Clinical Pharmacy in Egypt :: An Insider's Look.
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An insider's look at the practice of clinical pharmacy in Egypt from my own experience. As well as tips on how to prepare for starting a new practice. Prepared and Presented by Pharmacist/ Mamdouh Ezz Samy
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Clinical Pharmacy in Egypt :: An Insider's Look.
- 1. Clinical Pharmacy in Egypt An Insider’s Look Pharmacist/ Mamdouh Ezz Samy
- 2. Intro
- 3. My Bio • 1998 – 1999 Worked at NCI ( Cairo) • 2000 – 2002 Established Unit in SECI ( Assiut) • 2002 – NOW Private Pharmacy and Online presence.
- 4. Here is where it all started…
- 5. How was the Beginning?
- 6. High-Dose MTX • Osteo-sarcoma in pediatrics up to 12 grams 1 mg/ml Further Reading: Google: high dose methotrexate protocol in osteosarcoma
- 7. What is Clinical Pharmacy? • An area of pharmacy concerned with the science and practice of rational medication use. ( ACCP) • The activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices. ( ESCP)
- 8. Pharmacist
- 9. Clinical Pharmacist • The focus of attention moves from the drug to the single patient receiving drugs.
- 11. Clinical Pharmacy Goal 1. Maximizing the clinical effect of medicines, i.e., using the most effective treatment for each type of patient. 2. Minimizing the risk of treatment-induced adverse events. 3. Minimizing the expenditures for pharmacological treatments, trying to provide the best treatment alternative for the greatest number of patients.
- 12. Level of Action of Clinical Pharmacists 1. Before the prescription 2. During the prescription 3. After the prescription
- 13. • • • • Before the prescription Drug Information( non-biased) Protocols Prescribing Policy Clinical trials
- 14. DURING the prescription • Choice of treatment by physicians • Patient Profile evaluation for interactions or errors • Dosage Calculation*
- 15. After the prescription • Patient Counseling • Preparation of unit doses* • Patient awareness, check and improve patient compliance. • Outcome research
- 16. Doctors?
- 17. 1. 2. 3. 4. Obstacles to Spreading Practice Administration and Legislations Doctors Pharmacists Patients
- 18. Remember, Teamwork is Key! By: Ph/ Mamdouh Ezz Samy
- 19. How to Get Started? 1. Study and document the current status of practice.( very important) 2. Look for special weakness points and needs 3. Start studying drugs and diseases used( protocols, if any). 4. Try to look for solutions to current problems 5. Approach doctors with respect offering your proposed solutions and ask for a chance to help. 6. Gather lots of books to use as references By: Ph/ Mamdouh Ezz Samy
- 20. How to Get Started? ( cont.) 7. Try to contact similar practices in other hospitals and ask for help and cooperation, visit them and ask them to visit back. 8. Build good relations with doctors, nurses and administration. 9. Offer to help others and be nice to them 10. Start creating cheat sheets and making them available to everyone for free. 11. Focus on problem drugs and devices. By: Ph/ Mamdouh Ezz Samy
- 21. How to Get Started? ( cont. 2) 12. Focus on high-risk drugs, expensive ones or hard to calculate doses as a start. 13. Look for need to apply dose modifications in case of renal problems or liver diseases. 14. Look for signs of toxicity and interactions with other drugs the patient might be taking. 15. Talk to nurses and discuss the problems they face and try to offer solutions. 16. Document and report every activity you do.* 17. Study Study Study... By: Ph/ Mamdouh Ezz Samy
- 22. Sample Documents
- 25. Storage
- 26. Maximum Doses
- 29. STUDIES
- 30. ADEs Study
- 32. What Happens?
- 34. Laminar Air Flow Hood
- 35. Glove Box
- 36. Supplies
- 38. Storage
- 39. What is Clinical Pharmacy? • Clinical Pharmacy includes all the services performed by pharmacists practicing in hospitals, community pharmacies, clinics and any other setting where medicines are prescribed and used. • The term "clinical" does not necessarily imply an activity implemented in a hospital setting. It describes that the type of activity is related to the health of the patient(s). This implies that community pharmacists and hospital pharmacists bothPh/ Mamdouh Ezz clinical pharmacy can perform By: activities. Samy
- 40. Community Pharmacy • Check drug and dose before dispensing, don't dispense if not 100% sure. • Make sure the patient understands how and when to use his medicine. • Ask if he told the doctor about other medicines he uses and herbs as well • Give information leaflets, if available • Demonstrate use of devices, if needed. By: Ph/ Mamdouh Ezz Samy
- 41. Community Pharmacy (2) • Make sure to have references available. • Have good relations with doctors and contact them regularly. • Be careful when measuring blood pressure or blood sugar at the pharmacy. By: Ph/ Mamdouh Ezz Samy
- 42. What YOU get for FREE Give for FREE And Give Credit By: Ph/ Mamdouh Ezz Samy
- 43. Thank YOU
Editor's Notes
- IV preparation Audience comments My comments
- What’s the difference? Sterile, multiple-use, bio-safety, individual protection. Chemotherapy risks to pregnant women
- First unit established in Egypt 1996 in the NCI. Dr. Sherif and Dr. Kamal Sabra
- Do you know what this is used for? Dose? 12.5mg per week How about this one? 250mg 1gm and then 5gm
- The discipline of pharmacy embraces the knowledge on synthesis, chemistry and preparation of drugs Focus on stock, inventory, profit and sales…
- Clinical pharmacy is more oriented to the analysis of population needs with regards to medicines, ways of administration, patterns of use and drugs effects on the patients.
- Maximising the clinical effect of medicines, i.e., using the most effective treatment for each type of patient Minimising the risk of treatment-induced adverse events, i.e., monitoring the therapy course and the patient's compliance with therapy Minimising the expenditures for pharmacological treatments born by the national health systems and by the patients, i.e., trying to provide the best treatment alternative for the greatest number of patients.
- Explain each in detail
- Are doctors against clinical pharmacy? What do you think? Story... How to approach?
- How do you sort those?
- Dr. Hatem
- Patient by name, and all details written and checked.
- Stability and savings and better doses.
- Optimal storage for each medication
- Watch for maximum doses for each drug and antibiotic
- Protocol sheet; Patient info Dose calculation guidelines Duration and dates of protocol All cycles in one sheet Dilution of each med and method of adminstration
- Self reporting of errors by staff, Aim is to correct them not punish the person who makes a mistake. Propose suggestion for prevention in the future. Discussed in privacy.
- Not the one we eat
- Errors reach the patient when team have similar qualities and way of thinking and knowledge. Adding Pharmacists prevents errors due to their experience and different weakness points so together they block errors.
- Supplies, Books Savings
- Each order is checked prior to dispensing to patients. Packed separately with patient info on it and then handed over to ward.
- Meds stored in fridge, labelled properly.