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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 01 2020
Journal Name
Plant Archives
Correlation study of obestatin and progranulin with liver function enzyme in Iraqi females patients with colorectal cancer
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The second most commonly diagnosed cancer is colorectal cancer (CRC) is in female. The levels of progranulin, obestatin and liver enzymes including ALT, AST and ALP were measured in forty five sera in female patients suffering from CRC before chemotherapy initiation treatment as G1, G2 after first chemotherapy cycle and G3 after second chemotherapy cycle compared with thirty female as a healthy control G4. Results showed a high significant increased in progranulin concentration and a high significant decrease in obestatin in G2 than other groups. The correlation between progranulin and ALP was a significant negative (-ve) relation while obestatin with AST gave a significant positive (+ve) correlation in G. The results also showed non signif

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Publication Date
Fri May 01 2020
Journal Name
Plant Archives
Correlation study of retinol binding protein(-4), nesfatin and thyroid hormones in colorectal cancer Iraqi Male patients
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The third most ordinarily cancer type diagnosed in male and is Colorectal cancer (CRC) and it is widely spread in developed countries. Most of CRC arises from development of adenomatous polyps. The current study aimed to determine whether serum retinol binding protein 4 (RBP4) and Nesfatin-1 can be used as a novel biomarker for diagnosis of CRC. Nesfatin-1, RBP4 and Thyroid Hormones (T3, T4 and TSH) levels were measured in fifty sera of male patients suffering from CRC before chemotherapy initiation treatment as G1, G2 after first chemotherapy cycle dose and G3 after second chemotherapy cycle dose compared with twenty five male volunteers as a control G4. The results showed a significant increased in RBP 4 concentration in G3 and a signific

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Publication Date
Sun Jan 01 2017
Journal Name
Current Research In Microbiology And Biotechnology
Immunological and molecular detection of Helicobacter pylori in patients clinically diagnosed with chronic urticarial and atopic dermatitis
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To determine the relationship between Helicobacter pylori infection and skin disorders, sixty six patients who suffering from skin diseases include chronic urticarial (CU) and atopic dermatitis (AD) who attended at Dermatological Clinic/ Al-Numan Teaching Hospital from the beginning of October 2015 to the end of January 2016 with age (6-62) have been investigated and compared to twenty two samples of apparently healthy individuals were studied as control group. All the studied groups were subjected to measurement of antiHelicobacter pylori IgG antibodies by enzyme linked immuno sorbent assay (ELISA) and detection of 16S rRNA and CagA genes by using singleplex and multiplex PCR methods. The results of current study revealed that there was a

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Levels of Total IgE, IL-12, IL-13 and IL-18 in Children Patients with Asthma
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T-cell activation and alteration of cytokine levels are involved in the pathogenesis of asthma. However, the profile of circulating T-lymphocyte subsets and related cytokines during asthmatic attacks is still unclear. We compared the serum concentrations of proinflammatory cytokines Interleukine-18( IL-18) and Interleukine-12(IL-12), T-helper 2 (Th2) cytokine Interleukine-13(IL-13 ) and Immunoglobuline-E ( IgE) in 27 asthmatic children and 21 sex and age matched healthy control subjects. Serum cytokines and IgE concentrations were measured by enzyme-linked immunosorbent assay. Serum IL-13 , IL-18 and IgE concentrations were significantly higher in asthmatic patients than normal control subjects ( IL-13: median 9.73 versus 4.43 pg/ml, P&l

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Publication Date
Tue Jan 01 2019
Journal Name
Current Research In Microbiology And Biotechnology
Detection of Anti-rubella virus, Cytomegalovirus and Chlamydia pneumonia antibodies in patients with type I diabetes mellitus
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Type-1 diabetes is defined as destruction of pancreatic beta cell, virus and bacteria are some environmental factor for this disease. The study included 25 patients with type-1 diabetes mellitus aged between 8 – 25 years from Baghdad hospital and 20 healthy persons as control group. Anti-rubella IgG and IgM, anti-Chlamydia pneumonia IgG and IgM were measured by ELISA technique while anti-CMV antibody were measured by immunofluorescence technique. The aim of current study was to know the trigger factor for type-1 diabetes. There were significant differences (P<0.05) between studied groups according to parameters and the results lead to suggest that Chlamydia pneumonia, CMV and rubella virus may trigger type-1 diabetes mellitus in Iraqi pat

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Publication Date
Thu Oct 13 2022
Journal Name
Plant Archives
ISOLATION AND SERODIGNOSTIC OF VIBRIO CHOLERAE FROM PATIENTS SUFFERED FROM WATERY DIARRHEA IN SUWAYRAH, WASIT GOVERNORATE, IRAQ
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Background: Cholera has been recognized as a killer disease since earliest time. The disease is caused by infection of the small intestine by Vibrio cholerae O1 and O1391 which is characterized by severe dehydrating diarrheal condition and is one disease in modern times that is epidemic, endemic and pandemic in nature. Objective: This study was carried out to detect and isolate V. cholerae from patients suffered from watery diarrhea, which may cause severe complications such as dehydration, shock followed by death. Materials and methods: stool specimens were collected from 308 patients with watery diarrhea. These samples were tested with many criteria such as TCBS agar, gram stain, biochemical tests and VITEK-2 system to improve the isolati

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Publication Date
Sat Jul 08 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Estimation of Superoxide Dismutase, Matrix-metalloprotinase-9, and Interleukin -18 in Patients with Type Two Diabetes Mellitus
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Antioxidant status imbalance and inflammatory process are cooperative events involved in type 2 diabetes mellitus. This study aimed to investigate     superoxide dismutase as a potential biomarkers of antioxidant imbalance, matrix-metaloprotinase-9,   and interleukin -18  as biomarkers of inflammation in serum and to estimate  the effects of other confounding factors  gender, age and finally measuring the relation among the interested biomarkers.

This case - control study included 50 patients,   and   45 of  healthy subjects matched age –gender were also enrolled  in this study as a control group.    The   focused &nbsp

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Publication Date
Mon Feb 01 2016
Journal Name
Al-mustansiriyah Journal Of Science
A comparative Study of Adiponectin and Oxidative Stress (malondialdehyde and peroxynitrite) levels in Iraqi Patients with Acromegaly
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The aim of this study is to find a relationship between oxidative stress and adiponectin in Iraqi patients with acromegaly. The present study included 30 patients with acromegaly disease attending at Al-Yarmuk teaching hospital , and 30 healthy individuals as a control group.The two groups with ages ranging (30-55) years. The results revealed a highly significant elevation in all parameters (GH,IGF-1 , adiponectin , malondialdehyde , and peroxynitrite ) levels in sera of patients when compared with healthy control .It can be concluded that oxidative stress (malondialdehyde and peroxynitrite ) may be valuable in detecting of endocrine diseases like acromegaly .

Publication Date
Sun Jun 04 2023
Journal Name
Iraqi Journal Of Biotechnology,
Gene Expression of Adenosine Deaminase Genes 1 and 2 in Female Iraqi Patients with Autoimmune Thyroid Disease
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The current study was carried out to investigate the correlation of gene expressions of ADA1 and ADA2 genes with the development of autoimmune thyroid disease (AITD) in a sample of Iraqi females. One hundred patients with AITD and 80 controls were included. Quantitative real time polymerase chain reaction (qRT–PCR) was utilized for investigation of ADA1 and ADA2 gene expression among patients and controls. The correlation of age and body mass index (BMI) with AITD occurrence comparing with controls was studied. Based on the results of this study, there is high expression level of ADA1 and ADA2 genes in patients compared with healthy controls; also, the gene expression fold (2-ΔΔCT) of ADA1 and ADA2 among AITD patients was recorded and a

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Publication Date
Tue Jun 25 2024
Journal Name
World Academy Of Sciences Journal
Expression of programmed death ligand 1 in patients with triple‑negative breast cancer: Association with clinicopathological parameters
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The utilization of targeted therapy for programmed death ligand 1 (PD‑L1) has emerged as a prominent focus in contemporary clinical trials, particularly in the context of immune checkpoint inhibitors. The prognostic significance of the expression of PD‑L1 in invasive mammary cancer remains a subject of discussion in clinical oncology, requiring further exploration, despite its recognition as a biomarker for responsiveness to anti‑PDL1 immunotherapy. The present study was conducted to investigate the immunohistological expression of PD‑L1 in women with triple‑negative breast cancer (TNBC), with a particular focus for searching for the associated clinical and pathological characteristics. The present retrospective study examined the

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