Person: GÖREN, MEHMET ZAFER
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GÖREN
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MEHMET ZAFER
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Publication Metadata only The Impacts of the Physiological Changes Occurring During Pregnancy on Pharmacokinetic Mechanisms(MARMARA UNIV, INST HEALTH SCIENCES, 2017) AKICI, AHMET; Akici, Ahmet; Tamirci, Mevhibe; Goren, Mehmet ZaferAlthough pharmacotherapy is avoided due to risks during pregnancy, sometimes drugs may be required for specific clinical conditions. Inappropriate use because of limited available information may lead to malpractice. Health professionals, especially physicians, should have a better knowledge of the fact that drug use in pregnant women has some important differences from that in normal adults. Thus, they must comply with these specific requirements. One of the major differences is the change in drug pharmacokinetics during pregnancy. Important changes related to drug absorption, distribution, metabolism, and elimination show wide variability in maternal body, placenta, embryo, and fetus. These changes determine the selection of drug, its dose, and duration of its use. The successful management of treatment process during pregnancy is difficult and sometimes requires professional support due to confounding reasons, including individual factors, gestational age, mothers' age, and underlying diseases and their impact on drug metabolism. Therefore, health professionals and patients are required to get better benefit from sources, especially from clinical pharmacology information services. The present review discusses the details of how and to what extent the pharmacokinetic mechanisms are affected by the physiological changes that occur during pregnancy and their interpretation to clinical conditions.Publication Open Access Evaluation of the pregnant women's approaches regarding drug utilization(KARE PUBL, 2020) AKICI, AHMET; Tamirci, Mevhibe; Aydin, Volkan; Soyalan, Mertdogan; Akici, Narin; Goren, Mehmet Zafer; Akici, AhmetOBJECTIVE: Drug utilization habits of the pregnant are a critical aspect of rational use of the medicine (RUM). This study aimed to analyze the RUM related attitudes and the behaviors of women during their pregnancies. METHODS: The data were collected between May 2016-October 2016 by conducting surveys to 71 pregnant women admitted to the private and governmental hospitals in five districts of Northern Cyprus. The sociodemographic characteristics of the pregnant as well as their attitudes and behaviors concerning drug use were evaluated. RESULTS: The mean age and the gestational week of the patients was 29.7 +/- 4.3 years and 25.7 +/- 11.2 weeks, respectively. Planned pregnancies constituted 71.8% of all. The percentage of patients with an unplanned pregnancies who were using drugs at the time of the survey (25.0%) was lower than that in those with planned pregnancies (49.0%, p<0.05). Almost two-thirds (66.2%) of the women were exposed to a drug during pregnancy, mostly for vitamin/mineral prophylaxis (38.3%) and agents controlling nausea/vomiting (19.1%). Two out of eleven women (18.2%) were using folic acid when they learned about their pregnancy. One of the drugs used for the chronic disorder in the third trimester was acetylsalicylic acid (11.1%), a category D drug in this setting. Most of the patients stated that they frequently read the instructions (60.9%), often paying attention to side effects (56.5%). Considering some of the habits related to drug use, 8.7% and 10.9% of pregnant women declared that they sometimes did not follow the instructions and dosage/duration of the drug usage, respectively. Seven patients (15.2%) declared that they did not consider side effects on the medication guide while more than half (56.5%) did it often. Near one in five (19.6%) of the pregnant women stated that they hesitated about the drug usage due to teratogenicity risks. CONCLUSION: Our study highlights the drug utilization attitudes and behaviors of pregnant women during pregnancy in Northern Cyprus, indicating several shortcomings, including insufficient prenatal folic acid use, occasional use of risky drugs, and unsatisfactory medication guide handling. Available findings underline the necessity of education not only for patients but also for healthcare providers to disseminate RUM in pregnancy.Publication Open Access Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy(MARMARA UNIV, 2021) AKICI, AHMET; Tamirci, Mevhibe; Akici, Ahmet; Aydin, Volkan; Sakarya, Sibel; Goren, Mehmet ZaferPregnancy is a critical aspect of rational use of medicine (RUM) and imposes important responsibilities on the parties. This study aimed to analyze the knowledge, attitudes, and behaviors of the physicians and pharmacists regarding pharmacotherapy in pregnancy. The data were collected between April 2016-July 2017 by questionnaires and analyses of the prescriptions in Northern Cyprus. Simulated prescriptions (n=50) for pregnant women (PW) were applied at pharmacies, and pharmacists' (n=95) and obstetricians' (n=30) attitudes were evaluated through surveys. In addition, PW prescriptions (n=122) were collected from pharmacies and evaluated. All data were re-obtained after one year. The mean number of drugs per PW prescription was 1.48 +/- 0.73. In teratogenicity risk evaluation, 6.6% of medicines were in D/X and 16.7% were in C categories. The ratio of these three categories medicines in scripts was about eight times higher than which was considered as teratogenic based on physicians' opinions. Serious shortcomings were found in writing the format information in prescriptions. In simulated prescription analysis, mean dispensing time was 3.3 +/- 2.3 min. Almost half of the pharmacists were observed to give the drug requested by simulated PW without any confirmation of the prescription. The dispensing performances of the pharmacists were mainly different than their related statements on the survey. Our study highlighted the deficiencies in physicians' and pharmacists' RUM knowledge, attitudes, and behaviors in pregnancy, where the gaps seem unchanged after one year. These findings underline necessity of education and counselling service interventions for healthcare providers to disseminate RUM in pregnancy.