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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 2023
Journal Name
Iraqi Journal Of Science
Efficacy of Amphotericine B Ddrug Against Promastigote and Axenic Amastigote of Leishmania Dononvani in Vitro
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Leishmania are protozoan parasites belonging to the family Trypanosomatidae that cause high morbidity and mortality levels with a wide spectrum of clinical syndrome. This study aimed to investigate the effect of liposomal amphotericine B (AmBisome) drug on promastigote and axenic amastigote stages of Leishmania donovani isolate (MHOM/IQ/2005/MRU15)in comparison with pentostam SbV drug. Different concentrations of AmBisome and SbV drugs were investigated against Leishmania donovani promastigote and axenic amastigote. The ICR50R values of SbV and AmBisome drugs on promastigote were10.12 mg/ml and 2.21μg/ml, respectively, while they were 0.77μg/ml for axenic amastigote for both drugs. The present study concluded that axenic amastigote was

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Histological Evaluation of Effect of beta-Tricalcium Phosphate on Bone healing in Alloxan-Induced diabetes
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Background: Improved glucose level control with insulin injections have allowed for the diabetic population to live longer and healthier lives. Unfortunately diabetes remains a worldwide epidemic disease with multiple health implications. Specifically, its effects upon fracture healing are compromised in diabetics with as high as 87% recovery delay relative to “healthy” counterparts. Current medical treatments for bone injuries have been largely focused on replacing the lost bone with allogenic or autogenous bone grafts, beta-tricalcium phosphate (β -TCP), a ceramic alloplast, has interconnected system of micropores, has been widely used as a biologically safe osteoconductive bone substitute. The aim of this study was histol

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering
A Case Study of Bus Line Passenger Volumes of Bakrajo Bus Lines in Sulaimani City
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Transit agencies constantly need information about system operations and passengers to support their regular scheduling and operation planning processes. The lack of these processes and cultural motivations to use public transportations contributes enormously to the reliance on the private cars rather than public transportation, resulting in traffic congestions. The traffic congestions occur mainly during peak hours and the accidents happening as a result of road accidents and construction works.  This study investigates the effects of weekday and weekend travel variability on peak hours of the passenger flow distribution on bus lines, which can effectively reflect the degree of traffic congestion. A study of passen

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Publication Date
Wed Aug 31 2022
Journal Name
Iraqi Journal Of Science
Study of Micellar Behavior of a Tween 80 Surfactant in Aqueous Media Containing Diphenhydramine Hydrochloride
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       The surface properties of mixtures of a nonionic surfactant Tween 80 (Tw 80) and a cationic drug, diphenhydramine HCl (DPH) have been investigated. This was done by calculating the surface excess concentration (Γmax), minimum molecular area (Amin), surface pressure at the CMC (ᴨcmc), Gibbs Free Energy of adsorption (ΔG°ads), Gibbs free energy of micellization (ΔG°m), the standard enthalpy of micellization (ΔH°m), and the standard entropy of micellization (ΔS°m). The calculation was performed using the surface tension in the temperature range of 293-323 K with the variation of surfactant concentration to determine the crit

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering
Utilization of Iraqi Metakaolin in Special Types of Concrete: A Review Based on National Researches
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Portland cement concrete is the most commonly used construction material in the world for decades. However, the searches in concrete technology are remaining growing to meet particular properties related to its strength, durability, and sustainability issue. Thus, several types of concrete have been developed to enhance concrete performance. Most of the modern concrete types have to contain supplementary cementitious materials (SCMs) as a partial replacement of cement. These materials are either by-products of waste such as fly ash, slag, rice husk ash, and silica fume or from a geological resource like natural pozzolans and metakaolin (MK). Ideally, the utilization of SCMs will enhance the concrete performance, minimize

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Publication Date
Wed Jul 19 2017
Journal Name
International Journal Of Advances In Chemical Engineering And Biological Sciences
Detection of Aflatoxin M1 in Pasteurized Canned Milk and Using of UV Radiation for Detoxification
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The current study was designed to investigate the presence of aflatoxin M1 in 25 samples of pasteurized canned milk which collected randomly from some Iraqi local markets using ELISA technique. Aflatoxin M1 was present in 21 samples, the concentration of aflatoxin M1 ranged from (0.25-50 ppb). UV radiation (365nm wave length) was used for detoxification of aflatoxin M1 (sample with highest concentration /50 ppb of aflatoxin M1 in two different volumes ((25 & 50 ml)) for two different time (15 & 30 min) and 30, 60, 90 cm distance between lamp and milk layer were used for this purpose). Results showed that distance between lamp and milk layer was the most effective parameter in reduction of aflatoxin M1, and whenever the distance increase the

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Publication Date
Tue Jun 01 2021
Journal Name
Political Sciences Journal
Regionalism Hegemony of Political Life in Tunisia and its influence upon construction of Political System
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The topic area of that’s paper dealing with regionalism hegemony upon ruling affairs and political life in Tunisia, this phenomena had historical origins, even before region of French occupation in 1881, after independence, the regionalism domination was practice and normal, the political system justified it's with many causes, like level of education, connection with Western civilization, enlighten intelligent, economic conditions in coast region and North of Tunisia compared with the South, also the role of President Bourqiba as founder of Modern Tunisia, he was from Monster (North of country) which was dominated as charismatic leader dedicate the regionalism domination through decades, yet after revolution in 2011, little changes ha

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Publication Date
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
New record of three species of Leeches (Annelida:Hirudinea) in Al-Hindyia River / Babil Province / Iraq
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In this study, a total of 209 individuals of leeches were collected from Al-Hindyia River / Babil Province. 116 individuals were identified as Erpobdella octaculata (Linnaeus, 1758), 50 individuals as Erpobdella punctata (Leidy,1870) and  43 individuals as Hemiclepsis marginata (Müller, 1774).  Four samples were collected monthly during a period from February to June 2018. Some physical and chemical water properties were also examined, including air and water temperature, potential of hydrogen pH, Electrical Conductivity EC, Total Dissolved Solid TDS, Dissolved Oxygen DO, and the Biological Oxygen Demand BOD₅.  Air and water temperature were r

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Publication Date
Wed Feb 08 2023
Journal Name
Iraqi Journal Of Science
Increasing of Some Medical Flavonoid Compounds of Dodonaea viscosa L. using AgNO3 Nanoparticles In Vitro
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The research was conducted to study the effect of adding different concentrations of AgNo3 Nanoparticles (0,0.5,1.0,1.5,2.0) mg/ l in the production of some secondary metabolic compounds(Quercetin, Luetolin and Apigenin) of plant Dodonaea viscosa L. Quantitative and qualitative analysis of secondary metabolites were estimated by using( HPLC ). The explants from leaves were culture on MS media supplemented with 2mg/l of 2,4-D, 0.5mg/l of NAA and 0.5 mg/l of BA for callus induction. Adding AgNo3 Nanoparticles (2 mg/l) cause in significant increase of Quercetin and Luetolin production, while adding AgNo3 Nanoparticles (0.5mg/l) led to significant increase of Apigenin in callus extract.

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Publication Date
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences
Assessment of Water Quality in Tigris River of AL-Kut City, Iraq by Using GIS
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The concerns about water contaminants affect most developing countries bypassing rivers over them. The issue is challenging to introduce water quality within the allowed limits for drinking, industrial and agricultural purposes. In the present study, physical-chemical parameters measurements of water samples taken from eleven stations were collected during six months in 2020 through flow path along the whole length of Tigris River inside AL Kut city (center of Wassit government) were investigated for six parameters are total hardness TH, hydrogen ion pH, biological oxygen demand BOD5, total dissolved solids TDS, nitrate NO3, and sulfate SO4. The water quality analysis results were compared with the maximum allowable limit concentrat

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