Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 26 39 40 Toktam Faghihi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. 2019 12 07 2019 12 07 No Abstract https://jpc.tums.ac.ir/index.php/jpc/article/view/300

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 26 41 48 Sara Nafisi Pharm D, Master of clinical pharmacology, University of Glasgow School of Medicine Dentistry and Nursing, Institute of cardiovascular and medical sciences, Glascow, United Kingdom Sina Akhavan Pharm D, Vice chancellery for food and drug, Urmia University of Medical Sciences, Urmia, Iran Afshin Shiva Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran Mahroo Ghasempour Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran Parisa Dariush Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran Khadijeh Makhdoomi Division of Nephrology, Department of Internal Medicine, Urmia University of Medical Sciences, Urmia, Iran Shima Hatamkhani Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran 2019 07 26 2019 08 27  Background: Albumin is generally used in hypovolemic conditions and due to its high cost and complicated manufacturing process, its appropriate use is a vital issue to be considered. The aim of this study was to evaluate the pattern of Albumin prescription in Imam Khomeini teaching hospital in Urmia, Iran.country. Methods: This study was carried out between December 2014 to December 2015 in the Imam Khomeini hospital, affiliated to Urmia University of Medical Sciences, using pre-designed forms covering demographic data and clinical and laboratory information that was completed by the educated pharmacist on a daily observational basis. Results: A total of 202 patients were selected with the mean age of 55.9±20.5 years, including 53% male patients. The highest prescription percentages were for patients with the diagnosis of Gastrointestinal Cancers (10.9%) while most of the patients were admitted in burn ward (16.3%). Overall 2755 Albumin 20% vials equal to almost 3030 million Rials were used while only 79 (39.1%) of the prescriptions were appropriate. Hypoalbuminemia was responsible for the highest number of inappropriate indications. Conclusion: Our results showed a low percentage of acceptable prescriptions which highlights the necessity for reviewing and supervising the utilization of Albumin in this hospital. https://jpc.tums.ac.ir/index.php/jpc/article/view/279

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 28 49 53 Mandana Izadpanah Assistant Professor of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Negin Amraie Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Farhad Soltani Department of anesthesiology and critical care medicine faculty of medicine, ahvaz jundishapur university of medical sciences, Ahvaz, Iran Leila Kouti Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran university of medical sciences, Tehran, Iran Sepideh Sayyadi Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Maryam Aghakouchakzadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran university of medical sciences, Tehran, Iran Maryam Hariri Pharm.D, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran 2019 05 18 2019 11 10 Background: Oral medication administration through enteral feeding tubes is a challenging issue in critically ill patients, which can lead to medication error. Patients admitted to the intensive care unit may not have the ability to swallow oral medications for various reasons such as lack of consciousness, or the need for mechanical ventilation. Improving the quality of drug administration through enteral feeding tubes is essential. Objectives: The present study aimed at evaluation of the prevalence of medication errors that occur during the administration of oral medications through enteral feeding tubes in mechanically ventilated critically ill patients. Methods: This study was a cross-sectional observational study conducted in Golestan Educational Hospital, Ahvaz, Iran. Oral medication administration was evaluated in 50 patients within three months; information about each patient was examined. The errors were measured according to the Handbook of Drugs Administration via enteral feeding tubes. Results: Errors occurred in percentage of total prescriptions as follows: Drug-drug interaction 26%, wrong preparation 22.28%, wrong form 12.09%, wrong time 11.57%, drug-food interaction 6.73%, wrong dose 5.53%, wrong route 3.8%, extra dose 0.86%, omission 0.18%, deteriorated drug 0.18%, and unordered drug 0.0%. In our study, it was found that most of the drugs were administered in solid dosage forms, and almost 33% of them could be substituted for injection or oral liquid formulations. Conclusion: Our study indicated the high frequency of drug administration and preparation errors in mechanically ventilated critically ill patients. Close teamwork between pharmacists or pharmacotherapists, physicians, and nurses can result in the appropriate administration of medications by an enteral feeding tube.  https://jpc.tums.ac.ir/index.php/jpc/article/view/263

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 28 54 58 EN Soodeh Ramezaninejad Department of Internal Medicine, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran Atefeh Amouzegar Department of Nephrology, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran Sohrab Aghabeigi Department of Internal Medicine, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran Maryam Farasati Nasab Department of Clinical Pharmacy, Firoozgar Clinical Research Development Center (FCRDC), School of Pharmacy International Campus. Iran University of Medical Sciences, Tehran, Iran Mitra Ranjbar Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Disease, Iran University of Medical Sciences, Tehran, Iran Mahin Jamshidi Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Disease, Iran University of Medical Sciences, Tehran, Iran Behrooz Ghanbari Department of Internal Medicine, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran Nashmin Pakdaman Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran Maryam Khorsani MA Student. English Language and Literature Department, Faculty of Foreign Languages and Literature, University of Tehran, Tehran, Iran 2019 06 17 2019 07 27 Purpose: Caspofungin is prescribed for systemic treatment of fungal infections and correct prescription pattern is an issue of importance. Hence in this study the Caspofungin utilization and the frequency rate of medication errors were investigated at a training hospital in a developing country. Methods: In this cross-sectional descriptive comparative study 43 consecutive patients receiving Caspofungin in Firoozgar Hospital, Tehran, Iran from March to September 2017 were enrolled. The prescription frequency of the drug was compared with the national data and the suggested rates by World Health Organization. Results: The prescription rate was higher in Intensive Care Unit with 72.1% rate. Infectious disease specialists were responsible for Caspofungin prescription only in 11 cases (25.5%). The cause of Caspofungin prescription was unknown in 18.6% of cases; but experimental treatment for febrile neutropenia and ICU patients with Candida Score > 2.5 were the most known causes. The drug administration in 11 cases (25.6%) occurred in less than one hour. The indication of treatment was incorrect in 12 out of 43 cases (28%). On the first day of the treatment a dose of both 70 mg and 50 mg was prescribed, which was higher than the appropriate dose and also it was lower than the optimal dose in five cases (83.7%). The mean treatment duration was 10.88 ± 5.35 days ranging from 2 to 24 days. The duration of treatment was correct in 20 cases (46.5%) and incorrect in 23 patients (53.5%). Conclusion:  According to the obtained results, it may be concluded that in comparison with the international guidelines there are multiple discordance in our setting including inappropriate duration, continuation, and indications. Hence these should be announced to the physicians for further cautions in this area, and it is better to consult with infectious diseases specialists for the administration of anti-fungal drugs. https://jpc.tums.ac.ir/index.php/jpc/article/view/266

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 28 59 66 Sepideh Elyasi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Hossein Khalili Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Alireza Abdollahi Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2019 10 23 2019 12 15 Background: Effects of different doses of vancomycin on the renal biomarkers (Cys-C and KIM-1) of acute kidney injury were compared in patients with severe bacterial infections.| Methods: Serum levels of Cys-C, KIM-1 and creatinine and urine level of Cys-C were measured at baseline and every other day in patients receiving different doses (15 mg/kg every 8 or 12h) of vancomycin. Results:  Level of serum Cys-C demonstrated significant increased during vancomycin treatment in both groups. However, there was no significant difference between the groups regarding serum Cys-C level. Urine Cys-C level neither changed significantly within nor between groups during vancomycin treatment. The same results were detected for serum KIM-concentrations. Conclusion: Different doses of vancomycin showed comparable effects on the serum and urine biomarkers of acute kidney injury. https://jpc.tums.ac.ir/index.php/jpc/article/view/292

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 28 67 71 Mehrdad Haghighi Infectious Diseases and Tropical Medicine Research Center, Imam Hossein Teaching and Medical Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, Imam Hossein Teaching and Medical Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamid Kariman Department of Emergency Medicine, Imam Hossein Teaching and Medical Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Sistanizad Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Department of Pharmaceutical Care Unit, Imam Hossein Teaching and Medical Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2019 10 10 2019 12 01 Background: Antimicrobial resistance among uropathogens causing community-acquired urinary tract infections (UTIs) is a worldwide concern. It has been suggested that diabetes could be a possible cause of antibiotic resistance. This study was undertaken to identify the responsible microbial culprits for UTI in patients with different range of glycosylated hemoglobin (HbA1C) and evaluate their corresponding resistance pattern. Methods: TIn a cross-sectional study between 2013 to 2018, data related to the urine culture and sensitivity of patients who had bacteriuria were gathered. For patients with positive urine culture, HbA1C was requested and correlations between HbA1C level with microorganism and its susceptibility were evaluated. Results: In total, 121 patients were recruited. All study participants were female. The mean age of the patients was 50.2 ± 22.5 (range 19-96). All study participants were of the same race. Fifteen (12.4%) out of 121 patients were diabetics. There were no difference between bacteriology of UTIs in diabetic and nondiabetic patients with the preponderance being caused by E. coli and other gramnegative organisms but, there were positive association between HbA1C and resistance to Nalidixic acid and Gentamicin. Conclusion: Our study supports the findings that diabetes in itself could be a possible cause of antibiotic resistance to some antimicrobial agents. https://jpc.tums.ac.ir/index.php/jpc/article/view/289

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 3 2019 12 28 72 79 Ștefana Stăcescu University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Faculty of Pharmacy, Department of Pharmaceutical Chemistry Gabriel Hancu University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Faculty of Pharmacy, Department of Pharmaceutical Chemistry Denisa Podar University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Faculty of Pharmacy, Department of Pharmaceutical Chemistry Ștefania Todea Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy from Tîrgu Mureș, Tîrgu Mureș, Romania Amelia Tero-Vescan University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, Faculty of Pharmacy, Department of Biochemistry 2019 06 28 2019 08 11 Relatively few medications are available for the management of obesity and all are indicated as adjuncts to increased physical activity, caloric restriction and lifestyle modification. Among different weight-loss drugs, the most intriguing and controversial class is the one of anorexic amphetamines, due to their high efficiency but also relevant side-effects. Several previously approved anorexic amphetamines like fenfluramine, phenylpropanolamine, phenmetrazine and sibutramine have been withdrawn from the market due to unanticipated adverse effects. Nowadays only four amphetamine derivatives are approved for short-term treatment of obesity: amfepramone, benzphetamine, phendimetrazine and phentermine. The article provides an overview of both the history, and the current status, of the use of amphetamine derivatives in the obesity pharmacotherapy. https://jpc.tums.ac.ir/index.php/jpc/article/view/274