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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 Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Clinical and Doppler Study of Restrictive Filling Pattern in Patients with Dilated Cardiomyopathy
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Background: Dilated cardiomyopathy (DCM) is a well-recognized cause of cardiovascular morbidity and mortality.Objectives: To evaluate the prognostic implications of the restrictive left ventricular filling pattern (RFP) in dilated cardiomyopathy.Methods: Patients with DCM admitted to Ibn AL-Bitar Hospital for Cardiac Surgery, Baghdad-Iraq, from May 2006 to August 2008, underwent a full clinical evaluation and Doppler echocardiography study. Patients were classified into three groups: Group I had persistent restrictive filling pattern; Group II had reversible restrictive filling pattern; and Group III had nonrestrictive filling pattern. Results: The current study was conducted on a total number of 80 patients with DCM, fifty (62.5 %) were

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Publication Date
Sun Oct 02 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Clinical Evaluation of Prochlorperazine Risk / Benefit in Emergency Department Patients Receiving I.V Tramadol
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Background: antiemetics are commonly prescribed as prophylactic for nausea and vomiting when opiates analgesics are prescribed in the emergency department.
Objective: to assess the incidence of nausea and vomiting after tramadol analgesia, and the effect of prochlorperazine on this incidence.
Patients and methods: I.V tramadol was administered with prochlorperzine (group I) or pyridoxine (group II) to 44 patients with acute sever pain.
Results: the incidence of nausea and vomiting was not significant between patient groups; while the occurance of extrapyramidal side effects was only seen in the prochlorperazine group. The low incidence of nausea and vomiting after opiate analgesic and higher incidence of side effects with prochl

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Publication Date
Tue Jan 30 2024
Journal Name
Iraqi Journal Of Science
Clinical and Histopathological Features of Breast Cancer in Iraqi Patients between 2018-2021
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     Breast cancer (BC) is the most common malignancy in women worldwide and a major cause of cancer-related deaths for women in Iraq. This assignment was created to investigate the characteristics of BC diagnosed in Baghdad from 2018 to 2021. A total of eighty-nine of paraffin embedded tissue blocks of different breast tissue tumors (71 females and 18 males) with their data, were collected from archive of Histopathology Department, Teaching Laboratories of Medical City, Al-Yarmouk Teaching Hospital, and a private laboratory in Baghdad-Iraq. The clinical information regarding age, gender, tumor size, tumor stage and grade, lymph nodes metastasis, in addition to the findings of estrogen receptor (ER), progesterone receptor (PR), human

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Publication Date
Sun Jun 11 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Glucagon-like Peptide-1 Levels and Related Parameters in Rheumatoid Arthritis Patients Prone to Atherosclerosis
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  The study aimed to estimate  the role of glucagon-like peptide-1 (GLP-1)  and visfatin as a novel  pro inflammatory marker in Rheumatoid Arthritis (RA ) according to the activity scores of disease to assess the possibility of introducing glucagon-like peptide-1 and visfatin in the diagnosis and monitoring of RA patients and to found the correlation  of visfatin level with GLP-1 and AIP in patients prone to atherosclerosis ,fifty  healthy individuals as control group (G1) and fifty rheumatoid arthritis (RA) patients (G2) were enrolled in this study with middle age  ranged (30 – 40) years and BMI ≥24 kg/m2. ESR ,RF, lipid profile, CRP,insulin, visfatin and GLP-1were determined. Results in t

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Publication Date
Tue Jan 02 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Role Of Tumor Markers In The Diagnosis And Follow Up In Patients With Pancreatic Cancer
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Background: To shade a light on certain tumor markers and their sensitivity and specificity in determination of pancreatic cancer.
Patients & Methods :- A total of 35 patients with pancreatic cancer were studied between June 2003 and April 2004 in Specialized Surgical - Baghdad Teaching Hospital . These patients were compared with other 25 non malignant G.I diseases patients as well as 35 healthy controls . The serum was estimated for CAI 9-9 , and CEA by ELFA (Enzyme Linked Fluorescent Assay) method and CPR by ELISA method.
Results :- Five patients with pancreatic cancer were excluded from this study because they were beyond surgery.The results show that there is significant differences between se

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Publication Date
Sun Apr 03 2005
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serum Lipids in Patients with Active Rheumatoid Arthritis And It's Relation to Drug Therapy
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Objective To detect the changes in serum Lipids among Iraqi patients with active Rheumatoid Arthritis (RA) and the effects of drug therapy.
Patients and methods Fifty Iraqi patients with untreated active Rheumatoid Arthritis and 50 matched healthy control were studied with concentration on estimation of fasting serum Lipid profile which is repeated after 3month treatment with different disease modifying anti Rheumatic drugs (DMARDs) regimens.
Results Fifty Iraqi patients were included in this prospective study 47 females (94%) and 3 males (6%). The mean age of patients was (45±3.20).
fifty healthy individuals were included in this study as a control group 45 females (90%) and 5 males (10%) the mean age of the control group was

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Publication Date
Sat Sep 03 2022
Journal Name
International Journal Of Health Sciences
Correlation between oxidative stress and clopidogrel drug in Iraqi patients with coronary artery disease
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Background: Coronary Artery Disease (CAD) is one of the largest causes of mortality worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. The current study aimed to investigate the effect of clopidogrel on the oxidative stress in CAD patients. Methods: One hundred CAD patients, who were followed-up for 5 days after receiving clopidogrel, and 50 healthy volunteers were included in this study. Parameters include catalase (CAT), total antioxidant capacity (TAC), total oxidant capacity (TOC), total protein, albumin, and globulins were determined before and after treatment with clopidogrel. Results: CAT, TAC, and Tp were significantly decreased (P<0.0001) in CAD patients compared to healthy control and

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
Detection a New Antiseptic Resistant Variant of qac Gene in Some Multi Drug Resistant Staphylococcus aureus Isolated from Different Clinical Sources
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The increasing use of antiseptic compounds creates selective pressure cause emergence of antiseptic resistance among Staphylococcus aureus .Resistance mechanism of antiseptic is driven mainly by multi drug resistant (MDR) efflux protein.Sixty five isolates of S.aureuswere collected from different clinical sources and subjected to 11 antibiotics most of them are recognized by efflux systems as extruded substrates. Range of efflux activity was estimated using cartwheel method. Simultaneous discrimination of antiseptic coding genes (qacA/B, smr and norA)as well as nuc and mecA genes among multidrug resistantS.aureus(MRSA) isolates was preformed using multiplex PCR assay

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Publication Date
Mon Sep 25 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study the Levels of Glucagon Like Peptide-1(GLP-1) and Related Parameters in Iraqi Hyperlipidemia Patients with Diabetes Mellitus.
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     The glucagon-like peptide-1 is secreted by intestinal L cells in response to nutrient ingestion. It regulates the secretion and sensitivity of insulin while suppressing glucagon secretion and decreasing postprandial glucose levels , additionally, glucagon-like peptide-1 delays gastric emptying and suppresses appetite. The impaired secretion of glucagon-like peptide-1 has negative influence on hyperlipidemia, diabetes  and insulin resistance related diseases the levels of its secretion change with the intake of different nutrients. Some drugs also have influence on GLP-1 secretion .

 

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Suggested Model for The Work of the Certified Fraud Examiner & His Role in Reducing The Incidents of Fraud and Corruption: An Applied Study in The Federal Board of Supreme Audit
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Is hardly day expire without hearing the news either Abuse Managementthe accounting standards or the existence of serious misstatements by someauditors.Which caused the demanding of many companies in the recent republication of the financial statements and the re-announcement of its financialresults. Such acts raise questioning about the role that should be played by theauditors, prompting agencies responsible for setting auditing standards to takeTo throw increasingly responsibility on the auditors in order to interest risksfraud The Risks of Fraud in their review of the financial statements.also The Public Company Accounting Oversight Board in the U.S.called about the need of owning the Certified Public Accountants those whoaudits for

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