MCPC II: Study Group Session #1 PDF 2024

MCPC II: Study Group Session #1 Jacob McGregor PharmD Candidate, 2024 Hello again! MCPC Exam #2: March 20th, 2024 MCPC Exam #3: April 26th , 2024 Review on EXAM WEEKS will be on Sunday evenings Stewardship Defining stewardship Supervising or “taking care” of something Medication-related stewardship ○...

MCPC II: Study Group Session #1 Jacob McGregor PharmD Candidate, 2024 Hello again! MCPC Exam #2: March 20th, 2024 MCPC Exam #3: April 26th , 2024 Review on EXAM WEEKS will be on Sunday evenings Stewardship Defining stewardship Supervising or “taking care” of something Medication-related stewardship ○ Promotes optimal selection, dosing, route, duration of medication ○ Limits inappropriate/excessive use ○ Improves therapy and outcomes for patients Types of stewardship? ○ ~All areas~ ○ Pain Management, Antimicrobial, Fluids ○ Okay, but what’s the goal? Starting a stewardship program https://www.cdc.gov/antibiotic-use/core-elements/ health-departments.html Antimicrobial Stewardship What interventions can be implemented? Action Document, document document! ○ Indications of medications ○ Dose adjustments ○ Pertinent patient characteristics (i.e., true penicillin allergy) IV to PO automatic changes Duplicative therapy alerts Time-sensitive automatic stop orders What interventions can be implemented? Tracking ABx Days of therapy (DOT) ABx Defined Daily Doses (compared to a WHO-assigned value) SAAR (Standardized Antimicrobial Administration Ratio) Outcomes (i.e., C. diff infections, cost…) Example of prospective audit and feedback Yamaguchi, R., Yamamoto, T., Okamoto, K., Tatsuno, K., Ikeda, M., Tanaka, T., Wakabayashi, Y., Sato, T., Okugawa, S., Moriya, K., & Suzuki, H. (2022). Prospective audit and feedback implementation by a multidisciplinary antimicrobial stewardship team shortens the time to de-escalation of anti-MRSA agents. PloS one, 17(7), e0271812. https://doi.org/10.1371/journal.pone.0271812 Opioid Stewardship The Main Points Non-opioids when available/appropriate Start with low doses and IR formulations Reserve opioids for period of pain severe enough to warrant them Fluids Stewardship The Main Points Prevent fluid overload and lyte imbalances Is it the right… ○ Patient? Assess response ○ Drug? Does the patient needs specific nutrients? Lytes? blood? ○ Route? IV vs PO? ○ Dose? Response? Need more / less? Fluid Stewardship During Critical Illness: A Call to Action Questions? If you have any questions, you can reach out to me anytime! P: 662-509-1884 E: [email protected]