This document outlines the topics that will be covered in the Clinical Pharmacy II course, including rational use of drugs, rational prescribing, rational dispensing, problems of irrational drug use, and factors causing irrational drug use. It provides the course contents, marking scheme, topics to be covered, and expected learning outcomes. The key areas of focus for rational use of drugs are ensuring patients receive appropriate medications to meet their clinical needs at the lowest possible cost. Rational prescribing involves selecting drugs based on safety, effectiveness, tolerability, price and simplicity, while rational dispensing aims to provide patients with adequate counseling and instructions for proper medication use. Irrational drug use can result from improper prescribing, dispensing, or non-adherence and lead to negative
In this slides included clinical pharmacy introduction and pharmaceutical care, also explanation about the goals and objectives of the clinical pharmacy requirements
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
Prescribed Medication Order and Communication Skills.pptxSangam Kanthale
Prescribed medication orders must contain specific information to effectively communicate treatment regimens to pharmacists. This includes the patient's name, drug name, strength, dose, form, administration route, quantity, prescriber information, and date. PRN orders require additional details like maximum daily dose and signs/symptoms prompting administration. Proper interpretation of prescriptions by pharmacists can prevent medication errors by understanding abbreviations and Latin terms used. Effective communication between all healthcare professionals is critical for safe and accurate patient care.
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”.
Role of the pharmacist in medication safety.Subash321
Role of the pharmacist in medication safety. In this you know about the medication safety, medication error & how to prevent medication error. And the role of the pharmacists in medication safety.
Definition, Types of drug distribution systems, Dispensing of drugs to ambulatory (outdoor) patients, Distribution of controlled drug, Novel drug distribution methods
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.
In this slides included clinical pharmacy introduction and pharmaceutical care, also explanation about the goals and objectives of the clinical pharmacy requirements
A Ward round is a visit made by a medical practitioner, alone or with a team of health care professionals and medical students to hospital in-patients at their bedside to review and follow-up the progress in their health.
Usually at least one ward round is conducted
everyday to review the progress of each
patient outcome.
Pharmacist’s participating in medical ward
rounds promotes health care
Participation of the Pharmacists in ward
rounds in various practice settings helps to
provide rational drug use.
Prescribed Medication Order and Communication Skills.pptxSangam Kanthale
Prescribed medication orders must contain specific information to effectively communicate treatment regimens to pharmacists. This includes the patient's name, drug name, strength, dose, form, administration route, quantity, prescriber information, and date. PRN orders require additional details like maximum daily dose and signs/symptoms prompting administration. Proper interpretation of prescriptions by pharmacists can prevent medication errors by understanding abbreviations and Latin terms used. Effective communication between all healthcare professionals is critical for safe and accurate patient care.
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”.
Role of the pharmacist in medication safety.Subash321
Role of the pharmacist in medication safety. In this you know about the medication safety, medication error & how to prevent medication error. And the role of the pharmacists in medication safety.
Definition, Types of drug distribution systems, Dispensing of drugs to ambulatory (outdoor) patients, Distribution of controlled drug, Novel drug distribution methods
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.
Hospital and its organisation, BUDGET AND pHARMACY AND tHERAPEUTIC COMMITTEESanju Kaladharan
Hospital administration oversees hospital operations and policies. Therapeutic services provide medical treatment to patients, including physical, occupational, speech and respiratory therapy. Diagnostic services determine the cause of illness through medical testing. Support services maintain hospital facilities and equipment. The pharmacy and therapeutics committee advises on drug selection and use to ensure cost-effective and quality patient care.
This document outlines the importance and process of patient counseling by pharmacists. It defines patient counseling as providing medication information to patients regarding proper use, side effects, storage, and lifestyle changes. The goals of counseling are to ensure patient understanding, compliance, and active participation in their treatment. An effective counseling session involves verbal and non-verbal communication skills, explaining the purpose and use of medications, and addressing potential adverse effects or interactions. The pharmacist should prepare, open and close the session properly while gathering patient information to provide individualized counseling.
The document discusses hospital budget preparation. It defines a budget as a tool for hospital administration to review hospital services in a comprehensive financial plan. The objectives of a hospital budget are to develop standards, compare actual results to standards, identify deviations, analyze deviations, monitor financial activities, estimate costs of objectives, improve financial planning, focus decision making, and effectively manage finances. A budget includes income/revenue accounts, expenditure accounts, and requests for capital investments. The preparation process involves assumptions from administration, contributions from departments, hearings, preliminary budgets, and approval. Factors like local conditions, management policy, and authority confidence can influence the budget.
This document discusses drug therapy monitoring and pharmaceutical care. It outlines the key components and goals of drug therapy monitoring including medication order review, clinical review, and pharmacist intervention. The goals are to optimize drug therapy, prevent medication errors, and assess therapeutic outcomes. It also discusses the process of pharmaceutical care which involves identifying drug-related problems, determining treatment goals, developing and implementing care plans, and monitoring outcomes. The overall aim is to provide responsible drug therapy to improve patients' quality of life.
Clinical pharmacy involves applying scientific principles of pharmacology to optimize patient care and outcomes. It focuses on rational medication use and promoting health. Clinical pharmacists work directly with patients, assessing their medication-related needs and developing individualized care plans in collaboration with other healthcare providers. They are highly trained and educated professionals responsible for ensuring safe, effective, and cost-efficient use of medications across various healthcare settings.
Pharmacists in India play an important role in improving healthcare access and health outcomes. Currently there are around 10 lakh pharmacists in India working in various healthcare settings. Pharmacists can help overcome India's shortage of healthcare professionals by providing services like dispensing medicines accurately, counseling patients, aiding national health programs in tuberculosis and HIV/AIDS, and improving access to care in rural communities. By utilizing pharmacists' expertise and expanding their roles, India can more effectively achieve its public health goals.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
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”.
The document defines a hospital formulary as a compilation of pharmaceuticals and important information that reflects the current clinical judgement of medical staff. It discusses the origins of hospital formularies in India in 1968 and 1997. The need for formularies is explained as being due to the increasing number of new drugs, complex drug effects, and interest in lower healthcare costs. Advantages include improved quality, cost reduction, and education. Disadvantages can include restricting physician choice and allowing inferior drugs. The document outlines the process for preparing a formulary including necessary information, guidelines, and components. It emphasizes the role of the pharmacy and therapeutics committee in developing policies to select and use medications optimally.
This document discusses clinical pharmacy, including definitions, the status of clinical pharmacy in India, the scope and history of clinical pharmacy, activities of clinical pharmacists, clinical pharmacy practice areas, guidelines for pharmacotherapy specialists, clinical pharmacokinetics, drugs that can be monitored through therapeutic drug monitoring, reasons to request TDM, and the responsibilities of clinical pharmacists. It outlines how clinical pharmacy aims to optimize drug therapy for patients through various roles like consulting, drug information provision, and patient monitoring.
This document discusses rational drug use and provides strategies to promote it. It defines rational drug use according to WHO as using medicines appropriately for clinical needs in terms of drug choice, dosage, duration and cost. Common problems with irrational use include polypharmacy, overuse of antibiotics and injections. Reasons for irrational use include lack of skills/knowledge, inappropriate drug promotion, profits from drug sales, and lack of coordinated policies. Consequences are antimicrobial resistance, adverse drug reactions, and wasted resources. The document recommends educational and regulatory strategies to improve prescribing and dispensing practices and ensure appropriate drug use.
Drug use evaluation (DUE) is a quality improvement process that reviews prescribing patterns to promote appropriate drug use. It involves identifying a drug or therapeutic area, developing criteria and standards, collecting data, evaluating results, providing feedback, and implementing interventions. The process then reevaluates drug use and revises the DUE program as needed. The presented document outlines the 11 steps of a DUE process focusing on monitoring renal function during aminoglycoside therapy.
This document discusses hospital formularies, including their origin and objectives. It describes the types of formularies as open, closed, or incentive-based. It outlines the members involved in preparing the formulary such as clinicians, pharmacists, and administrators. The document discusses guidelines for formulary preparation, including identifying common diseases and treatments, drafting a list for review, and creating drug monographs. It notes steps to improve adherence and reviews advantages like standardized treatment and disadvantages like limiting physician choice. The role of pharmacists in the formulary process is also summarized.
Intravenous admixtures are sterile drug products added to IV fluids for medication purposes. They require strict aseptic technique during preparation to avoid contamination. Compatibility between drugs and solutions must also be considered to prevent precipitation or degradation. While IV admixtures provide benefits like convenience and accurate dosing, they carry higher risks than single drug infusions due to complexity and potential incompatibilities. Proper training and quality control processes are necessary for safe intravenous admixture preparation.
The document discusses hospital formularies, which are lists of approved medications used in hospitals. A hospital formulary is developed and revised by the Pharmacy and Therapeutics Committee to reflect the current views of medical staff. It includes generic drugs when possible to help control costs. The formulary provides essential information on approved medications to guide doctors' prescribing and aid rational drug use. It undergoes annual revisions to add new drugs and remove outdated ones.
The document discusses modern aspects of dispensing from a pharmacist's perspective. It covers several topics:
- The role of pharmacists in patient counseling to ensure proper medication use and adherence
- Common drugs that pharmacists need to provide advice on, such as opioids, antibiotics, and cholesterol medications
- The importance of obtaining an accurate medical and medication history from patients to identify potential issues and direct appropriate treatment
Systematic approach in answering DI queries requestKhadga Raj
This document outlines a systematic 7-step approach to answering drug information queries:
1. Secure demographics and contact information of the requestor.
2. Obtain relevant background information such as medical history, medications, and lab values.
3. Determine and categorize the ultimate question being asked.
4. Develop a search strategy and conduct research in primary, secondary, and tertiary literature resources.
5. Perform evaluation, analysis, and synthesis of the data found.
6. Formulate a response to the question and provide it to the requestor.
7. Conduct follow-up documentation and communication as needed.
The document discusses clinical pharmacy services provided at hospitals. It focuses on ward round participation, drug therapy review, and pharmacist interventions. Key services discussed include participating in ward rounds to optimize patient treatment, monitoring drug therapy through activities like therapeutic drug monitoring and medication order review, endorsing medication charts to prevent errors, and performing clinical reviews to evaluate treatment response and safety. The pharmacist plays an important role as part of the clinical team in these activities to enhance patient outcomes.
1) Adverse drug reactions (ADRs) are unwanted or harmful effects experienced after taking a medication. They can range from mild to severe or lethal. Elderly patients, women, and those taking multiple medications are most at risk.
2) Common ADR symptoms include skin irritation, nausea, vomiting, diarrhea, and breathing problems. Over 80% of ADRs are type A reactions, meaning they are dose-dependent and predictable based on a drug's known pharmacology.
3) In India, ADRs are monitored and reported through the Pharmacovigilance Program of India. Healthcare providers report suspected ADRs to monitoring centers to safeguard public health and inform regulatory decisions on drug safety.
Hospital and its organisation, BUDGET AND pHARMACY AND tHERAPEUTIC COMMITTEESanju Kaladharan
Hospital administration oversees hospital operations and policies. Therapeutic services provide medical treatment to patients, including physical, occupational, speech and respiratory therapy. Diagnostic services determine the cause of illness through medical testing. Support services maintain hospital facilities and equipment. The pharmacy and therapeutics committee advises on drug selection and use to ensure cost-effective and quality patient care.
This document outlines the importance and process of patient counseling by pharmacists. It defines patient counseling as providing medication information to patients regarding proper use, side effects, storage, and lifestyle changes. The goals of counseling are to ensure patient understanding, compliance, and active participation in their treatment. An effective counseling session involves verbal and non-verbal communication skills, explaining the purpose and use of medications, and addressing potential adverse effects or interactions. The pharmacist should prepare, open and close the session properly while gathering patient information to provide individualized counseling.
The document discusses hospital budget preparation. It defines a budget as a tool for hospital administration to review hospital services in a comprehensive financial plan. The objectives of a hospital budget are to develop standards, compare actual results to standards, identify deviations, analyze deviations, monitor financial activities, estimate costs of objectives, improve financial planning, focus decision making, and effectively manage finances. A budget includes income/revenue accounts, expenditure accounts, and requests for capital investments. The preparation process involves assumptions from administration, contributions from departments, hearings, preliminary budgets, and approval. Factors like local conditions, management policy, and authority confidence can influence the budget.
This document discusses drug therapy monitoring and pharmaceutical care. It outlines the key components and goals of drug therapy monitoring including medication order review, clinical review, and pharmacist intervention. The goals are to optimize drug therapy, prevent medication errors, and assess therapeutic outcomes. It also discusses the process of pharmaceutical care which involves identifying drug-related problems, determining treatment goals, developing and implementing care plans, and monitoring outcomes. The overall aim is to provide responsible drug therapy to improve patients' quality of life.
Clinical pharmacy involves applying scientific principles of pharmacology to optimize patient care and outcomes. It focuses on rational medication use and promoting health. Clinical pharmacists work directly with patients, assessing their medication-related needs and developing individualized care plans in collaboration with other healthcare providers. They are highly trained and educated professionals responsible for ensuring safe, effective, and cost-efficient use of medications across various healthcare settings.
Pharmacists in India play an important role in improving healthcare access and health outcomes. Currently there are around 10 lakh pharmacists in India working in various healthcare settings. Pharmacists can help overcome India's shortage of healthcare professionals by providing services like dispensing medicines accurately, counseling patients, aiding national health programs in tuberculosis and HIV/AIDS, and improving access to care in rural communities. By utilizing pharmacists' expertise and expanding their roles, India can more effectively achieve its public health goals.
Medication adherence refers to the extent to which a patient follows medical advice regarding prescribed medications. It is important for therapeutic outcomes, especially for chronic illnesses. While many factors can influence adherence, it is difficult to predict. Pharmacists are well-positioned to improve adherence through patient education about their medications, potential side effects, and the importance of adherence. Strategies like simplifying dosing regimens, using medication organizers, and addressing specific barriers can also help. Further research is still needed to better understand and promote adherence.
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”.
The document defines a hospital formulary as a compilation of pharmaceuticals and important information that reflects the current clinical judgement of medical staff. It discusses the origins of hospital formularies in India in 1968 and 1997. The need for formularies is explained as being due to the increasing number of new drugs, complex drug effects, and interest in lower healthcare costs. Advantages include improved quality, cost reduction, and education. Disadvantages can include restricting physician choice and allowing inferior drugs. The document outlines the process for preparing a formulary including necessary information, guidelines, and components. It emphasizes the role of the pharmacy and therapeutics committee in developing policies to select and use medications optimally.
This document discusses clinical pharmacy, including definitions, the status of clinical pharmacy in India, the scope and history of clinical pharmacy, activities of clinical pharmacists, clinical pharmacy practice areas, guidelines for pharmacotherapy specialists, clinical pharmacokinetics, drugs that can be monitored through therapeutic drug monitoring, reasons to request TDM, and the responsibilities of clinical pharmacists. It outlines how clinical pharmacy aims to optimize drug therapy for patients through various roles like consulting, drug information provision, and patient monitoring.
This document discusses rational drug use and provides strategies to promote it. It defines rational drug use according to WHO as using medicines appropriately for clinical needs in terms of drug choice, dosage, duration and cost. Common problems with irrational use include polypharmacy, overuse of antibiotics and injections. Reasons for irrational use include lack of skills/knowledge, inappropriate drug promotion, profits from drug sales, and lack of coordinated policies. Consequences are antimicrobial resistance, adverse drug reactions, and wasted resources. The document recommends educational and regulatory strategies to improve prescribing and dispensing practices and ensure appropriate drug use.
Drug use evaluation (DUE) is a quality improvement process that reviews prescribing patterns to promote appropriate drug use. It involves identifying a drug or therapeutic area, developing criteria and standards, collecting data, evaluating results, providing feedback, and implementing interventions. The process then reevaluates drug use and revises the DUE program as needed. The presented document outlines the 11 steps of a DUE process focusing on monitoring renal function during aminoglycoside therapy.
This document discusses hospital formularies, including their origin and objectives. It describes the types of formularies as open, closed, or incentive-based. It outlines the members involved in preparing the formulary such as clinicians, pharmacists, and administrators. The document discusses guidelines for formulary preparation, including identifying common diseases and treatments, drafting a list for review, and creating drug monographs. It notes steps to improve adherence and reviews advantages like standardized treatment and disadvantages like limiting physician choice. The role of pharmacists in the formulary process is also summarized.
Intravenous admixtures are sterile drug products added to IV fluids for medication purposes. They require strict aseptic technique during preparation to avoid contamination. Compatibility between drugs and solutions must also be considered to prevent precipitation or degradation. While IV admixtures provide benefits like convenience and accurate dosing, they carry higher risks than single drug infusions due to complexity and potential incompatibilities. Proper training and quality control processes are necessary for safe intravenous admixture preparation.
The document discusses hospital formularies, which are lists of approved medications used in hospitals. A hospital formulary is developed and revised by the Pharmacy and Therapeutics Committee to reflect the current views of medical staff. It includes generic drugs when possible to help control costs. The formulary provides essential information on approved medications to guide doctors' prescribing and aid rational drug use. It undergoes annual revisions to add new drugs and remove outdated ones.
The document discusses modern aspects of dispensing from a pharmacist's perspective. It covers several topics:
- The role of pharmacists in patient counseling to ensure proper medication use and adherence
- Common drugs that pharmacists need to provide advice on, such as opioids, antibiotics, and cholesterol medications
- The importance of obtaining an accurate medical and medication history from patients to identify potential issues and direct appropriate treatment
Systematic approach in answering DI queries requestKhadga Raj
This document outlines a systematic 7-step approach to answering drug information queries:
1. Secure demographics and contact information of the requestor.
2. Obtain relevant background information such as medical history, medications, and lab values.
3. Determine and categorize the ultimate question being asked.
4. Develop a search strategy and conduct research in primary, secondary, and tertiary literature resources.
5. Perform evaluation, analysis, and synthesis of the data found.
6. Formulate a response to the question and provide it to the requestor.
7. Conduct follow-up documentation and communication as needed.
The document discusses clinical pharmacy services provided at hospitals. It focuses on ward round participation, drug therapy review, and pharmacist interventions. Key services discussed include participating in ward rounds to optimize patient treatment, monitoring drug therapy through activities like therapeutic drug monitoring and medication order review, endorsing medication charts to prevent errors, and performing clinical reviews to evaluate treatment response and safety. The pharmacist plays an important role as part of the clinical team in these activities to enhance patient outcomes.
1) Adverse drug reactions (ADRs) are unwanted or harmful effects experienced after taking a medication. They can range from mild to severe or lethal. Elderly patients, women, and those taking multiple medications are most at risk.
2) Common ADR symptoms include skin irritation, nausea, vomiting, diarrhea, and breathing problems. Over 80% of ADRs are type A reactions, meaning they are dose-dependent and predictable based on a drug's known pharmacology.
3) In India, ADRs are monitored and reported through the Pharmacovigilance Program of India. Healthcare providers report suspected ADRs to monitoring centers to safeguard public health and inform regulatory decisions on drug safety.
1) Adverse drug reactions (ADRs) are unwanted or harmful effects experienced after taking a medication. They can range from mild to severe or lethal. The elderly, very young, and those taking multiple medications are most at risk.
2) ADRs are classified into 6 types based on their mechanism and predictability. Type A reactions are dose-dependent and common, while Type B reactions are unpredictable.
3) Common symptoms of ADRs include skin irritation, nausea, vomiting, and breathing problems. Suspected ADRs should be reported to the National Coordinating Centre to be monitored and help ensure safe medication use in India.
The document discusses rational use of medicines and the role of pharmacists in promoting rational use. It defines rational use of medicines according to WHO as ensuring patients receive appropriate medicines based on their clinical needs at the lowest cost. Pharmacists can promote rational use by properly managing drug stocks, dispensing medications correctly with patient education, and participating in pharmacovigilance programs. The document also outlines several other strategies to improve rational use, including developing treatment guidelines, regulating drug promotion, and educating both healthcare providers and the public.
This document provides an introduction to pharmacovigilance. It defines pharmacovigilance as the science relating to detecting, assessing, understanding, and preventing adverse drug reactions. The document outlines the need for pharmacovigilance due to limitations of clinical trials, medication errors, and adverse drug reactions being a leading cause of death. It describes Egypt's pharmacovigilance center and important terms like adverse drug reactions, adverse events, and serious reports. Healthcare professionals, patients, and marketing authorization holders should report valid adverse events containing identifiable information to the pharmacovigilance center.
Pharmacovigilance & Adverse drug reactionRahul Bhati
This document discusses pharmacovigilance and adverse drug reactions (ADRs). It begins by defining pharmacovigilance as the monitoring of drug safety, and describes how the thalidomide disaster in the 1960s prompted significant changes to drug safety systems worldwide. It then discusses various reasons for the need of pharmacovigilance like limited preclinical safety data and changing drug use patterns. The aims and methods of pharmacovigilance including spontaneous reporting, case studies, and periodic safety reports are summarized. It also provides an overview of the Pharmacovigilance Program of India and its goals of monitoring ADRs and ensuring drug benefits outweigh risks. Finally, it defines different types of ADRs and their
The document discusses the history and development of essential medicines. It outlines key events like the growth of new drugs post-WWII, the thalidomide tragedy of 1960, and the 1978 Alma-Ata declaration which established primary health care and inclusion of essential drugs. The WHO defines essential medicines as those that satisfy the majority of a population's health needs. Selection criteria include disease patterns, treatment facilities, and financial resources. National drug policies aim to ensure appropriate access to and use of essential medicines.
Pharmacovigilance is the science of monitoring the effects of medicines after they have been licensed for use, in order to identify new safety hazards and assess risks and benefits. It aims to improve patient care and safety in relation to medicine use. The thalidomide disaster in the 1960s demonstrated the need for formal pharmacovigilance systems to detect adverse drug reactions. Spontaneous reporting by healthcare professionals and mandatory reporting by manufacturers are key methods for collecting information on adverse drug events. Reports are assessed for causality and contribute to the ongoing evaluation of medicines to ensure their safe and effective use.
Introduction to rational use of drugs and role of pharmacist in rational use...Adhin Antony Xavier
This document discusses strategies for promoting rational use of drugs in healthcare systems. It recommends establishing a national drug regulatory authority to oversee drug quality, developing treatment guidelines and an essential drug list. Healthcare professionals should be provided drug information and undergo continuing education on rational prescribing. Generic names should be used and drugs prescribed according to their intended therapeutic uses and appropriate dosages. Quality of drugs must be ensured and irrational self-medication discouraged through public education. Monitoring drug use through indicators can help evaluate prescribing practices and promote rational drug utilization.
This document discusses polypharmacy, which is defined as the administration of many drugs simultaneously or an excessive number of drugs. Polypharmacy is common in elderly patients with multiple chronic conditions. It can be appropriate if all drugs achieve therapeutic objectives and minimize adverse effects, but is often inappropriate if drugs are unnecessary or cause harm. Tools like Beers Criteria, STOPP, and START can help identify inappropriate polypharmacy and guide deprescribing. The document outlines factors contributing to polypharmacy and consequences like adverse drug reactions, providing strategies to assess medication benefit-harm and safely discontinue unnecessary drugs.
Pharmacovigilance (PV) is defined as the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem.
a presentation in CME activities by Saad Specialist Hospital, KSA
This document discusses medical errors and medication errors. It defines medical errors as failures of planned actions or use of wrong plans that lead to patient harm. Medication errors are defined as preventable events involving medication use that may cause patient harm. The document notes that medical errors are the eighth leading cause of death in Pakistan, with around 7,000 deaths per year due to medication errors alone. Causes of medication errors discussed include errors of omission, errors of commission, communication failures, and failure to follow policies. The Swiss cheese model of layered defenses is presented as a way to understand how latent errors in the system can combine to cause patient harm. Types of medication errors like prescribing, dispensing, and administration errors are explained. Steps
This document discusses medical errors and medication errors. It defines medical errors as failures of planned actions or use of wrong plans that lead to unintended outcomes like adverse drug events. Medication errors are defined as preventable events involving medication use that may cause harm. The document notes that medical errors are the eighth leading cause of death in Pakistan, with around 7,000 deaths annually due to medication errors. Causes of medication errors discussed include omissions, commissions, communication failures, and environmental factors. The Swiss cheese model is presented as a way to understand how latent errors in the system can combine to cause patient harm when defenses are missed. Types of medication errors and steps to prevent errors are also outlined.
Pharmacovigilance & WHO Drug Monitoring Program.pptxEasy Concept
Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other medicine/vaccine related problem.
This document provides an overview of pharmacotherapeutics. It defines pharmacotherapeutics as the application of pharmacological information together with disease knowledge for disease prevention, mitigation or cure. The document discusses key topics in pharmacotherapeutics including rational drug use, evidence-based medicine, essential medicines lists, and irrational drug use. It emphasizes that pharmacotherapeutics aims to select the appropriate drug, dose, formulation and administration method based on the disease, its state and patient condition.
Rational Use of Medicine_Evidence Based Medicine_Therapeutic Drug Monitoring_...Dr Jeenal Mistry
Rational use of Medicine: Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards. Examples of irrational use of medicines include: use of too many medicines per patient ("poly-pharmacy"); inappropriate use of antimicrobials, often in inadequate dosage, for non-bacterial infections; over-use of injections when oral formulations would be more appropriate; failure to prescribe in accordance with clinical guidelines; inappropriate self-medication, often of prescription-only medicines; non-adherence to dosing regimes.
Evidence based medicine: Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."The aim of EBM is to integrate the experience of the clinician, the values of the patient, and the best available scientific information to guide decision-making about clinical management. The term was originally used to describe an approach to teaching the practice of medicine and improving decisions by individual physicians about individual patients.
Therapeutic drug monitoring: Therapeutic drug monitoring (TDM) is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication levels in blood. Its main focus is on drugs with a narrow therapeutic range, i.e. drugs that can easily be under- or overdosed.
Pharmacovigilance is the science of detecting, assessing, understanding, and preventing adverse effects of medicines. The goals of pharmacovigilance include early detection of unknown safety problems, quantifying risks, and preventing patients from being harmed. Adverse drug reactions are a major cause of mortality and healthcare costs worldwide. Ongoing pharmacovigilance is needed to monitor drug safety after approval and promote rational, safer drug use. Healthcare professionals play a key role by thoroughly investigating and reporting any suspected adverse drug reactions.
This document discusses pharmacovigilance and adverse drug reactions. It begins with background on the development of pharmacovigilance following the thalidomide tragedy. It then defines pharmacovigilance and adverse drug reactions, and describes various pharmacovigilance methods including spontaneous reporting, case studies, active surveillance, and observational studies. It also covers classifying adverse drug reactions and assessing causality in reported cases.
PHARMACOVIGILANCE - A Worldwide masterkey for Drug MonitoringVenugopal N
This document provides a history of pharmacovigilance and discusses key aspects of the field. It begins with important milestones in drug safety regulation dating back to the early 20th century. It then defines pharmacovigilance and describes stakeholders, methods used like individual case safety reporting, and the roles of organizations like the WHO and national regulatory authorities. The document emphasizes the importance of post-market drug safety monitoring to protect public health.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
2. Contents
• Concept of rational use of drugs
• Rational Prescribing
• Rational Dispensing
• Problems of Irrational drug use
• Factors causing Irrational drug use
• Learning about Drug Use Problems
5. Subject: Pharmacy Practice -VI (Advanced Clinical Pharmacy-II) New Scheme
Paper: 2Marks 100
Topic
MCQs
Marks SEQs Marks
Total Marks
1. RATIONAL USE OF DRUGS: Rational Prescribing, Rational Dispensing, 1
5
1 6
5+3=8
Problems of Irrational Drug Use 1
Learning about drug use problem, 1
Sampling to study drug use 1
1 1+3=4
Indicators of drug use 1
INTRODUCTION TO ESSENTIAL DRUGS: Criteria for selection, Usage and Advantages. 1
2. DRUG UTILZATION EVALUATION & DRUG UTILIZATION REVIEW (DUE/DUR):
Development of protocol of use of few very low therapeutic index drug groups like
Steroids
2
4 1 6 4+6=10
Vancomycin 1
Cimetidine. 1
3. CLINICAL PHARMACOKINETICS: Therapeutic Drug Monitoring of Digoxin 1
5 1 6 5+6=11
Theophyline 1
Gentamycin 1
Lithium
1
Phenytoin
Cabamazepine
Phenobarbitone
Primidone
Valparoic Acid
1
Cyclosporins
Vancomycin
4. PHARMACEUTICAL CARE, ITS SCOPE, MANAGEMENT AND APPLICATION OF
CARE PLAN.
2 2
1 6
2+3=5
5. CLINICAL THERAPEUTICS:
General Strategy 1
4 4+3=7
Terminology of Disease. 1
Management and
Treatment
1
Drug Selection 1
ToS
6. ToS
7. CLINICAL TOXICOLOGY:
General information
1
4 2 12 4+12=16
Role of pharmacist in treatment of poisoning and general management of poisoning & over
dosage.
1
Role andStatus of Poison Control Centre 1
Antidotes and their mechanism of action 1
8. SAFE INTRAVENOUS THERAPY & HAZARDS OF INTRAVENOUS
THERAPY.
3 3 1 6 3+6=9
9. NON-COMPLIANCE:
Definition, introduction, importance and extent of non-compliance
Methods of assessment
Reasons for non-compliance
Strategies for improving compliance and Designing of compliance trials.
1
4 1 6 4+6=10
1
1
1
10. DISEASE MANAGEMENT:
Unit V: Central nervous system unit (Stroke, Epilepsy, Psychosis)
1
8 2 12 8+12=20
Unit VI: Infectious diseases (Meningitis, tuberculosis, dermatological infections, Rabies,
Urinary track infection, Malaria fever, Typhoid fever, Fungal infections of skin, AIDS, Dengue
fever, Common Cold, Pharyngitis & Tonsillitis, Conjunctivitis)
2
Unit VII: Endocrinology Unit (Diabetes Mellitus, Hyper/Hypo-thyroidism, pituitary gland
non-malignant disorders)
1
Unit IX: Nephrology Unit (Renal failure, nephrotic syndrome) 1
Unit X: Hematology Unit (Bleeding disorders/coagulopathies/clotting disorders e.g.
thrombocytopenia, hemophilia, Vit. K deficiency, Anemia).
2
Unit VIII: Oncology Unit (Types of tumors, Brief introduction to oncological diseases e.g.
prostate cancer, breast cancer, lungs cancer )
1
Total 40 40 10 60 100
8. What is Rational Use of Drugs?
• “The rational use of drugs requires that patientsreceive
medications appropriate to their clinical needs, in doses that
meet their own individual requirements for an adequate
period of time, and at the lowest cost to them and their
community”
(WHO conference of experts Nairobi 1985)
9. What does RUD mean?
• correct drug
• appropriate indication
• appropriate drug considering efficacy, safety, suitability for
the patient, and cost
• appropriate dosage, administration, duration
• no contraindications
• pharmacaoeconomics
• correct dispensing, including appropriate information for
patients
• patient adherence to treatment
11. Why RDU/RUM?
• Factors that have led sudden realization for rational
drug use are.
• Drug explosion
• Efforts to prevent the development of
resistance
• Growing awareness
• Increased cost of the treatment
• Consumer Protection Act (Is there one in Pakistan?).
14. Why is RUM Important?
• ADRs and ADEs (Difference??)
• Antimicrobial Resistance (AMR)
• Malaria
– choroquine resistance in 81/92 countries
• Tuberculosis
– 0-17 % primary multi-drug resistance
• HIV/AIDS
– 0-25 % primary resistance to at least one anti-retroviral
• Gonorrhoea
– 5-98 % penicillin resistance in N. gonorrhoeae
• Pneumonia and bacterial meningitis
– 0-70 % penicillin resistance in S. pneumoniae
• Diarrhoea: shigellosis
– 10-90% ampicillin resistance, 5-95% cotrimoxazole resistance
• Hospital infections
– 0-70% S. Aureus resistance to all penicillins & cephalosporins
WHO Country Data
15. Side Effects, ADRs and ADEs
• Side effect: Unwanted effect occurring at normal dose –
related to pharmacological properties.
• ADRs: Refers to unwanted, uncomfortable, or dangerous
(noxious) effects that a drug may have. May be dose
related, allergic or idiosyncratic.
• ADEs/Serious ADR: Any untoward medical occurrence
that at any dose results in death, life-threatening, requires
or prolongs hospitalization, or results in persistent
or significant disability or incapacity.
Further reading: https://www.ema.europa.eu/en/documents/scientific-
guideline/international-conference-harmonisation-technical-requirements-registration-
pharmaceuticals-human-use_en-15.pdf
16. Factors Effecting Use of Medicine
Treatment
Choices
Prior
Knowledge
Habits
Scientific
Information
Relationships
With Peers
Influence
of Drug
Industry
Workload &
Staffing
Infra-
structure
Authority &
Supervision
Societal
Information
Intrinsic
Workplace
Workgroup
Social &
Cultural
Factors
Economic &
Legal Factors
17. Strategy to promote RUM
• STEP 1: IDENTIFY PATIENTS PROBLEM
- Focus on History
• STEP 2: DIAGNOSIS
- Based on history, physical chekup, current complaints
and lab findings
• STEP 3: THERAPEUTIC OBJECTIVES
- Symptomatic Relief or Treatment of Disease?
- Aggressive vs Passive Treatment
- QALY
18. • STEP 4: SELECT THE TREATMENT
- Lifestyle Changes, Medication (Prescribing the right
drug)
• STEP 5: START THE TREATMENT AND
COUNSEL
- Schedule, Side effects, Risks of ADR, Missing the
Dose, Stopping the Therapy etc.
• STEP 6: MONITOR (Passive and Active)
Strategy to promote RUM contd ..
19. Core Policies to Promote RUM
1. A mandated multi-disciplinary national body to coordinate
medicine use policies (FDA, DRAP)
2. Clinical guidelines (NIH, DRAP, do we need another body??)
3. Essential medicines list based on treatments of choice (WHO) –
Do we any such list in Pakistan??
4. Drugs and therapeutics committees in districts and hospitals
(THQ, DHQ) – Exist?
5. Problem-based pharmacotherapy training in undergraduate
curricula
(Basic Training and Course Design - PMC, PCP, HEC, Individual
Colleges)
6. Continuing in-service medical education as a licensure
requirement (PMC, PCP)
20. Core Policies contd ..
7. Supervision, audit and feedback (Pharmacists, P & T
Committee)
8. Independent information on medicines (From Where?)
9. Public education about medicines (Sponsored by??)
10.Avoidance of perverse financial incentives (Trips,
Conferences, Fridge, AC, TV etc)
11.Appropriate and enforced regulation (How?)
12.Sufficient government expenditure to ensure availability of
medicines and staff ???
21. Reality Check ..
• Global sales of medicines 2019-20 : US$ 1.25 trillion
• Drug promotion costs in USA 2004: US$ >50 billion
• Global WHO expenditure in 2020: US$ 5.84 billion
– Essential Medicines expenditure 2%
– Essential Medicines expenditure on
promoting rational use of medicines 10% (of 2%)
– WHO expenditure on promoting
rational use of medicines 0.2%
23. Rational Prescribing
• In light of WHO guidelines for rational use
of drugs
- A prescriber should have the following four
aims:
1)Maximize Effectiveness
2)Minimize Risks
3)Minimize Costs
4)Respect the Patient's Choices.
24. STEPS to Rational Prescribing
Another popular framework to support rational prescribing
decisions is known as STEPS (Preskorn, 1994). The STEPS
model includes five criteria to consider when deciding on the
choice of treatment:
• Safety
• Tolerability
• Effectiveness
• Price
• Simplicity
25. Why are we studying
Prescribing?
• Can Pharmacist Prescibe?
• If not …
• Can Pharmacist Help Prescribe?
• A Pharmacist can definitely Educate.
26. What's expected of us
Behavior Ethical Aspect
Do the very best you can for every patient Beneficence
In all cases, do no harm Non-maleficence
Tell the patient the truth Veracity
Be fair Justice
Be loyal Fidelity
Allow the patient to be the ultimate decision
maker
Autonomy
Always protect your patient's privacy Confidentiality
28. Irrational Prescribing
Poor choice of a medicine
Polypharmacy or co-prescribing of interacting
medicine
Prescribing for a self-limiting condition
Continuing to prescribe for a longer period than
necessary
Prescribing too low a dose of a medicine
Prescribing without taking account of the
patient'swishes.
29. Inappropriate or irrational prescribing can result in serious
morbidity and mortality, particularly when childhood
infections or chronic diseases such as hypertension, diabetes,
epilepsy and mental disorders are being treated.
Inappropriate prescribing also represents a waste of
resources and, as in the case of antimicrobials, may harm the
health of the public by contributing to increased antimicrobial
resistance.
Over-willingness to prescribe stimulates inappropriate
patient demand and fails to help the patient understand when
they should seek out support from a health care professional.
Consequences of Irrational Prescribing
30. WHO Guide to Good Prescribing
• WHO has produced a Guide for Good Prescribing - a
problem-based method
• Developed by Groningen University
in collaboration with 15 WHO offices
and professionals from 30 countries
• Field tested in 7 sites
• Suitable for medical students,
post grads, and nurses
• Widely translated and available
on the WHO medicines website
32. Dispensing – Prerequisites
i. Stability of dispensed medicine and their ingredients
ii. Principles of compounding
iii. Dosage form and dosage schedule
iv. Physical, chemical and therapeutic incompatibilities
v. Packaging materials and methods
vi. Labeling procedures
vii. Legal requirements
33. Rational Dispensing – Basics
• The objective of rational dispensing shall be to ensure
that patients receive adequate information on the use
of dispensed drugs in order to derive the desired
benefits to them. In this regard the following shall be
put in place:
i. Dispensing shall only be carried out on duly licensed
premises;
Licencing Requirements
in Pakistan?
34. Rational Dispensing – Basics
ii. The minimum information requirement on the label of
a dispensed medicine shall be the following:
• Name of patient,
• Generic name of dispensed drug,
• Strength of the drug,
• Dosage instruction in symbols or words as may be
appropriate,
• Duration of treatment
• Date of dispensing, and
• The name of the institution where the drug was
dispensed
35. Rational Dispensing – Basics
iii.The patient shall be counselled on the use of dispensed
drugs, in a conducive environment suitable for effective
communication; and
iv.Dispensing shall be carried out in a suitable container that
will be childproof and ensure the stability of the drug
dispensed.
37. Dispensing Process
1. Receiving of Prescription
2. Interpretation of prescription
3. Checking of Prescription
4. Filling of prescription
5. Labelling of Prescription
6. Handling of Prescription
7. Records
38. 1. Receiving of Prescription
- The dispenser receives the “correct” prescription from the
prescriber directly or through Patient. It can be through
Phone, oral/verbal and/or online computer system.
• Origin of the prescription
• Validity of the prescription
• Relevant instructions
• Information about patient
• Therapeutic appropriateness
• Economic considerations
• Communication with prescriber for unclear instructions
Rational Dispensing Process (GDP)
39. 2. Interpretation of prescription
• Name of the drugs
• Dosage, administration and duration
• Availability of drugs
• Retrieves drugs from storage area
3. Checking of the prescription
• Check the expiry date and storage condition of the
prescribed drug.
• Follow FIFO rule
• Checks and counter check (identify strength & dosage
form)
Rational Dispensing Process (GDP)
40. Rational Dispensing Process (GDP)
4. Filling of prescription
- The dispenser should have true knowledge of the medication and its
proper use and can:
• Precisely dispense products
• Re-check drugs and dosages
5. Labeling of prescription (identification of drugs and
instructions)
- The dispenser communicates in correct way to take the medication to
the patient through
• labels with patient’s name, drug name and directions for use, date of
dispensing, identity of dispenser
• Identity of prescriber
• symbolic instructions in case of illiterate patients
• Use of auxiliary labels
• Name and sign of dispenser
41. 6. Handling of Prescription
- Instruction to Patients:
• Repeat orally the labeled instructions
• Ask the patient to repeat the instruction
• Emphasizes the need for compliance
• Providing warnings and cautions
• Gives special attention to certain cases ( pregnant women,
those with visual/hearing problems, children and elderly
patients, those taking multiple medications
Rational Dispensing Process (GDP)
42. 7. Records
- Dispenser keeps accurate records of the following
operations
• Enters details of encounter on patient profile card
• Enters in prescription register
• Completes inventory records
- There are many potential areas in which the dispenser can
make mistakes. Dispensing requires trained, skilled,
responsible individual, proper policies and incentives must be
provided to attract such personnel and develop this
profession
Rational Dispensing Process (GDP)
43. Irrational Dispensing
• Incorrect interpretation of the prescription
• Retrieval of wrong ingredients
• Inaccurate counting, compounding, or pouring
• Inadequate labeling
• Unsanitary procedures
• Packaging:
• Poor-quality packaging materials
• Odd package size, which may require repackaging
• Unappealing package