Clinical Pharmacy and Duties
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Questions and Answers

Which of the following methods provides evidence of therapy effectiveness?

  • Patient testimonials
  • Systematic literature review (correct)
  • Individual case studies
  • Expert opinion only

What is a significant consideration when prescribing medication for patients with severe liver disease?

  • Doses need no adjustment.
  • High doses are recommended for effectiveness.
  • All medications can be used without concern.
  • Prescribing should be minimized. (correct)

What characterizes an adverse drug reaction (ADR)?

  • Expected side effects
  • No impact on patient prognosis
  • Predictable frequency
  • Unexpected and undesirable response (correct)

In patients with renal impairment, what is typically recommended regarding medication dosage?

<p>Dose adjustments are advised. (A)</p> Signup and view all the answers

Which of the following can be a sequelae of an adverse drug reaction?

<p>Temporary or permanent harm (C)</p> Signup and view all the answers

What is the primary focus of clinical pharmacy?

<p>Rational medication use (A)</p> Signup and view all the answers

Which of the following is NOT a clinical duty of pharmacists?

<p>Medical research publication (C)</p> Signup and view all the answers

How do clinical pharmacists contribute to patient safety?

<p>Through adverse drug reaction reporting (D)</p> Signup and view all the answers

What is one of the roles of clinical pharmacists in prescription monitoring?

<p>Reviewing for medication dosing errors (D)</p> Signup and view all the answers

What percentage of hospital admissions are associated with adverse events?

<p>10% (A)</p> Signup and view all the answers

Which task involves assessing drug interactions and side-effects?

<p>Medication history-taking (B)</p> Signup and view all the answers

What is a primary purpose of medications reconciliation?

<p>To ensure accurate medication lists (B)</p> Signup and view all the answers

Clinical pharmacists provide prescribing advice on which of the following aspects?

<p>Choice of medicine, monitoring requirements, and interactions (B)</p> Signup and view all the answers

What is the primary purpose of clinical audit in healthcare?

<p>To compare clinical practice against standards of care (C)</p> Signup and view all the answers

Which of the following best describes Patient-reported outcome measures (PROMs)?

<p>A method for evaluating patient satisfaction with care (C)</p> Signup and view all the answers

What do clinical guidelines provide to healthcare providers?

<p>Systematically developed statements for clinical decisions (D)</p> Signup and view all the answers

Who can participate in clinical audits?

<p>Healthcare professionals from multiple sectors (D)</p> Signup and view all the answers

What is a key outcome of a successful clinical audit?

<p>Implementation of necessary changes and verification of improvements (A)</p> Signup and view all the answers

Which of the following options is NOT a focus of clinical audits?

<p>Conducting clinical examinations (C)</p> Signup and view all the answers

What role do NICE guidelines serve in clinical practice?

<p>They represent international standards for best practices (C)</p> Signup and view all the answers

In clinical audit, what is typically examined?

<p>The compliance of current practices to established standards (C)</p> Signup and view all the answers

Which of the following outcomes qualifies as a serious adverse event associated with medical product use?

<p>Life-Threatening (C)</p> Signup and view all the answers

What is NOT a process involved in an Adverse Drug Reaction (ADR) monitoring program?

<p>Therapeutic Alliance Building (C)</p> Signup and view all the answers

What action should pharmacists NOT take in an ADR monitoring program?

<p>Conducting surgeries (D)</p> Signup and view all the answers

Which of the following is an example of a clinically significant drug interaction?

<p>Aspirin/Ibuprofen + Warfarin (C)</p> Signup and view all the answers

Which of the following best describes a prescribing error?

<p>Medication prescribed is inappropriate (C)</p> Signup and view all the answers

Which type of medication error involves medication being administered incorrectly?

<p>Wrong time error (D)</p> Signup and view all the answers

What distinguishes a dispensing error from other types of medication errors?

<p>Incorrect interpretation of the prescription (A)</p> Signup and view all the answers

What is the effect of drug interactions evaluated on?

<p>Clinical significance and potential for hazardous outcomes (C)</p> Signup and view all the answers

What are the two overlapping categories of non-adherence to treatment?

<p>Intentional and unintentional (A)</p> Signup and view all the answers

What role do self-administration schemes primarily serve?

<p>To check if patients can cope with their medicines regimen (D)</p> Signup and view all the answers

Who can submit reports of suspected adverse drug reactions (ADRs) in the Yellow Card Scheme?

<p>Pharmacists and the general public (C)</p> Signup and view all the answers

What is the principle behind the phrase 'nothing about me, without me' in patient care?

<p>Patients and carers must be well-informed to make decisions about treatment. (B)</p> Signup and view all the answers

What is NOT a factor considered when assessing the nature of the reaction in the Yellow Card Scheme?

<p>Patient demographics (B)</p> Signup and view all the answers

What is one potential challenge of self-administration schemes?

<p>Assessing patients' suitability can require considerable effort. (D)</p> Signup and view all the answers

What is the purpose of medication reconciliation?

<p>To create a current list of medications (D)</p> Signup and view all the answers

In what scenario might integrated medicines management be most beneficial?

<p>During critical phases like admission and discharge. (A)</p> Signup and view all the answers

How does patient education impact treatment adherence?

<p>It can improve patient adherence and outcomes. (C)</p> Signup and view all the answers

Which group has been shown to take more accurate medication histories than medical staff?

<p>Pharmacists (D)</p> Signup and view all the answers

Which role is NOT typically associated with self-administration schemes?

<p>Financial role (C)</p> Signup and view all the answers

What is required to submit a report of a suspected ADR?

<p>Only a suspicion of an association (B)</p> Signup and view all the answers

What should be considered as possible causes during the assessment of an ADR?

<p>Prior medication history and other medical conditions (A)</p> Signup and view all the answers

Who can support nursing staff in implementing self-administration schemes?

<p>Clinical pharmacists and pharmacy technicians (D)</p> Signup and view all the answers

Which of the following activities is part of the medicines reconciliation process?

<p>Verifying the medication list against the current prescription chart (C)</p> Signup and view all the answers

What can delayed reactions indicate in the context of the Yellow Card Scheme?

<p>They may indicate a longer-term association. (D)</p> Signup and view all the answers

Flashcards

Yellow Card Scheme

A system for reporting suspected adverse drug reactions (ADRs).

Adverse Drug Reaction (ADR)

An unwanted or harmful effect caused by a medicine.

Suspected ADR

A possible adverse drug reaction, not necessarily confirmed.

Reporting a Suspected ADR

The act of reporting possible ADRs

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Medication History

A record of all the medications a patient has taken.

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Medicines Reconciliation

Matching a patient's medication history with current prescriptions in a hospital.

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Accuracy of Medication History

Pharmacists typically take more accurate medication histories than medical professionals.

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Importance of Early Reconciliation

Pharmacist involvement in medicines reconciliation is recommended early after hospital admission to prevent errors.

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Clinical Pharmacy Definition

The science and practice of rational medication use, focused on optimizing medication therapy and promoting health.

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Prescription Monitoring

Reviewing prescriptions for errors, appropriateness, drug interactions, and ambiguities to ensure safe medication use.

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Prescribing Advice

Providing guidance to medical and nursing staff on medication choice, dosage, administration, side effects, interactions, and monitoring.

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Medication Errors & ADR Reporting

Identifying and managing adverse drug reactions (ADRs) and medication errors, often involving reporting mechanisms like the Yellow Card scheme.

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Medication History/Reconciliation

Gathering patient medication history, including allergies, efficacy, side effects and ADRs, and reconciling it with current prescriptions.

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Patient Education/Counselling

Providing education and information to patients about their medications, including how to take them and potential side effects.

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Pharmacokinetics & Monitoring

Evaluating how the body processes medications and monitoring drug levels to ensure optimal therapy.

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Clinical Outcomes

Assessing the effectiveness of medication strategies on patient health and outcomes.

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Patient Non-Adherence

Patients not following prescribed treatment recommendations.

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Intentional Non-Adherence

Patient chooses not to follow treatment recommendations.

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Unintentional Non-Adherence

Patient wants to follow treatment, but practical issues prevent it.

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Patient Education

Giving patients information to make informed treatment decisions.

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Self-Administration Schemes

Schemes allowing patients to manage their own medication in the hospital.

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Diagnostic Role (Schemes)

Assessing patient ability to manage their medication.

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Educational Role (Schemes)

Educating patients about medications prior to discharge.

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Integrated Medicines Management

Combining clinical pharmacy services for comprehensive patient care.

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Liver Disease & Drug Response

Liver disease can affect how drugs work because the liver is responsible for many important functions including metabolizing drugs.

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Drug Dose Adjustment: Renal Impairment

In people with reduced kidney function, drug doses may need to be adjusted to prevent the buildup of medications or their byproducts in the body.

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What is an ADR?

An adverse drug reaction (ADR) is an unexpected, unwanted, or harmful effect caused by a medication.

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Adverse Drug Reaction (ADR): Severe Outcomes

ADRs can have serious consequences, including hospital admissions, longer hospital stays, and even death.

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Side Effect vs Adverse Drug Reaction (ADR)

A side effect is a known, predictable effect of a medication, usually not serious. An ADR is unexpected, unwanted, and can be serious.

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Standardized Mortality Rate

A measure used to evaluate a healthcare organization's overall success by comparing its death rate to an expected rate.

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Patient-Reported Outcome Measures (PROMs)

Measures that assess patient satisfaction with their healthcare provider, focusing on their own experiences.

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Clinical Audit

A process of reviewing clinical practice to compare it with agreed standards and identify areas for improvement.

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Clinical Audit's Aim

To enhance the quality of patient care by implementing changes based on the findings of the audit.

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Clinical Pharmacist's Role in Audit

Clinical pharmacists can conduct audits on various aspects of pharmacy practice, ranging from service effectiveness to medication use evaluation.

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Clinical Guideline

A systematically developed set of statements that offer recommendations for appropriate healthcare in specific clinical situations.

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Guideline Development

Guidelines should be developed using a transparent and rigorous process, adhering to established best practices.

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Examples of Guidelines

The National Institute for Health and Care Excellence (NICE) and the Egyptian Guideline on ADR reporting for Healthcare Professionals are examples of well-known clinical guidelines.

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Serious ADR

An adverse drug reaction with severe consequences like death, hospitalization, or disability.

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ADR Monitoring Programme

A system to track, analyze, and report adverse drug reactions.

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Pharmacist Role in ADR Monitoring

Analyzing ADR reports, identifying high-risk drugs and patients, educating healthcare providers, and reporting to authorities.

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Drug Interaction

When two or more drugs taken together change each other's effects, either by increasing or decreasing their potency.

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Potentiation

When one drug increases the effect of another.

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Antagonism

When one drug decreases the effect of another.

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Medication Error

A mistake made during medication use, like prescribing the wrong drug or giving the wrong dose.

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Medication Error Types

Different types of medication errors include prescribing the wrong drug, dispensing the wrong drug, skipping a dose, administering it incorrectly, or using a degraded drug.

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Study Notes

Clinical Pharmacy

  • Clinical pharmacy is defined as the area of pharmacy focused on the science and practice of rational medication use.
  • Clinical pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention.

Clinical Duties

  • Prescription monitoring
  • Prescribing advice to medical and nursing staff
  • Medication errors and adverse drug reaction reporting
  • Medication history-taking and reconciliation
  • Patient education and counseling
  • Pharmacokinetics and therapeutic drug level monitoring
  • Personalized medicine
  • Education and training
  • Medicines formularies
  • Clinical outcomes
  • Professional and clinical audit

Prescription Monitoring

  • Reviews prescriptions for medication dosing errors, appropriate administration route, drug interactions, and potential problems.
  • Questions patients about their medication history, including allergies, intolerances, treatment efficacy, and adverse drug reactions (ADRs).

Medication Errors and Adverse Drug Reaction Reporting

  • Adverse events occur in approximately 10% of hospital admissions.
  • Medication errors account for about one-quarter of incidents that threaten patient safety.
  • Clinical pharmacists play a key role in detecting and managing adverse drug reactions (ADRs) and reporting them.
  • The Yellow Card Scheme allows pharmacists and other health professionals to report suspected ADRs.

Medication History-Taking and Reconciliation

  • Pharmacists can take more accurate medication histories than other healthcare staff.
  • Medicines reconciliation is recommended as soon as possible after admission to hospital.

Patient Education and Counseling

  • Helping patients understand their medications and administration is a crucial part of clinical pharmacy.
  • Empowers patients to take an active role in managing their own care.
  • Improves patient knowledge of their treatment which leads to improved adherence.

Patient Compliance

  • Defined as adherence to the prescribed treatment regimen.
  • Adherence can be poor, especially with long-term conditions, and increases with the number and complexity of medications.
  • Non-compliance can increase costs and lead to complications.

Concordance

  • Use of "compliance" is being criticized in recent years, as it implies patients simply follow orders rather than making informed decisions.
  • "Concordance" suggests a more appropriate description of the patient-healthcare professional relationship.
  • Concordance is an agreement reached between patients and healthcare professionals where the patients' beliefs and preferences are considered in determining how medications are taken.
  • Concordance involves patient education so patients can make informed choices about their medication.

Why Patient Education and Counselling?

  • Nothing about me, without me - patients should be informed and involved in their treatment decisions.
  • Importance of patients' understanding of treatment regimens.
  • Improves patient adherence to treatment.

Self-Administration Schemes

  • Systems to allow patients to administer their own medications while hospitalized.
  • Provides diagnostic, educational, and empowering roles for patients.

Integrated Medicines Management

  • Combines various clinical pharmacy services to improve patient care throughout their stay, especially at crucial phases like admission, monitoring, and discharge.

Pharmacokinetics and Therapeutic Drug Level Monitoring

  • Knowledge of drug pharmacokinetics assesses dosing requirements for various patients.
  • Clinically important drug interactions and adverse reactions can sometimes be predicted.
  • Therapeutic drug monitoring (TDM) is often necessary for certain drugs with a narrow therapeutic index to keep it safe.

Personalized Medicine

  • Focuses on tailoring treatment to individual patients' responses.
  • Use of biomarkers helps improve treatment effectiveness.
  • Pharmacogenetics helps to assess and account for significant variability in patient responses to medications.

Principles in the Use of Medicines

  • Medicines should be used only when necessary.
  • Benefit of use must be considered and balanced with possible risks.

Barriers to Proper Use of Medicines

  • Patient compliance issues
  • Patient confusion
  • Communication problems
  • Side effects
  • Dispensing errors
  • Cost of medicines
  • Accessibility and availability

Education and Training

  • Increased emphasis on postgraduate training for pharmacists.
  • Clinical pharmacists play a role in training other healthcare staff.

Medicines Formularies

  • Formularies are lists of recommended drugs for a given population.
  • Formularies help to manage prescribing and initiate, develop, monitor, manage, and review local prescribing policies.

Clinical Outcomes

  • Clinical outcomes are the best validation for the effectiveness and quality of medical care.
  • Standardized mortality rates are used in large medical institutions to measure overall success.
  • Patient reported outcome measures (PROMs) provide feedback on patient satisfaction in their healthcare experience,

Professional and Clinical Audit

  • Brings together healthcare professionals from different sectors to assess and evaluate clinical practice.
  • Aims to improve clinical care and outcomes for patients.
  • Clinical pharmacists play role in clinical audit, analyzing and improving drug use practices.

Guidelines

  • Guidelines are systematically developed statements to assist practitioners and patients, providing guidance for appropriate healthcare based on evidence and clinical practice.

Evidence-based Pharmacy

  • Evidence behind therapy (effectiveness) based on systematic literature reviews, randomized controlled trials, observational studies, and expert opinions.

Identifying Patient Needs - Liver disease

  • Liver disease can alter drug response due to metabolism issues.
  • Lower doses are usually advised in patients with severe liver disease, and dose variations must be considered.

Identifying Patient Needs - Renal Impairment

  • Renal impairment can cause issues with excreting drugs or metabolites.
  • Dose adjustment is often necessary.

Adverse Drug Reactions (ADRs)

  • ADRs are any unwanted effects to medications.
  • ADR detection and recording are crucial.
  • ADRs have classifications to determine their seriousness, and they can be mild, severe, or fatal reactions.

Pharmacist Actions in ADR Monitoring

  • Analysis of ADR reports to identify high-risk patients or drugs.
  • Educating prescribers and other healthcare personnel on the ADR program.
  • Reporting to relevant authorities.

Drug Interactions

  • Interactions (positive or negative) between medications can occur when multiple drugs are used simultaneously.
  • Clinical significance and potential harm must be carefully evaluated.

Medication Errors

  • Inappropriate prescribing, dispensing errors, or incorrect administration.
  • Causes for errors are reviewed.

Practices to reduce medication errors

  • Avoid unnecessary use of decimal points in drug quantities.
  • Avoid using abbreviations for drug units.
  • Names of drugs should be clearly written and not abbreviated.

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Clinical Pharmacy-I PDF

Description

Explore the essential aspects of clinical pharmacy, including medication therapy management and patient care practices. This quiz covers the roles of clinical pharmacists in prescription monitoring, medication safety, and patient education, emphasizing rational medication use and optimal health outcomes.

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