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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
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation, In-vitro, and Ex-vivo Evaluation of Ondansetron Loaded Invasomes for Transdermal Delivery
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Invasomes are newly developed types of nanovesicles. A vesicular drug delivery system is considered one of the approaches for transdermal delivery to enhance permeation and improve drug bioavailability. Ondansetron is a serotonin receptor antagonist used for treating vomiting associated with different clinical cases. The study aimed to prepare invasomal dispersions for improving permeation of ondansetron across the skin with a controlled release pattern. Twenty-seven formulas of ondansetron-loaded invasomes were prepared by a modified mechanical dispersion method. These formulas were optimized by studying the effect of variables on entrapment efficiency. Vesicle size, polydispersity, zeta potential, in-vitro release and ex-vivo perm

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Publication Date
Mon Nov 01 2021
Journal Name
2021 International Conference On Intelligent Technology, System And Service For Internet Of Everything (itss-ioe)
Application of MQ-Sensors to Indoor Air Quality Monitoring in Lab based on IoT
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Publication Date
Fri Mar 05 2021
Journal Name
Materials
Optimum Placement of Heating Tubes in a Multi-Tube Latent Heat Thermal Energy Storage
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Utilizing phase change materials in thermal energy storage systems is commonly considered as an alternative solution for the effective use of energy. This study presents numerical simulations of the charging process for a multitube latent heat thermal energy storage system. A thermal energy storage model, consisting of five tubes of heat transfer fluids, was investigated using Rubitherm phase change material (RT35) as the. The locations of the tubes were optimized by applying the Taguchi method. The thermal behavior of the unit was evaluated by considering the liquid fraction graphs, streamlines, and isotherm contours. The numerical model was first verified compared with existed experimental data from the literature. The outcomes re

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Publication Date
Sun Jun 12 2022
Journal Name
Sensors
Recent Advances in Bipedal Walking Robots: Review of Gait, Drive, Sensors and Control Systems
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Currently, there is an intensive development of bipedal walking robots. The most known solutions are based on the use of the principles of human gait created in nature during evolution. Modernbipedal robots are also based on the locomotion manners of birds. This review presents the current state of the art of bipedal walking robots based on natural bipedal movements (human and bird) as well as on innovative synthetic solutions. Firstly, an overview of the scientific analysis of human gait is provided as a basis for the design of bipedal robots. The full human gait cycle that consists of two main phases is analysed and the attention is paid to the problem of balance and stability, especially in the single support phase when the biped

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Publication Date
Wed May 01 2019
Journal Name
Ieee International Electric Machines & Drives Conference (iemdc)
An Investigation of Short Translator Linear Machines for Use in a Free Piston Engine
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Publication Date
Thu May 21 2015
Journal Name
Environmental Monitoring And Assessment
Water quality monitoring of Al-Habbaniyah Lake using remote sensing and in situ measurements
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Publication Date
Mon Jun 04 2018
Journal Name
Baghdad Science Journal
Disturbance of Arginase Activity and Nitric Oxide Levels in Iraqi Type 2 Diabetes Mellitus
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This study is an attempt to find whether arginine metabolism dysregulation by arginase activity is related to hyperglycemia, followed by changes in nitric oxide (NO) generation in type 2 diabetic patients. This study includes 42 control subjects (Group I), and 92 Iraqi patients with type 2 diabetes mellitus (T2DM). The patient group was subdivided into two groups: Group II (54) with T2DM only and Group III (38) with T2DM and dyslipidemia (who were treating with atorvastatin along with diabetes treatment). The samples were obtained to measure arginase activity and NO levels. Serum arginase activity increased significantly in patients(groupII and groupIII) compared to control group. While serum NO level was significantly lower in diabetic pa

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Publication Date
Sun Jan 01 2012
Journal Name
Evidence-based Complementary And Alternative Medicine
Gelam Honey Inhibits the Production of Proinflammatory, Mediators NO,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:msub><mml:mrow><mml:mtext>PGE</mml:mtext></mml:mrow><mml:mtext>2</mml:mtext></mml:msub></mml:mrow></mml:math>, TNF-<b><i>α</i></b>, and IL-6 in Carrageenan-Induced Acute Paw Edema in Rats
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Natural honey is well known for its therapeutic value and has been used in traditional medicine of different cultures throughout the world. The aim of this study was to investigate the anti-inflammatory effect of Malaysian Gelam honey in inflammation-induced rats. Paw edema was induced by a subplantar injection of 1% carrageenan into the rat right hind paw. Rats were treated with the nonsteroidal anti-inflammatory drug (NSAID) Indomethacin (10 mg/kg, p.o.) or Gelam honey at different doses (1 or 2 g/kg, p.o.). The increase in footpad thickness was considered to be edema, which was measured using a dial caliper. Plasma and paw tissue were collected to analyze the production of inflammatory mediators, such as NO, PGE2

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
Theoretical asp ects of trans lation of a lite rary text in the fram ework of lingu istic and cult ural analysis: Теоретические асп екты перевода художес твенного текста в рам ках лингвокультурологического ана лиза
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          The present art icle discusses the prob lems of understanding and translating the lingu istic and cult ural aspect of a foreign lite rary text. The article considers the trans lation process through the pr ism of cult ural orientation. In the process of transl ation, the nati onal cultural iden tity should be expressed to the max imum extent, through all me ans of expre ssion that include imagery and inton ation. In addi tion to the author's sty le, special atte ntion should al so be pa id to tro pes, phraseological uni ts, colloquial wo rds and dial&n

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Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Inorganic And Organometallic Polymers And Materials
Ultrasound-Assisted and One-Pot Synthesis of New Fe3O4/Mo-MOF Magnetic Nano Polymer as a Strong Antimicrobial Agent and Efficient Nanocatalyst in the Multicomponent Synthesis of Novel Pyrano[2,3-d]pyrimidines Derivatives
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