March 2025 Volume 1, Issue 1

Editors
Dr. Fatma Ibrahim

Dr. Abdallah El Shawadify

Dr. Abdallah AlAdl

Dr. Aya Farid

Founder & Chief Editor

Clinical Pharmacist-DIS.
Dr. Aya Farid

Inside this issue:

Inside Story 2

Inside Story 3

Inside Story 4

Ulcerative Colitis 5

Drug Spotlight 6

Medical puzzles 7

Vision & Insights 8

Head of Clinical Pharmacy Dep. Head of Pharmacy Dep.

Dr. Fatma Ibrahim Dr. Sanaa Elshibany - Dr. Hanaa Hana

General Manager of Al Ahrar Teaching Hospital

Prof. Dr. Sameh Hussien
 Page 2

Inside Story Headline

This story can fit 150-200 words. tent to your newsletter is to for your Web site. Microsoft
Caption describing picture develop and write your own Publisher offers a simple way to
or graphic. One benefit of using your news- articles, or include a calendar of convert your newsletter to a
letter as a promotional tool is upcoming events or a special Web publication. So, when you’re
that you can reuse content from offer that promotes a new prod- finished writing your newsletter,
other marketing materials, such convert it to a Web site and post
uct.
as press releases, market stud- it.
ies, and reports. You can also research articles
or find “filler” articles by ac-
While your main goal of distrib- cessing the World Wide Web. You
uting a newsletter might be to can write about a variety of
sell your product or service, the topics but try to keep your arti-
key to a successful newsletter is
cles short.
making it useful to your readers.
Much of the content you put in
A great way to add useful con- your newsletter can also be used

Inside Story Headline

“To catch
This story can fit 100-150 words. tomers or clients. column that is updated every
the reader's issue, for instance, an advice
The subject matter that appears If the newsletter is distributed column, a book review, a letter
attention, in newsletters is virtually end- internally, you might comment from the president, or an edito-
less. You can include stories that upon new procedures or im-
place an focus on current technologies or provements to the business.
rial. You can also profile new
employees or top customers or
interesting innovations in your field. Sales figures or earnings will
vendors.
show how your business is
sentence or You may also want to note busi-
growing.
ness or economic trends, or
quote from make predictions for your cus- Some newsletters include a
the story
here.”

Inside Story Headline

This story can fit 75-125 words. Microsoft Publisher includes
thousands of clip art images
Selecting pictures or graphics is from which you can choose and
an important part of adding import into your newsletter.
content to your newsletter. There are also several tools you
Think about your article and ask can use to draw shapes and
yourself if the picture supports symbols.
or enhances the message you’re Once you have chosen an image,
trying to convey. Avoid selecting place it close to the article. Be
Caption describing picture
images that appear to be out of sure to place the caption of the
or graphic.
context. image near the image.
Page 3 Volume 1, Issue 1

Inside Story Headline

This story can fit 150-200 words. tent to your newsletter is to for your Web site. Microsoft
develop and write your own Publisher offers a simple way to
One benefit of using your news- articles, or include a calendar of convert your newsletter to a
letter as a promotional tool is upcoming events or a special Web publication. So, when you’re
that you can reuse content from offer that promotes a new prod- finished writing your newsletter,
other marketing materials, such convert it to a Web site and post
uct.
as press releases, market stud- it.
ies, and reports. You can also research articles
or find “filler” articles by ac-
While your main goal of distrib- cessing the World Wide Web. You
uting a newsletter might be to can write about a variety of
sell your product or service, the topics but try to keep your arti-
key to a successful newsletter is Caption describing pic-
cles short.
making it useful to your readers. ture or graphic.
Much of the content you put in
A great way to add useful con- your newsletter can also be used

Inside Story Headline

“To catch the
This story can fit 100-150 words. tomers or clients. column that is updated every
issue, for instance, an advice reader's attention,
The subject matter that appears If the newsletter is distributed column, a book review, a letter
in newsletters is virtually end- internally, you might comment from the president, or an editori- place an interesting
less. You can include stories that upon new procedures or im-
focus on current technologies or provements to the business.
al. You can also profile new em- sentence or quote
ployees or top customers or
innovations in your field. Sales figures or earnings will
vendors. from the story
show how your business is grow-
You may also want to note busi-
ing.
here.”
ness or economic trends, or
make predictions for your cus- Some newsletters include a

Caption describing pic-

Inside Story Headline
ture or graphic.
This story can fit 75-125 words. Microsoft Publisher includes
thousands of clip art images
Selecting pictures or graphics is from which you can choose and
an important part of adding import into your newsletter.
content to your newsletter. There are also several tools you
Think about your article and ask can use to draw shapes and
yourself if the picture supports symbols.
or enhances the message you’re Once you have chosen an image,
trying to convey. Avoid selecting place it close to the article. Be
images that appear to be out of sure to place the caption of the
context. image near the image.
 Page 4

Inside Story Headline

This story can fit 150-200 words. tent to your newsletter is to for your Web site. Microsoft
Caption describing picture develop and write your own Publisher offers a simple way to
or graphic. One benefit of using your news- articles, or include a calendar of convert your newsletter to a
letter as a promotional tool is upcoming events or a special Web publication. So, when you’re
that you can reuse content from offer that promotes a new prod- finished writing your newsletter,
other marketing materials, such convert it to a Web site and post
uct.
as press releases, market stud- it.
ies, and reports. You can also research articles
or find “filler” articles by ac-
While your main goal of distrib- cessing the World Wide Web. You
uting a newsletter might be to can write about a variety of
sell your product or service, the topics but try to keep your arti-
key to a successful newsletter is
cles short.
making it useful to your readers.
Much of the content you put in
A great way to add useful con- your newsletter can also be used

Inside Story Headline

“To catch
This story can fit 100-150 words. tomers or clients. column that is updated every
the reader's issue, for instance, an advice
The subject matter that appears If the newsletter is distributed column, a book review, a letter
attention, in newsletters is virtually end- internally, you might comment from the president, or an edito-
less. You can include stories that upon new procedures or im-
place an focus on current technologies or provements to the business.
rial. You can also profile new
employees or top customers or
interesting innovations in your field. Sales figures or earnings will
vendors.
show how your business is
sentence or You may also want to note busi-
growing.
ness or economic trends, or
quote from make predictions for your cus- Some newsletters include a
the story
here.”

Inside Story Headline

This story can fit 75-125 words. Microsoft Publisher includes
thousands of clip art images
Selecting pictures or graphics is from which you can choose and
an important part of adding import into your newsletter.
content to your newsletter. There are also several tools you
Think about your article and ask can use to draw shapes and
yourself if the picture supports symbols.
or enhances the message you’re Once you have chosen an image,
trying to convey. Avoid selecting place it close to the article. Be
Caption describing picture
images that appear to be out of sure to place the caption of the
or graphic.
context. image near the image.
 Page 5 Volume 1, Issue 1
Latest Updates on Ulcerative Colitis Treatment for patients
with moderate-to-severe UC disease activity
Ulcerative colitis (UC) is a chronic inflammatory indicates moderate-to severe UC disease activity.
bowel disease (IBD) that affects the lining of the colon
and rectum, leading to symptoms such as diarrhea, UC treatment generally follows two main phases:
abdominal pain, rectal bleeding, and fatigue. The Induction Phase: This is the initial stage where
severity of the disease varies, and treatment aims to treatment is started to reduce symptoms and
control inflammation, achieve remission, and improve inflammation.
quality of life.
Maintenance Phase: Once symptoms are under
Severity is based on rectal bleeding and diarrhea. control, ongoing treatment is necessary to prevent
stool frequency score ≥2, and rectal bleeding score ≥2, future flare-ups and keep the condition stable.

Summary of AGA 2024 UC Treatment Recommendations Pharmacists Role

Recommended Medications for Moderate-to- corticosteroid dependence and prevents long-term Optimize dosing,
Severe UC: complications. monitor side
Combination Therapy vs. Monotherapy: effects, guide
•Higher-Efficacy (First-line for treatment-naïve treatment
patients): Infliximab, Vedolizumab, Ozanimod, •TNF inhibitors (Infliximab, Adalimumab, Golimumab) adjustments, and
Etrasimod, Upadacitinib, Risankizumab. work better with immunomodulators (Thiopurines, educate patients
Methotrexate). on medication
•Intermediate-Efficacy (Second-line for previously
adherence.
treated patients): Golimumab, Ustekinumab, Tofacitinib. •Non-TNF biologics (Vedolizumab, Ustekinumab, IL-23
•Lower-Efficacy (Last-line): Adalimumab. inhibitors) have no clear benefit with combination
therapy.
Prioritize highly effective treatments early instead of Monitor infection risk and hepatotoxicity with
escalating after 5-ASA failure. combination therapy.

Step-Up vs. Early Use of Advanced Therapies: De-Escalation & Discontinuation Strategies:
If in remission (≥6 months) on TNF inhibitor +
•Traditional “step-up” approach (5-ASAs first) is no immunomodulator: Continue TNF inhibitor. No clear
longer preferred. guidance on stopping immunomodulators.
•Early advanced therapy and/or immunomodulators
Monitor closely to balance relapse risk vs. side effects.
are recommended for high-risk patients as it reduces

Additional Key Recommendations

Monitoring Treatment Response: Preventive Vaccination: Patients should receive
influenza, pneumococcal pneumonia, and herpes zoster
•Assess symptomatic response within 3 months. vaccines before starting immunosuppressive therapy.
•Evaluate biochemical remission within 3-6 months.
•Aim for endoscopic remission within 6-12 months. Steroid-Sparing Strategies: Avoid prolonged
Pre-Treatment Screening: Check for hepatitis B, TB corticosteroid use and transition to advanced
exposure, and thiopurine methyl transferase (TPMT) therapies as soon as possible. Edit By
levels before initiating therapy. Dr. Aya Farid

•References: Singh, S., Loftus, E. V., Jr, Limketkai, B. N., Haydek, J. P., Agrawal, M., Scott, F. I., Ananthakrishnan, A. N., & AGA Clinical Guidelines Committee. Electronic address: clinicalpractice@gastro.org
(2024). AGA Living Clinical Practice Guideline on Pharmacological Management of Moderate-to-Severe Ulcerative Colitis. Gastroenterology, 167(7), 1307–1343. https://doi.org/10.1053/j.gastro.2024.10.001
•Medscape
 Page 6

Drug Spotlight

Cefazolin

Cefazolin, a first-generation cephalosporin, is widely used for treating MSSA infections,

surgical prophylaxis, and various serious bacterial infections. It is often preferred over
vancomycin for MSSA bloodstream infections due to superior efficacy and lower
toxicity.
Below is a comprehensive review of indications, dosing, and key considerations.

Renal Dose Adjustments

(Cr Cl in mL/min) Indications & Dosing
≥50: 1-2g IV q8h Bloodstream Infections (MSSA, nterobacteriaceae) Non-purulent cellulitis: 1-2g IV q8h for 5-14 days,
depending on severity.
10-30: 500mg-1g IV q12h
Dose: 2g IV q8h
Duration: 7-14 days (longer if complicated) Bone & Joint Infections
≤10: 500mg-1g IV q24h
Endocarditis (MSSA) Dose: 2g IV q8h for ≥6 weeks.
Native Valve: 2g IV q8h for 6 weeks
Pneumonia (MSSA)
Prosthetic Valve: 2g IV q8h for ≥6 weeks, combined with
rifampin and gentamicin
Dose: 2g IV q8h for 5-7 days (community vs. hospital-
Surgical Prophylaxis acquired).
Dose: 2g IV (3g if >120kg) 30-60 min before incision Complicated Urinary Tract Infection (Pyelonephritis,
Use metronidazole if anaerobic coverage is required Systemic Symptoms)
(e.g., colorectal surgery).
Dose: 1g IV q8h
Repeat dose if surgery is prolonged (>4 hours) or with
significant blood loss. Switch to oral therapy when symptoms improve, based
on culture results.
Post-op prophylaxis is not recommended for clean/
clean-contaminated surgeries. Total Duration: 5-14 days, depending on response and
oral agent chosen.
Skin & Soft Tissue Infections

Intact vials: 20-25°C

Light protection recommended
Important Notes
Preferred over vancomycin for MSSA infections due to better outcomes.
No CNS penetration → Avoid for meningitis.
Edit By Max dose: 12g/day
Dr. Aya Farid Caution in penicillin-allergic patients, but cross-reactivity is low (<2%).
Page 7 Volume 1, Issue 1

Inside Story Headline

This story can fit 150-200 words. tent to your newsletter is to for your Web site. Microsoft
develop and write your own Publisher offers a simple way to
One benefit of using your news- articles, or include a calendar of convert your newsletter to a
letter as a promotional tool is upcoming events or a special Web publication. So, when you’re
that you can reuse content from offer that promotes a new prod- finished writing your newsletter,
other marketing materials, such convert it to a Web site and post
uct.
as press releases, market stud- it.
ies, and reports. You can also research articles
or find “filler” articles by ac-
While your main goal of distrib- cessing the World Wide Web. You
uting a newsletter might be to can write about a variety of
sell your product or service, the topics but try to keep your arti-
key to a successful newsletter is Caption describing pic-
cles short.
making it useful to your readers. ture or graphic.
Much of the content you put in
A great way to add useful con- your newsletter can also be used

Inside Story Headline

“To catch the
This story can fit 100-150 words. tomers or clients. column that is updated every
issue, for instance, an advice reader's attention,
The subject matter that appears If the newsletter is distributed column, a book review, a letter
in newsletters is virtually end- internally, you might comment from the president, or an editori- place an interesting
less. You can include stories that upon new procedures or im-
focus on current technologies or provements to the business.
al. You can also profile new em- sentence or quote
ployees or top customers or
innovations in your field. Sales figures or earnings will
vendors. from the story
show how your business is grow-
You may also want to note busi-
ing.
here.”
ness or economic trends, or
make predictions for your cus- Some newsletters include a

Caption describing pic-

Inside Story Headline
ture or graphic.
This story can fit 75-125 words. Microsoft Publisher includes
thousands of clip art images
Selecting pictures or graphics is from which you can choose and
an important part of adding import into your newsletter.
content to your newsletter. There are also several tools you
Think about your article and ask can use to draw shapes and
yourself if the picture supports symbols.
or enhances the message you’re Once you have chosen an image,
trying to convey. Avoid selecting place it close to the article. Be
images that appear to be out of sure to place the caption of the
context. image near the image.
 PHARMACONNECT
Vision & Insights

The General Organization For

Teaching Hospitals & Institutes

AL-Ahrar Zagazig Teaching

Hospital

Email: alahrarhospital@hotmail.com
Email: alahrarhospital@yahoo.com
Fax: 055-2362739
Phone: 055-2362740
055-2362741
055-2362742
055-2362743