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Medication Use Systems Case 4: Principles of Medications Management Objectives 1. To understand the operational necessities for a safe and effective medications use system. 2. To be able to determine which principle(s) might have been violated when a drug-therapy problem occurs. Instructions: For each of the 14 exercises from Case 1: (a) make sure you know what the problem is, (b) write down which principle of medications management was likely to have been violated to set the stage for a potential DTP or to initiate it. and (c) briefly support your decision. In many cases multiple principles may have been violated. Since all of the principles are related at some level, try to choose the most immediate issue. Your explanation ( c) will be especially important. Example: Consider the case of Sarah Bellum (Case 1, exercise 1) (a) Her problem is that her asthma is poorly controlled by her over-use of Ventolin® and TheoDur® and her under-use of Asthmacort®. (b) Does her DTP mainly involve . . . i. a lack of response to signs and symptoms? Not her present problem, but maybe her next problem will if you don’t respond! ii. a lack of access to safe and cost-effective medications? Yes. iii. a lack of follow-up? No. This could have been involved in the past but the case does not say so. iv. Poor cooperation with and among health professionals and herself? No. She is probably trying to cooperate because she told the pharmacists how she uses her meds. She is not cooperating correctly but there is no reason given to think that she is willfully not cooperating. v. Lack of a medications management system? No. If this type of problem kept recurring in a patient because nobody did anything about it, it would suggest a breakdown in the system of care. If a population had too many such cases then this would suggest that the overall system has no way to detect and to resolve such breakdowns on the patient care level. NOTE: You do not need to write out every one like this, just your choice for the correct answer to b with a brief explanation. (c) She has physical and financial access to her medicines but does not know how to use them correctly.