D5W
5 g dextrose per 100 ml fluid
0.9% sodium chloride
0.9 g per 100 ml fluid
Dx
diagnosis
Hx
history
collect, assess, plan, implement, follow-up: monitor & evaluate
Pharmacists' Patient Care Process
collect
the pharmacist assures the collection of the necessary subjective & objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient.
assess
the pharmacist analyzes the information collected and analyzes the clinical effects of the patient's overall health goals in order to identify and prioritize problems and achieve optimal care
plan
the pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective
Implement
the pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver
Follow-up: Monitor and Evaluate
the pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed.
Primary goals of the PPCP
-promote consistency across the profession
-provide framework for any setting
-patient-centered care delivered in collaboration
-applicable to a variety of patient care services
Accreditation Council for Pharmacy Education (ACPE)
set standards for the education of pharmacists to prepare them for delivery of pharmacist-provided patient care
CAPE educational outcomes
-foundational knowledge
-essentials for practice and care
-approach to practice and care
-personal and professional development
-name & address of prescribing practitioner
-name and address of patient
-date of issuance
-name, strength, dose form, quantity, and instructions for drug prescribed
-refills authorized
-prescribers signature
What are the required elements of a prescription?
inpatient order
institutional setting
outpatient order
community pharmacy or ambulatory care
name & strength of med, quantity dispensed, refill info
What elements are NOT required on a label in MS?
right patient, right drug, right dose, right time, right route
5 rights of prescription verficaiton
valid DEA number, patients physical address
what must be included on a controlled substance prescription?
emergency prescription for CII
amount dispensed must be limited to the quantity necessary to cover the emergency period only, make sure oral order is legitimate, a written prescription must be provided within 7 days and "authorization for emergency dispensing" must be written on its face
Partial filling of C2 prescriptions
quantity dispensed must be noted on the face of the prescription and the remaining portion must be provided within 72 hours
The joint commission
a not-for-profit organization that evaluates and accredits different types of healthcare facilities
barriers to empathy
judging, advising, reassuring, generalizing, quizzing, distracting, sympathy
to verify that the patient understands how to take the medication properly
what is the goal of patient medication counseling
3 open-ended questions to verify patients understanding of their meds
What is IHS counseling method?
what did your prescriber tell you this medication was for; how did the prescriber tell you to take this medication; what did the prescriber tell you to expect
what are the 3 prime questions?
Glucophage
metformin brand name
Hypoglycemic agent; biguanide
metformin pharmacologic class
Metformin MOA
decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization)
lactic acidosis
metformin boxed warning
Synthroid, levoxyl
levothyroxine brand name
Amaryl
glimepiride brand name
thyroid hormone replacement
levothyroxine pharmacologic class
Antidiabetic Agent, Sulfonlyurea
glimepiride pharmacologic class
Hypothyroidism
levothyroxine primary indication
type 2 diabetes
glimepiride primary indication
do not use for weight reduction; ineffective & potentially life-threatening
levothyroxine black box warning
same time each day on empty stomach; preferably before breakfast
levothyroxine administration
older adults
Levothyroxine should not be used in ______
glimepiride contraindications
pregnancy; breastfeeding; type 1 diabetes; diabetic ketoacidosis (with or without coma); severe renal or hepatic impairment
administer once daily with breakfast or first meal of the day
Glimepiride administration?
heart failure, hypertension, myocardial infarction
what conditions is valsartan used to treat?
aliskiren use
Contraindications associated with valsartan include: