Pharmaceutical Care PDF

**[Pharmaceutical care]** Pharmacist provide drug therapy for the best therapeutic outcomes for the betterment quality of life. **Rational use of drug** : proper use of drug **Functions of therapeutic care :** **IRP** I : Identification of both drug and patient related problems R : Resolving o...

**[Pharmaceutical care]** Pharmacist provide drug therapy for the best therapeutic outcomes for the betterment quality of life. **Rational use of drug** : proper use of drug **Functions of therapeutic care :** **IRP** I : Identification of both drug and patient related problems R : Resolving of both patient and drug related problems P : Prevention of the both patient and drug related problems **[Outcomes ]** Cure Elimination Slow down disease Prevention **Pharmaceutical care plan** Written individualized plan of the drug based on clear therapeutic goals **Pharmacotherapy :** It utilize one or more drug for the treatment prevention and diagnosis of disease ( without radiations and surgery) **Steps of pharmaceutical care** 1. Patient Dr relationship 2. Data collection 3. Interpretation of data 4. identification of drug related problem 5. identifying priority of drug related problem 6. develop therapeutic plan 7. implement monitoring plan 8. follow up **DRH** : drug related morbidity It is the process of therapeutic malfunction including both addition of new effect or development of toxic effect **Reasons** 1. Untreated indications 2. Over dose 3. Sub therapeutic dose **Adverse effect :** Accumulation of drug in the body may be neurotoxic ototoxic **Drug interactions:** 1. Drug-drug interaction 2. Drug-food interaction 3. Drug disease interactions Drug use of without identification **Individualization of dosage regimen** Adaptation of drug to achieve best outcomes **Patient related factors** **Drug related factors** --------------------------------- -------------------------------------- Diagnosis Efficacy Therapeutic goals Adverse effect Contraindications Drug administration Allergy Pharmacokinetic and pharmacodynamics Patient compliance Dosage form Patient medical history Ability to monitor Patient cooperation from public Route of administration **Reasons of non compliance** 1. Health care provider behavior 2. Inappropriate prescription 3. Dispensing error 4. Patient idiosyncrasy 5. PWDT ( pharmacist workup drug therapy) 6. Systemic documentation provide guidelines for the documentation to pharmacist **Formats** **PHARME** **PRIME** P pharmacotherapy problem list P Pharmacotherapy problem H history R Risk factor A assessment I interactions b/w drug-drug food R recommendation M mismatch M Monitoring E Efficacy E Evaluation **SOAP** Subjective objective assessment plan **Core** Condition of factor Outcomes Regimen Evaluation **Chapter no 2** **Adverse drug reactions** ( unwanted outcomes of drug) **Classification** Based on 1. Onset of action 2. Active sub active latent 3. Severity 4. Minor moderate severe lethal **Types of reaction** ABCDEF **Others** Hypersensitivity allergic shocks toxic effect **Acute** 60 mins onset of action , subactive 1-2 hrs latent 72 days Minor No therapy required **Moderate** Need to change therapy **Severe** Intense care need **Lethal** Directly or indirectly patient is moving death **Type A** Augmental dose depended ADRs e.g anticoagulant **Type B** Bizzore dose independent e.g hypersensitivity reactions due to penicillin G **TYPE C** Chronic they occur due to chemical structure metabolitic e.g paracentamal cause hypatoxicty **Type D** delayed ADRs occurs after the years e.g blader carcinoma occurs due to cyclophosphamide **Type E** end of therapy due to withdrawal of medicine e.g phenobarbit one is used in seizure **Type F** failure of therapy mostly drug interaction **Type of ADRs** **Pharmaceutical** Change in dosage form the active substance decrease or increase as result they produce toxity or therapeutic index Eg indomethacin drug increase the active ingredients as a result the indomethacin cause gestro hemorrhage **Drug index dieses** The disease caused by drug 2 conditions Drug withdrawal Drug elimination not properly