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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
Tue Dec 31 2024
Journal Name
Iraqi Geological Journal
Geomechanical Modeling and Artificial Neural Network Technique for Predicting Breakout Failure in Nasiriyah Oilfield
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Wellbore instability is one of the major issues observed throughout the drilling operation. Various wellbore instability issues may occur during drilling operations, including tight holes, borehole collapse, stuck pipe, and shale caving. Rock failure criteria are important in geomechanical analysis since they predict shear and tensile failures. A suitable failure criterion must match the rock failure, which a caliper log can detect to estimate the optimal mud weight. Lack of data makes certain wells' caliper logs unavailable. This makes it difficult to validate the performance of each failure criterion. This paper proposes an approach for predicting the breakout zones in the Nasiriyah oil field using an artificial neural network. It

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Publication Date
Wed Sep 09 2020
Journal Name
Frontiers In Plant Science
Red Light Controls Adventitious Root Regeneration by Modulating Hormone Homeostasis in Picea abies Seedlings
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Publication Date
Fri Jan 08 2010
Journal Name
Al-kindy College Medical Journal
Maternal and fetal outcomes in emergency versus elective two or more previous cesarean deliveries
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Publication Date
Wed Dec 01 2010
Journal Name
Iraqi Journal Of Physics
Inelastic magnetic electron scattering M1 form factors in Ca-48 (M3Y fitting parameters consideration)
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Inelastic magnetic electron scattering M1 at Ex =10.23 MeV form factors in Ca-48 have been investigated. The fp shell model space with four orbits and eight neutrons have been considered and FPD6 has been selected between 32 model space effective interactions to generates the model space vectors for the M1 transition with excitation energy Ex =10.23 MeV and for constructing OBDM. Discarded space (core and higher configuration orbits) has been included through the first order perturbation theory to couple the partice-hole pair of excitation in the calculation of the total M1 form factor and regarding the realistic interaction M3Y as a core polarization interaction with six sets of fitting parameters. Finally the theoretical calculations h

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analytical Study Compared Between Poisson and Poisson Hierarchical Model and Applied in Healthy Field
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Through this research, We have tried to evaluate the health programs and their effectiveness in improving the health situation through a study of the health institutions reality in Baghdad to identify the main reasons that affect the increase in maternal mortality by using two regression models, "Poisson's Regression Model" and "Hierarchical Poisson's Regression Model". And the study of that indicator (deaths) was through a comparison between the estimation methods of the used models. The "Maximum Likelihood" method was used to estimate the "Poisson's Regression Model"; whereas the "Full Maximum Likelihood" method were used for the "Hierarchical Poisson's Regression Model

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
Residual cardiovascular risk in diabetes and obesity: Targeting lipid abnormalities other than LDL cholesterol
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Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD)

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Iron Chelation Therapy in Sickle Cell/Beta Thalassemia Syndrome, a 2 years’ Extension Study
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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
He-Ne Laser Irradiation Encourages reparative processes After cartilage loss in New Zealand rabbits
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Many therapeutic methods used to encourage reparative processes of cartilage and accelerate their healing such as drugs, magneto-laser and so on. Twenty four adult New Zealand rabbits used in this study. They were divided in to two groups; control and treaded with He –Ne laser. A square skin flap done on the medial aspect of both auricles followed by pealing a square piece of cartilage from the auricle then the flaps sutured .The site of the operation in the rabbits of the treated group were irradiated with He –Ne laser 5mw power for seven days began after the operation directly. 3 rabbits from each group used for collection of specimens for histopathological examination at the 1, 2, 4 & 6 weeks post the operation. Significant

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Publication Date
Sun Mar 25 2018
Journal Name
Biomedical And Pharmacology Journal
Anti CD20 Monoclonal Antibody (Rituximab) as a Rescue Treatment in Severe and Refractory SLE
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Systemic lupus erythematosus (SLE) is an autoimmune disease with polymorphic expression. B cells have an essential contribution in immune system activation via the production of different cytokines and functioning as potent antigen-presenting cells. Therefore, a drug that particularly targets B cells may represent an ideal therapeutic approach for SLE. Rituximab (RTX), an anti-CD20 monoclonal antibody causing transient B-cell depletion, has been used to manage SLE. This study aims to assess Rituximab effects on lupus nephritis (LN) patients when added to conventional immunosuppressants. Twenty four patients, 15-32 years old, with class III/IV/V LN were involved in this study. All were on steroids before lupus nephritis occurrence. They were

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of Planner And Development
Case studies on urban agriculture as a planning strategy for achieving sustainability in cities
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 Urban agriculture is one of the important urban uses of land in cities since the inception of cities and civilizations, but the great expansion of cities in the world during the twentieth century and the beginning of the twentieth century and the increase in the number of urban residents compared to the rural population has led to a decline in this use in favor of other uses.

 This decline in agricultural and green land areas in cities has negatively affected the environment, natural life and biological diversity in cities in addition to the great impact on the climate and the increase in temperatures and the negative impact on the economic side, since urban agriculture is an important pillar of the economy, especially

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