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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 Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
Performance Improvement of Neural Network Based RLS Channel Estimators in MIMO-OFDM Systems
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The objective of this study was tointroduce a recursive least squares (RLS) parameter estimatorenhanced by using a neural network (NN) to facilitate the computing of a bit error rate (BER) (error reduction) during channels estimation of a multiple input-multiple output orthogonal frequency division multiplexing (MIMO-OFDM) system over a Rayleigh multipath fading channel.Recursive least square is an efficient approach to neural network training:first, the neural network estimator learns to adapt to the channel variations then it estimates the channel frequency response. Simulation results show that the proposed method has better performance compared to the conventional methods least square (LS) and the original RLS and it is more robust a

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Publication Date
Sun Jul 02 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Morphological Description and Histological Study of Thyroid Gland in Felis catus (Linnaeus,1758)
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The results of the current study showed that the thyroid gland in adult domestic cat (Felis catus) is located in the neck area on both sides of the trachea at rings (1-5). The gland consists of two lobes (right and left) and it is surrounded by a capsule of connective tissue consisting of two outer and inner layers, and a layer of fatty tissue overlaps with the outer layer of the capsule. In addition, the results of this study found that the histological structure of the thyroid gland is composed of several follicles that appear in different sizes and shapes; the follicles are lined with simple cuboidal epithelial tissue and sometimes appear lined with high and low simple cuboidal epithelial tissue. The gland is histologically composed of t

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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
Mon Mar 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Simulation of Two Phase Flow Mixing Co – Current in T Junction Using Comsol
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The analysis, behavior of two-phase flow incompressible fluid in T-juction is done by using "A Computational Fluid Dynamic (CFD) model" that application division of different in industries. The level set method was based in “Finite Element method”. In our search the behavior of two phase flow (oil and water) was studed. The two-phase flow is taken to simulate by using comsol software 4.3. The multivariable was studying such as velocity distribution, share rate, pressure and the fraction of volume at various times.  The velocity was employed at the inlet (0.2633, 0.1316, 0.0547 and 0.0283 m/s) for water and (0.1316 m/s) for oil, over and above the pressure set at outlet as a boundary condition. It was observed through the program

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Publication Date
Mon Mar 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Optimization of Hole Cleaning and Cuttings Removal in High Inclined Till Horizontal Well
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The goal of this experimental study is to determine the effects of different parameters (Flow rate, cuttings density, cuttings size, and hole inclination degree) on hole cleaning efficiency. Freshwater was used as a drilling fluid in this experiment. The experiments were conducted by using flow loop consist of approximately 14 m (46 ft) long with transparent glass test section of 3m (9.84 ft.) long with 4 inches (101.6 mm) ID, the inner metal drill pipe with 2 inches (50.8 mm) OD settled with eccentric position positive 0.5. The results obtained from this study show that the hole cleanings efficiency become better with high flow rate (21 m3/hr) and it increase as the hole inclination angles increased from 60 to 90 degree due to dominated

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Publication Date
Wed Aug 23 2017
Journal Name
Journal Of Physics G: Nuclear And Particle Physics
Shell closures in Fl superheavy isotopes via determination of alpha decay preformation factor
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Publication Date
Sun Apr 30 2023
Journal Name
Iraqi Geological Journal
Sonic Scanner Helps in Identifying Reservoir Potential and Isotropic Characteristics of Khasib Formation
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Natural fractures provide an important reservoir space and migration channels for oil and gas reservoirs and control the reservoir potential. Therefore, it is essential to understand the methods for identifying accurate reservoir permeability and characterizing reservoir fractures. In particular, using conventional measurements to identify permeability and characterize fractures is very expensive. While using conventional logging data is very challenging, and an efficient characterization correlation method is urgently needed. In this paper, we have evaluated reservoir potential based on the sensitivity of sonic scanner tools to fluid mobility, maximum stress direction, and fractures presence. This tool provides a continuous estimat

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Publication Date
Tue Feb 20 2018
Journal Name
Reporters, Markers, Dyes, Nanoparticles, And Molecular Probes For Biomedical Applications X
Dual-radiolabeled nanoparticle probes for depth-independent in vivo imaging of enzyme activation
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Publication Date
Sat Jul 17 2021
Journal Name
International Journal Of Research In Social Sciences And Humanities
Reconstruction of Female Identity Through Unattainable Beauty Standards in Zadie Smith's White Teeth
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Reconstruction of female identity is one of the important issues in modern times. The majority of the females who descent from the countries of the third world confront lots of problems because of their race and gender. Black females or colored skin females because of the oppression of the white society upon them, try hard to cope with society in order to get some relief and feel that they are part of this cruel white society. One of the solutions for these black females is to reconstruct their identity by mimicry to the English beauty standards. Zadie Smith is a postcolonial author. She deals with third- world women and how they are treated in a minority and in a racist way. She strives to empower the subaltern black females who ha

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Publication Date
Sun Jan 01 2012
Journal Name
Lambert Academic Publishing
Expressions of Gratitude in American English and Iraqi Arabic, Al-Zubaidi Nassier |... | bol
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Expressions of Gratitude in American English and Iraqi Arabic (). Expressing gratitude is one of the most frequently occurring communicative acts in...

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