Day 2 :
Keynote Forum
Roseane M Santos
South University School of Pharmacy, USA
Keynote: Coffee consumption: A genetic approach
Time : 09:00-09:25
Biography:
Roseane Maria Maia Santos is BS in Pharmacy and Biochemistry, MS in Hospital Pharmacy, both from Federal University of Rio de Janeiro, Brazil. She completed her PhD in Pharmaceutical Sciences at SUNY at Buffalo, New York. Later, she was appointed as Assistant Professor at Nova Southeastern University College of Pharmacy, Fort Lauderdale, FL. At present, she is an Associate Professor at South University School of Pharmacy, Savannah, GA, lecturing on various topics in pharmacology, biochemistry and molecular biology. Her research laboratory is focused on bioactive compounds present in coffee and coffee and health effects.
Abstract:
Coffee is among the most widely consumed beverages in the World. Coffee consumption has been receiving a lot of attentionrnin regards to its potential health benefits and risks as well. Caffeine, polycyclic phenols such as chlorogenic acids are somernof the most studied constituents from coffee. It has been attributed to various properties to those compounds such as central nervous system stimulant and antioxidants respectively. Coffee is in fact a very complex mixture that varies according withrnthe origin of the beans and roasting process. A new approach to look into possible effects of drugs is through genetic andrngenomic studies. Actually, it was recently created The Coffee and Caffeine Genetics Consortium with the purpose to identify DNA loci associated with habitual coffee consumption. The technique utilized is called genome-wide meta-analysis (GWMA). This seminar intends to briefly review the results obtained so far. Following the presentation of this seminar, we will open arnworkshop that will focus in 3 main areas of interest:rn• Pharmacogenomics of coffee consumptionrn• What’s inside a cup of coffee • Epidemiology of coffee consumption
Keynote Forum
Roger W Jelliffe
University of Southern California, USA
Keynote: Managing Drug Dosage in the ICU – is Augmented Renal Clearance what we really want to Know?
Time : 09:25-09:50
Biography:
Roger Jelliffe MD, FCP, FAAPS, developed the first computer software for individualizing drug dosage regimens in 1967. He was the first to relate renal drug elimination to creatinine clearance. He developed the first method for estimating creatinine clearance when serum creatinine is changing. He founded the USC Laboratory of Applied Pharmacokinetics in 1973, and the USC*PACK and more recent MM-USCPACK clinical software for individualizing drug dosage regimens most precisely. His laboratory developed the Resource for Population Modeling at the San Diego Supercomputer Center, the nonparametric adaptive grid (NPAG) population modeling approach, and Multiple Model (MM) design of maximally precise dosage regimens. This is now the Bestdose clinical and Pmetrics research software. We have developed three new methods of Bayesian analysis for individual patients. This adds great capability and safety in managing unusual patients.He is author or co-author of 132 peer reviewed publications, has mentored over 100 visiting scientific scholars, 1 sabbatical scholar, 2 Master’s Students, 3 Ph.D candidates, and 3 mini-sabbaticals.
Abstract:
Clearance (CL) is often felt to be the most physiologic parameter to describe elimination of substances from the body, and to be an independent parameter. However, there is an intimate relationship between CL, apparent volume of distribution (V) and the rate constant for elimination (K), in which CL = V times K, K = CL/V, and V = CL/K. Clearly none is independent. If one looks at general ways of describing similar systems, radioactive decay for example, there is no V, and K is the parameter giving accurate information about disappearance. In general, one can describe the behavior of a system as amount in a compartment, and the rate of movement from one compartment to another in terms of rate constants K. Observations of concentrations can be made as amount/V. CL is never needed. Further, since CL = KV, and since K has units of 1/time and V has units of volume, the units of CL are volume/time, and the actual information of rate of movement of drug becomes obscured when CL is used. However, V and K each give direct information about drug behavior. CL is not needed at all. CL is an unnecessary parameter. Further, since unstable ICU patients often have both rapidly changing renal function and unstable fluid balance at the same time, CL comingles and obscures the information of V and K, while V and K carry the needed information directly. This also facilitates separation of the two clinical issues of fluid balance and drug dosage for optimal management of these separate problems. Further, since ICU patients are so often unstable, conventional software for analyzing data of therapeutic drug monitoring (TDM) is no longer very useful, as it assumes that all the patent’s pharmacokinetic (PK) parameters are fixed and unchanging over the period of the data analysis. However, the interacting multiple model (IMM) algorithm developed in the aerospace community for tracking hostile targets most precisely has been developed [1] and implemented in the Bestdose clinical software [2] specifically to deal with this clinical situation. It tracks gentamicin and vancomycin in post-cardiac surgical ICU patients better than other methods [3]. It tracks changes in V and K as each new data point becomes available, resulting in the most recent Bayesian posterior parameter distributions. These then provide the foundation for dosage regimens to achieve desired target drug concentrations in the near future with maximum precision, using multiple model (MM) dosage design [4]. Illustrative clinical cases will be presented and discussed.
Keynote Forum
Yousef A Alomi
Ministry of Health, Saudi Arabia
Keynote: Hotline calling services of national drug information center in Saudi Arabia
Time : 09:50-10:15
Biography:
Dr. Yousef Alomi, Head of General Administration of Pharmaceutical Care Administration, and Head of National Drug Information Center, MOH Saudi Arabia Dr. Alomi is a product of King Saud University confirmed with the degree of Bachelor of Pharmaceutical Sciences in the year 1992. After six-years of higher study, he earned his Master of Clinical Pharmacy from the same university in the 1998. He is an affiliated clinical instructor of Purdue University in the USA. He is adjunct assistant professor of King Saud University college of Pharmacy. Dr. Alomi was a member of Pharmacy Board at Saudi commission for health Specialties for 1998-2002 and 2008-2012 and Head of Pharmacy Accreditation committee in 2010-2012. He was team member of establishing 1st Pharmacy Residency Program in Saudi Arabia . In the year 2005 he obtained Board Certification of Pharmacotherapy Specialist (BCPS). In the year 2008, he obtained his diploma in business administration from American University in Egypt in 2007, and he obtained a Board Certification of Nutrition Support Pharmacy (BCNSP) in 2009. Dr. Alomi worked as clinical pharmacist in critical care area and nutrition support. He is He is establish and implement several programs at MOH Hospitals at first time; Clinical Pharmacy Program, Medication Safety Program, Pain Management Program, Anticoagulation Program and Pharmacy Infection Control, including 30 Adult and 20 Pediatrics Clinical Pharmacy Program; he is the founder of Mass Gathering Pharmaceutical Care in Saudi Arabia He became a member of advisory board of the Arab Pharmaceutical Journal in 2010. He became as Pharmacy Board Member of Saudi Commission of Health Care Specialities 2010-2013. He had several research in clinical Pharmacy and Pharmacy practice published in ACCP and ISPOR conferences, He had several presentations in the clinical pharmacy and pharmacy practice at several conference in and outside Saudi Arabia.
Abstract:
National Drug Information Center has started providing services since January 2013; and started answering public andrnprofessional inquires through Ministry of Health Hotline Calling Services (937) since December 2013. Ten on call clinical pharmacist and expert trained pharmacist over 24/7 received calls asking about drug information, through manual documentation system of drug information inquiries. It consisted of type and qualification of caller, type of inquiries, and medications and cost avoidance of expected results of drug related problems sequel of drug information inquires if drugrninformation services did not exist and were not answered using USA model. After 12-months of providing services, therntotal number of answered calls were 976 calls with 264 (27%) answered calls documented; with 300 answered drug inquires.rn60% of inquiries were from the public and 40% were from professionals. The most type of inquiries were about medication identification and dose standardization, followed by drugs in pregnancy, the most medications were asked in both public and professional were antimicrobial. The average costs avoidance per each answered call received was (415.78 USD), and totalrnestimated cost avoidance was (405.801 USD) per year. Hotline calling services of National Drug Information Center is costefficient in Saudi Arabia, it was associated with preventing drug related problems and cost savings per each receiving call. Expanding drug information services with electronic documentation excepted healthcare improvement and better care, better patient outcomes, and reduced costs.
- Track 3: Clinical Pharmacy and Its Key Role in Treatment
Location: Grand Ball Room-A
Chair
Yousef Alomi
Ministry of Health, KSA
Co-Chair
Sathish Amirthalingam
International Medical University, Malaysia
Session Introduction
Yousef A Alomi
Ministry of Health, Saudi Arabia
Title: National antimicrobial stewardship program in Saudi Arabia: Experiences and future vision
Time : 11:30-11:50
Biography:
Dr. Yousef Alomi, Head of General Administration of Pharmaceutical Care Administration, and Head of National Drug Information Center, MOH Saudi Arabia Dr. Alomi is a product of King Saud University confirmed with the degree of Bachelor of Pharmaceutical Sciences in the year 1992. After six-years of higher study, he earned his Master of Clinical Pharmacy from the same university in the 1998. He is an affiliated clinical instructor of Purdue University in the USA. He is adjunct assistant professor of King Saud University college of Pharmacy. Dr. Alomi worked as clinical pharmacist in critical care area and nutrition support. He is He is establish and implement several programs at MOH Hospitals at first time; Clinical Pharmacy Program, Medication Safety Program, Pain Management Program, Anticoagulation Program and Pharmacy Infection Control, including 30 Adult and 20 Pediatrics Clinical Pharmacy Program; he founder of Mass Gathering Pharmaceutical Care in Saudi Arabia. He became a member of advisory board of the Arab Pharmaceutical Journal in 2010. He became as Pharmacy Board Member of Saudi Commission of Health Care Specialities2010-2013. He had several research papers in clinical Pharmacy and Pharmacy practice published in ACCP and ISPOR conferences; He had several presentations in the clinical pharmacy and pharmacy practice at several conferences in and outside Saudi Arabia.
Abstract:
National antimicrobial stewardship is continuous work to optimize Antimicrobial usage to improve patient outcomes and prevent antimicrobial related Problems. General Administration of Pharmaceutical care established the program in 2013 by formulate Central Antibiotic Committees, this committee established National Antimicrobial Stewardship program consisting of formulating peripheral antibiotics, infectious diseases team, antibiotics physician order form, antibiotics consumption and usages, antibiogram regulations, and USA General of disease control antimicrobial stewardship monitoring outcome indicators. In 2014, Peripheral Antibiotics Committees were established at twenty regions to follow up the implementation of the program national wide, and started with antimicrobial stewardship education and orientation. In 2015, the real applications of the program was started in more than ten region and more than forty hospitals. Antimicrobial stewardship will be expanded to cover 20 regions and more ninety biggest hospitals, medical cities and privates hospital and primary care centers in Saudi Arabia. The program is excepting to reduce antimicrobial consumption more than 50% with reduction of bugs resistance to medication, reduction of antimicrobial related problems, better patients care with tremendous reduction of unnecessary cost.
Fahad I. Al-Saikhan
Prince Sattam Bin Abdulaziz University (PSAU), Saudi Arabia
Title: Clinical Pharmacy Experience in Ophthalmology setting by Utilizing Collaborative Drug Therapy Management (CDTM)
Time : 11:50-12:10
Biography:
Dr. F. I. Al-Saikhan has completed his bachelor in pharmaceutical sciences at age of 23 from King Saud University in Riyadh, K.S.A., PharmD from St. Louis College of Pharmacy at age of 27 from St. Louis College of Pharmacy in St. Louis, MO. He has completed ambulatory care residency at Oklahoma Uni. He worked as a hospital pharmacist, then consultant clinical pharmacist and director of pharmacy services at KKESH-Wilmer Eye Institute (John Hopkins hospital-Baltimore) then assistant professor at PSAU. He has published several research papers in reputed journals and was invited to speak at several professional meetings. He serves as a consultant at different organization
Abstract:
Background: The increased influx of patients and limited access to specialized healthcare due to insufficient number of medical staff in ophthalmology setting has been reported for more than a decade. For same reason, our pharmacy services introduced clinical pharmacists as an alternative healthcare provider for routine patient’s visits in such setting. Aim: The aim of this study was, to allow ophthalmology medical staff to focus on more important patients’ needs and also to explore the potentials of clinical pharmacist engaged in the ophthalmology clinic. Method: This study assessing the potential impact of several problems for patients suffering from eye disorders that usually encounter and must visit the ophthalmologists for help. Among which is chronic medications’ supply. Step-by-step protocols for 65 of the most frequently prescribed ophthalmic drugs were developed to guide the clinical pharmacist in decision-making. Results: Over a period of 15 months, the refill clinic was responsible for reviewing 8,572 medical records with an average review time of 5.5 minutes per chart. Based on an average 8-hour workday, this study saved and equates approximately 98 days per 15 month about (23%) that returned to clinicians for patients in greater need of their immediate expertise. The rate of pharmacist chart intervention was 16.3%. Conclusion: This experience was very successful for dispensing ophthalmic drugs safely, and saving patient and clinician time. I recommend this to be expanded to include additional and advanced clinical specialty.
Marie Smith
University of Connecticut, School of Pharmacy, USA
Title: Primary Care Medication Management Services with a Shared Resource Pharmacists Network: Multistakeholer Prespectives
Time : 10:00-10:20
Biography:
Marie Smith, Palmer Professor and Asst. Dean, Univeristy of Connrecticut School of Pharmacy, is a nationally-recognized scholar in the area of primary care practice transformation and health policy. She completed a sabbatical at the CMS Innovation Center in 2013 and has facilitated the Practice Transformation Taskforce with the CT Healthcare Innovation Office. She is a frequent invited speaker for international, national, and regional conferences; she has published landmark articles on the role of pharmacists in medical homes and accountable care organizations in Health Affairs (premier health policy journal) and serves on the AHRQ Study Seciton for Healthcare Quality and Safety.
Abstract:
Objectives: To assess the current knowledge of consumers and physicians about pharmacist training/expertise and capacity to provide primary care medication management services in a shared resource network; determine factors that will facilitate/limit pharmacists as a member of community-based “health care team;” determine factors that will facilitate/limit pharmacists integration in primary care teams; determine factors that will facilitate/limit payer reimbursement for medication management services. Methods: Qualitative research methods; focus groups were conducted with primary care physicians and consumers, while semi-structured discussions were conducted with a public and private payer. Results: Consumers viewed pharmacists in traditional dispensing roles and were unaware of the direct patient care responsibilities of pharmacists as part of community-based health teams. Physicians noted several chronic disease states where clinically-trained pharmacists could collaborate as health care team members yet had uncertainties about integrating pharmacists into their practice workflow and payment sources for pharmacist services. Payers were interested in having credentialed pharmacists provide medication management services if the services improved quality of patient care and/or prevented adverse drug events, and the services were cost neutral Conclusions: Pharmacists must disseminate the existing body of evidence on pharmacists as direct patient care providers of medication management services and the related impact on clinical outcomes, patient safety, and cost savings to external audiences.
Asim Ahmed Elnour
UAE University-United Arab Emirates
Title: Medication errors: The perspective of a clinical pharmacist
Time : 12:10-12:30
Biography:
Dr. Elnour has received his PhD in School of Pharmacy, Queen’s University Belfast, N. Ireland-United Kingdom during the period of 2000-2004. Currently, he is working as Adjunct Clinical Associate Professor in Pharmacology Department at United Arab Emirates University. He is serving as an editorial member of several reputed journals like Journal of Medicine, Institute of Research Engineers and doctors, Journal of Pharmacy Research, International Journal of Biomedical Sciences and Bioinformatics, Symbiosis Journal of Pharmacy and Pharmaceutical Sciences, Pharmacology and Pharmacy, International Journal of Medical Sciences and Biotechnology. He has authored 31research articles, Meta-analysis and Editorial Letters. He is a member of several professional and therapeutics committees like Clinical pharmacy Council, Al Ain hospital representative, SEHA, Abu Dhabi and chairperson for Team Leader of Pharmacy and Therapeutic Committee (PTC) – Drug Utilization Evaluation Subcommittee (DUES).
Abstract:
Objective: The study objective was to design and implement an educational program to raise the awareness of in-patient nursing staff about medication errors and other medication-related safety issues. Method: A sample of in-patient nursing staff in Al Ain Hospital (n=370) was included in the study and completed a self-reported questionnaire about medication errors. A structured program was developed and used by the clinical pharmacists to identify the nursing knowledge on medication errors and other medication-related safety issues. The program consisted of a pre/post self-reported questionnaire, a training service, educational material, successive presentations and handouts. The self-reported questionnaire included twenty closed questions asking nurses opinions about medication errors. A training program on medication safety (Med Safe tool) was carried out by [clinical pharmacy team (n=2) and quality coordinator nurse (n=1)], for each group of 10 nurses. Main outcome measure: The study outcomes were the change in mean scores pre and post intervention. Results: Findings revealed differences in the knowledge of nurses about the causes and reporting of medication errors. There were statistically significant differences in responses across the participant’s years of experience and the current clinical working area. The participant’s responses improved significantly [57.4%±8.2, (95% CI: 56.6-58.2) vs. 68.9±10.3, (95% CI: 67.8-69.9); p<0.05] pre and post questionnaire, respectively. Conclusions: The clinical pharmacist’s structured program has improved knowledge of the in-patient nursing staff in terms of raising their awareness about medication errors.
Mohamed Abd-Elghany Abd-Elaziz
Prince Sattam Bin Abdulaziz University, Saudi Arabia
Title: Assessment of antibiotic prescription in hospitalized patients at Alkharj University Hospital, Saudi Arabia
Time : 12:30-12:50
Biography:
Mohamed Abd-Elghany Abd-Elaziz has completed PhD in Clinical Pharmacology, College of Medicine, Mansoura University, Egypt, 1989. He is Professor of Clinical Pharmacology, Mansoura Faculty of Medicine, 2001, June, and has been the Head of Clinical Pharmacy Department, Faculty of Pharmacy, Salman Bin Abdulaziz University, Saudi Arabia, since October 2011. He has published more than 40 papers in reputed journals and is serving as an Editorial Board Member of repute. His area of interest is drug genotoxicity and hospital pharmacy.
Abstract:
Purpose: To review and understand types and pattern of antibiotic prescribed for patients admitting university hospital, in Alkharj, Saudi Arabia. Methods: Retrospective study using clinical data on antibiotic prescriptions in 925 patient cases chosen from 2500 patients admitting to university hospital by systematic sampling. All the antibiotic prescriptions written for therapeutic purposes were assessed and reviewed over the period of six months (from 1/06/2013 to 30/12/2013) in Alkharj, university Hospital, KSA. Data including patient’s demographic characteristics, clinical diagnosis, and the type of antibiotic administration were studied and analyzed. Results: Antibiotics were prescribed to 56.9% of patients, among which 55.7% were prescribed two or more kind of antibiotics. Two drugs were prescribed to 74%, three drugs for 22% and 4 or more than 5 drugs for only 4% of studied sample. Cephalosporin (73%) ranked first followed by quinoline (67%) then penicillin’s (42%). Conclusions: Further, long term and more detailed studies investigating antibiotics usage in Saudi Arabia, in an attempt to make rational choices for antibiotic use and recognize the potential problems of antibiotics abuse.
Abdul-Aziz Elshemary
Riyadh Military Hospital, Saudi Arabia
Title: Adhesion molecules and arginase enzyme: Promising therapeutic targets for human ulcerative colitis
Time : 12:50:13:10
Biography:
Abdul-Aziz Elshemary has completed his MBBcH from Northern borders University, Saudi Arabia. He is now working as a Resident Physician at Military Hospital in Riyadh, KSA. He is working on elaborating many researches for publishing with his staff members in the University.
Abstract:
Background & Aim of the work: Ulcerative Colitis (UC) is a chronic Inflammatory Bowel Disease (IBD). The hallmark of UC lesions is infiltration of the intestine by mononuclear cells, predominantly lymphocytes. This cellular infiltration is the result of increased leukocyte recruitment and proliferation in the inflamed colon. Adhesion molecules are cell surface-expressed glycoproteins that mediate cell-cell and cell-extracellular matrix interactions. They play a prominent role in leukocyte recruitment. Adhesion molecules, therefore, represent promising therapeutic targets for human inflammatory diseases, including UC. The arginase (AR) has gained attention in studies focusing on the pathophysiology of IBD. The aim of the present descriptive study is to investigate the serum level of the adhesion molecules (ICAM and E-selectin) and arginase enzyme of patients diagnosed with UC in central hospital, Arar, Saudi Arabia to illustrate the magnitude of UC problem in northern border region of Saudi Arabia and to confirm the role of adhesion molecules and arginase in pathogenesis of UC in these patients. Methodology: The study is a retrospective study of 24 cases of UC diagnosed and followed up in central hospital in Arar, Saudi Arabia, from January 2015 to July 2015. Samples of blood were taken from the diagnosed cases for measurement of serum levels of ICAM, E-Selectin and arginase enzyme by Enzyme-Linked Immunosorbent Assay (ELISA) in addition to C-Reactive Protein (CRP). Results: Compared to control groups formed by individuals without clinical and/or laboratory signs of UC, UC patients showed significant increased levels (p<0.001) of sICAM-1, E-selectin and CRP in serum samples. On the other hand, arginase serum levels decreased significantly in sera of UC patients. Conclusion: In conclusion, the present work confirmed the role of adhesion molecules notably ICAM and E-selectin and the acute phase biomarker CRP in pathogenesis of UC and suggested a protective effect of arginase enzyme in reducing inflammation in colitis. Anti-adhesion molecules targeting ICAM and E-selectin may be promising for treatment of UC.
Sathish Amirthalingam
International Medical University, Malaysia
Title: Management of drug interactions in common clinical practice: A soft technological approach
Time : 13:10-13:30
Biography:
Sathish Amirthalingam holds BPharm, MPharm, PhD and PGDHM degrees. He is a Clinical Pharmacist from India and is currently working in International Medical University, Malaysia. He was a state first and distinction Research Scholar in Post-Graduation level. He has a teaching and professional experience of 13 years in the field of pharmacy. He received 6 awards from various bodies from pharmacy fields including state and national levels for Best Research Paper and Research Project. He had written 2 books in pharmacy field like clinical pharmacy and pathophysiology for pharmacy students. He has published 21 national and international papers, 2 copyright of his innovative clinical software and has presented 18 papers in national and international conferences. He has guided 4 Under-Graduate, 8 Post-Graduate projects and he is guiding 4 more Under-Graduate projects currently. He is also associated with Life Member in various professional bodies like IPA, IHPA and was a Member of Board of Studies in Department of Pharmacology, S P University.
Abstract:
A large number of drugs are introduced every year and new interactions between medications are increasingly reported. Clinically significant drug interactions can occur when two or more drugs are taken in combination. DDIs may lead to adverse drug reactions that can be severe enough to necessitate hospitalization. The outcome can be harmful if the interaction causes an increase in the toxicity of drugs. Managing drug interactions in hospitalized patients is important and challenging. Recognizing drug interaction is a daily challenge for family physicians and remembering all potential interactions has become virtually impossible. Drug therapy is growing more complex, thus making appropriate drug prescribing increasingly challenging. More than 30 medications are introduced each year and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Safety is an essential principle of patient care; therefore, the Fifty-fifth World Health Assembly underlined the importance of promoting science based systems to improve patient safety and the quality of health care. Drug information increases at accelerating rate annually. Checking manually for drug interactions becomes more time consuming and error-prone. The use of computerized drug interaction screening system has been debated due to many false alerts, quality of the data held in the software. We compare the various drug interaction databases available in online and few of offline software revealed that, the entire software data base contains only limited drugs with its interactions of internal analysis. Our research created new outlook of drug interaction
Sathish Amirthalingam
International Medical University, Malaysia
Title: Management of drug interactions in common clinical practice – a soft technological approach
Time : 13:10-13:30
Biography:
Dr. Sathish Amirthalingam, B.Pharm., M.Pharm., Ph.D., PGDHM., is a clinical pharmacist from India and currently working in International Medical University, Malaysia. He was a state first and distinction research scholar in Post-Graduation level. He has a teaching and professional experience of 13 years in the field of pharmacy. He received 6 awards from various bodies from pharmacy fields including state and national levels for best research paper and research project. He had written 2 books in pharmacy field like clinical pharmacy and pathophysiology for pharmacy students. He has published 21 national and international papers, 2 copyright of his innovative clinical software and he has presented 18 papers in national and international conferences. He has guided 4 under graduate, 8 post graduate projects and he is guiding 4 more under graduate projects currently. He also associated with life member in various professional bodies like IPA, IHPA and he was a member of board of studies in Dept. of pharmacology, S. P. University.
Abstract:
A large number of drugs are introduced every year and new interactions between medications are increasingly reported. Clinically significant drug interactions can occur when two or more drugs are taken in combination. DDIs may lead to adverse drug reactions that can be severe enough to necessitate hospitalization. The outcome can be harmful if the interaction causes an increase in the toxicity of drugs. Managing drug interactions in hospitalized patients is important and challenging. Recognizing drug interaction is a daily challenge for family physicians and remembering all potential interaction has become virtually impossible. Drug therapy is growing more complex, thus making appropriate drug prescribing increasingly challenging. More than 30 medications are introduced each year and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Safety is an essential principle of patient care; therefore, the Fifty-fifth World Health Assembly underlined the importance of promoting science based systems to improve patient safety and the quality of health care. Drug information increases at accelerating rate annually. Checking manually for drug interactions becomes more time consuming and error-prone. The use of computerized drug interaction screening system has been debated due to many false alerts, quality of the data held in the software’s. We compare the various drug interaction databases available in online and few of offline software’s revealed that, the entire software data base contains only limited drugs with its interactions of internal analysis. Our research created new outlook of drug interaction software named as Dr.DRINSOTM and uploaded with drugs available with standard source of drug interaction materials.
- Track 6: Clinical Pharmacy and Drug Reactions
Location: Grand Ball Room-A
Chair
Yousef Alomi
Ministry of Health, KSA
Co-Chair
Sathish Amirthalingam
International Medical University, Malaysia
Session Introduction
Stig Larsen
Norwegian University of Life Science, Oslo Norway
Title: BP-C1 in treatment of Metastatic Breast Cancer; A randomised, double blinded and placebo controlled clinical study
Time : 16:25-16:45
Biography:
Prof. Stig Larsen has completed his DSc in Clinical Research Methodology at Ullevål Hospital, Oslo University Norway. He is professor at the Norwegian University of Life Science and has published more than 300 papers in international medical and clinical research methodological journals.
Abstract:
The aim was to compare the efficacy and tolerability of a new benzene-poly-carboxylic acids complex with cis-diammineplatium (II) (BP-C1) versus equal looking placebo in treatment of metastatic breast cancer patients. Material and Methods: A randomized, double blind, placebo controlled multi-center study was performed with semi-cross-over design. Patients allocated to placebo switches to BP-C1 after 32 days of treatment. Thirty patients were given daily intramuscular injection of 0.035 mg/kg bw BP-C1 or placebo in 32 days. Biochemistry, hematology, NCI Bethesda (CTC-NCI), EORTC QOL-C30&BR23 recorded at screening and after every 16 days of treatment. CT performed at screening and every 32-day. Results: The sum of target lesions increased 2.4% in the BP-C1 group and 14.3% in placebo. The increase in the placebo group was significant (p=0.013) but not in BP-C1. The difference between the group was significant in favor of BP-C1 (p=0.04). Significant difference (p=0.026) in favor of BP-C1 regarding RECIST classification. CTC-NCI toxicity score increased non-significantly in the BP-C1 group, but significantly in placebo (p=0.05). “Breast cancer related pain and discomfort†and “Breast cancer treatment problem last week†were significantly reduced (p=0.02) in the BP-C1 group and slightly increased in placebo. Significant difference in favor of BP-C1 (p=0.05). “Breast cancer treatment problem last week†was significantly reduced in the BP-C1 group (p=0.02) and slightly increased in placebo. “Breast cancer related pain and discomfortâ€. Conclusion: BP-C1 reduces the cancer growth, is well tolerated, improves quality-of-life and has few mainly mild AE in patients suffering from stage IV MBC.
Samah ElSalem
Hamad Medical Corporation, Qatar
Title: Misoprostol use in medical evacuation of spontaneous abortion: Drug use evaluation study at woman’s hospital in Qatar
Biography:
Samah ElSalem has completed her BSc Pharm (2011) and her PharmD (2012) from the College of Pharmacy, Qatar University. Since 2012, she has been working as a Clinical Pharmacist in Women’s Hospital, Doha, Qatar. She has been involved in several researches in the field of clinical pharmacy and has published some of her work in peer-reviewed journals.
Abstract:
Objectives: To conduct a drug-use evaluation by investigating indications, appropriateness of dosing, and clinical outcome of misoprostol-only regimen when used for medical evacuation of spontaneous abortion. Method: A retrospective descriptive drug-use evaluation was conducted on women with spontaneous abortion who received misoprostol for medical evacuation during August 2013. The current practice at Women’s Hospital was compared with World Health Organization (WHO) recommendation. Patients were stratified into three groups based on weeks of amenorrhea. Results: One-hundred and seven patients received misoprostol during August 2013. Thirty-three patients (31%) were included. In these patients, the main indication for using misoprostol was missed abortion (54.5%). In the group of ≤9 weeks, 80% of them received an initial dose of 800 mcg, 80% received frequency within WHO recommendation, and most of them had surgical evacuation (80%). In the group of 10 to 12 weeks, more than 80% received an initial dose of 800 mcg, 6% received frequency as WHO recommendation, and more than 75% had successful medical evacuation. In the group of 13 to 22 weeks, more than 80% of them received an initial dose of 400 mcg, more than 80% received frequency within WHO recommendation, and 54% of them had successful medical evacuation. Overall, more than 70% of patients received ≤3 total doses of misoprostol and more than 60% had successful medical evacuation as a clinical outcome. Conclusions: Despite that the current practice at Women’s Hospital was not always in accordance with WHO recommendation; successful medical evacuation was achieved in most patients.
Menyfah Q Alanazi
Drug and Economy center,Saudi Arabia
Title: A Focus on Recent Cases of Suicides among Saudi Children with oral ingestion at Tertiary Hospital: case series study
Biography:
Menyfah Al Anazi is a pharmacist currently working at the Drug policy and Economic Center of Ministry of National Guard – Health Affairs. She has completed Clinical Pharmacy Practice since 2007, and certificated in Clinical Research Coordinator since 2009.
Abstract:
BACKGROUND: Suicidal behaviors are among the leading causes of death worldwide. AIM: to assess the cases of suicide among children, potential risks, and outcome METHOD: Using a retrospective chart review of children who diagnosis with intentional poisoning between 2009 and 2011, RESULTS: We identified 10 cases of suicide among children (mean age 12 years, SD 1.98, range 8 to 14 years) 0.66% of poisoning cases in pediatric. The female: male ratio was 1:1. The majority of cases were middle social/economic class (n = 9; 90%). Chemical constituted the most commonly encountered group of toxins 60 %( mainly Clorox 50%) and drugs 40% (mainly acetaminophen 20%). Home Chicken was the commonest place of poisoned (50%); summer was the most common season of poisoning (40%) and Thursday most common day. Mothers of (90%) the children poisoned worked in the home. Symptomatic cases on admission were 80%, GI complication representing 60% and neurology 30% of the complication. Most of the poisoned cases undergo complete recovery and discharged from ER (60%) and 40% were hospitalized, the mean hospital stay was 2 days, and ranged from 0 to 9 days. There was a statistically significant difference between the lengths of stay of patients in terms of hospital cost (P < 0.05). CONCLUSIONS: The results point to the need to increase our understanding of the suicidal behaviors during childhood/adolescence and of the causal pathways linking these behaviors to child-adolescent mental disorders. During routine care visits, pediatricians should be skilled to recognize risk factors for adolescent suicide in order to intervene appropriately
Marilia Berlofa Visacri
State University of Campinas, Campinas – Sao Paulo – Brazil
Title: Toxicities and treatment response related to cisplatin chemotherapy and radiotherapy treatment in patients with advanced head and neck cancer: influence of different cisplatin doses.
Time : 16:45-17:05
Biography:
MarÃlia B. Visacri was born in São Paulo, Brazil, in 1989. She got her Pharmacist grade and her Master Degree in Medical Sciences by the State University of Campinas/Brazil in 2011 and 2013, respectively. She is currently a Ph.D Student at the Department of Clinical Pathology of the School of Medical Sciences from the same university. Her main research interests include clinical pharmacy, pharmaceutical care, pharmacovigilance, oncology and oxidative stress. Furthermore, she has publications in the areas of pediatrics and HIV/AIDS.
Abstract:
The most common treatment for patients with advanced head and neck cancer is chemotherapy with high doses of cisplatin and concomitant radiotherapy. The aim of this study was to determine the impact of cisplatin doses on toxicities and response to therapy in advanced head and neck cancer patients. It was an observational and prospective study at a hospital in Brazil where head and neck squamous cell carcinoma (stages III-IV) patients who received chemoradiation (80 or 100 mg/m2 of cisplatin per cycle) and completed 3 cycles were included. Two groups were studied considering the accumulated dose: G1 (280-300 mg/m2) and G2 (240-260 mg/m2). Audiometry was performed to evaluate ototoxicity and creatinine clearance to nephrotoxicity; severities were classified by CTCAE (v.4). Computed tomography and RECIST 1.1 were realized for treatment response. Forty patients were studied (G1: n=23; G2: n=17). There was a prevalence of male (90.0%), white (92.5%), Karnofsky Performance Scale 90-100% (63.2%) and had pharyngeal tumor (67.5%) in stage IV (85.0%), with a mean age of 52.9±7.5 years. Ototoxicity was present in 69.4% in G1 and 94.1% in G2, with a prevalence of grade 3 for both. In G1, 39.1% had nephrotoxicity versus 47.1% in G2, mostly grade 1. A complete response to treatment was observed in 8.7% in G1 and 3.5% in G2. For all outcomes there was no statistically significant difference between groups. In conclusion, the cisplatin doses had no statically significant impact on studied outcomes, however, a prevalence of complete response and toxicity was observed in G2.
- Track 11: Recent Advances in Pain Management
Location: Grand Ball Room-A
Chair
Yousef Alomi
Ministry of Health, KSA
Co-Chair
Sathish Amirthalingam
International Medical University, Malaysia
Session Introduction
Joachim Kaufmann
University of Bergen; Norway
Title: Dose-response study in Osteopathic treatment of patients suffering from foot related pain
Time : 13:50-14:10
Biography:
Joachim Roland Kaufmann has completed his MSc 2004 at the University of Greenwich / GB and the European School of Osteopathy (ESO), Maidstone / GB. He is the owner of Bergen Osteopatiklinikk and Korpus Berlin - clinics for treatment of injured athletes and other muscle skeletal pain, is a teacher at different Schools in the Manual field in Europe over 20 years. He is a part of the coaching staff of the German Basketball National team since 2000 and worked in different medical staff from soccer to track and field. Now he is in a PhD project in Norway.
Abstract:
The aim of the study was to determine the combination of “number of treatments†and “interval between treatments†in order to optimize the effect of Osteopathic treatment of foot related pain. Material & Methods: The material consists of 32 female and 22 male patients with a mean age of 42 years and a BMI of 27.0. The study was performed as an observer blinded, randomised single centre trial with 32-factorial design. “Number of treatments†and “Treatment intervals†was used as the two factors. The patients were allocated to treatment groups by nested block randomisation. The primary variables “Pain at rest†and “Pain at load†were recorded on 10 cm Visual Analogue Scales and the Ankle-Brachial Index. Results: Four treatments with seven days treatment interval were the superior combination regarding reduction in pain at rest (p<0.01). Four treatments gave also significant (p<0.01) reduction in pain at load both for seven and ten days treatment intervals, but 10 days treatment intervals were the superior combination for reduction in pain at load. Number of treatments seems to be the dominant factor regarding both pain reductions at rest and at load. The study detected an obvious interaction between the two factors. By increasing the number of treatments, the duration between treatments has to be increased similarly. Conclusion: The combinations for obtaining the largest pain reduction at rest and load seem to be four treatments with seven and ten days treatment intervals, respectively.