Download Clinical Pharmacy

Introduction to Clinical
Pharmacy
What topics are covered in this course ?
Concept
What is
clinical
pharmacy
TDM
What is TDM
Role in
treating
patient
Application
Drug
Pharmacist as Rational Use
Development
of Drugs
councilor
In depth
review of this
major role of
pharmacist in
healthcare
DDI
ADR
Drugs used in
special
populations
What are
different
stages in drug
development
Special
emphasis on
clinical
development
What is clinical pharmacy ?
 In short its is area of pharmacy concerned with the “Science
and Practice of Rational medication use”
 Clinical Pharmacy is branch of pharmacy where pharmacist
promote RATIONAL DRUG THERAPY that is
 SAFE,
 APPROPRIATE,
 COST EFFECTIVE
How did clinical pharmacy evolve
SEPARATE
ROLES FOR
DOCTORS &
PHARMACIST
“PHARMACEUTICS” ROLE
DOCTOR + PHARMACIST
PURE “PHARMACEUTICS” ROLE
“CLINICAL” ROLE
How did clinical pharmacy evolve
 3 Major reasons for the evolution of clinical pharmacy
1. No more formulator role
Pharma companies take over the role as major formulator
Only dispensing role left that can be given to tech
Opportunity for pharmacist to utilize his expertise for clinical setting, improving
patient care
How did clinical pharmacy evolve
 3 Major reasons for the evolution of clinical pharmacy
2:
Large increase products along with complexity
Dramatic increase in number of drug products
Increase in tech improvement, diagnosis, treatment
Also requires parallel increase in knowledge for diverse areas
Difficult for doctors to maintain expertise in “drug therapy” and “disease
diagnosis and management”
Opportunity for Pharmacist to support doctors here for safe & effective drug
therapy
How did clinical pharmacy evolve
 3 Major reasons for the evolution of clinical pharmacy
3:
Promote Better Drug Usage
Effectiveness, safety of drug depends on drug & HOW it is used as well
Pharmacist can take this role as a guide to help doctors to optimize use of drugs
This increases EFFICACY & Lowers SIDE EFFECTS
Pharmaceutical care
 Pharmaceutical care requires Rational & Safe drug Use
 In the new concept of pharmaceutical care ,
Pharmacist directly interacts with patient & Doctor
Patient
Takes Direct responsibility of patient care
With Common goal >>>> Improving patient care !
Doctor
Pharmacist
Different Components of Pharmaceutical care
Assessment
of the patient
Evaluation of
medication
therapy
Development
and
implementation
of a plan of care
Follow-up
evaluation
and
medication
monitoring
Different Components of Pharmaceutical care
Assessment of
the patient
Prioritize Patient
Medication Needs
Understanding/
interpreting Patient Data
Medical History
Review medical Records
Different Components of Pharmaceutical care
Evaluation of
medication
therapy
Identify medication
related problems
Asses medication
behavior , adherence
Evaluate Effectiveness,
safety, affordability
Asses therapeutic Goals
Different Components of Pharmaceutical care
Develop &
Implement Plan
of care
Establish pt specific
parameters
Educate patient on plan
Formulate comp plan
Review patients problem
list
Different Components of Pharmaceutical care
Follow up &
Monitoring
Modify, monitor care
plan if needed
Conduct ongoing asses &
refine plan if needed
Review updates on clin
status
Followup aligned with
Med needs
Clinical pharmacy practice
Hospitals
Clinical
Pharmacy
practice settings
Community
based
Clinical practice in hospitals
Clinical role of pharmacist in hospitals
Drug Therapy Selection
• Education program
Right Dose
• Provide pts with right medication
Therapeutic Drug Monitoring
• Drug Education
Drug Use Evaluation
Clinical role of pharmacist in hospitals
Community Pharmacist
Health care professionals MOST accessible to public
Major roles of community pharmacist
PROCESSING OF PRESCRIPTIONS
 Verify if prescription is LEGAL, SAFE, Appropriate
 Check Patient record before dispensing
Major roles of community pharmacist
CARE OF PATIENTS
 Collect, Integrate Info on Patient drug history
 Counsel patient on dosing regimen, method
administration
 Advise on precautions to be taken

Major roles of community pharmacist
Monitoring of drug utilization
 Participate in monitoring drug use
 Analyze prescription use for patterns of Adverse events
Responding to symptoms of Minor Ailments
 Provides advise to general public on minor ailments
 Can directly supply non-prescription medication

Major roles of community pharmacist
Informing health care professionals and the public
 New drugs
 Evolving new information
Health promotion
 Health related, drug-related topics
Role of Clinical Pharmacist in health care
Ensure &
Advance
Rational
Drug
Therapy
Drug
Therapy
Expert
Objective,
evidence based
source of
Information
Unique set of
knowledge &
skills
Primary source
of valid
information and
best use of
Community
pharmacy
role in india
Actual Case studies
A 68-year-old man, was discharged from the hospital
after a myocardial infarction (MI) 2 weeks ago.
At the routine office visit, the patient is diagnosed with
depression. His doctor considers prescribing a tricyclic
antidepressant (TCA), but contacts his community
pharmacist for a recommendation.
Actual Case studies
• Background of MI & Drug use in this condition:
• Studies suggest that 1 in 5 patients become depressed
during their initial hospitalization for an MI, and that a
significant number of patients experience continued
depression 1 month or longer after discharge.
Furthermore, the medical literature suggests an
unfavorable association might exist between post-MI
depression and cardiac-related mortality, implying that
proper diagnosis and treatment are important.
Actual Case studies
• What are the guidelines:
• Physicians guidelines for the detection and management of post-MI
depression recommend that post-MI patients with depression be
treated with selective serotonin reuptake inhibitors (SSRIs) rather
than TCAs.
• WHY? : This recommendation is based upon TCA's tendency to cause
cardiac adverse effects, including heart rate and conduction
disturbances.
Actual Case studies
• What in Pharmacist Recommendation:
• Based upon the proven efficacy and the lack of cardiac toxicity
associated with SSRIs, SSRI (Fluoxetine, paroxetine etc.) be prescribed
instead of a TCA (amitriptyline, imipramine etc.)
THANK YOU
-PHARMA STREET