Introduction Flashcards
Pharmacotherapeutics is
The study of the therapeutic uses (indications) and effects of drugs
QUM includes
- Selecting management options wisely
- Choosing suitable medicines if it’s is considered neccessary
- Using medicines if it is appropriate, safe and effective
(QUM) Management options include
Medicines, surgery, lifestyle changes , radiation, allied health and Wait & watch
Medications considerations include
Individual ( age, weight and pregnancy)
Clinical condition ( kidney impairment)
Weighing the Risk Vs Benefit
Dosage form ( liq, tablet or capsule)
Duration ( short Vs long)
Co-morbidities ( drug or medical disorders interaction)
Monitoring (eg warfarin via INR)
Cost
Other therapies ( physiologist, counselling, nutritionist)
Achievement of the health goals include
- Solving med related problems
- Minimising the misuse, overuse or underuse
- Monitoring the outcomes
- Feedback to the prescriber
- Review of the Rx
Definition of Pharmaceutical care
Pharmaceutical care is the provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life, in a relationship where the patient grants authority and the provider gives competence and commitment.
Patient and provider work together to achieve definite outcomes
Pharmacotherapy review process
- Patient assesment
- Care plan
- Management & follow up
Pharmacotherapy review includes
- Gather relevant patient information
- Interpret information to identify actual or potential problems
- Developaprioritisedproblemlist
- Consider possible treatments and their appropriateness for the individual patient and individual patient goals
- Make a plan for treatment
- Describe the required follow-up
…Then communicate with other care providers and the patient
Outcome of Communication with patient and other care providers is to achieve..
A shared and informed decision
Findings described but cannot be quantified is
Subjective information
Example of Drug interactions is
Glyceryl trinitrate and sildenofil (Viagra)
As the nitrates can potential the effects of pjosphodiestrase inhibitors thus resulting in profound Hypotension or MI.
Should wait until 24 hours of the next dose of Sildenafil then give a nitrate followed by careful Monitoring
Findings that can be specifically quantified are
Objective information
Eg; documented histories and lab tests results
An
Abnormal test result is a
Sign
A patient complaint is a
Symptom
Classifying Medicated related problems include :
( this is not to identify them)
D: Drug selection
O: Over or underdose prescribed
C: Compliance
U: Undertreated
M: Monitoring
E: Education or information
N: Not classifiable (usually not required) T: Toxicity or adverse reaction
What kind of Medication related problem is the following?
Mrs M has broken out in a rash after taking amoxicillin
(Remember DOCUMENT)
Drug selection &
Toxicity and adverse/ side effects
What kind of amen is the following?
Mr X has told the pharmacist that he often forgets to take his BP medication.
Compliance
An ASE check is to
Identify problems and determine whether the medicine is appropriateX safe and effective for the patient.
The comprehensive care review include
4 Cs
Conditions/ co morbidities
Compliance
Care factor (lifestyle factors eg diet, ex, comp meds, alcohol or smoking)
Concerns
It is also important to ensure that a problem that impacts on another problem is corrected first… is called
A Prescribing Cascade
Factors to consider and assist prioritisation of PROBLEM
- Acuity- (acute or chronic)
- Severity- (mild moderate or severe)
- Symptom level (symptomatic or asymptomatic)
- Degree of control (controlled or uncontrolled)
- Classification ( staging of disease)
