The document provides an overview of the history and current state of oncology clinical pharmacy from practice to research. It discusses how clinical pharmacists can play important roles in patient care by developing pharmaceutical care plans, managing side effects of cancer treatment, preventing and treating complications, and counseling patients. Clinical pharmacists are also involved in research by conducting clinical trials, publishing original research and reviews, and developing evidence-based guidelines. Overall, the involvement of clinical pharmacists in direct patient care and research has been shown to improve outcomes and reduce healthcare costs.
Principles of cancer chemotherapy: a deep insight, by RxVichuZ!!RxVichuZ
This presentation deals with PRINCIPLES OF CANCER CHEMOTHERAPY.
The following headings are included:
A. PRINCIPLES OF ONCOLOGY
B. CELL-CYCLE
C. PRINCIPLES OF CANCER CHEMOTHERAPY
Precise details have been provided.
Do go through!!
Principles of cancer chemotherapy: a deep insight, by RxVichuZ!!RxVichuZ
This presentation deals with PRINCIPLES OF CANCER CHEMOTHERAPY.
The following headings are included:
A. PRINCIPLES OF ONCOLOGY
B. CELL-CYCLE
C. PRINCIPLES OF CANCER CHEMOTHERAPY
Precise details have been provided.
Do go through!!
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
REVIEWING THE CLINICIANS PRESCRIPTION AND TREATMENT PROGRESSION IS THE FUNDAMENTAL RESPONSIBILITY OF PHARMACIST. THIS PRESENTATION WILL DEAL WITH VARIOUS ASPECTS OF REVIEWING PATIENT DRUGTHERAPY PLAN
a beautiful ppt, illustrating the principles for prescribing, current concepts for clinical decision making, for practicing medicine and health care planning worldwide...
Clinical pharmacokinetics and its application--
1)definition
2) APPLICATIONS OF CLINICAL PHARMACOKINETICS
Design of dosage regimens:
a) Nomograms and Tabulations in designing dosage regimen,
b) Conversion from intravenous to oral dosing,
c) Determination of dose and dosing intervals,
d) Drug dosing in the elderly and pediatrics and obese patients.
Pharmacokinetics of Drug Interaction:
a) Pharmacokinetic drug interactions
b) Inhibition and Induction of Drug metabolism
c) Inhibition of Biliary Excretion.
Therapeutic Drug monitoring:
a) Introduction
b) Individualization of drug dosage regimen (Variability – Genetic, Age and Weight, disease, Interacting drugs).
c) Indications for TDM. Protocol for TDM.
d) Pharmacokinetic/Pharmacodynamic Correlation in drug therapy.
e) TDM of drugs used in the following disease conditions: cardiovascular disease, Seizure disorders, Psychiatric conditions, and Organ transplantations
Dosage adjustment in Renal and Hepatic Disease.
a. Renal impairment
b. Pharmacokinetic considerations
c. General approach for dosage adjustment in renal disease.
d. Measurement of Glomerular Filtration rate and creatinine clearance.
e. Dosage adjustment for uremic patients.
f. Extracorporeal removal of drugs.
g. Effect of Hepatic disease on pharmacokinetics.
Population Pharmacokinetics.
a) Introduction to Bayesian Theory.
b) Adaptive method or Dosing with feedback.
c) Analysis of Population pharmacokinetic Data
Clinical pharmacy may be defined as the science and practice of rationale use of
medications, where the pharmacists are more oriented towards the patient care
rationalizing medication therapy promoting health , wellness of people.
It is the modern and extended field of pharmacy.
“ The discipline that embodies the application and development (by pharmacist) of
scientific principles of pharmacology, toxicology, therapeutics, and clinical pharmacokinetics, pharmacoeconomics, pharmacogenomics and other allied
sciences for the care of patients”.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
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A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
REVIEWING THE CLINICIANS PRESCRIPTION AND TREATMENT PROGRESSION IS THE FUNDAMENTAL RESPONSIBILITY OF PHARMACIST. THIS PRESENTATION WILL DEAL WITH VARIOUS ASPECTS OF REVIEWING PATIENT DRUGTHERAPY PLAN
a beautiful ppt, illustrating the principles for prescribing, current concepts for clinical decision making, for practicing medicine and health care planning worldwide...
Clinical pharmacokinetics and its application--
1)definition
2) APPLICATIONS OF CLINICAL PHARMACOKINETICS
Design of dosage regimens:
a) Nomograms and Tabulations in designing dosage regimen,
b) Conversion from intravenous to oral dosing,
c) Determination of dose and dosing intervals,
d) Drug dosing in the elderly and pediatrics and obese patients.
Pharmacokinetics of Drug Interaction:
a) Pharmacokinetic drug interactions
b) Inhibition and Induction of Drug metabolism
c) Inhibition of Biliary Excretion.
Therapeutic Drug monitoring:
a) Introduction
b) Individualization of drug dosage regimen (Variability – Genetic, Age and Weight, disease, Interacting drugs).
c) Indications for TDM. Protocol for TDM.
d) Pharmacokinetic/Pharmacodynamic Correlation in drug therapy.
e) TDM of drugs used in the following disease conditions: cardiovascular disease, Seizure disorders, Psychiatric conditions, and Organ transplantations
Dosage adjustment in Renal and Hepatic Disease.
a. Renal impairment
b. Pharmacokinetic considerations
c. General approach for dosage adjustment in renal disease.
d. Measurement of Glomerular Filtration rate and creatinine clearance.
e. Dosage adjustment for uremic patients.
f. Extracorporeal removal of drugs.
g. Effect of Hepatic disease on pharmacokinetics.
Population Pharmacokinetics.
a) Introduction to Bayesian Theory.
b) Adaptive method or Dosing with feedback.
c) Analysis of Population pharmacokinetic Data
Clinical pharmacy may be defined as the science and practice of rationale use of
medications, where the pharmacists are more oriented towards the patient care
rationalizing medication therapy promoting health , wellness of people.
It is the modern and extended field of pharmacy.
“ The discipline that embodies the application and development (by pharmacist) of
scientific principles of pharmacology, toxicology, therapeutics, and clinical pharmacokinetics, pharmacoeconomics, pharmacogenomics and other allied
sciences for the care of patients”.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Medical Conferences, Pharma Conferences, Engineering Conferences, Science Conferences, Manufacturing Conferences, Social Science Conferences, Business Conferences, Scientific Conferences Malaysia, Thailand, Singapore, Hong Kong, Dubai, Turkey 2014 2015 2016
Global Research & Development Services (GRDS) is a leading academic event organizer, publishing Open Access Journals and conducting several professionally organized international conferences all over the globe annually. GRDS aims to disseminate knowledge and innovation with the help of its International Conferences and open access publications. GRDS International conferences are world-class events which provide a meaningful platform for researchers, students, academicians, institutions, entrepreneurs, industries and practitioners to create, share and disseminate knowledge and innovation and to develop long-lasting network and collaboration.
GRDS is a blend of Open Access Publications and world-wide International Conferences and Academic events. The prime mission of GRDS is to make continuous efforts in transforming the lives of people around the world through education, application of research and innovative ideas.
Global Research & Development Services (GRDS) is also active in the field of Research Funding, Research Consultancy, Training and Workshops along with International Conferences and Open Access Publications.
International Conferences 2014 – 2015
Malaysia Conferences, Thailand Conferences, Singapore Conferences, Hong Kong Conferences, Dubai Conferences, Turkey Conferences, Conference Listing, Conference Alerts
How to have quality of life in Advanced ovarian malignancyRajesh Gajbhiye
Presentation given by Dr Rakhi Gajbhiye, Mauli Hospital Nagpur at MGIMS sewagram for an International conference on Womens Health Fatal Disorders Survival with Quality in collaboration with FOGSI.
This was the function to commemorate 100 th birth centenary of Dr Sushila
Cancer Clinical Trials_ USA Scenario and Study Designs.pdfProRelix Research
Clinical trials in oncology are vital for the advancement of cancer treatments and
care. The US is at the forefront of these clinical trials, with many different study
designs being used to assess the efficacy and safety of new treatments. This article
will explore the current state of oncology clinical trial services in the US, as well as
discuss different types of study designs that are commonly used. It will provide
insight into how these trials are conducted, what data is collected, and how this
information can be used to improve patient care.
The United States Food and Drug Administration (FDA) has released
several guidance documents over the years through the Oncology Center
of Excellence to support the development of oncologic treatments and
diagnoses. Furthermore, information on the clinical trials for the treatment
of different types of cancer or specific interventions can be found on the
National Cancer Institute (NCI) website and Clinical Trials. Currently,
ClinicalTrials.gov, a website maintained by the National Library of
Medicine (NLM) and the National Institutes of Health (NIH) contains
listings of publicly and privately sponsored trials and includes information
on 91,937 studies related to cancer indicating the high volume of
research being conducted in this field.According to the World Health Organization (WHO), cancer is the leading
cause of death worldwide, with a death rate of one in six in 2020 (1).
Aside from the high mortality rate and morbidity associated with cancer, it
also negatively impacts the quality of life and poses a significant financial
burden on patients and payers making it imperative to develop effective
treatments for the disease. According to Global Cancer Observatory
(GLOBACAN), the United States accounted for 13.3% of all estimated
new cases of cancer in 2020 (2). In 2020, the single leading type of
cancer in the United States was breast cancer (11.1%) followed by lung
cancer (10%), prostrate (9,2%), colorectum (6.8%), and melanoma of the
skin (4.2%). Despite the significant prevalence of cancer and numerous
clinical trials conducted for oncology treatments, data have shown an
almost 95% attrition rate for anticancer drugs from Phase I trials until
marketing authorization. Various factors such as inaccurate preclinical
models, lack of suitable biomarkers in clinical trials, and a disconnect
between industry, academia, and regulators are responsible for the high
attrition rate (3). Therefore, it is vital to develop suitable study designs
and protocols for candidate molecules such that they obtain regulatory
approval and can be marketed. In addition to these challenges, the
development of anti-cancer agents comes at a monumental cost of an
estimated $2.8 billion. Several factors such as the choice of relevant
endpoints, the choice of appropriate biomarkers that are guided by tumor
biology, and careful patient selection are expected to improve the overall
fate of oncologic agents in the clinical trial phase
Clinical Questions types .
A Hierarchy of Preprocessed Evidence.
EBM definition and value.
Knowledge and Skills Necessary for Optimal Evidence-Based Practice.
Basic computer and internet knowledge for electronic searching of the literature
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Oncology clinical pharmacy from practice to research
1. Noha El Baghdady, M.Sc.
Oncology Clinical Pharmacy from
Practice to Research
2. Cancer was first described
by the ancient Egyptians
The earliest description of
cancer was found in the
Edwin Smith Papyrus dating
back to 1600 B.C.
The document describes
breast tumours removed by a
tool called the fire drill.
However, it states that "there
is no treatment".
3. • Fact 1
There are more than 100 types of cancers; any part of the body
can be affected.
• Fact 2
In 2008, 7.6 million people died of cancer - 13% of all deaths
worldwide.
• Fact 3
About 70% of all cancer deaths occur in low- and middle-income
countries
4. • Fact 4
Worldwide, the 5 most common types of cancer that kill men are
(in order of frequency): lung, stomach, liver, colorectal and
oesophagus.
• Fact 5
Worldwide, the 5 most common types of cancer that kill women
are (in the order of frequency): breast, lung, stomach, colorectal
and cervical. In many developing countries, cervical cancer is the
most common cancer.
5. • Fact 6
Tobacco use is the single largest preventable cause of cancer in the
world causing 22% of cancer deaths
• Fact 7
One fifth of all cancers worldwide are caused by a chronic infection, for
example human papillomavirus (HPV) causes cervical cancer and
hepatitis B virus (HBV) causes liver cancer.
• Fact 8
Cancers of major public health relevance such as breast, cervical and
colorectal cancer can be cured if detected early and treated
adequately.
• Fact 9
All patients in need of pain relief could be helped if current knowledge
about pain control and palliative care were applied.
6. • Fact 10
More than 30% of cancer could be prevented,
mainly by not using tobacco, having a healthy
diet, being physically active and moderating the
use of alcohol.
In developing countries up to 20% of cancer
deaths could be prevented by immunization
against the infection of HBV and HPV.
7. • The Lowest income countries have a survival
rate for oncology patients of 25% compared
with 56% in wealthiest.
9. Symposium on Clinical Pharmacy and
Clinical Pharmacology,1981
• The purpose of the Symposium is
to describe the present and future
functional roles of clinical
pharmacists and clinical
pharmacologists in drug
research, professional
education, and patient care.
RUSSELL R. MILLER Pharm.D., Ph.D, 1981
11. Level of Action of Clinical
Pharmacists(ESCP)
Before The Prescription
During The Prescription
After The Prescription
12. 1- Before the prescription
• Clinical trials
• Formularies
• Drug information
• Clinical pharmacists have the
potential to implement and
influence drug-related policies’
national and local formularies’,
which prescribing policies and
treatment guidelines should be
implemented.
• Clinical pharmacists are also
actively involved in clinical trials at
different levels.
13. 2- During the prescription
• Counseling activity
• Clinical pharmacists can influence the attitudes and
priorities of prescribers in their choice of correct
treatments.
• The clinical pharmacist monitors, detects and prevents
harmful drug interaction, adverse reactions ad medication
errors through evaluation of prescriptions' profiles.
• The clinical pharmacist pays special attention to the dosage
of drugs which need therapeutic monitoring.
• Community pharmacists can also make prescription
decisions directly, when over the counter drugs are
counseled.
14. 3- After the prescription
• Counseling
• Preparation of personalized
formulation
• Drug use evaluation
• Outcome research
• Pharmacoeconomic studies
16. Oncology Pharmaceutical Care Plan
• Cancer therapy
• Side effects or consequences of the cancer
therapy
• Complications of the problems associated with
the cancer (e.g. pain)
• Comorbidities
18. B - Side effects or consequences of the
cancer therapy
1-Recognition
2-Prevention strategies
3- Management strategies (CTC grading
system)
4- Patient counseling
19. B- Side effects or consequences of the
cancer therapy
• Hematological.
• Gastrointestinal.
• Mucocutaneous.
• Hypersensitivity
• Renal Toxicity
• Bladder Toxicity
• Hepatotoxicity
• Nervous System Toxicity
• Gonad Dysfunction
• Extravasation
• Infusion related reactions
20. Principles for the Prevention and Management
of CINV
1. Evaluate each patient individually
2- Evaluate the emetogenic potential and pattern of the
chemotherapeutic regimen to be given
3- Antiemetics are most effective when given prophylactically
4. Flexibility is the key
a. There are many “right” answers for anti‐emetic regimens.
b. Remember that every patient has
a different “threshold” for nausea/vomiting;
cost‐effective therapy does not mean being
stingy with antiemetics.
c. Institution‐specific guidelines standardize therapy,
facilitate tracking of outcomes, and reduce costs.
21. C- Complications of the problems
associated with the cancer
• Pain Management.
22. 2- Patients Issues
1- Performance status (ECOG)
2- Health status
a)Organ function
b)Nutritional status
3- Comorbidities
31. Guidelines
1- NCCN (National Comprehensive
Cancer Network)
2- ASCO (American Society of Clinical
Oncology)
3- ESMO(European Society of Medical
Oncology)
4- MASCC guidelines
37. Evidenced based practice guidelines often
recommend enrollment in a clinical trial when
other standard therapies fail and a treatment or
cure is not possible.
40. Pharmacists as PI
• 1983, U.S. Food and Drug Administration
(FDA) Associate Commissioner for Health
Affairs, who stated, “It has long been FDA
policy to accept Doctors of Pharmacy as
principal investigators of studies of
investigational drugs within their expertise.”
ACCP, Update: The Clinical Pharmacist as Principal
Investigator American. Pharmacotherapy, 2010
41. www.ClinicalTrials.gov
• Use of www.ClinicalTrials.gov provided a stronger
picture of clinical pharmacist research, with 523
studies performed by those with a Pharm.D.
degree when searched in 2009.
ACCP, Update: The Clinical Pharmacist as Principal Investigator American.
Pharmacotherapy, 2010
44. ACCP, Evidence of the Economic
Benefit of Clinical Pharmacy Services
1979, the first cost- benefit
analysis of a clinical pharmacy
service was published.
ACCP, Evidence of the Economic Benefit of
Clinical Pharmacy Services: 1996–2000.
(Pharmacotherapy 2003;23(1):113–132)
45. Evaluation of Clinical Pharmacy Services in
a Hematology/ Oncology Outpatient
Setting
• A clinical pharmacist in outpatient hematology
- oncology clinics can potentially result in
overall decreased health care costs and in an
improvement in the quality of patient care
(Wong and Gray 1999).
46. Breast cancer risk assessment
The first study assessed the impact of breast
cancer risk assessment and education provided
by a community pharmacist.
• The pharmacist provided direct patient care
to 140 women.
• There was a positive correlation to
adherence of breast self-examination by the
patients after patient education was
performed by the clinical pharmacist (Giles
et al. 2001).
47. Interventions documentation
• In another study, Where Washington DC
Medical Center.
• Over an 8 month period, the pharmacy staff
reported 503 interventions, the 2 most
common being clinical consultation (33%) and
correction of prescribing errors (17%).
• There were 129 supportive care services
provided by pharmacists, including
nausea/vomiting, hematologic toxicity, pain
control, mucositis, allergy, and other general
issues. Overall interventions by oncology
pharmacists resulted in a medication cost
avoidance of $23,091 (Waddell et al. 1998).
52. Original Research
• Original research articles
are primary sources of
scientific literature and
present an original study.
• Authors have to conduct
research on a particular
topic through experiments,
surveys, observation, etc.
and report the findings of
their study through original
research articles.
53. Literature Review
• In writing the
literature review, your
purpose is to convey
to your reader what
knowledge and ideas
have been established
on a topic, and what
their strengths and
weaknesses are.
a. Review medical history, diagnosis, and concurrent medications
b. Consider any contributing causes to nausea/vomiting, and treat appropriately
c. Butyrophenones, corticosteroids, and serotonin antagonists are the least sedating
d. EPS are a risk with phenothiazines, butyrophenones, and metoclopramide
4. Flexibility is the key.
a. There are many “right” answers for anti‐emetic regimens.
b. Remember that every patient has a different “threshold” for nausea/vomiting; cost‐effective therapy does not mean being stingy with antiemetics.
c. Institution‐specific guidelines standardize therapy, facilitate tracking of outcomes, and reduce costs.
The circle formed by two ‘C’ shapes represents our global collaboration. The lines within illustrate the summary results from an iconic systematic review. Each horizontal line represents the results of one study, while the diamond represents the combined result, our best estimate of whether the treatment is effective or harmful. The diamond sits clearly to the left of the vertical line representing “no difference”, therefore the evidence indicates that the treatment is beneficial. We call this representation a “forest plot”. This forest plot within our logo illustrates an example of the potential for systematic reviews to improve health care. It shows that corticosteroids given to women who are about to give birth prematurely can save the life of the newborn child.
Despite several trials showing the benefit of corticosteroids, adoption of the treatment among obstetricians was slow. The systematic review (originally published by Crowley et al. and subsequently updated) was influential in increasing use of this treatment. This simple intervention has probably saved thousands of premature babies.