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OKUYAN, BETÜL

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OKUYAN

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BETÜL

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2005 - 200912010 - 201926
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    Evaluation of potentially inappropriate medication utilization in elderly patients with cancer at outpatient oncology unit
    (SAGE PUBLICATIONS LTD, 2019) OKUYAN, BETÜL; Paksoy, Ceylan; Ozkan, Oznur; Ustaalioglu, Bala B. O.; Sancar, Mesut; Demirtunc, Refik; Izzettin, Fikret V.; Okuyan, Betul
    Background The aim of the study was to evaluate potentially inappropriate medication use in elderly patients with cancer. Method This study was conducted at outpatient oncology clinic from December 2014 to March 2015 among elderly cancer patients. Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria were used to identify potentially inappropriate medication in elderly patients. Results Among 114 cancer patients 55.26% of them were male and the mean age of them was 71.78 +/- 5.50 (years). The most common concurrent diseases were hypertension in 45 (39.47%) and diabetes in 26 (22.81%) patients. Polypharmacy (>= 5 medications) was seen in 94.73% of them. Eighteen patients (15.79%) utilized medications inappropriately according to Screening Tool of Older Person's Prescriptions criteria. Medication omissions were identified in 112 patients (98.25%) with Screening Tool to Alert doctors to Right Treatment criteria. Conclusions Clinical pharmacists could improve the current prescribing practices in elderly patients with cancer by assessing potentially inappropriate medications.
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    The effect of pharmacist-led education on inhaler use skills in hospitalised patients with chronic obstructive pulmonary disease
    (BMJ PUBLISHING GROUP, 2015) OKUYAN, BETÜL; Sancar, Mesut; Sirinoglu, Yasemin; Okuyan, Betul; Karagoz, Turan; Izzettin, Fikret Vehbi
    Objective To assess patient inhalation skills and the effect of pharmacist-led education on these skills in chronic obstructive pulmonary disease (COPD) patients using inhalers in a hospital setting. Methods Pre- and 1month post-intervention were evaluated by scoring essential steps during inhaler use for each inhaler device. Results 41 patients participated in the study (mean age 64.3611.78 years, range 29-83 years). The female-male ratio was 7:34. Patients' inhaler administration skills were found to be improved by pharmacist-led education (p<0.05). Conclusions Evaluation of accurate inhaler device usage in patients with COPD should be performed periodically, and training regarding the inhaler device should be reconsidered according to the needs of patients.
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    Protective effect of ferulic acid on cisplatin induced nephrotoxicity in rats
    (ELSEVIER, 2017) OKUYAN, BETÜL; Bami, Erliasa; Ozakpinar, Ozlem Bingol; Ozdemir-Kumral, Zarife Nigar; Koroglu, Kutay; Ercan, Feriha; Cirakli, Zeynep; Sekerler, Turgut; Izzettin, Fikret Vehbi; Sancar, Mesut; Okuyan, Betul
    This study aims to determine the potential protective effects of ferulic acid against cisplatin-induced nephrotoxicity and to compare its effect with curcumin, a well-known protective agent against cisplatin- induced toxicity in rats. Administration of cisplatin resulted in high BUN (Blood Urea Nitrogen), creatinine, MDA (Malondialdehyde), MPO (Myeloperoxidase), TOS (Total Oxidative Status), PtNT (Protein Nitrotyrosine) levels (p < 0.05). Histological observations showed abnormal morphology of kidney; in addition with appearance of TUNEL positive cells indicating apoptosis in cisplatin administered group. HO-1 (Heme Oxygenase-1) levels measured by RT-PCR (Real Time Polymerase Chain Reaction), and TAS (Total Antioxidative Status) revealed antioxidant depletion due to cisplatin toxicity in animals (p < 0.05). All parameters showed improvement in groups treated with ferulic acid (p < 0.05). Ferulic acid treatment was found significant in preventing oxidative stress, increasing antioxidative status and regaining histological parameters to normal, indicating nephroprotective and antioxidant effects of this phenolic compound.
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    Adverse drug reactions due to drug- drug interactions with proton pump inhibitors: assessment of systematic reviews with AMSTAR method
    (TAYLOR & FRANCIS LTD, 2016) OKUYAN, BETÜL; Yucel, Emre; Sancar, Mesut; Yucel, Aylin; Okuyan, Betul
    Introduction: Many systematic reviews resulted in claims on drug-drug interactions (DDIs) with proton pump inhibitors (PPIs). Such a large number begs for consensus on the clinical significance of findings.Areas covered: We critically evaluated the safety of PPI use with respect to DDIs with a meta-review of systematic reviews published between 1978 and 2015. We assessed the evidence by their reliability, repeatability, transparency, and objectivity according to the Assessment of Multiple Systematic Reviews (AMSTAR) criteria.Expert opinion: Clinicians must assess risks for each PPI for certain comorbid conditions. DDIs don't substantiate class effect for PPIs; each PPI could induce unique DDIs. Concomitant use of PPIs with thienopyridines (e.g. clopidogrel) could be justified in patients without strong affinity to cytochrome CYP2C19 and with high risk of bleeding (e.g. patients with prior upper gastrointestinal bleeding, Helicobacter pylori infection, advanced age, steroid treatment, and nonsteroidal anti-inflammatory drug use). DDIs could occur in an AIDS subpopulation treated with highly active antiretroviral therapy (HAART). DDIs exist for cancer patients undergoing targeted therapy. Hypomagnesemia could increase in the setting of advanced age and polypharmacy. Omeprazole poses high risks owing to its pharmacokinetic DDI profile. Future systematic reviews should incorporate these additional risks for better clinical guidance
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    The impact of pharmacist-led smoking cessation program at community pharmacy
    (2012-01-01) SANCAR, MESUT; OKUYAN, BETÜL; Atalay L., SANCAR M., OKUYAN B., Izzettin F. V.
    Amaç: Çalışmada, bir serbest eczanede klinik eczacı tarafından yürütülen ‘nikotin replasman tedavisiyle (nikotin sakızı ve nikotin tabletini içeren) sigara bırakma programının bir yıllık sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma Haziran 2009 - Haziran 2010 tarihleri arasında gerçekleştirilmiştir. İlk görüşmede katılımcıların demografik ve klinik verileri toplanmış ve her bir katılımcıya ‘Fagerstrom Nikotin Bağımlılık Testi’ uygulanmıştır. Daha sonra klinik eczacı tarafından katılımcılar sigaranın zararları hakkında bilgilendirilmiş ve her bir katılımcının bağımlılık derecesine göre uygun OTC (tezgah üstü ilaç- reçetesiz ilaç) nikotin replasman ürünü tavsiye edilmiştir. Katılımcılar klinik eczacı tarafından on iki ay boyunca yüz yüze veya telefonla yapılan düzenli görüşmelerle takip edilmiştir. Bulgular: Çalışmaya katılan 33 katılımcının yaş ortalaması 41.57±11.90 (aralık: 24-66 yıl) olarak hesaplanmıştır. Fagerstrom Nikotin Bağımlılık Testi sonuçlarına göre katılımcıların onbeşinde düşük nikotin bağımlılığı, dokuzunda orta bağımlılık ve kalan dokuz katılımcıda ise yüksek nikotin bağımlılığı saptanmıştır. Hastaların ikisi bir yıllık takipte kaybedilmiş, çalışma 31 hasta ile tamamlanmıştır. Çalışma sonunda, klinik eczacı danışmanlığında serbest eczanede yürütülen sigara bırakma programıyla bir yıl boyunca takip edilen otuz bir katılımcının yirmisinin (%64.5) sigara kullanmayı bıraktığı görülmüştür. Sonuç: Bu bilgiler ışığında, eğitimli ve kolay ulaşılabilir sağlık mensupları olan eczacıların sigara bırakma programlarında aktif rol almaları gerekmekte olduğu sonucuna ulaşılmıştır. Anahtar sözcükler: Sigara bırakma, klinik eczacılık, nikotin replasman tedavisi
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    PublicationOpen Access
    Eczacının Yer Aldığı Antimikrobiyal Yönetim_x000D_ Programlarının Klinik ve Ekonomik Sonuçları
    (2019) OKUYAN, BETÜL; Mesut SANCAR;Zeynep SAYIN;Sercan CANKATAR;Nazan DALGIÇ;BETÜL OKUYAN
    Antimikrobiyal yönetim programı, antimikrobiyal ilaç tedavisinin iyileştirilmesine yönelik düzenlemeleri kapsayan, multidisipliner bir yaklaşımdır. Son yıllarda, özellikle antibiyotik direncinin azaltılmasında önemli yeri olduğu kabul edilen antimikrobiyal yönetim programlarında öncelikle doktor, klinikeczacı ve klinik mikrobiyologlardan oluşan bir ekibe yer verilmesi önerilmektedir. Eczacının, antimikrobiyallerin uygulama zamanı ve veriliş sıklığı konusundaki danışmanlığının yanı sıra, bu ilaçlara bağlı ilaçilaç, ilaç-besin ve ilaç-hastalık etkileşimleri, ilaç istenmeyen etkileri gibi alanlarda da katkı yapabilecekleribilinmektedir. Bu çalışmada, enfeksiyon hastalıklarının kontrolünde ve tedavisinde önemli yeri olan antimikrobiyal yönetim programlarında sağlık ekibinin önemli bir parçası olarak bulunan eczacıların olası etkilerinin klinik ve ekonomik boyutlarının irdelenmesi amaçlanmıştır. Bu amaca yönelik olarak, Pubmedveri tabanında 01.01.2010 - 31.12.2015 yıllarını kapsayan 5 yıllık bir literatür taraması yapılmıştır. Uygunsözcükler kullanılarak doğrudan eczacı katkısını araştıran çalışmalar seçilmiştir. Bu çalışmanın amacınauygun olarak 34 orijinal makale incelenmiştir. Bu çalışmalarda, eczacı müdahalelerinin yer aldığı antimikrobiyal yönetim programlarının pozitif klinik ve ekonomik sonuçları olduğu görülmüştür. Eczacının buyönetim programlarında antimikrobiyallerin daha akılcı kullanılmasına, antibiyotiklerin daha az sayıda reçete edilmesine, direnç oranlarının azaltılmasına, daha fazla klinik değerlendirme yapılmasına, ilaç dozunun ayarlanmasına, antimikrobiyal ilacın kesilmesi veya başlanması süreçlerine, parenteral kullanımdan oralkullanıma geçiş oranlarının artırılmasına ve nihai olarak bakım kalitesinin iyileştirilmesine fayda sağladıkları sonucuna varılmıştır. Ülkemizde klinik eczacılık uzmanlık eğitiminin başlamış olması, meslek içi eğitim programlarının artırılması ve klinik eczacılık lisansüstü programlarının yaygınlaştırılması, eczacının buçalışmada adı geçen görevleri yerine getirebilmesi için önemli fırsatlardır.
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    PublicationOpen Access
    Determination of Potential Drug-Drug Interactions Using Various Software Programs in a Community Pharmacy Setting
    (TURKISH PHARMACISTS ASSOC, 2019-03-01) OKUYAN, BETÜL; Sancar, Mesut; Kasik, Aksa; Okuyan, Betul; Batuhan, Sevda; Izzettin, Fikret Vehbi
    Objectives: The aim of the present study was to compare various software programs in detecting potential drug-drug interactions in a community pharmacy setting. Materials and Methods: Details of prescriptions were collected from 50 community pharmacies located in Istanbul in March and April 2015 (two days per week). From each pharmacy, the first 20 prescriptions that included more than one drug were collected to evaluate potential drug-drug interactions. The following software programs were utilized to detect potential drug-drug interactions: micromedexsolutions.com , medscape.com , and drugs.com . The number of potential interactions detected by the software programs was determined. Results: At least one potential drug-drug interaction was detected in 39.2% of the 1000 prescriptions by one of the software programs. According to the rates of total drug-drug interactions gathered from various software programs, these programs gave the following results: medscape.com 33.3%, drugs.com 31.3%, and micromedexsolutions.com 21.2%. Conclusion: After comparing different software programs, the potential drug-drug interactions found by the programs proved to be different. Therefore, we recommend that pharmacists confirm with a different program before making a decision when they detect clinically significant potential drug-drug interactions.
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    Validation of the Turkish version of medication regimen complexity index among elderly patients
    (WILEY, 2016) OKUYAN, BETÜL; Okuyan, Betul; Babi, Bedis; Sancar, Mesut; Ay, Pinar; Yucel, Emre; Yucel, Aylin; Izzettin, Fikret Vehbi
    ObjectiveThe aim of this study was to validate the Turkish version of the Medication Regimen Complexity Index' (MRCI). MethodsThis validation study has been conducted in prescriptions of the first 100 elderly patients who had visited the pharmacy for their prescription refill to evaluate convergent and divergent validity of the Turkish version. The reliability of the Turkish version was assessed with inter-rater and test-retest analysis after its translation and cultural adaptation. ResultsThe mean age of the 100 patients (53 women) was 74.9years (SD=7.58, 65-95). The scale showed high inter-rater reliability and test-retest reliability for the total and subscale scores (p<0.05). A strong and positive correlation between the number of medications in a prescription and the total Medication Regimen Complexity Index scores (r=0.930, p<0.001) was determined. There were no statistically significant differences between age, gender and MRCI scores (p>0.05). ConclusionThese results show that the Turkish version of MRCI is a reliable and valid tool in elderly patients.
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    Determination of geriatric patients' drug profile and identify their pharmaceutical care requirements by determining potential risk factors
    (SPRINGER, 2011) OKUYAN, BETÜL; Sancar, M.; Mutlu, B. Yalcin; Okuyan, B.; Izzettin, F. Vehbi
    Purpose: The aim of this study is to evaluate the geriatric drug usage, assess the appropriateness of their drug treatment and identify their pharmaceutical care requirements. Patients and methods: The demographic, clinical and drug data of the patients was obtained. Patients' knowledge about their drugs was also assessed. The patients at risk of drug induced problems were defined and a risk map was determined. Patients, who were 65-years-old and over and live in a nursing home in the Anatolian part of Istanbul, were included in our study. Results: Polypharmacy was identified in 44% of those included in the study (total of 146 patients who take drug therapy). Eighty of the patients (54.8%) did not know reason they were taking drugs. Eighty-eight of the patients (60.3%) were not aware how or when they should take drugs. Although, 24 patients (16.4%) were using their drugs by self-administration, the drugs of 122 patients (83.6%) were administered by their nurse; 24.65% of patients were in a high-risk category. The mean of number of drug used by patients was 5.89 +/- 3.61. Discussion and conclusions: According to our results, patients have lack of knowledge about drug usage and they have rarely been informed about rationale drug usage. First, it is necessary to determine geriatric patients' pharmaceutical care needs in order to prevent and solve their drug-related problems. Pharmacists will contribute to the development and spread of patient oriented pharmacy services by working in specialist geriatric teams with physicians, nurses and other health professionals. (c) 2011 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
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    PublicationOpen Access
    Determination of CYP2C19 Polymorphism, Side Effects, and Medication Adherence in Patients Who have Utilized Selective Serotonin Reuptake Inhibitors
    (KURE ILETISIM GRUBU A S, 2016-06) OKUYAN, BETÜL; Deniz, Semanur; Sancar, Mesut; Okuyan, Betul; Ata, Pinar; Ozakpinar, Ozlem Bingol; Talas, Anil; Gunes, Tufan; Caliskan, Mecit; Izzettin, Fikret Vehbi
    Objective: The aim of this study is to determine relationship of cytochrome P-450 2C19 (CYP2C19) enzymes polymorphism, side effects, and medication adherence in patients who have been diagnosed with major depression and have utilized selective serotonin reuptake inhibitors. Methods: Fifty-three major depression patients (mean of age: 33.25 +/- 11.29 years old; male/female: 7/46) were included in this study. Polymorphisms were determined from genomic DNA by using the 'Real-Time Polymerase Chain Reaction' method. Side effects and medication adherence levels were assessed by using the 'Toronto Side Effects Scale' and the four items medication adherence scale (Morisky, Green and Levine), respectively. Results: The most common side effects that patients reported were drowsiness/daytime somnolence (54.7%), malaise or fatigue (43.4%), sweating (43.4%), nausea (41.5%) and dry mouth (41.5%). Only nine (17%) patients were found to be highly adherent to their medication. When evaluating the CYP2C19 polymorphisms of patients, 37.7%, 24.5% and 20.8% of the patients were classified as intermediate, extensive and ultra-rapid metabolizers, respectively. Allele frequencies of CYP2C19*17 and CYP2C19* 2 was calculated as 24.5% and 27.4%, respectively. Although there were some differences in side effect scores and medication adherences among the polymorphism groups, these relationships were not found to be statistically significant. Conclusion: This study shows that patients who utilized antidepressants frequently experienced side effects and had low medication adherence. Another interesting finding is the high rate of ultrarapid metabolizers of CYP2C19.