PHA101_Drug-related Information.pdf

Introduction to Pharmacy PHA 101 Drug-related Information Rana A. Alaaeddine, RPh, PhD Assistant Professor of Pharmacology 1 FDA-required prescribing information (what is it used for) (how is a patient sup...

Introduction to Pharmacy PHA 101 Drug-related Information Rana A. Alaaeddine, RPh, PhD Assistant Professor of Pharmacology 1 FDA-required prescribing information (what is it used for) (how is a patient supposed to take it)  Drug information Medscape: Tylenol (acetaminophen) dosing, indications, interactions, adverse effects, and more (medscape.com)  Medication Alert Notification ▪ Situations that require the pharmacy department to alert the medical and nursing staff of an important medication-related issue. ▪ One of the most important examples of these types of issues has been medication shortages. ▪ Change in pharmacy procedures, formulary updates, or withdrawal of a drug from the market. ▪ Most effective method is generally the preparation of a one-page communication that clearly states the problem or issue and provides a recommendation for managing the problem Medication Alert Notification  The Prescription ▪ The prescription is a set of specific directions issued by a medical practitioner to a pharmacist for the appropriate use of a medication or medications in a particular patient ▪ An individual plan of care to remedy a medical problem ▪ Prescribing authority is granted to correspond only with the provider’s scope of practice ▪ The pharmacist will often advise the prescriber related to drug product selection based on clinical protocols, drug formularies or patient financial considerations ▪ Medications: “over-the-counter (OTC) drugs” or ‘‘Rx only’’ Prescription Abbreviations Decoded  Prescription Label Information 1. Patient name 2. Directions for use, e.g. Take 2 tablets by mouth in the morning and 2 tablets in the evening. 3. Drug name and strength (generic and brand) 4. Beyond use date (not expiration date) 5. Pharmacy name, address, and telephone number 6. Prescription number 7. Date of dispensing 8. Quantity dispensed 9. Number of refills Prescription Label  Medication Safety ▪ Framework for ensuring medication safety ▪ 7000 to 9000 people die in the US from Medical errors ▪ 400,000 drug related injuries in hospital from medical errors ▪ Global cost associated with medication errors - estimated at US$42 billion ▪ Build safety system to prevent errors at all levels  Adverse Drug Reactions ▪ Definition: World Health Organization (WHO): ‘‘A response to a drug that is noxious and unintended, and that occurs at doses normally used in humans for the prophylaxis, diagnosis, or therapy of disease or for the modification of physiological function.’’ ▪ Adverse Drug Reaction (ADR) from an adverse drug event (ADE): o ADE is an injury resulting from taking a drug. ADEs encompass all steps that can go wrong with drug therapy including preventable mistakes in prescribing, administering, dispensing, monitoring, and documenting (that is, medication errors) o ADRs: non-preventable. An ADR is the result of the intrinsic properties of the drug and cannot be prevented.  Drug Interactions 1. Drug-drug Interactions: A drug interaction may be considered a situation in which the effects of one drug are altered by prior or concurrent administration of another drug. 2. Drug-food interaction 3. Drug-herbal or natural product interaction 4. Smoking interacts with drugs 5. A drug causes alterations of laboratory test results (i.e., drug– laboratory test interactions) 6. A drug causes undesired effects in patients with certain disease states (i.e., drug–disease interactions).  Poison Control ▪ The objective of poison centers is to reduce mortality and morbidity ▪ 55 poison centers in the US ▪ Poisoning: medications, supplements, illicit drugs, household industrial ▪ Chemicals, environmental toxins, venomous insects, animals ▪ Majority - intentional self poisonings. Unintentional – preventable ▪ Acute and chronic poisonings ▪ Pharmacist can play a key role: — work in many poison centers — Provide consultation to physicians treating poisoned patients — Identify antidotes available for certain medications, assist dosing  Medication Disposal ▪ Medication disposal is challenging in complex - follow the law ▪ Environmental impact, type, volume & toxicity of medications ▪ Optimal method - incineration - many barriers ▪ Incinerator accessibility, cost, cumbersome laws and regulations ▪ Multiple regulatory agencies — Environmental Protection Agency (EPA) — Drug Enforcement Administration (DEA) — Occupational Safety and Health Administration (OSHA) ▪ Hazardous waste: Ignitability, corrosively, Toxicity, chemotherapy ▪ Biohazardous waste (body fluids, needles, Surgical blood/tissue)  Medication Disposal ▪ Hazardous waste must be incinerated at an EPA approved facility ▪ Non-hazardous waste in a medical waste or municipal incinerator ▪ Some states allow sewers, but not optimal for environment. ▪ Healthcare facility should partner with approved waste management company ▪ Controlled substances waste: potential for diversion: destroyed such they are beyond recovery, witnessed and documented by two healthcare professionals Ex: Morphine 10 mg; dose is 5 mg, remaining 5 mg is destroyed/witnessed ▪ DEA-registered reverse distributors → manufacturers for credit who destroy those meds following law/ regulations. ▪ Healthcare professionals role in minimizing waste, educate consumers.