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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
Fri May 03 2024
Journal Name
Doklady Biochemistry And Biophysics
Superoxide Dismutase and Clopidogrel: A Potential Role in Peripheral Arterial Disease Treatment
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Oxidative stress plays a crucial role in the pathogenesis of peripheral artery disease (PAD). This study aimed to investigate the effect of clopidogrel on oxidative stress in PAD patients. Seventy subjects were divided into three groups: PAD patients before treatment (B-PAD), PAD patients after treatment with clopidogrel (A-PAD), and healthy controls. Serum levels of superoxide dismutase (SOD), copper (Cu), zinc (Zn), manganese (Mn), and oxidized protein were measured. SOD activities were also determined. The results showed that SOD activities, and SOD specific activities were significantly decreased in PAD patients compared to healthy individuals. After treatment with clopidogrel, SOD activities, and SOD specific activities were continuous

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Publication Date
Mon May 12 2025
Journal Name
The International Journal Of The History Of Sport
Exploring Sport’s Role in Mitigating Conflicts Gulf Cup as a Case Study
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Conflict, peace, and sports have a long history as practical realities, and their correlation has become an important subject of study in the last decades of the twentieth century. Sport has infiltrated peace and conflict studies as a tool for resolving conflict and building peace, but opinions have differed between those who say it is a positive tool and others who see it as negative. The Gulf Cup is one of the champions that have never been studied, and in-depth research about it has not been done. This tournament has affected the relations between the states involved. The politics cast its shadow on the Gulf Cup. The paper aims to shed light on how political events in the region have consistently affected the Gulf Cup and how politics in

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Publication Date
Sat Dec 10 2022
Journal Name
المجلة العراقية لعلوم التربة
ACTINOMYCETES GENERAL CHARACTERISTICS AND THEIR ROLE IN SOIL, PLANT, AND HUMAN *HEALTH
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Actinomycetes are free, spore-forming, high (G+C) ratio (>55%) saprophytic microorganisms that are widely distributed in most soils, colonize plants, and are prevalent in water. This is frequently accompanied by the production of filament airborne mycelium. Actinomycetes are well-known microcolonies for creating antibiotics and other critical bioactive components that are beneficial to humans. Approximately 70% to 80% of commercially available medications and antiviral active compounds have been synthesized so far. Secondary metabolites produced by microbes have the potential to be used in a variety of sectors, including antimicrobial agents, enzyme technology, pigment manufacture, antitumor agents against cancer cells, and toxin pr

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Publication Date
Wed Oct 25 2023
Journal Name
Urban Planning And Construction
A Review on Urban Planning and Its Role in Managing Flood Risks
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This review delves deep into the intricate relationship between urban planning and flood risk management, tracing its historical trajectory and the evolution of methodologies over time. Traditionally, urban centers prioritized defensive measures, like dikes and levees, with an emphasis on immediate solutions over long-term resilience. These practices, though effective in the short term, often overlooked broader environmental implications and the necessity for holistic planning. However, as urban areas burgeoned and climate change introduced new challenges, there has been a marked shift in approach. Modern urban planning now emphasizes integrated blue-green infrastructure, aiming to harmonize human habitation with water cycles. Resil

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Publication Date
Mon Mar 06 2023
Journal Name
Rheumatology (bulgaria)
Tenascin-C and Interleukin-17 Up-regulation in Axial Spondyloarthritis Patients
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Background: Axial spondyloarthritis (axSpA) is an inflammatory, systemic rheumatic condition that mostly affects the axial skeleton. Tenascin-C (TN-C) is a hexameric glycoprotein of considerable size, upregulated in many inflammatory conditions, while Interleukin-17 (IL-17) a cytokine that plays an important role in SpA symptoms. Objective: to investigate the upregulation between the serum levels of TN-C and IL-17 in Iraqi axSpA patients and the disease characteristics. Patients and Methods: Seventy-four axSpA patients and 28 matched controls were studied. Fifty-four patients received a tumor necrosis factor inhibitor (TNFi) and 20 did not. Serum TN-C and IL-17 concentrations were determined using the ELISA technique. The Bath Ankyl

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary Immunoglobulin A Assessment in Lymphoma Patients before and after Chemotherapy
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Background: Lymphomas are group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and caused the characteristics lymphadenopathy. Occasionally, they may spill over into blood or infiltrate organs outside the lymphoid tissue. The major subdivision of lymphomas is into Hodgkin lymphoma and non–Hodgkin lymphoma and this is based on the histologic presence of Reed-Sternberg cells in Hodgkin lymphoma. Salivary immunoglobulin A is the prominent immunoglobulin and is considered to be the main specific defense mechanism in oral cavity. The aim of this study was to determine the level of salivary immunoglobulin A in lymphoma patients before and after chemotherapy treatment. Subjects, materials and methods: The study i

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Exfoliative Cytological Changes in Peritoneal Fluid from Patients on Peritoneal Dialysis
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Background: Ambulatory peritoneal dialysis
introduced by Popvich et al (13) in 1978 , consists of a
four to five hours lavage of peritoneal cavity with 2000
ml of glucose solution .It remains a useful method for
treating patients with end stage renal failure till renal
transplantation becomes possible.
Objectives: The aim of the study is to evaluate the
value of cytological changes of mesothelial cells in
dialysate patients.
Methods: Within one year period, 32 cytological
peritoneal fluid samples were collected from patients
with end stage renal failure regardless of the underlying
causes, admitted to the dialyzing unit in Kadimya
Teaching Hospital. Smears were prepared and fixed in
95 % ethyl al

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Lipid Profile and Fasting Blood Sugar Analysis in Patients with Cholelithiasis
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Cholelithiasis is one of the commonest surgical problems and one of the most common gastrointestinal diseases throughout the world but its pathogenesis remains unclear. Many theories have been proposed forward to explain the mechanism of stone formation. It is not fully clear if symptomatic gallstone disease is associated with a specific pattern of some biochemical abnormalities, as lipid profile and fasting blood sugar in serum of patients.

This study was designed to estimate lipid profile and fasting blood sugar in the sera of patients with cholelithiasis in comparison with normal individuals (control).

In this study, 104(male=16, female=88) were symptomatic gallstone patients (aged 42.79± 12.18 years), and 38(male=6

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Cox proportion hazard model for patients with hepatitis disease in Iraq
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Cox regression model have been used to estimate proportion hazard model for patients with hepatitis disease recorded in Gastrointestinal and Hepatic diseases Hospital in Iraq for (2002 -2005). Data consists of (age, gender, survival time terminal stat). A Kaplan-Meier method has been applied to estimate survival function and hazerd function.

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Publication Date
Sat Sep 01 2018
Journal Name
Saudi Medical Journal
Relationship between human leukocyte antigen DRB1 and psoriasis in Iraqi patients
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