Intro to Pharm Care

Question 1

Define Pharmaceutical Care

Answer 1

Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life

Question 2

Impact of Pharmacy on Patient Care : Pharmacy in a New Age Consultation 1995

Answer 2

1. Management of prescribed medicines
2. Management of chronic conditions
3. Management of common ailments
4. Promotion and support of healthy lifestyles
5. Advice and support for other healthcare professionals

Question 3

Responsible provision of pharmacists?

Answer 3

Share responsibility for the consequences to the patient.

1. Incorrectly dispensed item
2. Overdose
3. Sub-optimal therapy

can all lead to HARM

Question 4

How do we achieve definite outcomes?

Answer 4

1. Dialogue with consumers/patient
2. Teamwork among providers
3. Implement and monitor processes

Question 5

Dialogue with patient?

Answer 5

1. Determine patient needs
2. Identify potential and actual problems with medication
3. Establish relationship so drug therapy can be monitored

Question 6

Teamwork?

Answer 6

1. Document drug treatment and related issues.

2. Share the info

Question 7

Implement and monitor processes?

Answer 7

1. Document processes and assign responsibilities

2. Outcomes recorded so improvements can be made

Question 8

Roles of Clinical Pharmacist - Hospital

Answer 8

Before, On, During admission and on discharge.
Drug history
Medicines Reconciliation
Screening Prescriptions
Monitoring
Counselling

Question 9

Roles of Clinical Pharmacist - Community

Answer 9

Screening Prescriptions
Assessing patients during RTS consultation
MUR
NMS

Question 10

What to look for during prescription screening? (12)

Answer 10

1. Legible
2. Correctly written
3. No ambiguities
4. Cautions
5. Contraindications
6. Appropriateness
7. Dose & frequency
8. Duration
9. Route
10. Interactions
11. Side effects
12. Therapeutic monitoring

Question 11

Cautions with Metoclopramide (used for short term heartburn)

& Recommended alternative?

Answer 11

Caution with those with Parkinsons disease

Alternative: Cyclizine

Question 12

Caution with Propranolol?

Answer 12

Caution in Diabetes

Monitor patient and change to cardio selective beta blocker if necessary

Question 13

Propranolol Contraindication?

Answer 13

Contra-indicated in second and third AV block

Alternative- a drug group that is not negatively inotropic

Question 14

Gentamicin contraindication?

Answer 14

Contraindicated in myasthenia (long term: causes muscle weakness)

Alternative- use another antibiotic

Question 15

Things to do to ensure Medicine Optimisation?

Answer 15

1. Check Appropriateness
2. Interactions
3. Therapeutic Drug monitoring - safety and therapeutic effect

Question 16

Record Keeping (6)

Answer 16

1. Green Pen
2. Writing on Drug charts
3. Writing in medical notes/ discharge letter
4. Accountability - sign and date
5. pc - prescriber contacted
6. pnc - prescriber not contacted