Clinical PHARMACY

Practice
 PRESENTAION OUTLINES
1. What is clinical pharmacy.
2. getting started...!!!
3. CLINICAL Pharmacist competencies
4. BASIC CLINICAL SKILLS.
5. Imp.Websites , apps ,text books.
6. References.
1 Clinical Pharmacy
Definition
 what is clinical pharmacy?
what is the core of this service ?

the area of practice in which pharmacists provide patient care

that optimizes medication therapy and promotes health, wellness
and disease prevention.
 The clinical pharmacist

primary job is to :
1. Interact with the health care team.
2. Interview and assess patients.
3. Make patient specific therapeutic recommendations.
4. Monitor patient response to drug therapy.
5. Provide drug information.
Secondary job is to :
1. Documentation.....
2.Reporting.....
3. Attending.....
4.Education/ training....
Getting
Started...!!!
 REQUIREMENTS

Motivation

Tools Knowledge Skills

1 Tools
 TOOLS
1. Team work
2. Forms
3. Dic( textbooks,guidlines,….
4. Websites,mobile apps
5. Internet
6. Documentation system pt profiles , DIRs, interventions ,
Reports to evaluate , educate , recall……
7. Egyption clinical pharmacy Standards of practice .
8. Access to pts. & their profiles.
9. Evaluation tools...to assure quality
 Medical
2 Knowledge
 read more…MUCH MORE...

Self education:
where should I get my knowledge...
books?... Websites?

As a clinical pharmacist how to study?

Medical background
Dx
Pharmacotherapy management, algorithms
Clinical pharmacology
LATEST GUIDLINES
 Basic
3 ClinicalPharmacy
Skills
1. Communication Skills.
2. Medication History Taking.
3. Physical Assessment Skills.
4. Review Lab &Diagnostic Tests.
5. Patient Case Presentation.
6. Therapeutic Planning.
7. Pharmacotherapy workup & DTP Analysis
8. Time management .
9. Paper work / Computer Skills/ Statistics.
10. Providing Drug Information/Searching(DI skills).
1. Communication skills :

Physician ’’ what is your job exactly ”

what is clinical pharmacology

We diagnose and you treat !!!

PREPARE YOUR ANSWER

 RESISTANCE CAUSES

poor communication
poor knowledge & evidence
poor confidence
Consultation with physicians:
WHY Make Interventions ... >> better Patient care

How to communicate ... ex: (CI Medication renal pts.)

No patient involved or around
 2. Pt. Interviewing :

MEDICATION
HISTORY
Take it by yourself
Drug Allergy
Side effects
Drug abuse
Duplication
compliance ..sr..coating..
Forgot to treat
The patient will tell u too little ..keep digging…
Dosage forms & trade names 
 3. Lab interpretation / investigations :

Disease + labs & tests

Meds + therapeutic & toxic
• LIVER • CULTURES
• URINALYSIS • ECG
• CARDIAC • ECHO
ENZYMES • X-RAY.
• CBC
• INR
• ELECTROLYTES
 4. Physical assessment :

Monitor Drug therapy outcomes( therapeutic & toxic)

CLINICALLY.
6. Pharmacotherapy workup & DTP Analysis

Indicated , effective , safe

1. Matching indications with medications.
2. Contraindications. Absolute & relative
3. DOSE\ REGIMN.
4. Drug interactions ... monitor
5. MONITORING & NEW complications .
 Time management :
7.
 8. documentation

(computer , presentation , documentation skills)

 To RECALL pt. data , EVALUATE practice & EDUCATE new practitioners....... legal issues.
 How to write...a Complete intervention
Med. + Med Error Detected + Pt.Data + Recommended Management + Reference
used

 How to write ... a Complete drug info. answer

UQ + ANSWER+REF USED +time of Q&A +DISCLAIMER

(Not documented...not done)

9. Providing Drug Info :

Scientifically Valid
• How to use my drug info resources …
• How to evaluate a new book…
• How to classify (DIRs)
• critical appraisal
• DISCLAMER .
Clinical pharmacist in ICU
Monitor

HR
RR
O2 saturation
Bl pl

R.R

B.P

O2 sat.
MV
MV Complications
1. Ventilator-associated pneumonia (VAP).

2. Stress ulcers.

3. Venous thrombosis.
4. Acid–base disturbance

5. Respiratory muscle wasting

 1. Ventilator-associated pneumonia (VAP).

How to prevent VAP : Ventilator Bundle

1.Head of the bed elevation : (30–45º).

2. Daily sedation interruptions to assess readiness to extubate

3.Daily oral care with chlorhexidine

Websites,apps..
.!!!
websites
 Case Handling
• History
*Medical
*Medication
• Care plane
• Sheet
• Drug drug interaction
• Patient Education