9^th Annual European Pharma Congress June 26-28, 2017 Madrid, Spain

Dr. Shereen Elazzazy received her bachelor degree in Pharmacy from Egypt in 1997 and her Doctor of Pharmacy degree at Purdue University, USA in 2011. She has extensive international experience working in Egypt, KSA, and Qatar, and recently completed internship in Indiana, USA. Her areas of expertise are mainly oncology, nutrition, palliative care, aseptic pharmaceutical preparations and pharmaceutical registration/ regulations. Currently she is an Asst. Director of Pharmacy - Clinical Services in the National Center for Cancer Care and Research, Qatar, an Adjunct Clinical Faculty in College of Pharmacy, Qatar University, a Clinical Preceptor for Collage of Science, North Atlantic, Qatar, local mentor for Pharmacy School, Queen’s University, UK, and a Clinical Sponsor, PharmD program, University of Colorado, USA. She has numerous peer-reviewed publications and active presentations in national, regional and international conferences in the areas of oncology, hematology, infectious diseases, palliative care, clinical pharmacokinetics, and nutrition.

Medication Reconciliation (Med.Rec) is a major intervention which reduces medication discrepancies and subsequent patient harm at different patients’ care transitions. Data on the incidence of the unintended medications discrepancies ranges from 40–50% upon admission to acute care hospitals and 40% at hospitals discharges. Pharmacists’ role in Med.Rec is highly recommended due to their distinct knowledge, skills, and abilities to establish and maintain effective Med.Rec process. Pharmacy Med.Rec at admission or discharge is a crucial step for an error free environment. Outpatient pharmacist play a lead role in detecting medication related problems; this urges the need to translate their qualitative values into quantitative measures.\r\nPrimary objective: to investigate the impact of outpatient pharmacists’ interventions during discharge reconciliation, in reducing medication errors and discrepancies. Secondary objective: to detect the most common medication related problems.\r\nMethods: A prospective observational study, conducted at a 62-bed tertiary care cancer center (National Centre for Cancer Care & Research) in Qatar. All discharged patients were included in the study over duration of 10 months (from 1st April 2014 to 31st January 2015). Patients who were discharged from the chemotherapy infusion unit were excluded. A standardized intervention form was generated to document interventions. Collected data were categorized into medication error or medication discrepancy. A statistical analysis included exploratory analysis and descriptive statistics using STATISTICA 11.0 Version.\r\nResults: Total of 591 discharge prescriptions included, 278 (47%) required pharmacist interventions; with 190 medication discrepancies and 122 medication errors. The most common medication related problems were incomplete orders (34%) and prescribing restricted medication without privilege (29%). \r\nConclusion: Outpatient pharmacists have a significant role towards detecting and reducing medication errors and discrepancies upon patient discharge. However, despite their effective interventions, most of these medications related problems are preventable. An improved quality process and awareness can create an efficient medication safety environment.\r\n

The Top Five Global Pharma Companies; Key Financial\r\nIndicators & Performance Forecasting

Dr. Valery Gmiro is the leading researcher of Institute Experimental Medicine (Russia). He has published more than 150 papers in reputed journals. The main scientific interest concerns the chemistry and pharmacology of biologically active compounds. He is the USSR State Prise Winner for the investigations in the field of physiology of synaptic transmission. During last years V.Gmiro is working on the problem of the creation of adaptogenic drugs acting through activation of afferent nerves. These drugs were shown to be effective tools to study the mechanisms of transmission of afferent signals and may be of interest in clinic using.

Mecamylamine, nonselective antagonist of cholinergic nicotinic receptors after intramuscular (i.m.) and intragastric (i.g.) administration causes maximal analgesia in the tail-flick test only 30% of the rats, and also reduces time of paw licking in the formalin test only 30% compared with the control, suggesting relatively weak analgesic activity of mecamylamine in both tests. Adenosine in a dose of 25-30 mg/kg and IEM-1556 (N-decyltropin chloride) in a dose of 1-3 mg/kg after intramuscular and intragastric administration cause maximal analgesic effect in the tail-flick test and formalin test in 80-100% of the rats. Dipyridamole inhibiting reuptake of adenosine, in 9-12 times reduces ED50 of adenosine and IEM-1556, and antagonist of adenosine receptors of 1,3-dipropyl-8-phenylxanthine (DPX) in 3.8-4.5 times increases ED50 of adenosine and IEM-1556 in both tests. The received results evidence in favor of participation of endogenous adenosine in the mechanism of the analgesic action IEM-1556. Preliminary anesthesia of the gastric mucosa with 1% lidocaine and subdiaphragmatic gastric vagotomy almost equally in 3.7-4.4-fold increase ED50 IEM-1556 and adenosine in both tests, indicating the involvement of vagal afferents in gastric mucosa in the development of analgesic action both IEM-1556, and adenosine. Coincidence of mechanisms of the vagus-stimulating and analgesic action of exogenous adenosine and IEM-1556 demonstrates that IEM-1556 as a probable liberator of endogenous adenosine after system and oral administration in a low dose of 1-3 mg/kg causes development of analgesia as a result of stimulation of adenosine -sensitive vagal afferents in gastric mucosa. In higher doses the analgesic effect of IEM-1556 (which isn\'t eliminated by DPX, vagotomy and lidocaine) is presumably explained by additional blockade of cholinergic nicotinic receptors in CNS.

Sahar Nasser received her bachelor degree in pharmacy from Qatar University, college of pharmacy (CCAPP accredited) in 2011. She began her pharmacy career in the National Center of Cancer Care and Research (NCCCR). She is also a clinical preceptor for undergraduate pharmacy students and got promoted to senior pharmacist in 2015. She is recently completing her post graduate year 1 (PGY1) pharmacy practice residency in Hamad medical corporation (in candidate status for accreditation by ASHP). Her early-career focus was on patient centered care practice and medication safety. Throughout her career, she participated in various educational activities directed to healthcare providers, students and patients. Her main research interest is in improving cancer patients’ outcomes and cancer epidemiology.

Background: Bone-targeting agents (BTA) like Zoledronic acid (ZA) and Denosumab (DE) are approved for prevention of skeletal-related events (SREs) in patients with Bone Metastases (BM) including hypercalcemia of malignancy (HCM). Hypocalcemia has been observed with both ZA and DE. However, Studies showed a higher incidence of hypocalcemia with Denosumab. International guidelines do not favor one BTA over the other. Due to the differences in patients’ characteristics and treatment related factors; hypocalcemia incidence might differ in varying Cancer settings. The primary objective: to identify the incidence of hypercalcemia and hypocalcemia in ZA and DE groups. Secondary objective: to identify the correlation between calcium supplement and calcium level control. Methods: An observational retrospective cohort study, conducted by reviewing patients’ electronic records, laboratory and medication reports from August 1st 2015 till July 31st 2016. Adult Cancer patients diagnosed with BM secondary to a solid tumor or Multiple Myelomas and receiving either ZA or DE were included. Other indications for BTA were excluded. BTA administration visits were collected, evaluated and analyzed. Results: A total of 271 patients (1367 visits) were included in our study. Over Incidence of hypocalcemia in DE group compared to ZA was (4.1% vs 3%, OR=0.72, CI 95% [0.43 – 1.19]). Hypercalcemia was reported in both groups (3.5% vs 5.3% respectively, CI 95% [0.97 – 2.4]). Breast cancer was the most common malignancy associated with hypocalcemia (70%) followed by (10%) in both prostate cancer and Multiple myelomas. Patients received calcium supplement were 23% less likely to develop hypocalcemia (RR= 0.77, CI 95% [0.48 – 1.23]). Conclusion: Despite hypocalcemia was common in DE group, it was not statistically significant. Adequate calcium intake substantially reduces the risk of hypocalcemia. Our results highlight the importance of preventing hyper and hypocalcemia upon BTAs initiation and during treatment by regular monitoring of calcium levels, and providing calcium supplements accordingly.

Dr Alaraj (Associate Professor) was educated at Warsaw University, Poland and received a MS in Chemistry and Drug Technology in 1987. He obtained his PhD in 1995 from the College of Pharmacy, Medical University of Warsaw, Poland, having worked on the effects of polypeptide on the activity of some antiepileptic drugs. Dr Alaraj moved to “Mossakowski Medical Research Centre”, Polish Academy of Sciences where he begun research in calcium signaling and role of glucose on neurodegeneration. Since joining the Medical Faculty-University of Hail (2008), Dr Alaraj has been mainly involved in evaluating the hemodialysis efficiency and implication of uric acid in kidney impairment and other aspects of kidney diseases- among end stage renal disease (ESRD) patients. Recently he has identified that serum uric acid negatively affect the efficacy of HD. He is currently involved in identifying the relationship between drugs used and HD efficacy among ESRD patients

Statement of the Problem: Inefficiency of hemodialysis (HD) is a major cause of the increased rate of morbidity and mortality observed in patients with end stage renal disease (ESRD). The recommended techniques to optimize HD achievement are still not fully successful. This may, at least in part, relate to inadequate understanding of the factors affecting the HD process, including drugs taking by these patients. Previously, we demonstrated that hemodialysis efficiency, particularly in patients with less than 50 years of age may be improved by decreasing the serum uric levels. In the current study, we assessed the potential relationship between ranitidine intake and hemodialysis efficiency among ESRD patients in Hail, Saudi Arabia. Methodology: A total of 275 hemodialysis patients (122 males and 153 females) were enrolled in this retrospective study. The range was 25 to 83 years with median age of 51 years. Blood sampling was collected pre- and post-HD to calculate the HD efficiency indices, particularly Kt/V, creatinine reduction ratio, uric acid ratio, and urea reduction ratio. Results: We found that the proportion of female patients with ESRD was significantly higher (60%; p<0.05), than the males in the patient group examined. Among hemodialysis patients, the incidence of hypertension was 86 % (p<0.05). There was a positive association between ranitidine supplementations and HD efficiency. A significant increase in Kt/V (p=0.03) ratio was detected in patient taken ranitidine. Also, significant increase in creatinine (p=0.008), uric acid (p=0.008), and urea (p =0.029) reductions were observed. Conclusions: Taken together, the results of this study indicate that the hemodialysis efficiency in HD subjects may be significantly improved by supplementation with ranitidine.