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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 Feb 27 2024
Journal Name
Pharmacia
Association of the rs1801133 and rs1801131 polymorphisms in the MTHFR gene and the adverse drug reaction of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients
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Background: Methotrexate is one of the mainstays for treating rheumatoid arthritis (RA) with a wide range of adverse drug reactions, however, it’s the relationship between adverse drug reactions and genetic polymorphism remains to be highlighted, and there is a lack of studies concerning Arabic Iraqi population regarding this aspect.

Objective: Evaluate the association between genetic mutations in the MTHFR gene in SNPs (rs1801133G>A and rs1801131T>G) on the adverse drug reaction for RA Iraqi patients.

Methods: An observational study, that involved 95 Iraqi RA patients with established RA. Patien

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Coronary angiogriphy in left ventricular dysfunction patients with no clinical evidence of ischemic heart disease
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Background : Coronary artery disease is theunderlying cause in approximately two thirds of
patients with systolic heart failure ;
Coronary artery angiogriphy may be useful to
define the presence ,
Anatomical characteristics ,and functional
significance of Coronary artery disease in
selected heart failure patients with or without signs
and aymptoms of Coronary artery disease.
Objectives: to verify the clinical usefulness of
coronary angiography (CA) in congestive heart
failure (CHF) patients with no history of ischemic
heart disease and to identify predictive factors for
performing coronary angiography to patients with
congestive heart failure with no obvious ischemia.
Methods :this is a cross-ses

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical significance of Osteoprotegerin, Vitamin D, Obestatin and some biochemical variables in Kidney failure Patients
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Chronic kidney disease (CKD) is described as an abnormalities of renal function, existing for a long period of time. By reason of the early grades of Chronic kidney disease can be experiences no symptoms, its premature identification is strenuous. initial stage CRD can cause various complications, such as anemia, matabolyic disorders of bone mineral. The study was done to assess the effect the chronic renal disease stage on the Osteoprotegerin, 1,25 dihydroxyvitamin D, Obestatin levels and some biochemical parameters in patients not undertaken dialysis therapy. In this case-control study fifty-five patients with Kidney failure and fourty healthy people were examined. Circulating concentrations of Osteoprotegerin, 1,25 dihydroxyvitamin D

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Publication Date
Fri Sep 15 2023
Journal Name
History Of Medicine
The multifaceted role of Dectin-1 and Card9 in inflammatory bowel disease Iraqi patients
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The study aimed to investigate the role of Dectin-1 and Card-9 in pathogenicity of inflammatory bowel disease (IBD). This investigations involved 150 blood samples for IBD patients which divided in to two groups (50 for crohns disease CD (G2) and 50 for ulcerative colitis UC (G3)). All a apparently (male and female) attended to) Al-Kindy hospital) in Baghdad city, department of Gastroenterology. and all of thin were diagnosis by consulters medical staff and pathologists with age range 15-65years average 40 years. in addition to 50 blood samples were collected from apparently healthy individuals as control group (G1). 10 ml were withdrawn from all participants, 5ml for the immunological study which carried by ELISA technique and 5 ml used fo

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Publication Date
Sun Jul 31 2022
Journal Name
Iraqi Journal Of Science
The Key Role of Bone Function Markers in Patients with Type (II) Diabetes Mellitus
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      Complications associated with diabetes are a consequence of acute disturbance in glucose metabolism in a human body. The most significant complication of diabetes is bone disorders which contributes to high levels of bone disability. This study included 118 diabetic patients, 56 males, 62 females, and 60 healthy non-diabetic controls, 30 males, 30 females. The patients and controls were age matched. Circulating levels of bone function markers (osteoprotegerin, vitamin D, PTH, total calcium and inorganic phosphorus) were determined in all subject groups. The data obtained from this study showed that the serum levels of osteoprotegerin had significantly increased in both diabetic male & female in both age ranges which were 4

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Reducing Organizational Anomie in Light of Entrepreneurial Behavior
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The research aims to clarify the role of the main variable represented by the four dimensions of entrepreneurial behavior (creative, risk-taking, seizing opportunities, proactivity), in Reducing the dependent variable of organizational anomie with the dimensions (Organizational Normlessness, Organizational Cynicism, Organizational Valuelessness).

The experimental, analytical method was adopted in the completion of the research, and an intentional sample of (162) individuals in the administrative levels (higher and middle) in the factory was taken. The questionnaire was also adopted as the main tool, which

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Role Of IL-4 And IL-8 In The Itiology Of Tinea Versicolor In Group Of Iraqi Patients
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Background: Tinea versicolor is a common dermatological problem ,world wide distribution , caused by a dimorphic fungus called Malassezia furfur ,it live normally on skin as a commensal . Many factors play a role in the etiology of TV among these could be the disturbed immune system which may be related to the ability of TV alter the immune system by a process called Immunomodulation leading to subsequent infection. Immuno-inflammatory activity mediated by different cytokines could have a role in the etiology of TV.
Objective: To evaluate the serum level of the inflammatory cytokines ,IL-4andIL-8,in patients with TV as compared to immunocompramized patients and healthy groups.
Patients and methods

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Publication Date
Sun Apr 03 2005
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Possible Role of Interleukins 6 and 10 in Colorectal Carcinoma in Iraqi Patients
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Background : It is quite accepted that interleukins (IL) in general play a crucial role in response to injuy , infection and on cogenic trans formation , among there are IL-6 and ILJO.
Aim of this study is to find out the possible role of IL_ and IL, 10 in colo rectaI carcima in Iraqi patients.
Subjects and Methods: forty patients with colorectal cancer (CRC) composed with 30 healthy controls were enrolled in this study. Serum conc. Of IL-6 and IL -lOwere estimated in both groups using ELIZA technique.
Results: Serem levels of IL-6 and IL-10 were significantly increased (P<0.001) in compassion with control group.
Conclusion: these cytokins could be used as a markers for tumor progression .

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Publication Date
Wed Jan 01 2020
Journal Name
Medico-legal Update
Effect of Some Alcoholic Extracts in Reducing the Fat Content of the Liver Tissue in Rat.
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Objective: This research was carried out in rats in a special place of the laboratory of histopathological diseases in the period 6/9/2018 until 23/11/2018, this study to detect effect of the addition of the alcohol extract of ginger in the reduction of fat in liver tissue of rats. Method: Eight groups and replicates for each group. The groups were homogenous in weights and were placed in 13 cages. Each group consisted of 10 rat and at 5 fares each. In the first treatment, rat were fed on regular feeding without adding and feeding rats in the second treatment sessions add to it the alcoholic extract of ginger in Turkey 150 mg/kg. The third group is the same as the normal food after adding the alcohol extract of ginger at a concentration of

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Publication Date
Fri Aug 28 2020
Journal Name
Iraqi Journal Of Science
Role of oqxA and oqxB Genes in the Development of Multidrug Resistant Phenotype among Clinical Klebsiella pneumoniae Isolates from Various Cases
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This study investigated the prevalence of oqxA and oqxB genes and their effective roles in the development of multidrug resistant (MDR) phenotype among clinical isolates of Klebsiella pneumoniae. Out of 150 clinical samples, 50 (33%) isolates were recognized as K. pneumoniae according to the morphological and biochemical properties. The minimum inhibitory concentrations (MICs) assay revealed that the resistance values of the isolates were 43 (86%) against ceftriaxone (4- ≥64 µg/ml), 42 (84%) against ceftazidime (16- ≥64 µg/ml), 41 (82%) against cefepime (≥16 µg/ml), 21 (42%) against ertapenem (≥8 µg/ml), 18 (36%) against imipenem (4- ≥16 µg/ml), 15 (30%) aga

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