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Papers by Duaa Alsulaiman

SPIRIT checklist. (DOCX 45 kb)

Ketamine for acute painful crisis in sickle cell diseaseâ pain algorithm. (DOCX 176 kb)

Ketamine for acute painful crisis in sickle cell disease patientsâ recognition pathway. (DOCX 115... more Ketamine for acute painful crisis in sickle cell disease patientsâ recognition pathway. (DOCX 115 kb)

Imam Journal of Applied Sciences, 2019

Improper storage and disposal of medications potentially pose a significant risk to both humans a... more Improper storage and disposal of medications potentially pose a significant risk to both humans and animals. It also increases the economic burden to the society. The objective of this study was to investigate the storage and disposal habits of medications among the public of Saudi Arabia. The common place for storage for most of the medications was the fridge, followed by bedroom, kitchen, living room, and bathroom. An average of one to five unused medications were stored inside the house in Saudi. Antipyretic, pain medications and cough medications were the most common stored medications. Furthermore, we attempt to endorse the guidelines by the Food and Drug Administration for the best disposal practices.

Academic Emergency Medicine, 2021

The objective was to evaluate the efficacy and safety of single‐dose ketamine infusion in adults ... more The objective was to evaluate the efficacy and safety of single‐dose ketamine infusion in adults with sickle cell disease (SCD) who presented with acute sickle vasoocclusive crisis (VOC).

Journal of Pharmaceutical Policy and Practice, 2021

Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to ... more Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). Results The r...

Risk Management and Healthcare Policy, 2020

The aim of this study was to determine and compare the level of knowledge and perception of ADRs ... more The aim of this study was to determine and compare the level of knowledge and perception of ADRs reporting and pharmacovigilance among interns and hospital pharmacists in different health-care settings in Saudi Arabia. Methods: A cross-sectional study was conducted among pharmacists and pharmacy interns in different hospitals in Saudi Arabia. A total of 315 participants completed the self-administered and validated questionnaire during the period from August 2018 to March 2019. Results: There was poor perception and knowledge of pharmacovigilance and ADRs reporting among pharmacists as well as intern pharmacists. However, pharmacists had better knowledge score compared to interns (P=0.043). Most of the respondents believed that ADRs reporting is important. The majority of both interns and pharmacists stated that they did not receive adequate education about pharmacovigilance during their undergraduate or internship program. Conclusion: There is a gap in knowledge and perception about pharmacovigilance among practicing pharmacists and new pharmacy graduates. Drug safety fundamentals and policies should be taught to undergraduate pharmacy students in Saudi Arabia.

Trials, 2019

Background: Sickle cell disease (SCD) is an inherited hematological disorder where the shape of r... more Background: Sickle cell disease (SCD) is an inherited hematological disorder where the shape of red blood cells is altered, resulting in the destruction of red blood cells, anemia, and other complications. SCD is prevalent in the southern and eastern provinces of the Arabian peninsula. The most common complications for individuals with SCD are acute painful episodes that require several doses of intravenous opioids, making pain control for these individuals challenging. Instead of opioids, some studies have suggested that ketamine might be used for pain control in acute pain episodes of individuals with SCD. This study aims to evaluate whether the addition of ketamine to morphine can achieve better pain control, decreasing the number of repeated doses of opiates. We hypothesize that early administration of ketamine would lead to a more rapid improvement in pain score and lower opioid requirements. Methods and analysis: This study will be a prospective, randomized, concealed, blinded, pragmatic parallel group, controlled trial enrolling adult patients with SCD and acute vaso-occlusive crisis pain. All patients will receive standard analgesic therapy during evaluation. Patients randomized to the treatment arm will receive low-dose ketamine (0.3 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to standard intravenous hydration, while those in the control group will receive a standard dose of morphine (0.1 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to the standard intravenous hydration. All healthcare providers will be blinded to the treatment arm. Data will be analyzed according to the intention-to-treat principle. The primary outcome is improvement in pain severity using the Numerical Pain Rating Score. Trial registration: Clinicaltrials.gov, NCT03431285. Registered on

Hospital Pharmacy, 2016

Background For patients on continuous IV unfractionated heparin (UFH), failing to achieve a thera... more Background For patients on continuous IV unfractionated heparin (UFH), failing to achieve a therapeutic aPTT by 24 hours can be associated with increased morbidity. A pharmacy clinical surveillance system (PCSS) subtherapeutic aPTT alert was implemented at our institution to improve achievement of therapeutic aPTT goals by 24 hours. Objective The primary objective was the time to achieve the minimum goal aPTT before and after the alert implementation. The secondary objectives were to examine the percentage of patients who achieved the minimum goal aPTT by 24 hours and the number of dose changes to achieve the minimum goal aPTT Methods A single-center retrospective study was conducted to include all adult inpatients receiving a continuous UFH infusion during a 3-month period prior to the implementation of a subtherapeutic aPTT alert and a 3-month period after implementation. Results 317 patients were included in the analysis. The average time to achieve the minimum goal aPTT was 21.8...

Current Emergency and Hospital Medicine Reports, 2017

Purpose of Review Various definitions and scoring systems for sepsis were available but none of t... more Purpose of Review Various definitions and scoring systems for sepsis were available but none of them was perfect due to the incomplete knowledge of sepsis syndrome pathobiology. Sepsis is a collection of diseases described mainly by systemic host response to infection. An international consensus first defined sepsis in 1991 and was later updated in 2001. Definitions of sepsis, severe sepsis, and septic shock remained the same for two decades. The systemic inflammatory response syndrome (SIRS) criteria were used widely in hospitals to identify sepsis. The third international consensus definitions for sepsis and septic shock (sepsis-3) recently revisited the definition. Sepsis and septic shock definitions were revised, while severe sepsis was omitted and considered to be redundant. Recent Findings The development in understanding sepsis pathobiology led to this new definition by a task force of sepsis clinicians and researchers. The sepsis-related organ failure assessment (SOFA) was developed to recognize sepsis, which replaced the SIRS criteria. Quick SOFA (qSOFA) was developed for patients outside intensive care units (ICUs) as a risk stratification tool to determine patients with suspected infection and poor outcomes in a quicker manner. Summary The third international sepsis consensus definitions taskforceaimstodifferentiatesepsisfromuncomplicatedinfection and to update definitions of sepsis and septic shock as knowledge of sepsis syndrome pathobiology continues to improve. Keywords Sepsis. Septic shock. Sepsis-related organ failure assessment (SOFA). Systemic inflammatory response syndrome (SIRS). Quick sepsis-related organ failure assessment (QSOFA). Sepsis-3 This article is part of the Topical Collection on Pharmacology of Acute Care

SPIRIT checklist. (DOCX 45 kb)

Ketamine for acute painful crisis in sickle cell diseaseâ pain algorithm. (DOCX 176 kb)

Ketamine for acute painful crisis in sickle cell disease patientsâ recognition pathway. (DOCX 115... more Ketamine for acute painful crisis in sickle cell disease patientsâ recognition pathway. (DOCX 115 kb)

Imam Journal of Applied Sciences, 2019

Improper storage and disposal of medications potentially pose a significant risk to both humans a... more Improper storage and disposal of medications potentially pose a significant risk to both humans and animals. It also increases the economic burden to the society. The objective of this study was to investigate the storage and disposal habits of medications among the public of Saudi Arabia. The common place for storage for most of the medications was the fridge, followed by bedroom, kitchen, living room, and bathroom. An average of one to five unused medications were stored inside the house in Saudi. Antipyretic, pain medications and cough medications were the most common stored medications. Furthermore, we attempt to endorse the guidelines by the Food and Drug Administration for the best disposal practices.

Academic Emergency Medicine, 2021

The objective was to evaluate the efficacy and safety of single‐dose ketamine infusion in adults ... more The objective was to evaluate the efficacy and safety of single‐dose ketamine infusion in adults with sickle cell disease (SCD) who presented with acute sickle vasoocclusive crisis (VOC).

Journal of Pharmaceutical Policy and Practice, 2021

Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to ... more Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). Results The r...

Risk Management and Healthcare Policy, 2020

The aim of this study was to determine and compare the level of knowledge and perception of ADRs ... more The aim of this study was to determine and compare the level of knowledge and perception of ADRs reporting and pharmacovigilance among interns and hospital pharmacists in different health-care settings in Saudi Arabia. Methods: A cross-sectional study was conducted among pharmacists and pharmacy interns in different hospitals in Saudi Arabia. A total of 315 participants completed the self-administered and validated questionnaire during the period from August 2018 to March 2019. Results: There was poor perception and knowledge of pharmacovigilance and ADRs reporting among pharmacists as well as intern pharmacists. However, pharmacists had better knowledge score compared to interns (P=0.043). Most of the respondents believed that ADRs reporting is important. The majority of both interns and pharmacists stated that they did not receive adequate education about pharmacovigilance during their undergraduate or internship program. Conclusion: There is a gap in knowledge and perception about pharmacovigilance among practicing pharmacists and new pharmacy graduates. Drug safety fundamentals and policies should be taught to undergraduate pharmacy students in Saudi Arabia.

Trials, 2019

Background: Sickle cell disease (SCD) is an inherited hematological disorder where the shape of r... more Background: Sickle cell disease (SCD) is an inherited hematological disorder where the shape of red blood cells is altered, resulting in the destruction of red blood cells, anemia, and other complications. SCD is prevalent in the southern and eastern provinces of the Arabian peninsula. The most common complications for individuals with SCD are acute painful episodes that require several doses of intravenous opioids, making pain control for these individuals challenging. Instead of opioids, some studies have suggested that ketamine might be used for pain control in acute pain episodes of individuals with SCD. This study aims to evaluate whether the addition of ketamine to morphine can achieve better pain control, decreasing the number of repeated doses of opiates. We hypothesize that early administration of ketamine would lead to a more rapid improvement in pain score and lower opioid requirements. Methods and analysis: This study will be a prospective, randomized, concealed, blinded, pragmatic parallel group, controlled trial enrolling adult patients with SCD and acute vaso-occlusive crisis pain. All patients will receive standard analgesic therapy during evaluation. Patients randomized to the treatment arm will receive low-dose ketamine (0.3 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to standard intravenous hydration, while those in the control group will receive a standard dose of morphine (0.1 mg/kg in 0.9% sodium chloride, 100 ml bag) in addition to the standard intravenous hydration. All healthcare providers will be blinded to the treatment arm. Data will be analyzed according to the intention-to-treat principle. The primary outcome is improvement in pain severity using the Numerical Pain Rating Score. Trial registration: Clinicaltrials.gov, NCT03431285. Registered on

Hospital Pharmacy, 2016

Background For patients on continuous IV unfractionated heparin (UFH), failing to achieve a thera... more Background For patients on continuous IV unfractionated heparin (UFH), failing to achieve a therapeutic aPTT by 24 hours can be associated with increased morbidity. A pharmacy clinical surveillance system (PCSS) subtherapeutic aPTT alert was implemented at our institution to improve achievement of therapeutic aPTT goals by 24 hours. Objective The primary objective was the time to achieve the minimum goal aPTT before and after the alert implementation. The secondary objectives were to examine the percentage of patients who achieved the minimum goal aPTT by 24 hours and the number of dose changes to achieve the minimum goal aPTT Methods A single-center retrospective study was conducted to include all adult inpatients receiving a continuous UFH infusion during a 3-month period prior to the implementation of a subtherapeutic aPTT alert and a 3-month period after implementation. Results 317 patients were included in the analysis. The average time to achieve the minimum goal aPTT was 21.8...

Current Emergency and Hospital Medicine Reports, 2017

Purpose of Review Various definitions and scoring systems for sepsis were available but none of t... more Purpose of Review Various definitions and scoring systems for sepsis were available but none of them was perfect due to the incomplete knowledge of sepsis syndrome pathobiology. Sepsis is a collection of diseases described mainly by systemic host response to infection. An international consensus first defined sepsis in 1991 and was later updated in 2001. Definitions of sepsis, severe sepsis, and septic shock remained the same for two decades. The systemic inflammatory response syndrome (SIRS) criteria were used widely in hospitals to identify sepsis. The third international consensus definitions for sepsis and septic shock (sepsis-3) recently revisited the definition. Sepsis and septic shock definitions were revised, while severe sepsis was omitted and considered to be redundant. Recent Findings The development in understanding sepsis pathobiology led to this new definition by a task force of sepsis clinicians and researchers. The sepsis-related organ failure assessment (SOFA) was developed to recognize sepsis, which replaced the SIRS criteria. Quick SOFA (qSOFA) was developed for patients outside intensive care units (ICUs) as a risk stratification tool to determine patients with suspected infection and poor outcomes in a quicker manner. Summary The third international sepsis consensus definitions taskforceaimstodifferentiatesepsisfromuncomplicatedinfection and to update definitions of sepsis and septic shock as knowledge of sepsis syndrome pathobiology continues to improve. Keywords Sepsis. Septic shock. Sepsis-related organ failure assessment (SOFA). Systemic inflammatory response syndrome (SIRS). Quick sepsis-related organ failure assessment (QSOFA). Sepsis-3 This article is part of the Topical Collection on Pharmacology of Acute Care