4.14 The contribution of the clinical pharmacist in PC

Question 1

A new clinical pharmacist joins your PC team and asks about what the responsibilities are on the team. Please list five responsibilities of a clinical pharmacist on a PC team

Answer 1

box 4.14.1

• assessing appropriateness of orders and ensuring timely provision of effective meds for symptom control
• counselling and educating the hospice team about med therapy
• ensuring patients and caregivers understand and follow the directions provided with medications
• providing efficient mechanisms for extemporaneous compounding of non standard dosage forms
• addressing financial concerns
• ensuring safe and legal disposal of all medications after death
• establishing and maintaining effective communication with regulatory and licensing agencies

Question 2

A pharmacist approaches you and says that they would like to create an emergency kit that can be put into patient’s homes to allow a peaceful death rather than transfer to acute care. Please list five medications you would want in the box

Answer 2

strong opioid in injectable form
midazolam for sedation
haloperidol or methotrimeprazine for nausea
glycopyrrolate or hyoscine butylbromide for secretions

other: lorazepam SL tabs, oral morphine liquid

Question 3

Many drugs that are used in PC for symptom control are off label. What three uses of a drug make it off label?

Answer 3

• crushing tab or opening capsules and sprinkling contents
• sublingual or buccal administration (ie fentanyl)
• subcutaneous administration