Bioavailability Of Inhalers

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F patients, it may lead to a decrease in the bioavailability of theophylline and higher doses could be required. Secondly, theophylline is metabolised in the liver via cytochrome P450, as a result it involves in a lot of drug interactions. Therefore, monitoring by a clinical pharmacist is necessary with this medication (Dipiro et al., 2008). Additionally, when using inhaled drugs, clinical pharmacists can assist in determining a number of factors such as if it is suitable to give inhalers as a combination, which inhaler can be given with the others and which cannot (Kerem, Conway, Elborn & Heijerman, 2005).
Mucolytic Therapies, such as dornase alfa and hypertonic saline, are also used to decrease sputum viscosity and enhance clearance. However,
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The most common manifestations are pancreatic insufficiency, meconium ileus, distal intestinal obstruction syndrome (DIOS), gastro-oesophageal reflux disease (GORD) and liver disease.
Children with cystic fibrosis often suffer from growth failure caused by malabsorption. For this reason, nutritional support is essential to achieve normal growth. Pharmacists can evaluate the use of dietary supplements because they may interact with other prescribed medications (Murray et al., 2008, cited in Benavides et al., 2013).
Pancreatic insufficiency is usually treated with pancreatic enzyme replacement. Clinical pharmacists have several rules in their management. Firstly, these enzymes are available in multiple formulations. However, they are not interchangeable, and should be prescribed by the brand. Therefore, patients should be monitored to see if there is any change in the dose or the product. Secondly, dosing of these enzymes may require monitoring and adjustment depending on the patient symptoms such as diarrhoea, bloating and abdominal pain (Mascarenhas, 2003). For example, there are cases where an avoidable severe complication has been reported with the use of pancreatic enzymes after changing the product. It turns out this complication was a consequence of using of an enteric coated excipient (Peckham & Whitaker, 2013). Moreover, using acid suppression medication, such as proton pump inhibitors, may boost the effect
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However, the management of CF is evolving with new approaches to the gene therapy. Clinical pharmacists can play a significant role in managing CF patients and improving their overall health outcomes. This is mainly due to the fact that pharmacokinetics and pharmacodynamics characteristics can be altered among CF patients. Additionally, because of the special formulation and the multi dosage forms that can be used in CF, a great deal of evidence has evaluated the impact of clinical pharmacy services in hospitals and revealed positive outcomes. Despite the fact there is limited data on the role and the impact of clinical pharmacists in CF, by examining all the evidence it would seems clear that a clinical pharmacist’s role in CF is

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