Person: AKICI, AHMET
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
AKICI
First Name
AHMET
Name
16 results
Search Results
Now showing 1 - 10 of 16
Publication Metadata only Prescription audit adjunct to rational pharmacotherapy education improves prescribing skills of medical students(SPRINGER HEIDELBERG, 2005) AKICI, AHMET; Akici, A; Goren, MZ; Aypak, C; Terzioglu, B; Oktay, SObjective: To assess the impact of a rational pharmacotherapy (RP) teaching program during clinical pharmacology clerkship by analyzing the results of prescription audits (PAs) of the medical students. Collectively, we intended to observe the possible improvement of the students in their prescribing, problem solving and self-directed learning skills. Design: At the beginning and end of the clerkship, the students were presented with cases of uncomplicated osteoarthritis to assess their prescribing skills; format and rationality were scored. Setting: A medical school in Turkey that teaches RP to the fourth-year students in clinical pharmacology clerkship. Participants: There were 94 students of the 2002-2003 academic year in three groups and a single group of students belonging to the previous academic year tested. Of those students from the previous academic year, 26 were also analyzed a year later to demonstrate the long-term impact of the training. Main outcome measures: Prescribing skills of medical students and their opinions about PA. Results: Direct assessment via PA demonstrated that the scores for post-clerkship prescriptions were far better than those for pre-clerkship prescriptions in terms of format and rationality. Long-term assessment showed that the scores declined within a year following clerkship, but they were still higher than those of their pre-clerkship scripts. Analysis of the questionnaires revealed that the students were satisfied with PA. The majority of the students stated they had learned the general principles of RP and gained better prescribing skills, and they intended to apply most of the principles learned to their future professional lives. The script format scores of a retrospectively created PA-exempted group were significantly lower than those of the students to whom an established PA education was given. Conclusion: PA sessions were shown to be an easy and a useful method of both evaluating and reinforcing prescribing skills gained though problem-based RP education.Publication Metadata only Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey(Dustri-Verlag Dr. Karl Feistle, 2005) AKICI, AHMET; Ay P., Akici A., Harmanci H.Objective: This study investigates drug utilization and estimates the prevalence of potentially inappropriate drug use in a Turkish population aged 70 years or older. Material and methods: A cross-sectional study was carried out on a total of 1,019 participants who accepted face-to-face questionnaires in home interviews in Istanbul. All medications used in the three weeks prior to the study were recorded. Some major risk factors that might influence the use of inappropriate medication such as socio-demographic characteristics and concomitant disease such as depression and dementia were also questioned. Inappropriate drug use was assessed using the Beers criteria. Results: Among the 1,019 participants, 903 (88.6%) had been using at least one medication during the last three weeks. The average number of medications used was 2.9 ± 2.0. The most frequently drugs used were cardiovascular drugs (39.9%), followed by analgesics /anti-inflammatory drugs (16.2%), vitamin/mineral preparations (10.6%) and central nervous system drugs (10.2%). Of the 1,019 participants, 9.8% were using one potentially inappropriate medication and one patient was using two inappropriate drugs. The most common of these drugs were reserpine (23.7%), dipyridamole (21.8%), antihistamines (14.8%), and benzodiazepines (10.9%). Only age and total number of medications were associated with potentially inappropriate drugs in the multivariate analysis. Conclusions: This study revealed that drug utilization and the prevalence of inappropriate medication use in the elderly were lower than in published reports from most developed countries. Furthermore, polypharmacy and higher age were the main risk factors for potentially inappropriate drug use in the elderly. ©2005 Dustri-Verlag Dr. K. Feistle.Publication Open Access Impact of a short postgraduate course in rational pharmacotherapy for general practitioners: Rational pharmacotherapy course: impact on GPs(2003-11-14) AKICI, AHMET; Akici, Ahmet; Kalaça, Sibel; Ugurlu, M. Ümit; Karaalp, Atila; Çali, Şanda; Oktay, ŞulePublication Metadata only Antihypertensive drug utilization at health centres in a district of Istanbul(SPRINGER, 2007) AKICI, AHMET; Akici, Ahmet; Kalaca, Sibel; Ugurlu, Uemit; Toklu, Hale Z.; Oktay, SuleObjective: Since irrational use of antihypertensives has considerable clinical and economical consequences, this study was conducted to evaluate antihypertensive drug utilization in hypertension at seven State Health Centres in Istanbul. Method: A total of 297 hypertensive patients who accepted to participate in the study were evaluated by a face-to-face questionnaire and a copy of their prescriptions were collected for prescription analysis. Results: Angiotensin-converting enzyme (ACE) inhibitors (31.7%), calcium channel blockers (28.8%), diuretics (16.2%), beta blockers (7.5%) and others (15.8%) have been prescribed. There were no statistically significant relation between prescribed antihypertensive drug groups and gender, age, and NSAIDs co-prescribing. The most frequent comorbidity in hypertensive patients was diabetes mellitus (10.4%) and calcium channel blockers (35.5%) have been prescribed to them as a first antihypertensive medication. Average cost per prescription was $42.7 +/- 38.1. According to the patients' self-reporting, the majority of them (85%) were prescribed without a physical examination. The physicians failed to write the prescriptions appropriately; only 5% of the scripts contained all information about the drug(s) and use instructions in full format. Conclusion: The present study indicates that GPs working at primary healthcare centres were rational in terms of antihypertensive drug choice. However, they poorly applied rational pharmacotherapy principles such as (a) writing a good prescription which is easily readable by the pharmacist and the patient and that contains full essential information; (b) a medical examination of the patient to assess her/his current clinical condition; and (c) taking care of not prescribing drugs with potential interaction like antihypertensives and NSAIDs together.Publication Metadata only Rational pharmacotherapy and pharmacovigilance(2007) AKICI, AHMET; Akici A., Oktay S.Pharmacovigilance is defined as "the detection, evaluation, understanding and prevention of adverse drug reactions (ADRs)". The ultimate aim of pharmacovigilance is the optimization of the risk-benefit ratio of marketed drugs at the individual level (i.e. the choice of the most suitable treatment for a given patient) and at the population level (i.e. maintenance or removal of a drug from the market, informing prescribers of its potential risks, etc.). Prevalence of drug-related morbidity and mortality increase in correlation with the increase in drug use. Both physicians and patients prefer polypharmacy because of different reasons such as insufficient knowledge, lack of enough time for the patients, being misled by non-scientific newspaper/ TV news, etc. Polypharmacy is among the major causes of drug-related morbidity and requires additional medication as treatment. On the other hand, adverse reactions might be minimized by adequate knowledge and rational prescribing, simply by reducing inappropriate polypharmacy. Therefore, physicians' prescribing habits based on rational pharmacotherapy processes which include choosing suitable drug(s), at an optimum dose and duration of use, among the effective and safe treatment alternatives, and informing patients about the diagnosis and treatment, can be a major contribution to optimize the risk-benefit ratio of drugs. As an essential step in the rational pharmacotherapy process, giving adequate information to the patients about their treatment (i.e. dosage, use instructions, warnings, effects, side effects, etc.) may prevent some of the drug-related problems. In addition, informed patients are more likely to seek advice from their physicians to seek advice for ADRs. In this review article, therefore, the influence of rational pharmacotherapy training on the pharmacovigilance of drugs will be discussed. © 2007 Bentham Science Publishers Ltd.Publication Metadata only What do graduates think about a two-week rational pharmacotherapy course in the fifth year of medical education?(CARFAX PUBLISHING, 2003) AKICI, AHMET; Karaalp, A; Akici, A; Kocabasoglu, YE; Oktay, SThe present study aims to assess the short-and mid-term post-graduation impact of a pharmacotherapy course in the fifth year at Marmara University School of Medicine by an objective (OSCE) and a subjective (questionnaires) evaluation. Statistical comparison of pretest, posttest-exposed case and posttest-unexposed case scores indicated both a retention and a transfer effect of training. The post-course questionnaire revealed that 95% of the students found the course useful and necessary; 97% reported that they will apply a rational pharmacotherapy approach using this model and communicate better with their patients. The post-graduation questionnaire also showed that the majority of them have learned general principles of rational pharmacotherapy (90%), gained good prescribing (90%) and communication skills (87.5%), and understood the importance of non-pharmacological treatment alternatives (100%). In general, they stated that they would apply the principles during their medical practice and they believed their colleagues would do too. In conclusion, the present study demonstrates the benefit of a clinical pharmacology programme focused on rational pharmacotherapy during the clinical years of medical education.Publication Metadata only Inhibition of substance P activity prevents stress-induced bladder damage(ELSEVIER SCIENCE BV, 2006) AKICI, AHMET; Ercan, F; Akici, A; Ersoy, Y; Hurdag, C; Erin, NSubstance P is a neuropeptide involved in inflammation, immune regulation and stress response. Stress may induce bladder damage by stimulating inflammatory response such as mast cell activation. We here examined the role substance P during stress-induced mast cell degranulation and urothelial injury in rat bladder. Adult Sprague-Dawley rats (200-270 g) were either exposed to cold-immobilization stress or substance P (SP) intracerebroventricularly. Different doses of substance P receptor (NK1R) antagonist CP 99994 were administered peripherally or centrally before the stress exposure. From each group, samples of the bladder were examined with light and electron microscope. Stress- and SP-injected centrally, increased the number of both granulated and degranulated mast cells. Ultrastructurally, urothelial degeneration with vacuolization in the cytoplasm and dilated intercellular spaces were seen. Both central and peripheral injection of CP 99994 prevented stress-induced urothelial degeneration as well as stress-induced mast cell degranulation. In conclusion, centrally and peripherally released substance P is involved in stress-induced bladder damage. Inhibition of NK1R prevents stress-induced pathological changes of urinary bladder and NK1R antagonist can be considered for the treatment of inflammatory bladder diseases. (c) 2005 Elsevier B.V. All rights reserved.Publication Metadata only Impact of a short postgraduate course in rational pharmacotherapy for general practitioners(WILEY, 2004) AKICI, AHMET; Akici, A; Kalaca, S; Ugurlu, MU; Karaalp, A; Cali, S; Oktay, SAims The impact of a short postgraduate course on rational pharmacotherapy planning behaviour of general practitioners (GP) was investigated via a face-to-face interview with 25 GPs working at health centres in Istanbul. Methods GPs were randomly allocated to control and intervention groups. Intervention group attended a 3-day-training program preceded and followed by a written exam to plan treatment for simulated cases with a selected indication. The participants' therapeutic competence was also tested at the post-test for an unexposed indication to show the transfer effect of the course. In addition, patients treated by these GP's were interviewed and the prescriptions were analysed regarding rational use of drugs (RUD) principles at the baseline, 2 weeks and 4 months after the course. Results At the baseline there was not any significant difference between the control and intervention groups in terms of irrational prescribing habits. The questionnaires revealed that the GPs were not applying RUD rules in making their treatment plans and they were not educating their patients efficiently. Training produced a significant improvement in prescribing habits of the intervention group, which was preserved for 4 months after the course. However, very low scores of the pretest indicate the urgent necessity for solutions. Conclusions Training medical doctors on RUD not only at the under- but also at the postgraduate level deserves attention and should be considered by all sides of the problem including academia, health authorities and medical associations.Publication Metadata only Cardiovascular responses to NMDA injected into nuclei of hypothalamus or amygdala in conscious rats(KARGER, 2000) AKICI, AHMET; Goren, MZ; Akici, A; Berkman, K; Onat, FThe nuclei of hypothalamus and amygdala have been shown to be involved in the central cardiovascular homeostasis. Recent studies suggest that glutamate-containing neurons have an important role in the regulation of the central cardiovascular function. In this study, we demonstrate the roles of the central nucleus of the amygdala and the paraventricular nucleus of the amygdala and the paraventricular nucleus or the dorsomedial nucleus of the hypothalamus in N-methyl-D-aspartate (NMDA) induced blood pressure and heart rate changes in conscious Sprague-Dawley rats. Intracerebroventricular or parenchymal injections of NMDA evoke increases in arterial pressure. The NMDA-induced elevations in brood pressure are more prominent when NMDA is administered into the dorsomedial nucleus of the hypothalamus, Microinjections of NMDA into the dorsomedial hypothalamus exert significant heart rate increases, whereas NMDA when administered into the paraventricular nucleus of the hypothalamus or into the central nucleus of the amygdala has no significant effect on the heart rate. The dorsomedial nucleus of the hypothalamus is found to be the most effective site in this respect, The present study provides strong evidence for the tonic glutamatergic influence on blood pressure and heart rate via NMDA receptors located within the dorsomedial nucleus and to a lesser extent via those located within the paraventricular nucleus of the hypothalamus. Copyright(C) 2000 S. Karger AG, Basel.Publication Metadata only Comparison of rational pharmacotherapy decision-making competence of general practitioners with intern doctors(SPRINGER HEIDELBERG, 2004) AKICI, AHMET; Akici, A; Kalaca, S; Goren, MZ; Akkan, AG; Karaalp, A; Demir, D; Ugurlu, U; Oktay, SObjective. The aim of this study was to compare rational pharmacotherapy decision-making competency of interns (final-year medical students) who had received rational pharmacotherapy education (RPE), with their classmates at another medical school and general practitioners (GPs) who had not been exposed to RPE. Design. A written, objective, structured clinical examination (OSCE), consisting of open and structured questions, was given to all participants. The participants were expected to make a treatment plan and prescribe for simple, uncomplicated beta-hemolytic streptococcal tonsillitis and mild-to-moderate essential hypertension patients, explain their proposed treatment plans and reasons affecting their drug choice. After the OSCE, a questionnaire to assess knowledge of the rational use of drugs was given to the participants. Results. Fifty RPE(+) interns, 54 RPE(-) interns and 53 GPs participated in the study. Mean scores of RPE(+) interns were higher than those of GPs, which were in turn found to be higher than those of RPE(-) interns for all cases. The RPE(+) interns scored the highest regarding all components of rational pharmacotherapy process for all cases of both indications. However, participants in all groups had higher scores for the structured questions compared with the corresponding open ones for both diseases. Prescription analysis also revealed better results for RPE(+) interns regarding the number of drugs/prescription and treatment costs. Conclusion. The present study demonstrated that the final-year medical students (interns) markedly benefited from undergraduate RPE at the medical school in developing rational prescribing skills compared with their classmates from a medical school with traditional pharmacology education. Interestingly, they got higher scores than not only RPE(-) interns, but also than the GPs participating in this study, indicating the urgent need for continuous medical education programs in this field throughout the country for practicing GPs.