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Kevork Clinical Pharma

Kevork Khorozian, Clinical Pharmacy resident, provide latest Clinical Pharmacy news and updates!

29/10/2024

👩‍🎓Student: Sir, please tell me how to remember Heparin contraindications?

👨‍⚕️Mr. Kevork: Sure!😊With this mnemonic, you can easily remember the contraindications 👇

🌱"Teacher" 🌱

26/10/2024

Easy to remember😉 Baby Aspirin: side effects ⚠️

A: Asthma 🫁
S: Salicylism ⬆️
P: Peptic ulcer disease ⚔️
I: Intestinal blood loss 🩸
R: Reyes syndrome 👦👧
I: Idiosyncrasy (hypersensitivity) 🤧
N: Noise (tinnitus) 👂

21/10/2024

⚠️⚠️ Why is Ceftriaxone 💉 contraindicated in neonate ?

In neonates, it is essential not to use it in patients with hyperbilirubinemia.

✅ Because it causes the displacement of bilirubin bound to albumin.

♻️ This increases the level of free bilirubin, thereby increasing the chance of it spreading to the brain, which makes them more susceptible to kernicterus.

✅ So, what is kernicterus? 🤔
It is a type of brain damage that occurs due to high levels of bilirubin in the brain.

So Ceftriaxone is contraindicated in neonates who are less than 28 days old and are receiving calcium-containing IV solutions.

📖 Reference:
Nelson Pediatric Antimicrobial Therapy, 29th Edition, 2023, Page 78.

20/10/2024

Since bleeding🩸is one of the primary adverse events associated with anticoagulants ⚠️

Here are the latest guidelines on how to manage such cases for each medication 👇👇

13/10/2024

💡American Geriatrics Society had published an updated Beers Criteria, which serves as a follow-up to the 2019 list of medications to be avoided in elderly patients (65 years and older).

⚠️One of the notable change was that Anti-diabetics Sulfonylurea (all, including short- and longer-acting): is not preferred ❌ due to high risk of cardiovascular 🫀events and hypoglycemia👇; the previous recommendation was about the long-acting drugs only of this class.

✅I would recommend to replace it with Metformin, GLP-1 receptor agonists, SGLT2 inhibitors, and DPP-4 inhibitors. These groups offer excellent glucose control, promote weight loss, provide cardiovascular and renal protection, and have a low risk of hypoglycemia.

🌍Reference:

https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18372

23/10/2023

🎓 Exciting News! 🎓

I'm thrilled to share that I've successfully completed a 2-year program and earned my Clinical Pharmacy Specialist diploma! 🌟 It's been an incredible journey, and I'm so proud to add this diploma alongside my previous bachelor's and master's degrees. 😊

Since childhood, I've always dreamed of achieving these milestones, and it's amazing to see those dreams turn into reality. 🌠 In the field of medicine, the pursuit of knowledge and achievements never ends.

I want to express my heartfelt gratitude to my mentor Տա Թև for her unwavering support and guidance throughout these years. Her mentorship played a significant role in my passion for this subject and my decision to make it my career.

I'd also like to extend my thanks to Sargis Meliksetyan and Vahe Meliksetyan Foundation for their invaluable support during this journey. Your support has made a world of difference.

Here's to new beginnings and endless possibilities! 🥂👩‍⚕️

03/10/2023

Greetings, everyone! I'm Kevork, Clinical Pharmacist, offering a range of medications and supplements at highly competitive prices, all sourced from the USA.

Here's what's available:

Tylenol (Day and Night): 5500 dram
Vaseline: 3500 dram
Cranberry + probiotics + vitamin C: 8500 dram
CoQ10: 10,000 dram
Vitamin C + Zinc: 6500 dram
Vitamin D 5000IU: 20000 dram
Zinc 30mg: 10000 dram

Feel free to ask any questions or seek medical advice 😊

P.S. If you're interested in a specific medication or supplement, please don't hesitate to reach out. I'll do my best to import it to Armenia at an excellent price!

28/09/2023

Greetings, everyone! I'm Kevork, Clinical Pharmacist, offering a range of medications and supplements at highly competitive prices, all sourced from the USA.

Here's what's available:

Tylenol (Day and Night): 5500 dram
Vaseline: 3500 dram
Cranberry + probiotics + vitamin C: 8500 dram
CoQ10: 10,000 dram
Vitamin C + Zinc: 6500 dram
Vitamin D 5000IU: 20000 dram

Feel free to ask any questions or seek medical advice 😊

P.S. If you're interested in a specific medication or supplement, please don't hesitate to reach out. I'll do my best to import it to Armenia at an excellent price!

24/07/2023

🤣🤣🤣🤣👇👇👇👇

21/07/2023

🔥 Mono-clonal Antibodies are a promising treatment method for many diseases!

⁉️Do you know about Alzheimer's disease?

⭐A new trial on a large number of patients showed the success of a new drug called in significantly slowing down the deterioration of this disease.

1️⃣ Notice that Alzheimer's patients have large amounts of a protein called "Amyloid" in their brains.

2️⃣ Lecanemab antibody sticks and attacks the amyloid protein molecules 🚀

3️⃣ When this "antibody" grabs the amyloid protein, the cells of the immune system activate and attack the amyloid, hence destroy it.

4️⃣ Less Amyloid protein around the neuron

♨️ Of course, there are drawbacks to treatment with (Mono-clonal antibodies), the most important of which are:

1) Its expensive (because it is a modern used medicine).

2) Uncertainty about its side effects (due to the small number of its users).

Sincere regards 💐
Kevork Khorozian (Clinical Pharmacy Resident)

09/06/2023

What are the main drugs that cause QT- prolongation 🫀‼️

➡️Fluoroquinolones [ Moxifloxacin]
➡️Azole antifungals [Fluconazole]
➡️Macrolides [Azithromycin]
➡️SSRIs [Citalopram (possibly escitalopram)]
➡️Opioid Anelgesic [Methadone]
➡️Antiepileptic [Ezogabin]
➡️Class I anti-arrhythmic drug [quinidine]
➡️Class III anti-arrhythmic drug [amiodarone]
➡️Serotonin 5-HT 3 antagonist [ondansetron]
➡️Antipysychotic agents [Droperidol]
➡️Na+ Channel blocker [Ranolazine]

🔸 It is absolutely forbidden ⛔️ Combining two medications that cause QT interval prolongation, and if they are found in the prescription, it is necessary to alert the doctor and suggest an alternative ⚠️⚠️⚠️

☠️☠️QT prolongation increases the risk of developing abnormal heart rhythms, including the life threatening arrhythmia torsades de pointes (TDP). This type of arrhythmia can lead to sudden cardiac death

🌏🌎References:
-Basic & Clinical Pharmacology Fourteenth Edition
-RANG AND DALE'S Pharmacology
-Lippincott Illustrated Reviews: Pharmacology Sixth Edition

Kevork Khorozian/ Clinical Pharmacy Resident ❤️

27/05/2023

Important ‼️‼️‼️☠️☠️⚠️🦷🦷
Especially to my dentist friends ❤️
Plz ask your patients if they are using bisphosphonates before doing any procedure!!
Not asking them, might bring to bad consequences! 👇👇👇

⚡Oral bisphosphonates are the most commonly prescribed antiresorptive drugs for the treatment of osteoporosis.
Risedronate (Actonel), Alendronate (Fosamax), Ibandronate (Boniva), Zoledronic acid (Reclast), and Pamidronate (Aredia).

⚡⚠️However, there are several adverse effects associated with oral bisphosphonates including the bisphosphonate related osteonecrosis of the jaw (BRONJ).

⁉️The pathogenesis of BRONJ has not been well determined. Several risk factors such as dentoalveolar surgery, therapy duration, and concomitant steroid usage have been linked to BRONJ.

🏥❤️Preventative measures are of great importance for the patients at high risk.
In this link below, osteonecrosis of the jaw secondary to oral bisphosphonates was reviewed in order to increase awareness as well as to renew the current knowledge.

https://www.hindawi.com/journals/isrn/2013/215034/

Kevork Khorozian/Clinical Pharmacy Resident ❤️

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