In this slides included clinical pharmacy introduction and pharmaceutical care, also explanation about the goals and objectives of the clinical pharmacy requirements
Introduction to Clinical Pharmacy, Concept of clinical pharmacy, functions and
responsibilities of clinical pharmacist, Drug therapy monitoring - medication chart
review, clinical review
In this slides included clinical pharmacy introduction and pharmaceutical care, also explanation about the goals and objectives of the clinical pharmacy requirements
Introduction to Clinical Pharmacy, Concept of clinical pharmacy, functions and
responsibilities of clinical pharmacist, Drug therapy monitoring - medication chart
review, clinical review
Clinical pharmacy may be defined as the science and practice of rationale use of
medications, where the pharmacists are more oriented towards the patient care
rationalizing medication therapy promoting health , wellness of people.
It is the modern and extended field of pharmacy.
“ The discipline that embodies the application and development (by pharmacist) of
scientific principles of pharmacology, toxicology, therapeutics, and clinical pharmacokinetics, pharmacoeconomics, pharmacogenomics and other allied
sciences for the care of patients”.
Introduction to clinical pharmacy, Concept and Objectives of clinical pharmacy, Function and responsibilities of clinical pharmacist, Clinical Pharmacy services.
Pharmacy Practice
Scope of pharmacy practice
Community Pharmacy
Scope of community pharmacy
Community pharmacy management
Selection of Pharmacy site
Objective
Legal requirements
Drug procurement
Drug storage and inventory control
Pharmacy Practice is the discipline of pharmacy which involves developing the professional roles of pharmacists. Pharmacy Practice offers practicing pharmacists in-depth useful reviews and research trials and surveys of new drugs and novel therapeutic approaches.
Basic introduction to patient counselling for the clinical pharmacy services. Educating the patient on their disease, medication and lifestyle for better patient care and quicker recovery.
DRUG INFORMATION SERVICE AND DRUG INFORMATION BULLETINSHIVANEE VYAS
"Drug information center is one of the departments of the hospital and gives the recent knowledge and information about the medical, pharmacy field at any time to the physicians, staff of the hospital and to the citizens”.
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
Clinical pharmacy may be defined as the science and practice of rationale use of
medications, where the pharmacists are more oriented towards the patient care
rationalizing medication therapy promoting health , wellness of people.
It is the modern and extended field of pharmacy.
“ The discipline that embodies the application and development (by pharmacist) of
scientific principles of pharmacology, toxicology, therapeutics, and clinical pharmacokinetics, pharmacoeconomics, pharmacogenomics and other allied
sciences for the care of patients”.
Introduction to clinical pharmacy, Concept and Objectives of clinical pharmacy, Function and responsibilities of clinical pharmacist, Clinical Pharmacy services.
Pharmacy Practice
Scope of pharmacy practice
Community Pharmacy
Scope of community pharmacy
Community pharmacy management
Selection of Pharmacy site
Objective
Legal requirements
Drug procurement
Drug storage and inventory control
Pharmacy Practice is the discipline of pharmacy which involves developing the professional roles of pharmacists. Pharmacy Practice offers practicing pharmacists in-depth useful reviews and research trials and surveys of new drugs and novel therapeutic approaches.
Basic introduction to patient counselling for the clinical pharmacy services. Educating the patient on their disease, medication and lifestyle for better patient care and quicker recovery.
DRUG INFORMATION SERVICE AND DRUG INFORMATION BULLETINSHIVANEE VYAS
"Drug information center is one of the departments of the hospital and gives the recent knowledge and information about the medical, pharmacy field at any time to the physicians, staff of the hospital and to the citizens”.
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
brief review on clinical pharmacy, drug information centre & patient safety program
The lecture was presented at Al-Mahmoudiya General Hospital as part of the training course for fresh appointed pharmacist at 16/5/2023 at 11 & 15/5/2023
Clinical Pharmacy Introduction to Clinical Pharmacy, Concept of clinical pptxraviapr7
b) Clinical Pharmacy
Introduction to Clinical Pharmacy, Concept of clinical pharmacy
Functions and responsibilities of clinical pharmacist, Drug therapy monitoring
Medication chart review, clinical review., pharmacist intervention
Ward round participation, Medication history and Pharmaceutical care.
Dosing pattern and drug therapy based on Pharmacokinetic & disease pattern
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities.
It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
A cornerstone of the discipline is continuous improvement based on learning from errors and adverse events.
Let us see what Pharmacists, Doctors and Patients can do about it.
Topic on the introduction to the clinical pharmacy services. INTRODUCTION TO PHARMACY PRACTICE & CONCEPT OF CLINICAL PHARMACY add the fundamentals on Contribute significantly to patient care through obtaining the accurate medication histories from patients or other sources.
verifying medication histories obtained by other health care professionals.
To obtain the correct information on aspects of drug use.
Compare medication for best
Assess the rationale for drugs prescribed.
Assess patient medication compliance.
Screen for DRPs.
Document allergies, S/E and adverse drug reactions.
Assess the evidence of drug abuse.
Drug Therapy Monitoring
provided by a clinical pharmacist for specific patients to optimize drug therapy to achieve health outcomes.
Medication Order Review.
Adverse Drug Reaction Management.
Clinical Review.
Therapeutic Drug Monitoring.
Pharmacist Interventions
2. Minimum Standard for Hospital Pharmacy_ASHP_2022-2023.pptxssuserca7d2c
I’m going back in a minute I need a little more help I have a couple things I have a question about for the next two days and then I’m not going back in for a little while I need help I have a little more money to pay my my mom has to go back in the house so I’m going back in to the hospital so I’m going back to my room so I’m going back home to do my homework
Hospital Pharmacy is a very vast topic but in this presentation providing more information about hospital pharmacy but precisely described so for everyone easy to understand and using for his/her study or making any project regarding this topic or it can be related to this topic.
Thank you
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General Discussion on Clinical Pharmacy
1.
2. Development of clinical pharmacy
• Pharmacy is the science and technique of
preparing and dispensing drugs. It is
a health profession that links health
sciences with chemical sciences and aims
to ensure the safe and effective use
of pharmaceutical drugs.
3.
4. CLINICAL PHARMACY
• Clinic is a facility or area where ambulatory
patients are seen for appointments and
treated by a group of physicians practicing
together and also used to indicate the
outpatient diagnostic facility operated by a
hospital
• Pharmacists, also known as chemists or
druggists, are health professionals who
practice in pharmacy, the field of health
sciences focusing on safe and effective
medication use. A pharmacist is a member of
the health care team directly involved with
patient care
5.
6.
7. • The discipline that embodies the application and
development (by pharmacist) of scientific principles of
pharmacology, toxicology, therapeutics, and clinical
pharmacokinetics, pharmacoeconomics,
pharmacogenomics and other allied sciences for the care
of patients”.
• (Reference: American college of clinical pharmacy)
• It comprises a set of function that promote the safe,
effective and economic use of medicines for individual
patients.
• Clinical pharmacist often work in collaboration with
physicians, nurse practioners and other heathcare
professionals.
8.
9. Basic component of Clinical pharmacy
• Prescribing drugs
• Adminstering drug
• Monitoring prescription
• Managing drug use
• Counselling Patient
10. Qualification & skill of clinical pharmacist
Most clinical pharmacists have a B.Pharm,
M.pharm and Doctor of pharmacy(pharm D)
Degree and many have completed one or more
years of
post graduate training.
Clinical Pharmacist interact directly with patient in
several different ways.They use their knowledge/
skill of medication including dosage,drug
interaction,side effect,expese and effectiveness
etc to determine if a medication plan is
appropriate for their patients.
11. How does clinical pharmacy differ from pharmacy?
The discipline of pharmacy embraces the knowledge on
synthesis, chemistry and preparation of drugs
Clinical pharmacy is more oriented to the analysis of
population needs with regards to medicines, ways of
administration, patterns of use ,drugs effects on the
Patients,
‘the overall drug therapy management’.
The focus of attention moves from the drug to the
single patient or population receiving drugs.
12.
13. Hospital vs Clinical pharmacy
• Clinical pharmacist include hospital
pharmacist and community pharmacist.
They are the people who work in
healthcare field and have a main role in
prescription
• Hospital pharmacist are referred to those
who work in a hospital,while community
pharmacist are those who work in an
independent pharmacy.
14. • Clinical pharmacists participate in direct
patient care in hospitals and other
healthcare facilities, while hospital
pharmacists focus on preparing
prescriptions for patients.
• Clinical pharmacists and hospital
pharmacists are both involved in providing
medication to patients. Their scope of
duties differs, however, and clinical
pharmacists are required to complete
additional training
15. Job responsibilities of a clinical pharmacist
include:
• Evaluating for untreated health issues
• Performing medical tests on patients
• Ensuring patients receive the correct
medications
• Advising patients about health-related
matters
• Tracking the progress of patients
16. Job responsibilities of a hospital pharmacist
include:
• Preparing IV prescription medications
• Providing information to medical staff
• Ensuring the medication is safe for the
patient
• Filling out paperwork
• Monitoring and ordering inventor
17.
18. • Pharmaceutical Care is the direct responsible
provision of medication related care for the
purpose of achieving definite outcomes from
the responsible provision of medicines.
• Cause the use of drug:-
-cure of the disease
-elimination or reduction of symptoms
-arrest or slowing of a disease process
-prevention of disease or symptoms
19. • Clinical pharmacy include all the services
performed by pharmacist practising in
hospital,community pharmacies,nursing
homes,home based care service,clinics
and any other setting where medicines are
prescribed and used.
22. medicines management pathway
• There are nine steps and three
background processes
Steps include:-
1. Decision to Treat and Prescribe
2. Record Medicine Order
3. Review of Medicine Order
4. Issue of Medicine
5. Provision of Medicine Information
23. medicines management pathway
1. Distribution and Storage of Medicine
2. Administration of Medicine
3. Monitor for Response
4. Transfer of Verified Information
Background Processes include:-
1. Medicines Procurement and Materials
Management
2. Reporting and Quality Safety Audit Review
3. Communication
26. Goal of clinical Pharmacy
The main goal of clinical pharmacy are:
To assist the physician in doing a better job of
prescribing and monitoring drug therapy for the
patient.
To assist medical and Para-medical staff and
documenting medication incidents correctly
To Promote the correct and appropriate use of
medical product and devices
27. Goal of clinical Pharmacy
These activates aim at:
Maximizing the clinical effect of medicine
Minimizing the risk of treatment-induced
adverse events
Minimizing the expenditures for
pharmacological treatment
29. Clinical Pharmacy Requirements
Physical Assessment skills :
The clinical pharmacist assesses medication-related needs
by
Reviewing the medical record using a problem-oriented
framework
Meeting with the patient to obtain a complete medication
history to identify all of the patient’s current medications
Obtaining, organizing, and interpreting patient data
30. Clinical Pharmacy Requirements
Knowledge of drug therapy:
• Evaluating the effectiveness, safety, and affordability of
each medication
• Assessing medication-taking behaviors
• Identifying medication-related problems
Communication skills:
The pharmacist should communicate with patients about
how and when they should take medication and then
verify their understanding
31. Clinical Pharmacy Requirements
• Understand written information.
• Understand spoken information.
• Speak clearly so listeners can understand.
• Read and understand work-related materials
• Write clearly so other people can understand.
Laboratory and diagnostic skills:
Hospital pharmacists participate in activities that may be
considered diagnostic.
32. Clinical Pharmacy Requirements
Therapeutic Planning skills
therapeutic planning may incorporate :-
• patient education,
• dietary adjustment,
• an exercise program,
• drug therapy,
• And the participation of nursing and others health
professionals.
• Therapeutic plans are important in the management of
complex or chronic illnesses.
33. Level of Action of Clinical Pharmacists
Before prescription
During prescription
After prescription
35. During the
prescription
• Counselling activity:
Clinical pharmacists can influence the attitudes and priorities of
prescribers in their choice of correct treatments.
The clinical pharmacist monitors, detects and prevents the medication
related problems
The clinical pharmacist pays special attention to the dosage of drugs
which need therapeutic monitoring.
Community pharmacists can also make prescription decisions directly, when over
the counter drugs are counselled.
•
•
•
•
37. Prevention of MRP
Communicate
with healthcare
provider
Designate a
medication
manager
Keep a
medication list
Consult with
doctor or
pharmacist
Use common
sense when
using
medication
Obtain a refills in
timely manner
40. 2. During the
prescription
• Counselling activity
Clinical pharmacists can influence the attitudes and priorities of
prescribers in their choice of correct treatments.
The clinical pharmacist monitors, detects and prevents the medication
related problems
The clinical pharmacist pays special attention to the dosage of drugs
which need therapeutic monitoring.
Community pharmacists can also make prescription decisions directly, when over
the counter drugs are counselled.
•
•
•
•
42. Patient consultation
• Consultation is the act of seeking
assistance from another physicians or
health care professionals for diagnostic
studies, therapeutic interventions, or other
services that may benefit the patient.
43. Role of pharmacist in consultation
• Reorganization of the pharmacist's activities may
improve pharmaceutical consultations.
• The potential determinants of personal consultation
show that 52% of participants trusted pharmacist
and 55% considered the pharmacist as a friend%
agreed about full investigation. .
45. Consultation Process: WWHAM
• W= Who is it?
• W= What are the symptoms?
• H= How long has it going on?
• A= action taken?
• M= Medicine being taken?
46. Consultation Process: ASMETHOD
• A= Age of the patient?
• S= Self or someone else?
• M= Medicine has taken?
• E= Exactly what do you mean?
• T= Time of symptoms?
• H= History of diseases?
• O= Other symptoms?
• D= Doing anything for cure?
47. Consultation Process: ENCORE
• E= Evaluate the symptoms its onset
recurrence and duration?
• N= No medication is always and option?
• C= Care when dealing with specific patient
group?
• O= Observe the patient for sign of systemic
disturbance ?
• R= Refer when in doubt?
• E= Explain any course of action
recommended?
49. Role of Clinical Pharmacist
Step:1. Stabilizing the need for the drug therapy
Step:1.1 Relevant Patient Details
Step:1.2 Medication History
50. Step:1. Stabilizing the need for the drug therapy
The pharmacist often one provides information to
the independent prescribe on the expected
benefits and risk of drug therapy by evaluating
both the evidence base and individual patient
factor. The evidence for one specific mode of
therapy may not be conclusive. In this
circumstances, the pharmacist will need to call on
their understanding of the principles of
Pharmaceutical science and on clinical experience
to provide the best advice possible.
51. Step:1.1 Relevant Patient Details
Without background information of the patient
health and social circumstances it is difficult to
establish the existence of all potential for medical
related problems.So the following requirements
are need to be fulfilled:
Factor Implications
Age The very young and the very old are most at risk of
medication-related problems. A patient's age may indicate
their likely ability to metabolise and excrete medicines and
have implications for step 2 of the drug use process
Gender This may alter the choice of the therapy for certain
indications. I t may also prompt consideration of the
potential for pregnancy or breast feeding
52. Factors Implications
Ethnic or
Religious
Background
Racially determined predispositions to intolerance or
ineffectiveness should be considered with certain classes
of medicines, for example, ACE inhibitors in Afro-Caribbean
people. Formulations may be problematic for other groups, for
example, those based on blood products for Jehovah's
Witnesses or porcine-derived products for Jewish patients
Social History This may impact on ability to manage medicines and influence
pharmaceutical care needs, for example, living alone or in a
care home or availability of nursing, social or informal carers
53. Factor Implications
Presenting
complain
Symptoms the patient describes and the signs identified by the doctor on
examination. Pharmacists should consider whether these might be
attributable to the adverse effects of prescribed or purchased medicines
Working
Diagnosis
This should enable the pharmacist to identify the classes of medicines that
would be anticipated on the prescription based on current evidence
Previous Medical
History
Understanding the patient's other medical conditions and their history helps
ensure that management of the current problem does not compromise a
prior condition and guides the selection of appropriate therapy by identifying
potential contraindications
Laboratory or
Physical Findings
The focus should be on findings that may affect therapy, such as : renal
function,liver function, full blood count, blood pressure, cardiac rhythm.
Results may convey a need for dosage adjustment or presence of an
adverse reaction
54. Step:1.2 Medication History
A medication history is the part of a pharmaceutical consultation that identifies
and documents allergies or other serious adverse medication events, as
well as information about how medicines are taken currently and have been
taken in the past. It is the starting point for medicines reconciliation and
medication review.
Discrepancies between the history recorded by the medical team and that
which the pharmacist elicits fall into two categories:
1. Intentional (where the medical team has made a decision to alter the
regimen) or
2. Unintentional (where a complete record was not obtained).
Discrepancies should be clarified by the prescriber or referred to a more senior
pharmacist.
55. Key Components of Medication History:
1. Introduce yourself to the patient and explain the purpose of
theconsultation.
2. Identify any allergies or serious adverse reactions and record these on the
prescription chart, care notes or patient medication record.
3. Ascertain information about prescribed and non-prescribed treatments
from:
the patient's recall
medicines in the patient's possession
referral letter (usually from the patient's primary care doctor)
copy of prescriptions issued or a repeat prescription list
medical notes
contact with the appropriate community pharmacist or primary care
doctor.
4. Ensure the following are recorded:
generic name of medicine (unless specific brand is required)
dose
frequency
duration of therapy.
56. Key Components of Medication History:
5. Ensure items such as inhalers, eye drops, topical medicines, herbal and
homeopathic remedies are included, as patients often do not consider these as
medicines.
6. Ascertain the patient's medication-taking behavior.
7. Consider practical issues such as swallowing difficulties, ability to read labels
and written information, container preferences, ordering or supply problems.
8. Document the history in an appropriate format.
9. Note any discrepancies between this history and that recorded by other health
care professionals.
10. Ascertain if these discrepancies are intentional (from patient, nursing staff,
medical staff or medical notes).
11. Communicate non-intentional discrepancies to the prescriber.
12. Document any other important medication-related information in an appropriate
manner, for example, implications of chronic renal failure, dialysis, long-term steroid
treatment.
57. A) Identify drug patient interaction
Contraindication, drug related to age and
gender.
Identifies previous ADR allergy.
Abnormal renal and hepatic function.
Patient preference to certain treatment.
Route of administration.
Step:2-Seleciton of medicine
58. B) Identify drug disease interaction
Step:2-Seleciton of medicine
60. Elder patient :Drug therapy is essential when
caring for elderly patients, but clearly it is a double-
edged sword. Elderly patients are at high risk of
having drug interactions, but the prevalence of these
interactions is not well documented. Several types of
interactions exist: drug–drug, drug–disease, drug–
food, drug–alcohol, drug–herbal products, and drug–
nutritional status.
Step:2-Seleciton of medicine
61. C) Identify drug-drug interaction.
When two drugs interact, the overall effect of one or both of the drugs may be
greater than desired .
Example: Certain antacids can prevent certain medicine(such as antibiotics, blood-
thinners and heart medications) from being absorbed into the blood stream.
Step:2-Seleciton of medicine
63. Step-3: Administering medicine
A. Pharmacokinetic factor
i. Rate and extent of drug absorption
ii. Drug distribution
iii. Plasma protein binding
iv. Metabolism
v. Excretion
B. Pharmacodynamics factor
i. Receptor binding
ii. Enzyme
64. Continued…
C. Factors affecting bioavailability
Physicochemical Factor
• Surface area
• Particle size
• Dissolution rate
• Disintegration
time
• PH
Physiological Factor
• Small intestine
• GI motility
• Gastric emptying
time
66. E. Selection of appropriate regimen
Simple regimen
• Short term or long
term
• Increased
duration
• Decrease
frequency of drug
administration
• Oral route is more
Complicated Regimen
• For short half-life
• Short therapeutic
index
67. Step:4- Providing Medicine
• Prescription should be legal, legible and
accurate
• Right medicine for right patient at right
time
• Screening the prescription
• Continued the availability and supply of
medicine
• Risk related to providing medicine
• Proper labeling with clear dosage
instruction
68. Step:5- Monitoring Therapy
• Effectiveness of therapy
• Identification of potential ADR
• Required more care in low TI Drug
Example:
Digoxin, Phenytoin, Theophylline
• Anticoagulant
Example: Warfarin
69. Step:6- Patient Advice and Education
• Provide accurate and reliable information
• Convey the benefits and risk of therapy
• Patient reminder chart
• Ask any question they may have
• Provide info. Throughout the hospital and
during discharge
Step:7- Evaluating Effectiveness
70. Question?
• Think of someone in your family or a friend
that has had something go “wrong” with
their medicines?
– Caused an adverse or unwanted effect ?
– Had medicines stopped when should have
continued?
– Not worked?
– What happened ?
– Could it have been avoided ?
71. Sources of Error
Prescribing error - selecting the wrong or inappropriate
drug/dose/formulation/duration etc
::Communicating those instructions
Supply error - timely; wrong drug, dose, route; expired
medicines, labelling
Administration error - timing; wrong route; wrong
rate/technique
Lack of user education - actions to take