The role of Pharmacist in making the therapeutic decisions for safe and effective therapy is increasing all over the world. However, there are many aspects of drugs in making these decisions that are less commonly studied such as the correlation of cardiac output with pharmacokinetics of drugs. The cardiac output, besides the other factors, is also affected by drugs like atenolol. Therefore, the objective of the present open labeled study was to know the effect of reduced cardiac output induced by atenolol on its own excretion parameters. After taking the informed consent, five healthy volunteers were selected for the study. Atenolol tablet at a dose of 50 mg, 75 mg and 100 mg for three consecutive days were given to all the volunteers. The echocardiography and renal function clinical tests were conducted prior and 5 h after dosing and the urine samples were collected at 5 and 10 h post dosing. The prepared samples were analyzed for atenolol by High-Performance Liquid chromatography. For comparison of atenolol excretion for three days, One-way repeated measure Analysis of Variance statistical test was used as Wilks’ Lambda = 0. 2, F (2, 3) = 5. 986, p < 0. 1, multivariate partial squared = 0. 8. These results showed that atenolol affects its own pharmacokinetics by prolonging its excretion half-life.

Background: Remifentanil is a narcotic drug used in anaesthesia for establishment of hemodynamic stability. The purpose of this study was to compare the effects of remifentanil and fentanyl on urine excretion. Methods: In a randomized clinical trial, 60 patients, who were candidates for elective surgery for lumbar posterior spinal fusion, were divided randomly into two groups of 30 as remifentanil – propofol (R) and fentanyl-propofol (F). Maintenance of anaesthesia drugs in group R included 100 mcg/kg/min propofol and 0. 5-0. 25 mcg/kg/min remifentanil. It included 100 mcg/kg/min propofol and 5-0. 5 mcg/kg/min fentanyl in group F. Vital signs and urine output were recorded every half an hour. Results: The mean age of patients was 49. 5± 12. 7 years. Urine output in group R showed significantly greater reduction than in group F (p< 0. 001). Increase of urine output was seen in both groups over the time. Conclusion: Urine output in patients undergoing lumbar posterior spinal fusion who received remifentanil was less compared to the fentanyl group.

Background: Maintenance of the adequate intraoperative renal perfusion is very important during Orthotopic Liver Transplantation (OLT) to prevent acute renal failure.Objectives: For the first time, this study was designed to survey the effects of octreotide on urine output during anesthesia for OLT and early postoperative renal function.Patients and Methods: In this randomized double-blind placebo controlled clinical trial, 79 of 89 patients who underwent OLT and fulfilled the study requirement were randomly allocated into two groups. In the octreotide group, the patients received octreotide infusion from the start of the operation. On the other hand, the control group patients received physiologic saline infusion instead of octreotide. The Mean Arterial Pressure (MAP), heart rate, urine output, norepinephrine usage, and dosage during the three stages of OLT, and baseline and postoperative creatinine were recorded and compared between the two groups.Results: No significant differences were found between the two groups regarding the demographic characteristics and graft factors (P>0.05). However, urine output and MAP during the three stages of OLT were significantly higher in the octreotide group compared to the control group (P < 0.05). Moreover, no significant difference was observed between the two groups regarding baseline as well as postoperative creatinine (P>0.05).Conclusions: The results demonstrated that octreotide infusion during anesthesia for OLT not only augmented the vasoconstriction effect of norepinephrine to increase MAP, but also maintained better renal perfusion and urine output during the operation.

Introduction: Level of sodium (Na) intake has an important effect on blood pressure and cardiovascular disease, and reduction in salt consumption is important as primary prevention of hypertension and cardiovascular disease. Salt intake is estimated by either urine 24-hour sodium excretion or 24-hour dietary recall (which is unreliable). In this study, we evaluated salt intake and correlation of urine Na in spot urine and 24-hour urine collection.Methods: We evaluated 271 male aged 30 to 50 years old for urine Na, creatinine, and chloride in urine 24-hour collection and spot urine. Subjects have no history of DM, HTN, liver disease, renal failure, and they were not on any medication. Formore accuracy, both urine 24-hour and spot urine were collected 2 times in 2 different days.Results: The mean 24-hour urine sodium was 210.30 (79.53%) meq/d. Urine sodium was less than 100meq/d in 13 (4.8%), 100 to 170 meq/d in 84 (31%), 170 to 205 meq/d in 49 (18.1%), 205 to 256 meq/d in 56 (20.7%), and>256 meq/d in 69 (25.5%) of subjects. There is a significant correlation between Na/Cr and Cl/Cr in spot urine and urine 24-hour sodium. Pearson correlation coefficient was 0.268 and 0.198, respectively (that is a weak correlation).Conclusions: Salt intake is high in male and probably general population (>12 g/d). Salt intake is<6 g/d only in 5%, 6 to 10 g/d in 31%, 10 to 12 g/d in 18.1%, 12 to 15 g/d in 20.7%, and>15 g/d in 25.5%. Sodium and chloride in spot urine is not a good predictor for sodium in 24-hour urine.

Context: Delayed graft function (DGF) is an important clinical outcome following renal transplantation; therefore, it is important to be correctly diagnosed. The DGF is thought to correlate with the fi rst 24-hour urine output (UOP1), and this clinical sign is expected to predict DGF. Objectives: This study aimed to discover whether the UOP1 correlates signifi cantly to the DGF incidence and can be a DGF predicting factor. Data Sources: This study compared the incidence of DGF with the UOP1 reported by studies obtained from the electronic databases, namely MEDLINE, Cochrane, and EBSCO. Studies that performed multivariate or bivariate analysis and/or reported sensitivity and specifi city were included in this review. Results: A total of 1719 studies were obtained from the database search, and 2 studies were enrolled from other sources. Out of 1721 studies, 9 studies were recruited in this review, 5 of which reported sensitivity and specifi city. Overall, nine of these studies had a low to moderate risk of bias. Almost all studies reported a signifi cant relationship between the UOP1 and DGF. All studies agreed that the UOP1 is a sensitive predictive factor in predicting DGF. The specifi city reported by the studies examined in this review varied greatly. The use of optimum cut-off in each study is considered to be the cause of this variability. Conclusions: The UOP1 is signifi cantly related to the incidence of DGF and is a proper parameter for the prediction of DGF events.

Background: Staphylococcous-related urinary tract infection is a common problem. Antibiotic resistance has been reported hereby, for which incomplete recovery has occurred. The present study was conducted in 3 university hospitals in Shaheed Beheshti University of Medical Sciences to determine the type of staphylococcous ssp and their related sensitivity to antimicrobial agents. Materials and methods: 467 patients referred consecutively for UTI, were included in this descriptive study. Our inclusion criteria were: positive urine culture for staphylococcous ssp and antibiogram results. To determine drug resistance, isolated staphylococcous ssp were exposed to 17 different antibiotics by disc diffusion technique. Results: Of 467 positive urine cultures, coagulase-negative staphylococcous was found in 77% and S. aureus in 23%. Staphylococcous ssp have shown a complete resistance to penicillin and amoxicillin. Cloxacillin and vancomycin have shown the highest and the lowest sensitivity (100% and 20%, respectively). Conclusion: With respect to the varied antimicrobial resistance, antibiogram seems to be of utmost importance. Thus, misprescription would be ceased and better therapeutic outcomes will achieve.