http://blogs.najah.edu/author/rowa-alramahi An-Najah Blogs :: Rowa Jamal Al-Ramahi en-us Wed, 24 Apr 2024 05:46:41 IDT Wed, 24 Apr 2024 05:46:41 IDT [email protected] [email protected] http://blogs.najah.edu/staff/rowa-alramahi/article/Appropriate-use-of-oral-drops-perception-of-health-professionals-and-assessment-of-package-insert-informationPublished Articles Appropriate use of oral drops: perception of health professionals and assessment of package insert information Zaid AN Al-Ramahi R Abu Ghoush A 1Department of Pharmaceutics and Pharmacokinetics and 2Department of Pharmacology and Toxicology School of Pharmacy An-Najah National University Nablus Palestine Abstract Objectives: To evaluate the perception of health professionals and industry personnel towards the appropriate use of oral drops and to assess their package inserts with regard to presence of proper instructions for use and storage Methods: The first part was a cross-sectional self-administered questionnaire The questionnaires were distributed randomly to physicians pharmacists and decision makers in local pharmaceutical companies In the second part the package inserts of medications with oral drops were reviewed to check for presence of proper instructions for storage and proper use Results: The majority of physicians and pharmacists 733 and 712 thought that oral drops can be delivered from the dropper directly into the patient\s mouth 608 of physicians and 543 of pharmacists thought that the dropper should be clamped vertically when oral drop are dispensed 727 of industry personnel agreed that the angle of inclination affects the drop size Many of these personnel said their companies did not perform the recommended tests for dose uniformity and calibration Instructions for storage and proper use were not available in package inserts of many oral drop products in Palestine Conclusions: Health professionals should have complete and correct information regarding all factors that affect the proper delivery of oral drops and should counsel patients on the proper method of delivery Pharmaceutical companies should take into consideration the formulation issues that may affect drop size and provide leaflets and labels with complete and correct instructions on the proper use and storage of oral drops Package insert information in oral drops needs to be more comprehensive with regard to instructions for use and storage http://blogs.najah.edu/staff/rowa-alramahi/article/Adverse-drug-events-in-hospitalized-patients-with-chronic-kidney-diseasePublished ArticlesY Hassan1 RJ Al-Ramahi2 NA Aziz1 and R Ghazali3 1School of Pharmaceutical Sciences Universiti Sains Malaysia Penang Malaysia 2School of Pharmacy An-Najah National University Nablus Palestine and 3Department of Medicine Penang Hospital Penang Malaysia Background and objective: Adverse drug events ADEs are a common cause of hospitalization and in-hospital complications The aim of this study was to determine the rates types severity and preventability of pre-admission and in-hospital ADEs in patients with chronic kidney disease CKD Methods: This study was conducted at the nephrology unit at Penang General Hospital A random sample of 300 adult patients with CKD was included Medical records and charts were reviewed by a clinical pharmacist every work day to find any evidence of errors or complications related to drug use If a suspected ADE was found further investigations were carried out to assess the causality severity and preventability of the event Results: A total of 159 ADEs were reported in 122 407 of the patients We found 86 suspected pre-admission ADEs in 68 227 of the patients These were either the cause of admission for some patients or discovered by the initial physical examination and laboratory investigations During hospitalization 64 213 patients had 73 suspected ADEs Out of the total 159 suspected ADEs it was highly probable that 31 events were due to medication while 61 were of lower probability and 67 were merely possible A total of 48 302 events was considered preventable 46 events 289 were serious 93 585 were less serious and 20 126 were insignificant The medication classes most frequently involved in ADEs were diuretics antibacterials drugs used for diabetes mellitus antithrombotic agents mineral supplements and antihypertensive drugs Conclusion: ADEs are very common in hospitalized CKD patients and some of these events are preventable The service of a clinical pharmacist may help to reduce ADEshttp://blogs.najah.edu/staff/rowa-alramahi/article/Drug-Use-and-Dosing-in-Chronic-Kidney-DiseasePublished Articles Yahaya Hassan RowaJ Al-Ramahi Noorizan Abd Aziz Rozina Ghazali One of the most important drug-related problems in patients with chronic kidney disease CKD is medication dosing errors Many medications and their metabolites are eliminated through the kidney Thus adequate renal function is important to avoid toxicity Patients with renal impairment often have alterations in their pharmacokinetic and pharmacodynamic parameters The clearance of drugs eliminated primarily by renal fi ltration is decreased by renal disease Therefore special consideration should be taken when these drugs are prescribed to patients with impaired renal function Despite the importance of dosage adjustment in patients with CKD such adjustments are sometimes ignored Physicians and pharmacists can work together to accomplish safe drug prescribing This task can be complex and require a stepwise approach to ensure effectiveness minimise further damage and prevent drug nephrotoxicity http:wwwannalsedusgpdf38VolNo12Dec2009V38N12p1095pdfhttp://blogs.najah.edu/staff/rowa-alramahi/article/Impact-of-a-Renal-Drug-Dosing-Service-on-Dose-Adjustment-in-Hospitalized-Patients-with-Chronic-Kidney-DiseasePublished ArticlesYahaya Hassan Rowa J Al-Ramahi Noorizan Abd Aziz and Rozina Ghazali BACKGROUND: Appropriate drug selection and dosing for patients with chronic kidney disease CKD is important to avoid unwanted drug effects and ensure optimal patient outcomes OBJECTIVE: To assess the rate of inappropriate dosing in patients with CKD in a nephrology unit and to evaluate the impact on dose adjustment adverse drug events ADEs and drug cost of having a pharmacist accompany a team of physicians on their rounds METHODS: This was a comparative study with a preintervention and post-intervention design The preintervention phase served as the control; it was prospective and observational only and was conducted from the beginning of February to the end of May 2007 The second phase intervention phase was conducted from the beginning of March to the end of June 2008 Two random samples of 300 patients with an estimated creatinine clearance less than or equal to 50 mLmin were included During the intervention phase a clinical pharmacist made rounds with the nephrology unit team and gave dosing adjustment recommendations when needed A collection of reliable and up-to-date drug information references that are commonly used globally were used during the intervention RESULTS: In the preintervention group drug dosage adjustment or avoidance based on renal function was necessary in 607 of 2814 216 prescriptions Of these 322 530 did not comply with guidelines In the intervention group adjustment was necessary for 640 of 2981 215 prescriptions The pharmacist made 388 recommendations related to dosing adjustment 212 546 of which were accepted by physicians Clinicians noncompliance with dosing guidelines decreased to 176 275 p 0001 In the preintervention group 64 213 patients had a suspected ADE with a total of 73 events In the intervention group this number was significantly lower with 49 events in 48 160 patients p 005 The intervention resulted in drug cost savings of 2250 US CONCLUSIONS: A renal drug dosing service for patients hospitalized with CKD can increase the proportion of drug dosing that is adjusted to take into account renal function This can save drug costs and may prevent ADEs http:wwwtheannalscomcgicontentabstract43101598