THE ROLE OF A SPECIALIST PHARMACIST IN THE MANAGEMENT OF ADALIMUMAB IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Objective: The management of inflammatory bowel disease (IBD) patients on complex medications such as biologic disease-modifying anti-rheumatic drugs (DMARD) requires close supervision. At East Sussex NHS Healthcare Trust (ESHT), the multi-disciplinary team (MDT) already looking after these patients could benefit from the additional knowledge and support from a specialist pharmacist (SP). Methods: To assess if the MDT could benefit from an SP, all IBD patients on the DMARD adalimumab were identified. The patient records were screened for patient demographic data, clinical assessment and investigations, treatment, and follow-up clinics. Results: 162 patients at ESHT were identified as being on adalimumab treatment for either Crohn’s Disease (77%) or Ulcerative Colitis (23%). Disease activity scores, a clinical measure of IBD severity, were infrequently recorded (1%) on patient letters. Evidence of a biologic screen, a series of investigations to ensure safety in a biologic treatment, was only evident in one-third of patients. Clinic review of patients recently started on adalimumab and annual review of stable patients occurred 43% and 26% respectively. Conclusion: The results indicate that there is a need for an additional member to support the IBD MDT in managing this cohort of patients. An SP is uniquely positioned to fill this gap. They have extensive knowledge in drug indication, therapeutic drug monitoring, and side-effect profiles. Similar studies have been identified that support SP in this role.

Essential Oil Analysis of Coriander Plant of Konya Region

Coriander is a small aromatic perennial herbaceous plant that grows widely in western Asia, India, Pakistan, the Mediterranean basin, and the United States. Although all parts of the plant can be eaten, its fresh leaves and dry seeds are used more. fructose, sucrose), alkaloids, flavones, resins, tannins, anthroquinones, sterols (β-stesterol and β-cytosterelin), and fixed oils. Has a small amount of carminative agent. Coriander plant samples were collected by a specialist pharmacist and phytotherapist (Muammaer Şen). Cultured medicinal marshmallow herb flower was harvested and dried. The dried plant was sorted and packed in packages of 50 grams using precision scales. 100gr of randomly selected samples. It was sent to BATAM laboratory for analysis. The essential oil analysis of the coriander plant of the Konya region has been found in accordance with the pharmacopoeia standards. Coriander plant is used to take advantage of its heavy metal removal feature. Many factors can affect the essential oil ratio of the plant. It is possible to make maximum use of the essential oils of the coriander plant by making the environmental factors suitable.

Evaluation of Contraindicated Drug-Drug Interactions in Electronic Health Data Insurance at 3 Hospitals in Quang Ninh Province Through Navicat Software

Drug-drug interactions is a frequently encountered issue in clinical practice, reduce effectiveness of treatment and lead to dangerous complications for the patients, possibly even death. The purpose of this study is to analyze contraindicated drug interactions when prescribing in some hospitals in Quang Ninh Province. Subjects and methods: List of concentrated contractor drugs applied Quang Ninh province and within the scope of payment of Health Insurance Fund in 2018. The result: the group of researchers developed the list of 112 pairs of the cotraindicated drug-drug interactions to serve as a reference to determine the appearing frequency of contraindicated drug-drug interactions over 519500 medical records and 1254099 prescriptions at 3 hospitals in Quang Ninh province. Of which, 26 contraindicated drug-drug interactions (0.006%) was found over 297 medical records and 789 prescriptions. 5 pairs with the most appearing frequency are: Amiodarone-Amitriptyline, Amiodarone-Moxifloxacin, Amiodarone-Colchicine, Levodopa -Sulpiride, Amiodarone-Haloperidol. Medical reccords with contraindicated drug-drug interactions were found in 13 different departments or interdisciplinary deparments from all 3 hospitals, of which the highest rates were found in Intensive Care Unit and Emergency Departments (24.2%), Endocrinology Departments (16.2%) and Cardiology Pediatric Departments (10.4%). The average age of patients with contraindicated drug-drug interactions in all 3 hospitals was greater than or equal to 67, most are inpatients. Conclusion: Based on retrospective data on drug prescribing at 3 hospitals in Quang Ninh Province, the study analyzed 26 pairs of common contraindicated drug interactions in clinical practice. Keywords Contraindicated drug-drug interactions, hospitals in Quang Ninh Province, medication review tools. References [1] D.C. Malone, J. Abarca, P.D. Hansten, A.J. Grizzle, E.P. Armstrong, R.C.V Bergen, B.S. Duncan-Edgar, S.L. Solomon, R.B. Lipton, Indentification of Serious Drug-Drug Interactions: Results of the Partnership to Prevent Drug-Drug Interactions, J. Am. Pharm. Assoc. 44 (2004) 142-151. https://doi.org/10.1331/154434504773062591.[2] P. Vonbachl, A. Dubied, S. Kra¨henbu¨hl, J.H.Beer, Evaluation of frequently used drug interaction screening programs, Pharm. World. Sci. 30 (2008) 367-374. https://doi.org/10.1007/s11096-008-9191-x.[3] N.T. Hanh, V.T.P. Thao, H.Q. Tuan, N.X. Bach, N. T. Hai, Developing a list of important drug-drug interactions in the clinical practice in the internal department – Kien An Hospital, Hai Phong City, VNU Journal of Science: Medical and Pharmaceutical Sciences, 35(2) (2019) 54-67. https://doi.org/10.25073/2588-1132/vnumps.4179.[4] L.H. Duong, Developing clinically signification drug-drug interactions at Hop Luc General Hospital (2017), Specialist Pharmacist Graduation thesis – 1st Class, Ha Noi University of Pharmacy (in Vietnamese).[5] L.T. Phuong, Managing clinically signification drug-drug interactions at the National Geriatric Hospital (2018), Pharmacist Graduation thesis, Ha Noi University of Pharmacy (in Vietnamese).[6] T.T. Hoai, Examining drug-drug interactions in the inpatient medical records at the Thai Nguyen Lung Hospital (2017), Specialist Pharmacist Graduation thesis – 1st Class, Ha Noi University of Pharmacy (in Vietnamese).[7] Ministry of Health, Vietnam Regulatory Affairs Society, Medical Publishing House one member Company Limited, Vietnam, 2015 (in Vietnamese).[8] A.P. Heverton, R.L.P Leonardo, M.V Carlos, F.F.C. Maria, Patient’s lack of understanding producing insulin drug-interactions in Southeast Brazilian primary care clinics, Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 3(2) (2019) 1131-1136. https://doi.org/10.1016/j.dsx.2019.01.032

Deprescribing in mental health: pragmatic steps for a better quality of life

Half of the UK population take at least one prescribed medicine, while a quarter take three or more. Polypharmacy has become increasingly common, with the average number of items prescribed per person per year in England having increased by 53.8% in the last decade. Patients are prescribed, and may continue taking, medicines that cause adverse effects and where the harm of the medicine outweighs the benefit. Adverse reactions to medicines are connected to 6.5% of hospital admissions. Patients admitted with one drug side effect are more than twice as likely to be admitted with another. Deprescribing is the optimisation of medication and is a vital part of improving outcomes, managing chronic conditions, and avoiding adverse effects. The goal of deprescribing is to lessen medication burden and enhance quality of life. This article presents case studies from clinical practice in a mental health service, and highlights the merits of specialist pharmacist-led interventions with respects to medication reviews and deprescribing.