron oxide nanoparticles were tested against Gram-positive; Staphylococcus aureus and Gram-negative; Escherichia coli, Pseudomonas aeruginosa and Serratia marcescens. The results sh

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Publication Date
Fri Nov 24 2023
Journal Name
International Journal Of Statistics In Medical Research
A Novel Algorithm for Predicting Antimicrobial Resistance in Unequal Groups of Bacterial Isolates
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Choosing antimicrobials is a common dilemma when the expected rate of bacterial resistance is high. The observed resistance values in unequal groups of isolates tested for different antimicrobials can be misleading. This can affect the decision to recommend one antibiotic over the other. We analyzed recalled data with the statistical consideration of unequal sample groups. Data was collected concerning children suspected to have typhoid fever at Al Alwyia Pediatric Teaching Hospital in Baghdad, Iraq. The study period extended from September 2021 to September 2022. A novel algorithm was developed to compare the drug sensitivity among unequal numbers of Salmonella typhi (S. Typhi) isolates tested with different antibacterials.

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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Vitamin E and Q10 Supplementation against Doxorubicin-Induced Neurotoxicity in Rats
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Publication Date
Sun Feb 24 2019
Journal Name
Iraqi Journal Of Physics
Construction and performance study of a solar - powered hybrid cooling system in Iraq
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The systems cooling hybrid solar uses solar collector to convert solar energy into the source of heat for roasting Refrigerant outside of the compressor and this process helps in the transformation of Refrigerant from the gas to a liquid state in two-thirds the top of the condenser instead of two-thirds the bottom of the condenser as in Conventional cooling systems and this in turn reduces the energy necessary to lead the process of cooling. The system cooling hybrid use with a capacity of 1 ton and Refrigerant type R22 and the value of current drawn by the system limits (3.9-4.2A), the same value of electric current calculated by the system are  Conventional  within this atmosphere of Iraq, and after taking different readings

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Publication Date
Fri Oct 22 2021
Journal Name
Iraqi Journal Of Physics
Absorption properties of novolac-alumina-graphite mixture microwave absorbers in x-band frequencies
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Absorption properties (Attenuation coefficient, the percentage of the reflection, and the percentage of absorption) in x-band have been investigated in this paper for novolac – alumina- graphite mixture. Using novolac as the host material, the samples are prepared with alumina concentrations (5%,10%,15%,20%) and graphite concentrations (5%,10%) with thickness equal to 2.2mm .Network analyzer produced by HP-8510 was used in this work to measure the attenuation coefficient. The samples (3, 5) have good attenuation of wave with bandwidth of frequencies. The maximum of attenuation is -25dB at frequency 10.28GHZ in sample (3) which has concentrations (80%novolac,10%alumina,and 5% graphite) and -24 dB at frequency 10.56GHZ in sample (5) whic

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Investigation and Comparative Study Among Various Methods of Contraception Used in Erbil City
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The objective of this study was to investigate and compare among five different methods of contraception including combined oral contraceptive pills (COC), Depot medroxyprogesterone acetate (DMPA), copper Intrauterine contraceptive device (IUCD), vaginal spermicides and male condom used in Hawler City through estimate of their effect, relative failure rate, percentage of use, adherence and compliance and adverse effects of each contraceptive method. In order to reach to these aims, a retrospective study was conducted in Hawler City in Azadi Health Care Center over a period of 6 months from 22th November, 2010 to 15th May, 2011 during which data collection and subjects follow up for 3 months had been achieved. A conv

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Publication Date
Tue Sep 11 2018
Journal Name
Iraqi Journal Of Physics
Estimation of kidney tumor volume in CT images using medical image segmentation techniques
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Kidney tumors are of different types having different characteristics and also remain challenging in the field of biomedicine. It becomes very important to detect the tumor and classify it at the early stage so that appropriate treatment can be planned. Accurate estimation of kidney tumor volume is essential for clinical diagnoses and therapeutic decisions related to renal diseases. The main objective of this research is to use the Computer-Aided Diagnosis (CAD) algorithms to help the early detection of kidney tumors that addresses the challenges of accurate kidney tumor volume estimation caused by extensive variations in kidney shape, size and orientation across subjects.
In this paper, have tried to implement an automated segmentati

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