Pharmaceutical Care Flashcards
Define: Clinical Pharmacy
The discipline concerned with the use of medicines in patients
Define: Pharmaceutical Care
Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life
explain the Impact of Pharmacy on Patient Care
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
In providing medicines pharmacists share responsibility for the consequences to the patients. how do pharmacists protect patients from harm?
Legal responsibility to protect patients from harm
1) Overdose
2) Suboptimal therapy
3) Incorrectly dispensed item
what does Definite outcomes mean in the context of pharmacy?
1) Explicit patient outcomes: Communicated with doctor, patient and pharmacists
2) Pharmacist must establish exact purpose of drug treatment: Before and during provision of drug therapy
3) Outcomes should be documented and accessible to responsible healthcare providers
Outcomes should be expressed in terms of quality of life. a Blend of expectations between those technically possible and those desired. How do we ensure this happens?
1) Dialogue with consumers
2) Teamwork amongst providers
3) Implement and monitor processes
explain how Dialogue with consumers helps to implement good Pharmaceutical Care
1) Determine patient’s needs
2) Identify potential and actual problems with medication
3) Establish relationship so drug therapy can be monitored and condition improved
explain how teamwork helps to implement good Pharmaceutical Care
1) Document drug treatment and related issues
2) Share the information!
how does Implementing and Monitoring Processes help deliver good Pharmaceutical Care
1) Document processes and assign responsibilities
2) Outcomes should be recorded so improvements can be made
3) Different models of pharmaceutical care should be designed for different clinical contexts
4) Pharmaceutical care should be targeted to certain patient groups to contribute to health gains with health promotion
5) Pharmacists should be encouraged to contribute to pharmaceutical care by developing and evaluating new services to patients
outline the role of a pharmacist in delivering Pharmaceutical Care to a Hospital Patient
1) Drug History
2) Medicines Reconciliation
3) Screening prescriptions
4) Monitoring
5) Counselling
- all this leads to Medicines Optimisation
what do you look for when screening a prescription?
1) Contra-indications
2) Correctly written
3) Cautions
4) Appropriateness
5) Dose & frequency
6) Duration
7) Route
8) Interactions
9) Side-effects
10) Therapeutic monitoring
11) Legible!
Metoclopramide should be used cautiously in Parkinson’s disease. what is the recommended alternate drug?
Metoclopramide: caution in Parkinson’s disease
Recommend alternative e.g. cyclizine
1) Propranolol should be used cautiously in diabetes. what drug is recommended instead?
2) Propranolol is contra-indicated in second or third degree AV block what is recommended instead?
1) Monitor patient and change to cardio selective beta blocker if necessary
2) Propranolol: contra-indicated in second or third degree AV block. Use an alternative drug group that is not negatively inotropic
Gentamicin is contra-indicated in myasthenia gravis. what is recommended instead?
Use another antibiotic on microbiology recommendation
what do we mean when we refer to the appropriateness of a medication?
1) Is the drug therapy appropriate for the patient – is there a rationale/is it evidence based/is the patient seeing any benefit?
2) Is it following NICE guidance/Trust policy?
3) Does it cause problems with co-morbidities?
4) Can the patient swallow/use the device/inject themselves?
5) Is the patient happy to be on this medication?
6) Is it the most cost-effective treatment?
7) Is this the safest treatment?
