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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
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Clinical study of patients with primary pulmonary hypertension (PPH)
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Background: Pulmonary hypertension (PH) is a hemodynamic and pathophysiological condition
defined as an increase in mean pulmonary arterial pressure (PAP) ≥25 mmHg at rest as assessed by
right heart catheterization (RHC). Although there is some underestimation and overestimation of PAP
between transthoracic Doppler echo (DE) and RHC, Doppler echo remains an indispensable screening
tool for the assessment of PH.
Objective: clinical evaluation of patients with primary pulmonary hypertension (PPH) and assess
vasoreactivity testing to identify patients who may benefit from long term therapy with calcium channel
blockers (CCBs).
Patients and methods: This prospective study was performed in the cardiac catheterization

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Publication Date
Sat Sep 09 2017
Journal Name
International Journal Of Science And Research (ijsr)
Comparative Study of Sevelamer Carbonate and Calcium Carbonate on Fibroblast Growth Factor-23 and Parathyroid Hormone in Hemodialysis Iraqi Patients
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Fibroblast growth factor-23, play an important role in atherosclerosis, endothelial dysfunction and vascular calcification. Sevelamer can improve vascular calcification, serum uric acid, low-density lipoprotein-cholesterol and Fibroblast growth factor-23. Aim of study Assessment the effect of sevelamer as phosphate binder against calcium carbonate on Fibroblast growth factor-23. Methods A prospective open-labelled study that included patients on hemodialysis. A total of 72 patients were screened, only 53 patients completed the 10 week period. Adults patients with serum phosphate as> 5.5 mg/dl were included. There were Group1: Includes 28 patients (19 males and 9 females receiving sevelamer carbonate (Renvela) tablet. Group 2: Include 25pati

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Publication Date
Thu Aug 30 2018
Journal Name
Iraqi Journal Of Science
Effect of Anti Diuretic Hormon (ADH) in Kidney Function on Post Hemodialysis End Stage Renal Failure Disease (ESRD) Iraqi Patients
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Chronic renal disease (CRD) is a patho-physiologic process with multiple etiologies, resulting in the inexorable attrition of Nephron number and function and frequently leading to end-stage renal disease (ESRD). In turn, ESRD represents a clinical state or condition in which there has been an irreversible loss of endogenous renal function, of a degree sufficient to render the patient permanently dependent upon renal replacement therapy (dialysis of transplantation) in order to avoid life threatening uremia. The current study was applied on 80 patients, the age range within 25-70 years, selected sample of patients who attend Iraqi center of kidney dialysis, Baghdad Teaching Hospital and Al-Yarmok Teaching Hospital . All t

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Publication Date
Sun Jul 04 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The role of IL-6 in the etology of tinea versicolor in group of Iraqi patients.
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Background Tinea versicolor is a common dermatological problem worldwide in distribution, caused by dimorphic fungus called Malassezia furfur, they exist at the very interface between
commensal and pathogen and, as such, their interaction with the human immune system is of great interest. Immuno-inflamatory activity mediated by different cytokines could have a role in the etiology of tinea versicolor.
Patients and Method: The study covered 46 subjects .It comprised 26 patients with TV compared with 20 healthy normal controls. Serum IL-6 analysis was done by ELISA.
Results: The level of IL-6 was elevated in patients with tinea versicolor, when compared with healthy control
Conclusion: IL-6 increases du

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The impact of JAK2V617F allelic burden on clinical and laboratory parameters in patients with myeloproliferative neoplasms
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Role in the Management of Thalassemic Patients in Sulaimania Thalassemia Center
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The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Developmental Role of Social Work in Reducing Social Extremism:A Field Study in Baghdad University-College of Mass Communication as a Model: محمد حميد علوان
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This study deals with the role that social work profession plays in all its fields to reduce social extremismat home, or school or within society. The study aims to: examine the historical roots of social work in the Iraqi society, investigate the objectives of the developmental role of social work, review the theories of social extremism, its characteristics, and causes, and to analyze the developmental role of social work to limit social extremism. To meet the objectives of the study, a descriptive analytical approach has been adopted. It involves using the social sampling survey method, i.e., a questionnaire tool in the University of Baghdad community-College of Media. The sample was randomly selected to include (100) students from th

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Publication Date
Sun Apr 30 2023
Journal Name
Iraqi Journal Of Science
The role of Interleukin -18 / Interleukin -18 BindingProtein in Rheumatoid Arithritis patients
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Rheumatoid arthritis (RA) is a chronic inflammatory polyarithritic disease
associated with remission and exacerbation with different immunological
features.Rheumatoid factor(RF) screening test was used quantitatively and qualitatively
using an enzyme immunoassay (EIA), RF-isotypes (RF-IgG, RF-IgM, RF-IgA) ,
Interleukin-18 (IL-18) and Interleukin – 18 binding protein (IL-18BP) were detected
quantitatively usingenzyme linked immunosorbent assay(ELISA). Results indicated a
51% positivity in RF among RA patients and a prevalence of the RF-isotype (RF-IgM)
with the highest level at (41.6±16.3 U/ml) (p < 0.05) among other RF-isotypes at a
percentage of 85.5% , results also indicatedan elevated serum level of IL-18

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Publication Date
Mon Jan 02 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the role of antineutrophil cytoplasmic antibodies in patients with systemic lupus erthematosus
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Background:

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
The Role of Aspirin as Otoprotective Agent in Patients Receiving Amikacin Therapy
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Objective: To investigate and prove that aspirin
protects, or at least attenuates amikacin ototoxicity in
humans.
Method: This study was conducted in 60 patients that
completed all
requirements .The patients were divided into two
groups:
• Control group: receive placebo treatment.
• Drug–treated group: They receive aspirin
coated tablets (1.5gm/ day), 500mg 8 hourly.
Both groups had similar aspects regarding the gender,
age and weight. The duration of therapy was 7 days
and dosage of amikacin was 1gm/day (500mg 12
hourly).
Results: Comparison of Audiometry test in
Ear/Nose/Throat (E.N.T.) Department (Pure Tone
Audiometry) at 1000 Hertz (Hz), 2000 Hz, 4000 Hz,
and 8000 Hz showed sig

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