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AKICI, AHMET

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    PublicationOpen Access
    Kardiyovasküler komorbiditesi bulunan ve bulunmayan esansiyel hipertansiyon hastalarında ilaç kullanımının araştırılması
    (2020) AKICI, AHMET; Dilara BAYRAM;Volkan AYDIN;Orkun Celil SEL;Ali serdar FAK;Mehmet Sait AKMAN;Zehra Aysun ALTIKARDEŞ;Ahmet AKICI
    Amaç: Hipertansiyon, komorbiditesi sık bir hastalık olup bu durum tedaviyidüzenlenmede belirleyicidir. Bu çalışmada hipertansif hastalarda başkakardiyovasküler sorunların olup olmama durumuna göre ilaç kullanımınınincelenmesi amaçlandıGereç ve Yöntem: Bu retrospektif çalışmaya Türk Kalp Vakfı Tıp Merkezi’ninOcak 2016-Haziran 2018 arasındaki hasta verileri dahil edildi (n=11.085).Hastalara ait kayıtlı tanılar içerisinde (n=26.699) en sık karşılaşılan üç tanı olanhipertansiyon (HT), iskemik kalp hastalığı (İKH) ve dislipidemi (DL)bulunanların tedavilerindeki ilaçlar, tıbbi ve demografik özelliklerideğerlendirildi. Hipertansiyon verileri ile buna eşlik eden İKH ve DL verilerikarşılaştırıldı.Bulgular: Çalışma periyodunda oluşturulan protokollerin %22,2’sini (n=5929)HT oluşturmaktaydı. Toplam 3601 HT tanılı hastanın %43,7’sini (n=1572) tektanılı olanlar, %36,7’sini ise (n=1321) eşlik eden iki komorbiditenin en az biriniiçeren hastalar oluşturuyordu. İncelenen tüm tanı gruplarında en sık karşılaşılanilaç asetilsalisilik asit idi. En sık karşılaşılan antihipertansif ana ilaç grubu reninanjiyotensin sistemi (RAS) blokerleri, etkin maddeler ise metoprolol veamlodipin idi. Bunu tek başına HT ve HT’ye DL’nin eşlik ettiği grupta“valsartan+hidroklorotiyazid”, İKH’nin eşlik ettiği gruplarda ramipril izliyordu.Beta-bloker kullanımı ≥65 yaş hastalarda genç hastalara kıyasla daha düşüktü(sırasıyla %13,8 ve %16,1, p<0,05).Sonuç: Bu çalışmada en çok tercih edilen antihipertansif grubun, anjiyotensinreseptör blokerlerinin baskınlığında, RAS üzerinden etkililer, en çok tercih edilenilacın ise metoprolol olduğu göze çarpmaktadır. Son yıllardaki kılavuzlarda betabloker kullanımının nispeten geri plana düşmüş olmasına rağmen, bu çalışmadahipertansif hastalarda yaygın olarak kullanıldığı görülmektedir. Hipertansiyonaeşlik eden iki durumda da en sık kullanılan ilaçların genel olarak değişkenlikgöstermediği anlaşılmaktadır.
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    PublicationOpen Access
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    PublicationOpen 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, Şule
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    PublicationOpen Access
    The association of chiral characteristic with drug withdrawal due to safety: A comparative analysis
    (2022-08-01) AKICI, AHMET; Aydin V., Bahar A., Vizdiklar C., AKICI A.
    Aims Chirality of drugs might be associated with safety issues through pharmacokinetic or pharmacodynamic variations, interactions, or direct toxicological responses. We aimed to compare chiral status of the available drugs to that of drugs withdrawn due to adverse drug reactions (ADRs). Methods We searched the literature regarding withdrawn drugs due to safety-related issues (n = 391) to compare them with all available small-molecule drugs (n = 1633). We examined their chiral status and assigned as achiral compound, chiral mixture or pure enantiomer. We compared the mean survival (i.e., nonwithdrawal) time and withdrawal rates of drugs by their chirality, with further stratification by the launch year, ATC-1 (Anatomical Therapeutic Chemical) level and ADR. Results We identified higher withdrawal rate in achiral drugs (hazard ratio 2.1, 95% CI: 1.6-2.7) and chiral mixtures (hazard ratio 2.6, 95% CI: 1.9-3.5) compared to that in pure enantiomers. Pure enantiomers had the longest mean survival time (62.4 +/- 0.8 years), followed by achiral drugs (55.4 +/- 0.9 years, P < .01) and chiral mixtures (52.4 +/- 1.4 years, P < .01). Pure enantiomers had higher survival rates than chiral mixtures if launched before 1941 (P = .02), in 1961-1980 (P < .001) or 1981-2000 (P < .001). Pure enantiomers had lower withdrawal rate (18.2%) vs. chiral mixtures (35.1%, P = .02) in nervous system drugs. Pure enantiomers had lower withdrawal rate than chiral mixtures in hepatotoxic (P < .01) and cardiovascular ADRs (P < .01). Conclusion Our study showed lower likelihood of withdrawal for pure enantiomers compared to that in chiral mixtures and achiral drugs, which was more remarkable for those launched in certain time periods and several ADRs, including hepatotoxicity and cardiovascular toxicity.
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    PublicationOpen Access
    Di̇ş heki̇mli̇ği fakülteleri̇nde ve di̇ğer ağız di̇ş sağliğı kurumlarında anti̇bakteri̇yel reçetelenme durumlarının araştırılması
    (2017-12-01) AKICI, AHMET; KIRMIZI N. İ., Aydın M., KOYUNCUOĞLU C. Z., Aksoy M., Kadı E., Alkan A., AKICI A.
    Amaç: Diş hekiminin hizmet sunduğu yerin kendisinin reçeteleme performansı ile ilişkisi tam olarak bilinmemektedir. Bu çalışmada farklı sağlık kurumlarında çalışan diş hekimlerinin antibakteriyel reçeteleme davranışlarının incelenmesi amaçlandı. Materyal ve Metot: Türkiye genelinde diş hekimleri tarafından yazılan ve Türkiye İlaç ve Tıbbi Cihaz Kurumu’nca yönetilen Reçete Bilgi Sistemi’ne (RBS) kayıtlı antibakteriyel içeren reçeteler analiz edildi. 2013 yılından itibaren toplam 32 aylık dönemde üniversite ve diğer sağlık kurumlarında reçetelere yazılmış olan antibakteriyellerin dağılımı, yazıldığı tanı ve zaman dilimleri özelinde ayrıntılı olarak incelendi. Bulgular: Diş hekimlerince yazılan RBS’ye kayıtlı reçetelerdeki antibakteriyellerin çok azının “üniversite diş hekimliği fakültelerinde” (ÜDF), (n=9.952), çoğunun ise “diğer ağız ve diş sağlığı kurumlarında” (DADSK) yazıldığı (n=13.069.333) tespit edildi. Her iki sağlık kurumunda da en sık yazılan antibakteriyel ilaç grubunun “beta laktam antibakteriyellerpenisilinler” (sırasıyla %93,7 ve %71,3), antibakteriyel ilacın ise “amoksisilin+enzim inhibitörü” olduğu saptandı (sırasıyla %69,7 ve %57,9). Bu sıralamayı ÜDF’lerde “amoksisilin” (%21,9) ve “klindamisin”in (%1,5), DADSK’lerde ise “spiramisin” (%10,4) ve “amoksisilin”in (%9,2) izlediği belirlendi. ÜDF ve DADSK’lerde antibakteriyellerin en sık reçetelendiği tanılar sırasıyla “gömülü diş” ve “periapikal apsesinüs oluşmadan” tanılarıydı. Sonuç: ÜDF ve DADSK’lerde çalışan diş hekimleri arasında ülke genelinde antibakteriyel reçetelenme davranışının benzeşen ve ayrışan yönleri bu araştırma ile ilk kez ortaya konmuştur. Buna göre diş hekimlerinin en sık tercih ettikleri ilaç benzerlik gösterse de ayrıntıları incelendiğinde üniversite ile diğer kurumlarda çalışanların antibakteriyel reçeteleme davranışlarının farklılıklar içerdiği anlaşılmaktadır. Anahtar kelimeler: Diş hekimliği, üniversite, ağız ve diş sağlığı kurumu, antibakteriyel, reçeteleme.
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    PublicationOpen Access
    Prescribing Practices of Physicians at Different Health Care Institutions
    (2013-06-28) AKICI, AHMET; Mollaoglu, Salih; Alkan, Ali; Donertas, Basak; Ozgulcu, Senay; Akici, Ahmet
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    PublicationOpen Access
    Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey
    (CUKUROVA UNIV, FAC MEDICINE, 2020-06-30) AKICI, AHMET; Bayram, Dilara; Vizdiklar, Caner; Aydin, Volkan; Isli, Fatma; Akici, Ahmet
    Purpose: This study aimed to examine the details of prescriptions issued in primary care and the changes over the years in Turkey. Materials and Methods: We analyzed all electronic prescriptions registered to Prescription Information System by primary care physicians in Turkey between 2013 and 2016. The mean number of drugs per prescription (nDPP) was determined by patients' sex and age groups. The percentages of the prescriptions containing the top twenty most frequently encountered drugs were determined for each year of the study. In the four-year period, the percentage of prescriptions with the ten most common diagnoses among prescriptions with single diagnosis and nDPP were examined. Results: A total of 1.457.034.275 drugs were prescribed in 518.335.821 prescriptions and nDPP was 2.81 for the four-year period. The most commonly used drugs in all prescriptions were other cold preparations (19.2-19.7%) and amoxicillin+beta-lactamase inhibitor (9.9-10.5%). The diagnosis of hypertension (6.9%, nDPP: 2.00) and acute upper respiratory tract infection, unspecified (URTI), (6.5%, nDPP: 2.61) were in the top ranks in single-diagnosis prescriptions during four-year period. Conclusion: Primary care prescriptions appear to be mostly generated for women and elderly populations, with a tendency for URTI and hypertension indications. Overprescriptions of cold preparations, NSAIDs, PPIs, analgesics, and broad-spectrum antibiotics imply existence of important problems in the primary care regarding rational prescribing behavior.
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    PublicationOpen Access
    Assessment of the association between drug disposal practices and drug use and storage behaviors
    (ELSEVIER, 2018-01) AKICI, AHMET; Akici, Ahmet; Aydin, Volkan; Kiroglu, Arzu
    Objective: Keeping unnecessary drugs at home is a situation showing both causes and consequences of irrational use of medicine. This study aimed to evaluate the approaches of a company's employees regarding drug storage, use, and disposal. Method: This online-based descriptive study was held in a multi-centered private-sector company in a voluntary basis. The survey assessing participants' drug handling and storage behaviors was answered by 1121 employees from across eight provinces of Turkey in 2016. Main outcome measures were storage and disposal of unused/unwanted drugs at home in a rational way. Results: The percentage of participants who declared that they keep unused/unwanted drugs at home was 28.0%. About one-third of participants disposed their unused/unwanted drugs via the garbage, sink, toilet, etc.. Participants >= 30 years old and living with < 4 household members significantly tended to bring their unused/unwanted drugs to the company's drug-box. Nearly half of all participants (46.5%) stated a recent change in their disposal behavior. The vast majority of participants (94.6%) who previously took drugs back to the company's drug-box stated that they either had, or would, help their contacts adopt such behaviors. These participants were also significantly less likely to dispose of drugs inappropriately, practice self-medication, be unaware of expired drugs at home, or fail to store drugs according to the labelling. Conclusion: While our findings showed that a substantial number of participants still had unused drugs at home and disposed of them inappropriately, it is understood that they started to exhibit more favorable behaviors in recent years. (C) 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.
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    PublicationOpen Access
    Personal Analgesic List Definition in Accordance with the Rational Use of Medicine for Dentistry
    (MARMARA UNIV, FAC PHARMACY, 2017-10-03) AKICI, AHMET; Akici, Ahmet; Kirmizi, N. Ipek; Gocmen, Gokhan
    Physicians should prepare their own personal medicine list for each indication before consulting with patients. This approach is essential for rational use of medicine (RUM). One of the most commonly prescribed medicine groups by dentists is analgesics. The purpose of this review is to indicate how to perform medicine selection based on RUM principles. It is explained with the integration of personal analgesic list (PAL) concept to dentistry. PAL establishment is based on 4 main criteria, which are efficacy, safety, suitability and cost, and the knowledge of clinical pharmacology of analgesics. These principles are followed to choose the best alternative through all medicines. Therefore, dentists might minimize their necessity of knowledge about various kinds of analgesics. It will be easier to learn limited number of medicines in the PAL. In this method, dentists will precisely wise up about a few numbers of medicines, select the most proper one through them and easily remember every details of information that should be given to their patients. Consequently, a dentist with PAL will be able to perform a successful analgesic treatment. This rational approach, initiated with analgesics, might be used by the help of transfer effect in other medicine/product groups, such as antibiotics.
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    PublicationOpen Access
    Assessment of Methylphenidate Prescriptions Written for the Treatment of Attention-Deficit/Hyperactivity Disorder
    (KURE ILETISIM GRUBU A S, 2013-03) AKICI, AHMET; Akici, Ahmet; Gelal, Ayse; Demircan, Dilek; Tiskaoglu, Ramazan; Topcus, Ibrahim; Yilmaz, Huseyin
    Aim: Methylphenidate is a medication used for the treatment of attention deficit hyperactivity disorder (ADHD). In this study, we aimed to investigate the details of methylphenidate prescriptions. Materials and Methods: A total of 5681 methylphenidate prescriptions written for the treatment of ADHD were collected from the archives of the Provincial Health Directorate of Istanbul between January and December 2009 and were retrospectively evaluated regarding the details of drug usage. Statistical comparisons were based on the Chi-square test at a p<0.05 level of significance. Results: The ages of the patients were not mentioned in most of the methylphenidate prescriptions (85.4%). Out of those prescriptions with age information, 78.5% were written for patients younger than 18 years old. Methylphenidate prescriptions were mainly written for male patients (73.7%). Sixty three percent of methylphenidate prescriptions were written by pediatric and adolescent psychiatrists as well as pediatricians. Methylphenidate prescriptions for pediatric patients were more often written in university hospitals (64.5%), whereas those for adult patients were more often written in private hospitals (36.6%). Doctors treating pediatric patients more often mentioned dosage information than doctors treating adult patients (p<0.01). Methylphenidate prescriptions for pediatric patients were more often written in winter, whereas the majority of those for adult patients were written in summer (p<0.01). Conclusion: It was interesting to note that a remarkable percentage of adult patients get methylphenidate treatment although these prescriptions are written most often for pediatric patients. The findings of this study point out that methylphenidate treatment in adult patients should be more thoroughly evaluated and resolved.