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ROLE OF PHARMACIST IN PREVENTION & MANAGEMENT OF DRUG INTERACTIONS

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This presentation describes the steps to be performed by a pharmacist to play a major role in prevention and management of drug interactions and includes a case study.

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ROLE OF PHARMACIST IN PREVENTION & MANAGEMENT OF DRUG INTERACTIONS

  1. 1. ROLE OF PHARMACIST IN PREVENTION & MANAGEMENT OF DRUG INTERACTIONS BY: Komal Haleem Pharm-D
  2. 2. DRUG INTERACTIONS
  3. 3. The modulation of the pharmacologic activity of one drug (i.e. the object drug) by the prior or concomitant administration of •Food •Another drug or •Herbal product.
  4. 4. ROLE OF PHARMACIST IN PREVENTION OF DRUG INTERACTIONS
  5. 5. CASE STUDY: A patient named G.W. He was prescribed the following medications by 4 different physicians: •Inderal and Lasix for high blood pressure. (Internal) •Tricyclic antidepressants, for depression. (Psychiatrist) •Xanax for sleep. (Family Doctor) •Propoxyphene for chronic pain. (Orthopedist) •Prilosec for stomach irritation. (Internal) •Over-the-counter Tylenol from time to time. (Self) •Recently he was prescribed Ultram (analgesic for moderate pain) by a second opinion orthopedist. Suffered major automobile accident due to excessive dizziness and drowsiness resulting from drug interaction between ultram and xanax
  6. 6. 1. Take a MEDICATION HISTORY(AVOID mistakes) 2. Remember high risk patients •Any patient taking 2 medications •Anticonvulsants, antibiotics, digoxin, warfarin, amiodarone, etc 3. Check pocket reference 4. Check up-to-date computer program
  7. 7. 5. Documenting the care delivered 6. COUNSELING the patients 7. Monitoring and evaluating the patient’s response to therapy 8. Work with health care practitioners to eliminate unnecessary medications
  8. 8. 9.Maintaining patient data base including: •patient’s gender, •age, •vital signs, •medical diagnosis(es), •drug allergies, •relevant laboratory tests, •a complete listing of medication being taken routinely or taken on an as-needed basis
  9. 9. •Allergies? •Vitamins and herbs? •Old drugs & OTC? as well as current •Interactions? •Dependence? •Mendel: family history of benefits or problems with any drugs?
  10. 10. 1. Only take medication that has been specifically prescribed for you by your physician; 2. Medication must be taken properly to ensure its safety and effectiveness; 3. Unless otherwise instructed, take medicine on an empty stomach to achieve a faster onset of action;
  11. 11. 4. When taking medicine with food or around a meal time is not recommended, take medicine one hour before meal/food or two hours after meals or eating food; 5. Take your medicine with a full glass (1 cupful or 8 oz.) of water; 6. Avoid concurrent use of alcohol with medicine; 7. Avoid consuming excessive quantities of chocolate and beverages containing caffeine (coffee, tea, colas);
  12. 12. 8. If you have any questions / concerns about your medicine or you believe you are having an adverse drug reaction or drug interaction, consult your pharmacist or physician immediately. If there is a problem, your pharmacist can contact your physician, who can prescribe other medication to avoid the risk
  13. 13. ROLE OF PHARMACIST IN MANAGEMENT OF DRUG INTERACTIONS
  14. 14. Avoiding the combination entirely Adjusting the dose of the object drug Spacing dosing times to avoid the interaction Monitoring for early detection Provide information on patient risk factors that increases the chance of an adverse outcome
  15. 15. Improve computerized screening systems Excessive number of drug interactions on the systems Drug class differences not handled correctly
  16. 16. •http://www.fda.gov/drugs/developmentapprovalprocess/developmentreso urces/druginteractionslabeling/ucm110632.htm •http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964764/ •http://legacy.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/mar 00druginteractions.cfm&pub_id=8&article_id=522 •http://online.wsj.com/article/SB1000142405270230476530457748303361 4613256.html •http://www.environmentaldiseases.com/article-drug-interactions.html

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