Pharmacotherapy and Care Plan PDF

Pharmacotherapy By: Dr. Shadab Kashif Lecturer – Pharmacy Practice R.Ph, M.Sc (UK), PharmD What is Pharmacotherapy? – Pharmacotherapy may sound like a very serious medical term, and while that is not entirely true, it should be noted that it is not something to be scared of. P...

Pharmacotherapy By: Dr. Shadab Kashif Lecturer – Pharmacy Practice R.Ph, M.Sc (UK), PharmD What is Pharmacotherapy? – Pharmacotherapy may sound like a very serious medical term, and while that is not entirely true, it should be noted that it is not something to be scared of. Pharmacotherapy, very simply speaking, is the treatment of health conditions by using pharmaceutical products (drugs) as medication. – Pharmacotherapy is the use of medicine in the treatment of diseases, conditions, and symptoms. – Principally concerned with the safe and effective management of drug administration.  History of Pharmacotherapy: – Pharmacotherapy is not a contemporary science. The use of drugs to treat illness is a practice that has been accepted for thousands of years. A famous example is Hippocrates, who is generally credited with revolutionizing medicine in ancient Greece by using beneficial drugs to heal illness. Traditionally, plants have been the source of medicinal drugs, but modern-day medicine in the United States mostly utilizes synthesized or purified bioactive compounds, rather than an entire sample of plant matter. The advantage to this method of pharmacotherapy is that the dose of medicine rendered is standardized and pure, rather than an unknown drug dosage administered in addition to a wide variety of other chemicals present in the plant. Modern pharmacotherapy is the most common course of treatment for illness in the United States. Types of Pharmacotherapy – Pharmacotherapy can be broadly divided into the following categories: 1. Pharmacokinetics Pharmacokinetics mainly deals with how the concentration of a drug and its product changes in the body over time. Based on how the concentration level of the drug changes as time passes, the concentration of the subsequent doses will be determined. 2. Pharmacodynamics Pharmacodynamics measures how bodily functions change after the intake of a drug. These changes are usually quantifiable, such as the secretion of more hormones or other biological parameters. 3. Pharmacogenomics The concept of pharmacogenomics focuses on how variation in the genetic code could lead to the same drug exhibiting different effects. – For example: Irinotecan (Camptosar) is a type of chemotherapy. Doctors commonly use it to treat colon cancer. In some people, genetic variations cause a shortage of the UGT1A1 enzyme. This enzyme is responsible for metabolizing irinotecan. Metabolism is the chemical reaction that helps the body process the drug. – With a UGT1A1 shortage, higher levels of irinotecan remain in the body. This may lead to severe and potentially life-threatening side effects. The risk is greater with higher doses of the drug. – Doctors may use a pharmacogenomic test called the UGT1A1 test. It shows which people have this genetic variation. Then, the doctor may prescribe a lower dose of irinotecan. Often, the lower dose is just as effective for these people. 4. Pharmacoepidemiology This refers to the study of how large populations respond to a particular drug. This is done in order to address a variety of different matters such as how long the drug took to respond generally, the side effects reported the most, and other adverse effects. Pharmacotherapy plan – The pharmacotherapy care plan is the roadmap to achieving improved pharmacotherapy outcomes. – Care plans have been an integral component of nursing care, and other professionals or certain healthcare settings may utilize components of a care plan. – During any pharmacotherapy care encounter, the patient must be assessed to determine whether the following drug therapy needs are being met: 1. The medication is appropriate 2. The medication is effective 3. The medication is safe 4. The patient is adherent – The “art” of the pharmacotherapy plan is in applying knowledge and making therapeutic decisions that are most likely to have maximum positive benefit for a specific patient. – However, there is no standard or widely accepted method of care plan development in pharmacy. – The pharmacotherapeutic application is all about the patient care process: how to organize patient information, assess patients in a systematic way, and develop a pharmacotherapy care plan. – Drug therapy may aim to – (1) cure a disease; – (2) reduce or eliminate signs and/or symptoms; – (3) slow or halt the progression of a disease; – (4) prevent a disease; – (5) normalize laboratory values; and/or – (6) Assist in the diagnostic process. – The pharmacotherapy care plan has several key components for each problem: – Current drug regimen – Drug therapy problems – Therapy goals, desired endpoints – Therapeutic recommendations – Rationale – Therapeutic alternatives – Monitoring and follow-up – Patient Education. – As the care plan is developed, it is important for the student to see and understand the connections between multiple problems and the pharmacotherapy plan. For example, a patient with hypertension, type 2 diabetes, and chronic kidney disease may be treated with an ACE-I to lower blood pressure (BP), slow the progression of renal disease, and reduce the risk of cardiovascular events. – The goals of treating those disorders are to prevent cardiovascular disease (stroke, coronary artery disease, peripheral vascular disease), kidney disease, and other microvascular complications of diabetes (retinopathy, neuropathy), etc. We also want the patient to feel better and have an improved quality of life (QOL). – An important goal of any pharmacotherapy care plan is the avoidance of adverse events. – What would be the endpoints for the above hypersensitive diabetic patient? – some endpoints would include BP