Journal of Pharmaceutical Care
Volume:5 Issue: 1, Summer-Autumn 2017

When calling computers, we quickly remember a complex of hardware and software to do some types of zero-one calculations through processing in the silicon hearts. In addition to several public operations, the computers could very much help the scientists and engineers to extend the borders of science and technology. From earth to space, several applications are carried out by the computers and related computational tools for various purposes. In the case of complicated biological systems, computers are also very much helpful, in which so many scientists have dedicated considerable efforts to simulate these systems to obtain more knowledge and information about the mystery of human life. There are also significant advantages of computations for the medical and medicinal applications. By developments of computational chemistry theories and softwares in recent years, computer-aided drug design (CADD) has become a favorite technique for chemists and biochemists to design new chemical structures with higher potency of pharmaceutical applications. Besides very well known in vitro and in vivo environments, in silico is now a very much helpful environment for those scientists working with computer based research and development purposes of pharmaceutical laboratories and industries. The main advantage of in silico pharmacy is the capability of considering and examining so many chemical structures to find the lead compounds with possible pharmaceutical applications. Furthermore, lead optimizations could be very well done with various aspects of ligand based approaches to evaluate pharmacokinetic parameters. In the following, pharmacodynamic parameters of designed ligands could be evaluated by structure based approaches to find new receptors or to examine the targeted receptors for more interacting efficacy. Herein, among millions of raw chemical structures, lead compounds could be screened, evaluated and proposed for the pharmaceutical applications by in silico pharmacy approach. The dominant atomic and molecular scales investigations could be performed on ligand – receptor interactions to introduce new drugs for medicine. Avoiding too much use of chemicals and animals in the laboratories for in vitro and in vivo experiments and trials, in silico pharmacy could do all the jobs in the clean silicon heart of high performance computers to convey the new drug from computations to clinics.

Inappropriate use of antibiotic, leads to microbial resistance, nosocomial infections and increased hospital costs. Therefore, it is necessary to control and evaluate the use of these medications, especially broad-spectrum antibiotics. This study evaluated the pattern of meropenem utilization in Imam Reza hospital, Mashhad, Iran.
First, a guideline for proper indications of meropenem was designed and finalized based on the clinical pharmacists and infectious disease specialist’s comments. One hundred patients were chosen randomly from different wards of the hospital and their data were recorded in predesigned questionnaires. Then, the pattern of meropenem consumption was analyzed according to the guideline.
This study was performed in 100 patients, including 48 women and 52 men. In 13 cases (13%), patients had no approved indication for meropenem. The initial regimens were changed in 6 cases (6%) based on culture results and in 73 cases (73%) relied on clinical response. In 64 cases (64%), administrated doses were compatible with prepared guideline. Renal dose adjustment was acceptable based on guideline only in 30% of patients with renal impairment (30 patients out of 100). Hyper-sensitivity reaction, one of the adverse reactions of meropenem, was seen in 1 patient (1%).
According to the results, considerable errors occurred in meropenem administration and dosing. Therefore, it is necessary to design and implement a localized guideline for meropenem consumption in Imam Reza hospital of Mashhad, Iran.

Attendance management is one of the most important issues in the educational institutions. The traditional method for attendance recording is manually recording by professors in the school or university which is associated with several problems. We proposed the design and utilization of an electronic application for students’ attendance recording via smartphones and PCs.
This study was a cross-sectional and Quasi-experimental study, which held in the department of clinical pharmacy in the school of pharmacy in Ahvaz Jundishapur University of medical sciences. Group I is assigned to the manually recording of student attendance. Group II is assigned to the design and utilization of an electronic application for registration of attendance. Each of the professors records the students’ attendance in the class by smartphones. Finally, the satisfaction of the professors about the application was assessed with the 6-item questionnaire. Also, the efficacy of the application was evaluated through the comparison of the number of recorded attendance and the number of absent recorded in group I and II.
The results of satisfaction survey illustrated that all of the professors found the electronic recording of the attendance was the more useful than the traditional method and lead to the reducing the possibility of errors, the time spent, and the pleasure of students. Also, the comparison between the numbers of students’ recorded attendance and numbers of absence recorded were higher by utilization of the application more than by the traditional method.
The students’ attendance recording application can improve performance compared to the manually attendance management system via decreasing the possibility errors and continuous assessing during a semester.

Context:Selenium (Se) as an essential micronutrient with antioxidant and anti-inflammatory effects plays a primary role in human immune system and there are some evidences for its impact in reducing plasma levels of inflammatory factors on one hand and also their role in increased incidence of delirium on the other hand.
Aims:The aim of his study is evaluation of the effect selenium on CRP plasma levels and incidence of delirium.
Settings and Design:In a clinical trial included 100 patients admitted to the ICU of the Al-Zahra hospital in Isfahan (50 patients in the selenium group and 50 patients in the control group).
Methods and Material:The plasma levels of C-reactive protein and incidence of delirium examined within 5 days and then compared.
Statistical analysis used:The collected data were analysed using SPSS ver.23 (version 23, SPSS Inc., Chicago, IL).
During 5 days of hospitalization, 16 patients in the selenium group and 26 patients in the control group developed delirium in this term statistically there was no significant differences between the two groups (P=0.068).
During 5 days of hospitalization, plasma levels of CRPin the selenium group (mean = 11.1±2.20) significantly, was significantly lower than plasma levels of activated protein C in control group (mean= 16.75±1.65) (P Administering selenium lead to a decrease in plasma levels of CRP but administering selenium caused no significant changes in the incidence of delirium.

Linezolid has been recognized as a safe and effective medicine against a wide variety of Gram-positive pathogens.
The primary objective of this study was to assess utilization appropriateness of linezolid and explore the efficiency of protocol intervention to proceed to rational drug usage.
The project was conducted in a referral teaching hospital from September 2015 to January 2017 in two phases. In the first step, a six-month survey was performed to evaluate the prescribing appropriateness of linezolid. Patients receiving linezolid were identified using hospital IT system and the medical charts were analyzed based on accurate indications and duration of linezolid prescription. Subsequently, a restrictive protocol was developed and communicated after a consensus by Drug and Therapeutics Committee in May 2016. After introduction of the protocol, an active daily surveillance of patients was done by hospital pharmacists. The appropriateness of linezolid utilization and infectious consultations were compared before and after protocol implementation.
In the first phase of the study, the indication of linezolid was appropriate in 56.2% of cases and improved considerably to 68.6% (P value: 0.04) after protocol enforcement. Furthermore the duration of the linezolid consumption was correct in 66.6% of patients, increasing to 88.5% after protocol introduction (P value 0.07). In the first step, 56.9% of linezolid prescriptions were based on infectious disease consultation which enhanced remarkably to 87.5% in the second step (P value 0.001), while, 65.5% and 73.8% of these consultations were appropriate in the study surveys respectively.
The protocol intervention could improve appropriate prescribing of linezolid in the hospital setting. However, ongoing audit studies are recommended to maintain the rational prescription of linezolid.

Adverse drug events can cause serious consequences including death. A published report by Lazarou et al in 1998 showed that adverse drug events were the 4th to 6th leading cause of death in the United States. These events may lead to drug safety crises in some issues, which need to take crises management process for solving the problem and/or preventing similar events.
To evaluate nature of drug safety crises based on adverse events reported to Iranian Pharmacovigilance Center from 1999 through 2012. To mention success and failure outcomes of crises management process taken against detected crises.
All adverse drug events received by Iranian Pharmacovigilance Center from 1999 through 2012 were evaluated for reports with fatal outcome. All alerting letters and manuscripts published by the Center during the same period were reviewed for detailed information on detected crises. World Health Organization definition was used for detecting drug safety crises.
Among 42036 registered cases in our database, 463 deaths were recorded. The most frequent suspected drug for adverse events with fatal outcome was ceftriaxone (100 cases). Ten different drug safety crises issues were detected during the study period and their successful or failure outcomes were evaluated. There were 112 issued alerting letters and 17 published manuscript during the same period which was monitored for detailed information.
It is necessary for national pharmacovigilance centers to have prepared programs for crises management. This could be useful for reducing drug related mortality.

With the emergence of various developments in determining pathophysiology behind diseases, emergence of resistance against diseases and to utilize drugs for the long-term effects, and the need to design an effective treatment against most common infectious and non-infectious diseases, the need of developing more effective drug comes under the limelight. At present, more studies are being carried out on the utilization of monoclonal antibodies as successful therapeutic agents and to design them in such a way to target specific health-related conditions. This include conditions which affect livelihood of people, the most common an widespread diseases, infectious diseases caused by more virulent or drug-resistant micro organisms and viruses and also inherited diseases. Current review thus targets cancer, diabetes, autoimmune diseases, hypercholesterolemia, ophthalmology and infectious diseases and briefly discusses the pathophysiology behind the mode of action of the therapeutic agents based on monoclonal antibodies and the benefits and drawbacks of such developed agents. This also focuses on the areas where studies can be carried out to determine effective use of monoclonal antibodies in the future to answer and treat major medical related issues.

Prostatitis causes up to 25% of male genitourinary complaint. However, due to technical restrictions in sampling, only in 10% of cases pathogens were identified. In this paper, a patient with chronic prostatitis due to Staphylococcus hemolyticus is described. A 48-year-old man was referred with longstanding (approximately for 18 months) complaint of increased genitourinary symptoms and pain in perineum. In evaluation, moderate growth of methicillin-resistant Staphylococcus hemolyticus (MRSH) in post-prostatic massage voided urine and expressed prostatic secretion (EPS) was positive. Culture of urethral urine (urine or voided bladder 1; VB1), midstream urine (VB2) and post-ejaculation urine specimens were negative. Leukocyte count values in EPS and post-prostatic massage voided urine were 14 and 8 per oil immersion field respectively. PCR of urine samples was positive for Ureaplasma urealyticum and confirmed by repeated analysis.
Based on the antimicrobial susceptibility results patient was treated with teicoplanin 400 mg intramuscularly every 12 hours for three doses followed by the daily maintenance dose of 400 mg. In addition, doxycycline 100 mg twice daily was added to cover Ureaplasma urealyticum. Treatment course completed in 6 weeks. Alleviation of patient’s symptoms begun within the first week of treatment and this trend continued until the end of the treatment.