Person: KARAALP, ATİLA
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KARAALP
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ATİLA
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Publication Open Access COLCHICINE USE DURING PREGNANCY: CASE REPORTS(BMJ PUBLISHING GROUP, 2019-06) KARAALP, ATİLA; Duman, Nesrin Caglayan; Karabacak, Murat; Oglu, Medine Gulcebi Idriz; Inanc, Nevsun; Asik, Zehra Nur Turgan; Atagunduz, Pamir; Ozkula, Songul; Gulhan, Rezzan; Goren, Zafer; Onat, Filiz; Direskeneli, Haner; Karaalp, AtilaPublication 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 Distinct functional muscarinic receptors in guinea-pig gallbladder, ileum and atria(ACADEMIC PRESS LTD, 1999) AKICI, AHMET; Karaalp, A; Akici, A; Akbulut, H; Ulusoy, NB; Oktay, SObjective. The contractile responses of guinea-pig gallbladder smooth muscle cells have been suggested to be mediated by M-3 and M-4 muscarinic receptors by different research groups. Therefore, in the present study, several pharmacological properties of cholinergic functions in guinea-pig gallbladder, guinea-pig ileum (mediated via M-3 receptors), and guinea-pig and rat atria (mediated via Mt receptors) were compared, Methods: The isometric contractions of isolated guinea-pig ileum, guinea-pig gallbladder, guinea-pig and rat atrial strips in in vitro organ bath were recorded on a polygraph and the effects of carbachol, oxotremorine, McN-A-343, and clozapine have been investigated. Results: Three muscarinic receptor agonists, carbachol, oxotremorine and McN-A-343 showed different order of potencies in their negative inotropic effects and contractile actions in guinea-pig gallbladder suggesting that functional muscarinic receptors in the gallbladder are distinct from those in the atria, and similar to M-4-subtypes. Clozapine which was shown to have antagonistic affinity for muscarinic M-1, M-2, M-3 and M-5, but partial agonistic affinity for muscarinic M-4 receptors, contracted gallbladder concentration-dependently. On the other hand, clozapine antagonised carbachol-induced ileal and gallbladder contractions and negative inotropic effects indicating that it acts like a partial agonist in the gallbladder. Conclusion: It was concluded that the contractile muscarinic receptors of guinea-pig gallbladder are distinct from those of atria (M-2) and ileum (M-3), but seem to be of M-4 subtype. (C) 1999 Academic Press.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 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 Potential drug-drug interactions in a medical intensive care unit of a university hospital(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2016) KARAALP, ATİLA; Gulcebi Idriz Oglu, Medine; Kucukibrahimoglu, Esra; Karaalp, Atila; Sarikaya, Ozlem; Demirkapu, Mahluga; Onat, Filiz; Goren, Mehmet ZaferBackground/aim: Drug-drug interactions (DDIs) can impact patient safety. Occurrence of clinically important DDIs is higher for intensive care unit (ICU) patients. This observational study aimed to evaluate the potential DDIs in medical ICU patients of a university hospital. Materials and methods: The Medical Pharmacology Department organized consultation reports for ICU patients in order to detect the DDIs. To focus on clinically important DDIs, interactions in the C, D, or X risk rating categories of the Lexi-Interact online database were analyzed. Frequency and clinical risk rating categories of DDIs were detected. Relationship between number of prescriptions and DDIs were assessed. The most frequent drug/drug groups were identified. Results: Of 101 ICU patients, 45.5% were found to have DDIs. We detected 125 C (72.2%), 37 D (21.4%), and 11 X (6.4%) risk category interactions. A statistically significant increase in the number of DDIs was shown with the number of prescriptions (P = 0.002). The most frequent DDIs were between agents acting on the cardiovascular system and corticosteroids (12.8%). Conclusion: Results of this study show that pharmacological consultation plays a critical role in the recognition of DDIs for improvement of medication management and effective therapeutic endpoints without any adverse or toxic reactions.Publication Open Access EVALUATIONS OF ANTIRHEUMATIC DRUGS AT PRECONCEPTIONAL, PREGNANCY AND POSTPARTUM PERIODS OF RA PATIENTS' IN A UNIVERSITY HOSPITAL; PRELIMINARY RESULTS(BMJ PUBLISHING GROUP, 2019-06) KARAALP, ATİLA; Duman, Nesrin Caglayan; Karaalp, Atila; Inanc, NevsunPublication Metadata only p353 Evalution of antiepileptic drug use in the pregnant patients with epilepsy in a university hospital in Istanbul(2014-07-03) GÜLÇEBİ İDRİZ OĞLU, MEDİNE; GÜLHAN, REZZAN; KARAALP, ATİLA; GÖREN, MEHMET ZAFER; ONAT, FİLİZ; GÜLÇEBİ İDRİZ OĞLU M., Küçükibrahimoğlu E., JAFAROVA DEMİRKAPU M., GÜLHAN R., KARAALP A., GÖREN M. Z., ONAT F.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.Publication Metadata only Evidence for the presence of muscarinic M-2 and M-4 receptors in guinea-pig gallbladder smooth muscle(WILEY, 1998) KARAALP, ATİLA; Oktay, S; Cabadak, H; Iskender, E; Goren, Z; Caliskan, E; Orun, O; Aslan, N; Karaalp, A; Tolun, A; Ulusoy, NB; Levey, AI; El-Fakahany, EE; Kan, B1 The affinities of 10 selective muscarinic receptor antagonists against [H-3]-quinuclidinyl benzilate (QNB) binding were determined to characterize the muscarinic receptors present in guinea-pig gallbladder smooth muscle. The highest correlation was obtained for the comparison between the pK(i) values for the gallbladder smooth muscle and M-2 sites. Pirenzepine revealed two binding sites with affinities indicating the presence of muscarinic M-2 receptors in abundance and a minor population of an additional site(s). 2 Carbachol produced gallbladder contractions, stimulated phosphoinositide (PI) hydrolysis and inhibited cAMP formation concentration-dependently with pD(2) values of 6.12 +/- 0.11, 5.18 +/- 0.33 and 7.19 +/- 0.15, respectively. 3 Pirenzepine, 4-DAMP, HHSiD, pF-HHSiD, AF-DX 116, methoctramine, AQ-RA 741, guanylpirenzepine and AF-DX 384 showed competitive antagonism against carbachol-induced gallbladder contractions. There was no correlation between the pA(2) values for the gallbladder and pK(i) values for the M-2 sites, whereas significant correlations were found for the M-1, M-3 and M-4 sites, the best correlation being between the pA(2) values for the gallbladder and M-4 subtypes. 4 Finally, the presence of both m(2) and m(4) receptor proteins were demonstrated by Western blot analysis. It is concluded that guinea-pig gallbladder smooth muscle has both muscarinic M-2 and M-4 receptors, which are coupled to adenylate cyclase inhibition and PI hydrolysis. 5 Although it seems likely that Mt receptors do not play a primary role in carbachol-induced guinea-pig gallbladder contraction, the characterization of the muscarinic subtypes which mediate these contractile responses needs further evidence.