The Role of Clinical Pharmacist in Monitoring Drug Therapy in the Cardiovascular and Coronary Care Units in Libya.

Assessment of role of clinical pharmacist in decreasing morbidity and mortality among coronary artery disease patients.

- Methodology: Follow-up patients from (A to Z) and their risk factors in all phases of disease (CAD) in groups with advised patients to lose weight, decrease smoking, and take medication on time.

Monitoring drugs to CAD by studying its Pharmacodynamic:

Mechanism of action, therapeutic uses \[indication\], adverse effect and suitable doses, and drug-drug interactions and contraindications

\* The study shows the Compare between the patients in (Medical Center Hospital) with and without guidelines of clinical pharmacy. Were managed all by setting a plan with the cardiologist in Libya.

Follow-up was for the one hundred patients in the three groups {Outpatient, Inpatient, and the patients in Cardio Care Unit - CCU}.

* First subgroup, Outpatient: monitored the drugs used in HTN, DM, and Hyperlipidemia (dyslipidemia) to decrease levels of patients who come to the hospital with IHD; therefore, reduce morbidity. Also, it was followed by measurement of BP twice weekly, test for Blood sugar (glucose level) once monthly, and tests the Low-Density Lipoprotein (LDL) at the cardiologist's request.
* Second subgroup, Inpatient: monitored drugs according to international guidelines of clinical pharmacy to decrease the medication errors and management of the drug of stable angina and protected patients from increasing the problem, myocardial infarction, and reduce rates of entry to CCU.
* Third subgroup, Patients in CCU: Practiced the international roles of clinical pharmacy to monitor drug use to unstable Angina and MI, to decrease mortality in Libya.

  * Method of analysis:

Were monitored one hundred patients and divided into:

• Twenty patients from (outpatient) divided to (10pts.-10pts.). (Ten patients) was written the data collected in accordance with the system adopted at the (Medical Center Hospital).

(Ten patients)They are patients who applied the guidelines of clinical pharmacy to them in (Medical Center Hospital) by recommending cardiologists practice the clinical pharmacy guidelines and tailoring doses.

* 50 of inpatients as outpatient (25pts.-25pts.).
* 30 patients in CCU divided into (15pts.-15pts.).

  - The statistical analysis was the comparison between the two groups:
* The first group of patients was undergoing treatment in the (Medical Center Hospital) without applying guidelines. (10 patients-25pts.-15pts.).
* The second group; are a group of patients undergoing treatment in the (Medical Center Hospital) in accordance with guidelines. (10pts.-25pts.-15pts.).

The comparison was in terms of the rate of survival, the speed of symmetry to heal ( i,e. responsiveness to medications), the rate of complications, and death for both groups.

- The purpose of this review is to summarize the role of clinical pharmacy benefits in all aspects of cardiovascular diseases (CVD) in hospitalized patients.

Managed the risk factors (hypertension, diabetes, dyslipidemia) and Ischemic heart disease by monitoring the common drugs in Libya:

* Diuretics: ACEIs and ARBs for hypertension.
* Insulin and Biguanides (Metformin) for diabetes.
* Statins for dyslipidemia.
* Organic nitrates: CCB, BB, Antiplatelets, Anticoagulant, and Fibrinolytics for ischemic heart disease.

And the summary of the aim of the work is the practice of guidelines of clinical pharmacy to manage coronary artery disease to reduce levels of morbidity and mortality in Libya and to prove the need for the presence of clinical pharmacists in Libyan hospitals.

Eligibility Criteria:
Inclusion Criteria:

- The inclusion criteria were all adults ≥40 years of age, with a diagnosis of CAD.

Exclusion Criteria:

* exclusion criteria were patients with various comorbidities such as liver or kidney disease; patients intake alcohol, cardiac surgery and refusal to give informed consent.