Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 125 126 EN Amir H-Zargarzadeh Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran 2015 10 10 2015 10 10 #No Abstract # https://jpc.tums.ac.ir/index.php/jpc/article/view/28 https://jpc.tums.ac.ir/index.php/jpc/article/download/28/28

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 127 132 EN Yokabed Kazemi School of Pharmacy, International Campus, Tehran University of Medical Sciences, Tehran, Iran Naser Hadavand Shaheed Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran Alireza Hayatshahi Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Hassan Torkamandi Pharmaceutical Care Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Kheirollah Gholami Clinical Pharmacy Department, Faculty of Pharmacy and Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran Molouk Hadjibabaie Clinical Pharmacy Department, Faculty of Pharmacy and Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran Zahra Jahangard-Rafsanjani Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Javadi Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 10 2015 10 10 Background: Since albumin imposes a relatively high cost to a healthcare system, drug use evaluation for this drug is much more important. This study wants to evaluate pattern of albumin use in a large university affiliated hospital in Tehran, Iran. Methods: A concurrent, cross-sectional study was performed in “Shaheed Rajaei” Cardiovascular, Medical and Research Center. All inpatient adults that were prescribed albumin during the study period were evaluated to register the indications for albumin usage according to the evidence-based guidelines. Results: Only for five patients (4%) the albumin prescriptions were justifiable. Of these cases, intractable edema was the leading cause of albumin misuse (73 patients; 60.8%). The total 1468 vials of Albumin were prescribed for 120 patients during the study period. The most common reasons to prescribe albumin were acute normovolemic (34%), cardiac failure (0.83%), resistance edema with Albumin>2g/dL (61%), nephrotic syndrome (0.83%), plasmapheresis (1.67%), ascetic (1.67%). Conclusion: These data, together with previous national studies highly suggest a mandatory need for educational measures for practicing physicians along with strict regulations for prescription strategies regarding expensive drugs such as albumin. https://jpc.tums.ac.ir/index.php/jpc/article/view/29 https://jpc.tums.ac.ir/index.php/jpc/article/download/29/29

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 133 140 EN Matthias Adorka School of Pharmacy, University of Namibia, Windhoek, Namibia Kirk Allen Faculty of Health & Medicine, Lancaster University, Lancaster, England Martie Lubbe Medicine Usage in South Africa, School of Pharmacy, North-West University, Potchefstroom, South Africa Jan Serfontein Medicine Usage in South Africa, School of Pharmacy, North-West University, Potchefstroom, South Africa 2015 10 10 2015 10 10 Background: In-depth knowledge of antibiotic principles is widely considered a necessary condition for appropriate prescribing of antibiotics. The study aimed at determining the impact of healthcare providers’ level of knowledge in bacteriology and principles of antibiotic prescribing on their abilities to prescribe antibiotics appropriately. Methods: A structured questionnaire survey targeting all doctors, nurses and healthcare providers within Health Service Areas abounding and including five selected public hospitals in Lesotho was carried out. The questionnaire tested respondents’ knowledge in bacteriology of infections and principles of antibiotic prescribing. Relevant data on antibiotic prescriptions were also collected concurrently with the survey. Data were analysed to establish respondents’ level of knowledge and the influence of same on their abilities to prescribe antibiotics appropriately. Results: In inpatient and outpatient departments, 53.3% and 62.5% of respondents demonstrated inadequate levels of knowledge in the bacteriology and treatment of infections, respectively. Of the prescriptions analysed, 57.0% in the inpatient department and 19.1% in the outpatient department were  classified  as  inappropriate.  Appropriateness  of  antibiotic  prescriptions  was  positively associated with healthcare providers’ level of knowledge in inpatient but not outpatient settings. Conclusion: A majority of healthcare providers appear to lack sufficient knowledge in bacteriology of infections and principles of antibiotic prescribing. In respect to antibiotic prescribing among inpatients but not outpatients the study demonstrated a positive correlation between healthcare providers’ knowledge and their abilities to prescribe antibiotics appropriately. https://jpc.tums.ac.ir/index.php/jpc/article/view/30 https://jpc.tums.ac.ir/index.php/jpc/article/download/30/30

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 141 144 EN Shahrzad Mahini Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Alireza Hayatshahi1 Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Hassan Torkamandi Pharmaceutical Care Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Kheirollah Gholami Clinical Pharmacy Department, Faculty of Pharmacy and Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Javadi Clinical Pharmacy Department, College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 10 2015 10 10 Background: Drug Utilization Evaluation (DUE) studies are designed to evaluate and improve the rational use of medications. DUEs have focused on drugs used in high risk patients such as critically ill cases in this study. Carbapenems are beta-lactam type antibiotics with broad-spectrum of activity which cover Gram-positive, Gram-negative and anaerobic bacteria. The heavy use of carbapenems (imipenem or meropenm) could increase the risk of multi-drug resistant (MDR) pathogens. Methods: This study was a prospective and cross sectional study performed at three intensive care units (ICUs) of Shariati hospital, affiliated with Tehran University of Medical Sciences. The study was conducted from April 2012 to May 2013. All of the patients were on imipenem or meropenem as an empiric treatment or based upon microbiology culture results included in the study. Results: Total of 68 patients in three ICU wards evaluated. The most common diagnosis was Central Nervous System (CNS) infections and meningitis (36.8%). The most common microorganism derived from the patient’s specimen was Acinetobacter spp. (28%). Overall initial treatment for thirty five patients (51.4%) was justified versus nineteen cases (27.9%) of unjustified. For 14 patients (20.5%) empiric treatment was justified, but continuation of treatment was unjustified. Conclusion: The result of the study showed that empiric therapy was justified in most cases (72%), but according to the culture results, continuation of treatment in several cases was unjustified (47%). https://jpc.tums.ac.ir/index.php/jpc/article/view/31 https://jpc.tums.ac.ir/index.php/jpc/article/download/31/31

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 145 148 EN Maryam Etminani-Isfahani Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Sarah Mousavi Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Amin Rakhshan School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mehrdad Assarian School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Leila Kuti Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Kaveh Eslami Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2015 10 10 2015 10 10 Background: Adverse Drug Reactions (ADRs) are one of the leading causes of morbidity and mortality and contribute to excessive health care costs. Detection and reporting of ADRs could decrease these consequences. The present study was designed to assess the Knowledge, Attitude and Practice (KAP) of pharmacy students towards ADRs monitoring and reporting. Methods: A questionnaire was prepared to investigate the Knowledge, Attitude and Practice (KAP) of pharmacy students regarding ADR reporting. The questionnaire consisting of 17 questions (7 questions on knowledge, 5 on attitudes and 5 on practice) were given to pharmacy students randomly. Results: A total of 71 respondents participated in the study. 70% of participants had favorable general knowledge about ADRs but more than 60% of their professional knowledge was not satisfying. 60% of respondent believed that educational intervention will improve participating of health care professional in ADRs reporting. 63% of respondent observed ADRs cases but about 95% of them had never reported an ADR. Conclusion: In overall, pharmacy students have poor knowledge, attitude and practice towards ADRs reporting and pharmacovigilance. This suggests the need of suitable changes in the undergraduate teaching curriculum and additional training among the students regarding ADRs. https://jpc.tums.ac.ir/index.php/jpc/article/view/32 https://jpc.tums.ac.ir/index.php/jpc/article/download/32/32

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 149 152 EN Ladan Ayazkhoo Department of Clinical Pharmacy, Faculty of Pharmacy,Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Unit, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sarah Mousavi Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Farnaz Ramazani Department of Clinical Pharmacy, Faculty of Pharmacy,Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Unit, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Ayatollahi-Tafti Department of Clinical Pharmacy, Faculty of Pharmacy,Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Unit, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zeinab Sa’dabadi Department of Clinical Pharmacy, Faculty of Pharmacy,Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Unit, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Sistanizad Department of Clinical Pharmacy, Faculty of Pharmacy,Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmaceutical Care Unit, Emam Hossein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2015 10 10 2015 10 10 Background: Inappropriate use of vancomycin not only increase health care costs but also contribute to the emergence of resistant organisms. Higher trough serum vancomycin concentrations (>10mg/L) has been recommended for avoidance of development of resistance. We aim to compare the administered dose with recommended doses based on guideline-recommended weight-based dosing. Methods: In a cross sectional study, all patients who received vancomycin between July and October 2013, in infectious disease, internal medicine wards and emergency department of a teaching hospital in Tehran, Iran were entered to the study. Indication of vancomycin and necessary data for dose calculation including height and serum creatinine were recorded. Prescribed doses were compared with recommended doses in guidelines and calculated Glomerular filtration rate (GFR) for each patient. Results: One hundred and four patients (45 females and 59 males) recruited in the study. Our results indicated that, from all administered doses of vancomycin, 64.4% and 88.8% differs significantly (more than 20%) based on American Pharmacist Association (AphA) vancomycin monograph and guideline-recommended, weight-based vancomycin dosing (for adults), respectively. Conclusion: Underdosing of vancomycin is a major risk factor for developing resistance of gram positive organisms to this glycopeptide. Our results showed that more than half of patients receiving vancomycin are in the risk of low drug levels based on guidelines. So, having a comprehensive plan for the proper use of this drug especially designing effective internal guidelines can prevent emergence of resistance to vancomycin in future. https://jpc.tums.ac.ir/index.php/jpc/article/view/33 https://jpc.tums.ac.ir/index.php/jpc/article/download/33/33

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 1 4 2015 10 11 153 160 EN Kourosh Sadeghi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mehdi Mohammadi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Farhad Najmeddin Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mojgan Mashayekhi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Javadi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Kheirollah Gholami Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran 2015 10 10 2015 10 10 In recent decades, by increasing complexity of drug therapy, pharmacists considered as health- care members who can help optimizing drug therapy. We know that medicines do not have the anticipated effects all the times and a vast variability may exist in their behaviors in the body. So, it is very crucial to individualize treatment for every single patient. Nowadays, optimizing drug therapy in patients needs a collaborative interdisciplinary approach to patients care and treatment. Specifically when drug therapy is considered for a condition, pharmacists can enroll as a valuable professional to help for modification of therapy along with other clinicians. Abundant number of studies and reports exist in the literatures which address usefulness of pharmacist engagement in patient care. In this review we have presented some valuable evidences supporting pharmacist role in different clinical settings. https://jpc.tums.ac.ir/index.php/jpc/article/view/34 https://jpc.tums.ac.ir/index.php/jpc/article/download/34/34