Evaluation and determining of the Pattern of the Human Albumin Utilization at Shahid Rahimi Hospital, Khorramabad, Iran

Background: The World Health Organization (WHO) has supported many intervention strategies, including executive, educational, and monitoring proceedings to improve the evaluation of drug use and the drug management system. Since the resources are limited, it is essential to utilize existing resources properly. Serum albumin is the most abundant blood protein produced in the liver. Different forms of albumin are available in the market and employed to treat hypovolemia, Cirrhotic ascites, severe burns, septic shock, hyperstimulation syndrome, etc. Due to the high price of albumin and its importance for saving patient’s lives.Methods: precisely according to the determined protocols, and it’s unreasonable and irrational medication should be avoided. Statistical analysis was performed in Shahid Rahimi Hospital of Khorramabad, Iran, from March 2018 to March 2019. Albumin administration for randomly selected patients receiving albumin in different wards was evaluated. The main sources to retrieve information were pharmacy drug folders, patient folders (including laboratory information), and nursing folders. Age, sex, weight, ward, albumin level, symptoms, and final dose were recorded for each patient. Contraindications to the administration of albumin or any caution in its use were also considered. Data were analyzed by using SPSS16 and Excel software. Independent T-test and Chi-square test were employed to compare quantitative and qualitative variables. 271 patients were studied, including 160 men and 111 women.Results: The two male and female surgical wards with 41 patients had the highest percentage of patients admitted with albumin administration. Also, the most common cause of albumin administration in patients was hypoalbuminemia. 55% of albumin prescriptions in Shahid Rahimi Hospital of Khorramabad were irrational, driving a substantial financial burden for the healthcare system and patients. Among all the prescribed cases, only 5.2% were approved by the pharmacist. Finally, 77.1% of patients recovered, and 22.9% died.Conclusion: Considering that the highest percentage of patients receiving albumin administration, both among patients with irrational administration and in general, were in men's and women's surgical wards, it is recommended that the drugs prescribed in these wards be further investigated and get pre- Approved by a pharmacist to prevent higher medical costs for patients and healthcare system.          Keywords: Albumin; Hypovolemia; Cirrhotic Ascites; Septic Shock; Hyperstimulation Syndrome    

Evaluation of the antioxidant effects of zolpidem in the rat model of cisplatin-induced nephrotoxicity

Introduction: Nephrotoxicity is one of the most important side effects of cisplatin which has limited its use. Production of reactive oxygen species (ROS) and reactive nitrogen species (RNS) plays a significant role in the pathogenesis of this drug. Objectives: The aim of this study was to evaluate the antioxidant effect of zolpidem on the reduction of nephrotoxicity associated with cisplatin. Materials and Methods: In this study, 40 adult male rats were divided into 4 groups; 1) healthy group, 2) control group, 3, 4) cisplatin-induced nephrotoxicity + different doses of zolpidem. After a certain period of time, the urine, spinal cord and kidney samples of rats were collected. Then, urine levels of functional factors including urea, creatinine and albumin/creatinine ratio, antioxidant enzymes and malondialdehyde (MDA) levels were estimated. Consequently, histological studies were conducted with the collected samples. Results: Zolpidem reduced levels of urea, creatinine, albumin/creatinine ratio, and MDA. It also increased the amount of antioxidant enzymes of the kidney including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), and moderated the tubular damage caused by the use of cisplatin. Conclusion: Zolpidem is able to improve the nephrotoxicity by reducing oxidative stress

Increasing the Number of Adverse Drug Reactions Reporting: the Role of Clinical Pharmacy Residents

Abstract Detection of adverse drug reactions (ADRs) in hospitals provides an important measure of the burden of drug related morbidity on the healthcare system. Spontaneous reporting of ADRs is scare and several obstacles to such reporting have been identified formerly. This study aimed to determine the role of clinical pharmacy residents in ADR reporting within a hospital setting.Clinical pharmacy residents were trained to report all suspected ADRs through ADRreporting yellow cards. The incidence, pattern, seriousness, and preventability of the reported ADRs were analyzed. During the period of 12 months, for 8559 patients, 202 ADR reports were received. The most frequently reported reactions were due to anti-infective agents (38.38%). Rifampin accounted for the highest number of the reported ADRs among anti-infective agents. The gastro-intestinal system was the most frequently affected system (21.56%) of all reactions. Fifty four of the ADRs were reported as serious reactions. Eighteen of the ADRs were classified as preventable. Clinical pharmacy residents involvement in the ADR reporting program could improve the ADR reporting system

Neuroprotective and Anti-inflammatory Role of Atorvastatin and Its Interaction with Nitric Oxide (NO) in Chronic Constriction Injury-induced Neuropathic Pain

Prevention and treatment of neuropathic pain (NP) is one of the most difficult problems in clinical practice since the underlying mechanism of NP is unclear. In previous studies, the increased production of nitric oxide (NO) has been closely linked to the induced NP. In this study, we assessed the effect of atorvastatin through NO mechanism, on inflammation, thermal hyperalgesia, thermal allodynia, and mechanical allodynia as well as sciatic nerve histological score in rat with chronic constriction injury (CCI) model. Finally, we specified the role of cytokines such as TNF-alpha and IL-6 in the spinal cord. Treatment with atorvastatin and L-NAME (NO inhibitor) attenuated the thermal hyperalgesia, thermal allodynia and mechanical allodynia induced by CCI. The antinociceptive consequence was better elevated with a combination of atorvastatin and L-NAME in comparison with the other groups. In addition, the treatment with these drugs also attenuated the CCI-induced TNF-alpha and IL-6 level in the spinal cord. Furthermore, the histological analysis showed a low level of inflammation in the sciatic nerve in the CCI rats co treated with atorvastatin and L-NAME. Findings of our study in NP-induced CCI in the rat model demonstrate that inhibition of NO displays antinociceptive and anti-neuroinflammatory effects of atorvastatin in peripheral and central nervous system. In addition, we found that inhibition of the NO by atorvastatin could be one of the most important anti-inflammatory pathways of atorvastatin effect