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Pharmaceutical Care Midterm > Lecture 2 - Pharmacotherapy > Flashcards

Lecture 2 - Pharmacotherapy Flashcards

1
Q

What does PCCP stand for?

A

Patient centered care process

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2
Q

Explain what PCCP (patient centered care process) is

A

an approach to care that consciously adopts a patient’s perspective

Respect for a patient’s values, preferences and expressed needs

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3
Q

What are some drug therapy problems

A

nonadherence
drug ineffectiveness
adverse drug events
over/under dose
drug interactions
common drug-related problems in older adults

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4
Q

what is a significant public health issue in the healthcare system, resulting in an annual cost of $528.4 billion

A

drug therapy problems
nonoptimized medication therapy

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5
Q

What is the MISSION of pharmacy practice

A

to provide pharmaceutical care

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6
Q

Pharmaceutical care involves….

A

identifying, resolving, and preventing actual and potential DTP’s (drug therapy problems)

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7
Q

What is the CENTRAL TENET of pharmaceutical care

A

the recognition that patients have drug therapy needs — and problems can occur

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8
Q

What is the definition of pharmacotherapy

A

treatment of disease through the use of medications

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9
Q

What is the area of pharmacy practice that ensures the safe, appropriate, and economical use of medications?

A

pharmacotherapy

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10
Q

What is a good guiding principle to follow

A

there should be a justifiable and documented indication for every medication that is used

This includes STOPPING the medication when it’s no longer needed

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11
Q

Explain the guiding principle to follow for the length that a medication should be taken

A

a medication should be used at the LOWEST DOSAGE and for the SHORTEST DURATION that is likely to achieve the desired outcome

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12
Q

what is preferred – monotherapy or multitherapy

A

When a patient can be treated with a single drug, then monotherapy is preferred.
ie: avoid concomitant use of omeprazole and famotidine

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13
Q

What is the guiding principle to follow regarding newly approved medications?

A

newly approved medications should be used ONLY IF there are clear advantages over older medications

ie:
less drug interactions
less likely to cause bothersome side effects
longer duration of action
failure on older medications

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14
Q

Whenever possible, the selection of a medication regimen should be based upon evidence from……

A

CONTROLLED CLINICAL TRIALS

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15
Q

the _____ of drug administration should be considered as a possible influence on drug efficacy, adverse events, and interactions with other drugs

A

TIMING

ie:

-taking cipro with dairy decreases its absorption
-one drug binds to another in the stomach
-adderall is taken for ADHD so its taken in the morning instead of at bedtime

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16
Q

What fact about the patient may affect adherence and treatment outcomes?

A

a patient’s perception of an illness or the risks and benefits of therapy

ie:

-hypertension – “i dont need pills i dont feel sick”
-flu – i dont need medicine ill just be sick for a couple of days ( risk of developing pneumonia)
-“my fever is gone so i can stop the antibiotic”

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17
Q

What is a good way to avoid nonoptimal treatment outcomes associated with patient’s perception of the illness or the therapy?

A

counseling and the teach back method

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18
Q

A medication should not be given by injection when giving it by mouth would be just as effective and safe. Why does this principle exist?

A

because giving by mouth is less invasive, cost effective, and decreases the risk of infection

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19
Q

How do you avoid the “prescribing cascade”?

A

a drug regimen should only be initiated with full recognition that a medication may cause disease, symptoms, etc, or abnormal lab tests

THIS WILL HELP TO NOT TREAT SIDE EFFECTS OF A DRUG AS A NEW DISEASE

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20
Q

When a variety of drugs are equally efficacious and equally safe, which drug should be chosen?

A

the drug that results in the lowest health care cost or is most convenient for the patient

ie: brand vs generic, formulary issues

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21
Q

What should be done before medications are used?

A

lifestyle modifications or non-pharmacologic interventions should be made to potentially eliminate the need for drug therapy

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22
Q

When making decisions about drug therapy for individual patients, ______ effects should be considered

A

societal

23
Q

what are some societal effects

A

cost, education, access, equity
-social determinants of health

24
Q

Possible reasons for failure of medication regimen—-

A

-inappropriate drug selection
-poor adherence
-misdiagnosis
-concurrent illness (substance use and mental health disorder at the same time)
-interactions with food or drugs
-environmental factors
-genetic factors

25
Q

Define drug therapy problem

A

any undesirable event experienced by a patient that involves drug therapy. Interferes with achieving the desired goals of therapy

26
Q

How are drug therapy problems resolved?

A

by professional judgment

27
Q

what are the 3 primary components of a drug therapy problem-

A

-the undesirable event/risk experienced by the patient

-the drug therapy that caused the problem

-the RELATIONSHIP between the undesirable event and the drug therapy

28
Q

name 2 drug therapy problems under the drug related need of “indication”

A

-unnecessary drug therapy
-additional therapy needed

29
Q

name 2 drug therapy problems that fall under the drug related need of”effectiveness”

A

-ineffective drug
-dose is too low

30
Q

name 2 drug therapy problems that fall under the drug related need of “safety”

A

-adverse drug reaction
-dose is too high

31
Q

name a drug therapy problem falling under the drug related need of “adherence”

A

-nonadherence or noncompliance

32
Q

issues related to indication….

A

-needs additional therapy
-unnecessary drug therapy

33
Q

issues related to the drug product…

A

-ineffective drug
-adverse drug reaction

34
Q

issues related to the dosage regimen…

A

-dosage too low (ineffective)
-dosage too high

35
Q

Explain when unnecessary drug therapy exists

A

-duplicate therapy
-no medical indication
-nondrug therapy is more appropriate
-addiction/rec use
-prescribing cascade — treating adverse reactions

36
Q

explain when additional therapy would be needed

A

preventative therapy
untreated condition
synergistic therapy — need 2 meds to work together to produce outcome

37
Q

explain why a drug would be ineffective

A

-a more effective drug is available
-the condition is refractory (untreatable)
-the dosage form is inappropriate
-contraindication is present
-the drug is not indicated for the condition present

38
Q

DOSES NEED TO BE….

A

PATIENT SPECIFIC

39
Q

If the dosing is too high, the dosing interval could be too ____

A

short

40
Q

if the dose is too low, the dosing interval could be too _____

A

long

41
Q

What are some causes of an adverse drug reaction

A

-drug interaction
-incorrect administration
-allergic reaction
-dosage increase/decrease too fast

42
Q

What are some factors that could cause nonadherence?

A

-pt does not understand directions
-pt cannot afford medication
-pt prefers not to take medication
-pt forgets to take
-med is not available
-cannot swallow/administer drug
-pt afraid of adverse events
-previous medication experiences

43
Q

Stating a drug therapy problem should consist of 3 components:

A

-description of the patient’s medical record or clinical state
-the DTP
-the specific association between the drug therapy and the patient’s condition

44
Q

Patient’s may have several DTP’S.
The problems should be prioritized based on:

A

-extent of potential harm
-patient’s perception of potential harm
-rate at which the harm is likely to occur

45
Q

Once you prioritize the problems, what should you ask yourself?

A

-which problem must be resolved immediately?
-Which problem can be resolved by the practitioner and patient?
-Which problems require intervention by another member of the healthcare team?

46
Q

What do you document if there are NO drug therapy problems?

A

focus on achieving the goals of therapy and ensure that the pt is not at high risk of DEVELOPING any problems

we still need to develop a PLAN and periodic follow up

47
Q

What question should you ask yourself to recognize if there is any unnecessary drug therapy

A

“Why is the patient taking this medication?”
does the pt have a medical condition warranting its use?

48
Q

What questions should you ask yourself to determine if there is need for additional therapy?

A

what are the untreated medical conditions
what is the status of the current condition
does the pt require therapy
what is the treatment

49
Q

If a therapy is indicated, how do you choose which therapy to use?

A

evidence based reasoning (clinical trials)

50
Q

If a drug isn’t working (ineffective), what questions should you ask yourself?

A

is the pharmacotherapy appropriate?
is the drug contraindicated
is the most optimal agent being used

51
Q

If the dose is too low or too high, what questions should you ask to determine the issue

A

-is the dose appropriate for the patient’s renal and hepatic function

-do any drugs require adjustment based on weight or age

-what is the recommended dosage range and administration

-is the length of therapy appropriate

-where is the pt storing these meds

52
Q

If a patient is experiencing adverse reactions, what questions should you ask them?

A

what have you noticed different since starting this medication?

what has changed since starting this medication?
(ie: lifestyle changes, otc meds)

53
Q

If a patient is allergic to penicillin and you get a script for them for amoxicillin, what is the term for this?

A

contraindication – reason NOT to take the medication due to the harm it would cause

54
Q
A

Pharmaceutical Care Midterm (5 decks)

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