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Öğe A clinical pharmacist's intervention on interaction between meropenem and valproic acid in paediatric inpatient clinic: A case report(Istanbul Univ, Fac Pharmacy, 2023) Cakir, Ahmet; Memis, Hasan; Ozdemir, Nesligul; Gun, Zeynep UlkuBackground and Aims: Drug-drug interactions cause many complex drug events, especially adverse drug effects. It is known that drug interactions occur when meropenem and valproic acid are used together. It was aimed to back up existing research on the interaction of valproic acid. Methods: After an interaction had been suspected by the ward pharmacists, all of the patient's drugs were assessed via UpToDate (R) and Micromedex (R) databases and the interaction management was shared with the physician in charge. Results: The patient's serum valproic acid through level was in therapeutic range before meropenem administration. After the administration of meropenem, the patient's number of seizures increased and the serum trough level of valproic acid decreased to 4.3 mu g/ml. The valproic acid levels turned back to normal range after switching to a carbapenem antibiotic. Conclusion: Drug interactions are often encountered in paediatric patients and it is of critical importance in terms of seizure control. Because of the drug interaction between valproic acid and meropenem, one should avoid using these medications concomitantly. If that is impossible, daily serum valproic acid levels should be monitored with caution. Clinical pharmacists could increase the clinicians' awareness about drug-drug interactions.Öğe Determination of food-drug interaction knowledge levels of pharmacists and senior pharmacy students(Bmc, 2025) Cakir, Ahmet; Memis, HasanBackground: Food-drug interactions (FDIs) arise when a pharmaceutical and a botanical or dietary supplement food or nutrient interact physically, chemically, or physiologically. Pharmacists play key role in detecting and managing of FDIs. This study examined factors affecting licensed pharmacists and senior pharmacy students' FDI knowledge and understanding. In senior pharmacy students, short- and long-term training effects on FDI knowledge were evaluated. Methods: A validated Turkish FDI Knowledge Scale test was provided to the respondents online. After the scale had been implemented for the first time to the senior pharmacy students, a verbal face-to-face training session was organized to investigate the effects of the training on the FDI knowledge levels. After training, the same scale was administered two more times on different time points to reveal the effect of training in short and long term. A binary logistic regression identified characteristics affecting participants' good or very good scale-based FDI knowledge scores. Results: The study has 356 participants. The participants' age was 28.99 +/- 7.79 years. Based on participants' current education level, senior pharmacy students had the lowest mean FDI knowledge score (9.23 +/- 3.78), while having a specialty in pharmacy degree or being in continuum had the highest (17.00 +/- 2.73). The knowledge scores were compared based on the pharmacists' frequency of providing counsel on FDIs and the never-counselled group (8.80 +/- 4.18) had the lowest while the often-counselled group had the highest score (14.28 +/- 3.68). Age and working experience positively correlated with FDI knowledge score (Spearman's coefficient for age 0.354; for working experience 0.419; p < 0.001). After senior pharmacy students were trained on FDIs, the mean knowledge score increased significantly (p < 0.001) (pre-training mean knowledge score was 8.85 +/- 3.57, after-training short-term 16.24 +/- 3.15) and remained the same after-training long-term 16.67 +/- 2.59 (p = 0.307). Being female (Odds ratio [OR] 1.842; 95% Confidence interval [CI] 1.027-3.302) and having a good self-perception of FDI knowledge (OR 18.311; CI 95% 4.879-68.718) affected the achievement of a good or very good scale-based FDI knowledge scores significantly. Conclusion: As senior pharmacists had the lowest while specialty in pharmacy degree or being in continuum had the highest FDI knowledge levels, this study suggests adding an FDI course to the pharmacy undergraduate curriculum and in-service training for licensed pharmacists to foster the FDI knowledge of pharmacists.Öğe DETERMINATION OF KNOWLEDGE LEVELS OF PHARMACISTS AND PHARMACY SENIOR STUDENTS ON FOOD-DRUG INTERACTIONS(Springer, 2025) Cakir, Ahmet; Memis, Hasan[No abstract available]Öğe Development of a Liquid Chromatography-Tandem Mass Spectrometry Method for Quantifying Teicoplanin and Its Application in Critically Ill Patients(Doc Design Informatics Co Ltd, 2025) Memis, Hasan; Cakir, Ahmet; Gun, Zeynep Ulku; Saracoglu, Hatice; Karakukcu, Cigdem; Esmaoglu, Aliye; Dogan, ZaferObjective: Teicoplanin, a glycopeptide antibiotic, is used to treat infections caused by Grampositive pathogens. Trough-level monitoring of teicoplanin is recommended in specific patient populations, including critically ill patients. This study aimed to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify teicoplanin in human plasma and adapt the method to a critically ill patient sample. Materials and Methods: Teicoplanin trough levels were measured using a newly validated LC-MS/MS method. Analysis was conducted using a C18 column with an inner diameter of 2.7 mu m (50.0 x 3.0 mm), and vancomycin hydrochloride was used as the internal standard. The method's run time per sample was 5.5 minutes. Non-parametric tests were used for statistical analysis. Univariate and multivariate logistic regression were performed to identify teicoplanin target attainment factors. A p-value of <0.05 was considered statistically significant. Results: The method demonstrated linearity between 1.56-100 mg/L teicoplanin concentration and had a lower limit of detection and quantification of 0.33 mg/L and 1.00 mg/L, respectively. Precision, accuracy, recovery rate, and carry-over effects were all within acceptable limits, according to the U.S. Food and Drug Administration (FDA) guidance. Twenty patients were included in the study. The target teicoplanin trough level (>= 10 mg/L) attainment rate was 50%. The patient's laboratory values did not significantly change after teicoplanin treatment (p>0.05), except for erythrocyte count, haemoglobin, and haematocrit values, which decreased significantly (p<0.05). Multivariate analysis revealed no significant factors affecting target attainment (p>0.05). Conclusion: The LC-MS/MS assay validated in this study is high-throughput, robust, and quick enough to be implemented in clinical therapeutic drug monitoring (TDM) laboratories. More large-scale studies are needed to understand better the relationship between teicoplanin trough levels and patient-related factors.Öğe Is sitagliptin effective for the treatment of COVID-19?(Bmj Publishing Group, 2022) Memis, Hasan; Cakir, Ahmet; Durmus, Mefkure; Gok, Selim; Bahcecioglu, Omer Faruk[Abstract Not Available]Öğe TEICOPLANIN TROUGH LEVEL MONITORING OF ADULT CRITICALLY ILL PATIENTS: A PROSPECTIVE LONGITUDINAL STUDY(Springer, 2025) Memis, Hasan; Cakir, Ahmet; Gun, Zeynep U.; Saracoglu, Hatice; Karakukcu, Cigdem; Esmaoglu, Aliye; Dogan, Zafer[No abstract available]Öğe The Definition, Prevalence, and Risk Factors of Augmented Renal Clearance in Adult Patients on Antimicrobial Therapy: A Scoping Review(Doc Design Informatics Co Ltd, 2025) Memis, Hasan; Cakir, Ahmet; Pehlivanli, Aysel; Basgut, BilgenObjective: Augmented renal clearance (ARC), defined as rapid drug clearance, can lead to subtherapeutic antimicrobial concentrations in specific patient populations. This scoping review aimed to synthesize current evidence on ARC in adult patients receiving antimicrobial treatment, focusing on its prevalence, risk factors, and influence on attaining therapeutic drug levels. It also identified gaps for future research and provided dosage recommendations. Materials and Methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement for Scoping Reviews (PRISMA-ScR) reporting guidelines. The titles, abstracts, and keywords of the studies indexed in Web of Science, PubMed, or Scopus between 2019 and 2023 were extensively analyzed for relevance to ARC and antimicrobial therapy. Non-English articles, reviews, and non-human studies were excluded. Data extracted included article type, study details, patient population, ARC definition, ARC prevalence, methods of renal function assessment, and study results. Results: Of 492 articles identified, 47 met the inclusion criteria, covering a total of 6193 patients. ARC prevalence in the studies ranged from 3.3% to 100%. The Cockcroft-Gault equation was the most commonly used method for calculating creatinine clearance (66%). Risk factors for ARC were reported in 8.5% of the studies, and glycopeptides were the most frequently examined drug class (31.9%). In 26 (55.3%) studies, high doses or prolonged infusions were recommended to achieve therapeutic drug levels. Conclusion: beta-lactams and linezolid may require prolonged infusion or higher doses in ARC patients, while glycopeptides and aminoglycosides may also require higher doses. Further research is needed to clarify how ARC affects clinical outcomes and dosing strategies.Öğe Therapeutic drug monitoring of vancomycin in the case of augmented renal clearance: a case report of a paediatric patient(Bmj Publishing Group, 2024) Memis, Hasan; Cakir, Ahmet; Ulgey, AyseAugmented renal clearance (ARC) is a condition in which renal circulation increases, causing drug levels in the blood to remain at subtherapeutic levels in severe trauma patients. Vancomycin, a hydrophilic anti-Gram-positive drug, has been shown in the literature to have its levels fall below the therapeutic range in the case of ARC. However, vancomycin dosing recommendations in the case of ARC are still lacking. Here, we identify an ARC case measured with urinary creatinine clearance in a severe trauma paediatric patient, causing vancomycin blood trough levels to drop. We could not be able to increase the vancomycin trough levels with intermittent dosing; hence, we administered vancomycin with continuous infusion, and this resulted in vancomycin blood trough levels remaining in the therapeutic range. No adverse effect was seen. Continuous infusion of vancomycin can be safely administered to paediatric patients in these cases.
