Podcast
Questions and Answers
What is the primary goal of pharmaceutical care?
What is the primary goal of pharmaceutical care?
- To maximize the cost of medication therapy
- To create new medications
- To eliminate the need for healthcare providers
- To enhance or preserve a patient’s quality of life (correct)
Clinical pharmacy exclusively focuses on medication therapy optimization.
Clinical pharmacy exclusively focuses on medication therapy optimization.
False (B)
What philosophy does clinical pharmacy embrace?
What philosophy does clinical pharmacy embrace?
Pharmaceutical care
Match the following elements of clinical pharmacy with their corresponding descriptions:
Match the following elements of clinical pharmacy with their corresponding descriptions:
Clinical pharmacists work in a variety of ______ settings.
Clinical pharmacists work in a variety of ______ settings.
Which of the following is NOT a target for clinical pharmacy?
Which of the following is NOT a target for clinical pharmacy?
Clinical pharmacists are only found in hospital settings.
Clinical pharmacists are only found in hospital settings.
List one of the core frameworks used in clinical pharmacy.
List one of the core frameworks used in clinical pharmacy.
What is a key indicator of therapeutic drug monitoring (TDM)?
What is a key indicator of therapeutic drug monitoring (TDM)?
The trough concentration reflects the highest level of drug in the blood.
The trough concentration reflects the highest level of drug in the blood.
What is the first step in the medication reconciliation process?
What is the first step in the medication reconciliation process?
Therapeutic drug monitoring is performed for drugs with a ________ therapeutic index.
Therapeutic drug monitoring is performed for drugs with a ________ therapeutic index.
Match the following concentrations with their definitions:
Match the following concentrations with their definitions:
What happens to the trough level if the clearance rate of a drug increases?
What happens to the trough level if the clearance rate of a drug increases?
All medications require therapeutic drug monitoring.
All medications require therapeutic drug monitoring.
What is the consequence of overdosing and underdosing for certain medications?
What is the consequence of overdosing and underdosing for certain medications?
What is the primary goal of medication reconciliation?
What is the primary goal of medication reconciliation?
Medication reconciliation should only be done when a patient is admitted to the hospital.
Medication reconciliation should only be done when a patient is admitted to the hospital.
List two types of errors that medication reconciliation aims to prevent.
List two types of errors that medication reconciliation aims to prevent.
The process of comparing a patient’s medication orders to all medications they have been taking is known as __________.
The process of comparing a patient’s medication orders to all medications they have been taking is known as __________.
Match the types of medication errors with their definitions:
Match the types of medication errors with their definitions:
Which drug class requires therapeutic drug monitoring (TDM) to assess cardiac contractility?
Which drug class requires therapeutic drug monitoring (TDM) to assess cardiac contractility?
Drug interactions can affect therapeutic drug monitoring.
Drug interactions can affect therapeutic drug monitoring.
What is the recommended therapeutic range for digoxin levels?
What is the recommended therapeutic range for digoxin levels?
_______ patients are known to be resistant to digoxin.
_______ patients are known to be resistant to digoxin.
Which factor critically affects the interpretation of drug levels for bronchodilators?
Which factor critically affects the interpretation of drug levels for bronchodilators?
Match the following drug classes with their characteristics:
Match the following drug classes with their characteristics:
Renal filtration only affects the elimination of the free form of drugs.
Renal filtration only affects the elimination of the free form of drugs.
What is a common physiological change that can unpredictably affect drug concentrations?
What is a common physiological change that can unpredictably affect drug concentrations?
What is the bioavailability fraction (BA) of IV route administration?
What is the bioavailability fraction (BA) of IV route administration?
PO-administered drugs should achieve a bioavailability fraction of 0.5.
PO-administered drugs should achieve a bioavailability fraction of 0.5.
What is the therapeutic level of a drug in ng/mL?
What is the therapeutic level of a drug in ng/mL?
The elimination of Digoxin primarily occurs through __________.
The elimination of Digoxin primarily occurs through __________.
Match the following cardioactive drugs with their primary classifications:
Match the following cardioactive drugs with their primary classifications:
Which of the following is a symptom of drug toxicity?
Which of the following is a symptom of drug toxicity?
What concentration of free drug is considered toxic?
What concentration of free drug is considered toxic?
Lidocaine can be administered orally without any concerns about hepatic metabolism.
Lidocaine can be administered orally without any concerns about hepatic metabolism.
What is the therapeutic level range for Monoethylglycinexylidide (MEGX)?
What is the therapeutic level range for Monoethylglycinexylidide (MEGX)?
Quinidine is primarily eliminated through renal filtration.
Quinidine is primarily eliminated through renal filtration.
What is the peak serum level time for Quinidine sulfate after oral administration?
What is the peak serum level time for Quinidine sulfate after oral administration?
Propranolol is used to treat __________, hypertension, and coronary artery disease.
Propranolol is used to treat __________, hypertension, and coronary artery disease.
Match the following medications with their primary toxicity effects:
Match the following medications with their primary toxicity effects:
What is the toxic level for Procainamide?
What is the toxic level for Procainamide?
Disopyramide has an anticholinergic effect when its level exceeds 4.5 ug/mL.
Disopyramide has an anticholinergic effect when its level exceeds 4.5 ug/mL.
What percentage of Quinidine is protein bound?
What percentage of Quinidine is protein bound?
The therapeutic level for Amiodarone is __________.
The therapeutic level for Amiodarone is __________.
Which medication is NOT used to treat cardiac arrhythmias?
Which medication is NOT used to treat cardiac arrhythmias?
Flashcards
Pharmaceutical Care
Pharmaceutical Care
The responsible administration of medication therapy to achieve specific goals that improve or maintain a patient's quality of life.
Clinical Pharmacy
Clinical Pharmacy
The area of pharmacy that focuses on the science and practice of medication use in a way that is safe, effective, and efficient.
Clinical Pharmacy (Unabridged)
Clinical Pharmacy (Unabridged)
A health science discipline where pharmacists provide patient-centered care to optimize medication therapy, promote health, wellness, and disease prevention.
Pharmaceutical Care Philosophy
Pharmaceutical Care Philosophy
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Clinical Pharmacists' Practice Setting
Clinical Pharmacists' Practice Setting
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Medication Therapy Management
Medication Therapy Management
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SOAP/FARM
SOAP/FARM
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Patient Outcomes in Clinical Pharmacy
Patient Outcomes in Clinical Pharmacy
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What is Medication Reconciliation?
What is Medication Reconciliation?
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What's a Trough Concentration?
What's a Trough Concentration?
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What is a Peak Concentration?
What is a Peak Concentration?
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Why Is Reviewing Drug Use Important?
Why Is Reviewing Drug Use Important?
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Why Is Communication Key in Medication Management?
Why Is Communication Key in Medication Management?
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Transition in Care
Transition in Care
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Medication Reconciliation
Medication Reconciliation
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Therapeutic Drug Monitoring (TDM)
Therapeutic Drug Monitoring (TDM)
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Trough Concentration
Trough Concentration
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Peak Concentration
Peak Concentration
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Mixed Function Oxidase (MFO) System
Mixed Function Oxidase (MFO) System
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Drug Clearance
Drug Clearance
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Therapeutic Range
Therapeutic Range
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Bioavailability
Bioavailability
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Half-life (t½)
Half-life (t½)
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Drug Toxicity
Drug Toxicity
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Cardioactive Drug
Cardioactive Drug
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Class I - Rapid Sodium Channel Blockers
Class I - Rapid Sodium Channel Blockers
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Class II - Beta Receptor Blockers
Class II - Beta Receptor Blockers
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Class III - Potassium Channel Blockers
Class III - Potassium Channel Blockers
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Class IV - Calcium Channel Blockers
Class IV - Calcium Channel Blockers
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Drug Concentration and Therapeutic Effect
Drug Concentration and Therapeutic Effect
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Physiological State Affecting Drug Levels
Physiological State Affecting Drug Levels
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Drug Interaction
Drug Interaction
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Patient Compliance Monitoring
Patient Compliance Monitoring
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Common Drug Classes for TDM
Common Drug Classes for TDM
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Digoxin
Digoxin
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Anti-Epileptic Drugs
Anti-Epileptic Drugs
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Psychoactive Drugs
Psychoactive Drugs
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Disopyramide
Disopyramide
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Quinidine
Quinidine
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Propranolol
Propranolol
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Procainamide
Procainamide
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Amiodarone
Amiodarone
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Therapeutic Level
Therapeutic Level
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Toxic Level
Toxic Level
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Cinchonism
Cinchonism
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Anticholinergic Effect
Anticholinergic Effect
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Cardiac Arrhythmia
Cardiac Arrhythmia
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Study Notes
Clinical Pharmacy and Pharmacotherapeutics
- Clinical pharmacy is the science and practice of rational medication use
- Clinical pharmacy optimizes medication therapy, promotes health and wellness, and prevents disease
- Clinical pharmacists provide care in all healthcare settings
- Pharmaceutical care is the responsible provision of medication therapy to enhance a patient's quality of life
- CORE, PRIME, and SOAP/FARM are documentation methods for pharmaceutical care
- CORE documents patient condition, medication therapy evaluation, and outcomes
- PRIME documents pharmacotherapy needs and issues
- FARM/SOAP documents findings, assessment, resolution, and monitoring
- Medication reconciliation is the process of comparing a patient's current medications with prescribed medications
- Therapeutic Drug Monitoring (TDM) is a quantitative procedure for drugs with a narrow therapeutic index
- It allows for safe medication use when dealing with drugs that have toxic effects at small differences between therapeutic and toxic doses
- TDM involves measuring drug concentrations in the blood
- Trough concentrations are measured immediately before the next dose
- Peak concentrations are measured one hour after an oral dose, or after the infusion for IV drugs
- Drugs like Digoxin, Lidocaine, Quinidine, Procainamide, Disopyramide, Propranolol, Amiodarone, and Verapamil are common drugs that require TDM
- Some common drug classes that require TDM include cardioactive drugs, antibiotics, anti-epileptic drugs, psychoactive drugs, bronchodilators, immunosuppressants, antineoplastic drugs, anti-inflammatory/analgesics, and neuroleptics
- Routes of administration include intravenous (IV), intramuscular (IM), and oral (PO)
- Causes of drug toxicity include elevated free drug concentration, abnormal response, and presence of active drug metabolites
Medication Reconciliation
- Medication reconciliation compares a patient's current medications to prescribed medications
- Its goal is to prevent medication errors by identifying omissions, duplications, and dosage errors
- It is performed at every transition of care
Therapeutic Drug Monitoring (TDM)
- TDM measures drug concentrations in the blood to optimize therapy
- It is used for drugs with narrow therapeutic indexes
- Trough concentrations are measured before the next dose to ensure adequate drug levels
- Peak concentrations are measured after drug administration to evaluate drug absorption
- Indications for TDM include serious consequences of overdosing or underdosing the drug, small differences between therapeutic and toxic doses, poor correlation between the circulating dose and the therapeutic/toxic effects, and change in the patient's physiological state that might unpredictably affect the circulating drug concentrations
Common Drug Classes Requiring TDM
- Cardioactive drugs
- Antibiotics
- Anti-epileptic drugs
- Psychoactive drugs
- Bronchodilators
- Immunosuppressants
- Antineoplastic drugs
- Anti-inflammatory/Analgesics
- Neuroleptics
Anti-Inflammatory/Analgesics
- Salicylates (aspirin), Acetaminophen, and Ibuprofen are commonly used analgesic/anti-inflammatory drugs
- Salicylates, like aspirin, can cause chronic toxicity with side effects such as anemia, renal damage, and GI disturbance if abused
- Acetaminophen, when taken in high doses, can cause hepatotoxicity
- Ibuprofen, compared to the other two, carries minimal risks for toxicity.
Carbohydrates
- Carbohydrates are hydrates of aldehyde or ketone (e.g., glucose)
- Sugars are classified as reducing or non-reducing based on their chemical structure
- The brain depends on blood glucose for energy
Pancreas
- The pancreas has both exocrine and endocrine functions
- Islets of Langerhans are clusters of cells within the pancreas
- Beta cells secrete insulin
- Alpha cells secrete glucagon
- Delta cells secrete somatostatin
- F cells secrete pancreatic polypeptide
Diabetes Mellitus (DM)
- DM is characterized by hyperglycemia due to defects in insulin secretion or insulin receptors
- Types include Type 1 (insulin-dependent), Type 2 (non-insulin-dependent), Gestational, and other types
- Classification is based on the underlying cause of hyperglycemia
- Symptoms include polyuria, polydipsia, polyphagia, weight loss, and possible loss of consciousness.
- DM is often screened by fasting blood sugar (FBS), oral glucose tolerance test (OGTT), glycosylated hemoglobin (HbA1c), and other biomarkers.
Atypical Antipsychotics
- Atypical antipsychotics commonly include Risperdal, Olanzapine, Quetiapine, and Aripiprazole
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