Purpose: This study aimed to identify drug-related problems at treatment in patients with sepsis and septic shock and to evaluate the contribution of the clinical pharmacist. Methods: This study was conducted at intensive care units(ICU) of a university hospital. A study group in which the clinical pharmacist participated in the treatment management of septic patients and a control group in which the clinic did not have a pharmacist was formed. In the treatment of the control group, interventions were made for drug-related problems detected by the clinical pharmacist. Study and control group were compared in terms of length of ICU stay, time to initiation of appropriate antimicrobial drug(s), appropriateness of antimicrobial dosing, and drug treatment costs. Results: Total of 65 patients were included in the study group prospectively in which the intervention of clinical pharmacist provided for the drug treatments and retrospectively 65 patients in the control group without any intervention. In the study group, 670 recommendations were made for 753 problems related to their drug therapy. Between groups, improvement in appropriateness of antimicrobials in terms of dose, time to initiation of appropriate antimicrobial therapy, daily antibiotic costs in all patients and antibiotic costs in patients with impaired renal function statistically significant difference were found. Conclusions: As a result of clinical pharmacist involvement in sepsis management, it has been shown to contribute to the prevention and management of drug interactions, to start antimicrobial therapies more quickly, to select the appropriate drug and dose, especially antimicrobials, and to save the costs of antimicrobial drugs.

Aim Clinical application of insulin infusion therapy is usually accomplished with regular human insulin. It is known that the regular insulin adsorbed to the hydrophobic surfaces and different approaches were implemented into the clinical practices. It was aimed to evaluate the rate of adsorption of insulin to PP bags and PVC infusion sets and stability of insulin during the infusion. Methods 100 IU insulin was added to PP bags containing 100 ml of 0.9% NaCl solution(n = 6). The infusion was started at a rate of 2 ml/h using infusion sets in the PVC structure. Insulin quantification was performed in the samples taken both from the bag and from the end tip of the infusion set during infusion. The stability of insulin solutions stored at room (+24°C) and refrigerator (+4°C) temperatures were compared. Samples were analyzed using reverse-phase high-performance liquid chromatography. Results No statistically significant difference was found between the concentrations of the samples taken from the bags stored at room and refrigerator temperatures at the 4th, 12th, and 24th hours (p>0.05). It was seen that the adsorption rate of insulin to PVC set was 57% and PP bags is at most 5% at the 24th hour. Conclusion When PP bags are used for insulin infusion, it is predicted that 24-hour change can be made instead of frequent change. In addition, losses caused by the high rate of insulin adsorption to PVC infusion sets should be considered and PP infusion sets would be the better option to use if available.

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