Pharmaceutical care plan

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Pharmaceutical Care Plan MUHAMMAD AKRAM KHATRI PATIENT C RE

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Pharmaceutical care planning is the process in which a pharmacist cooperates with the patient and health care providers in designing, implementing and monitoring a therapeutic plan that will produce specific therapeutic outcomes. PATIENT C R E

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Physician TRIADE Pharmacist Patient

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The pharmacist designs, implements, and monitors a pharmaceutical care plan for each patient. The Pharmacist identifies desired therapeutic outcomes for each medication prescribed and drug-related problems. Pharmaceutical Care Plan PATIENT C R E

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The patient is assessed by the pharmacist at appropriate intervals for progress toward the therapeutic goals, and resolution of drug-related problems. PATIENT C R E

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The pharmacist continuously updates the pharmaceutical care plan with patient-specific information and recommends modifications in therapy. PATIENT C R E

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Three primary GOALS of pharmaceutical care plan. (PCP) Identifying potential and actual drug related problems

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Resolving actual drug related problems

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Preventing potential Drug related problems

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And The ultimate goal of pharmaceutical care plan is the safe and effective use of drugs by the patients. PATIENT C R E

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Drug-Related Problem A drug-related problem is the situation involving drug therapy that potentially interferes with the optimum therapeutic goals of patient. PATIENT C R E

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Drug-related problems include: Untreated indications. The patient has a medical problem that requires drug therapy but is not receiving a drug for that indication. Improper drug selection. The patient has a drug indication but is taking the wrong drug, or is taking a drug that is not the most appropriate for the special needs of the patient. Sub therapeutic dosage. The patient has a medical problem that is being treated with too little of the correct medication. PATIENT C R E

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Failure to receive medication. The patient has a medical problem that is the result of not receiving a medication due to economic, psychological or pharmaceutical reasons. Over dosage. The patient has a medical problem that is being treated with too much of the correct medication. Adverse drug reactions. The patient has a medical problem that is the result of an adverse drug reaction or adverse effect. PATIENT C R E

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Drug interactions. The patient has a medical problem that is the result of a drug-drug or drug-food interaction. Drug use without indication. The patient is taking a medication for no medically valid indication. Treatment failures. The patient has a medical problem that is being treated with a medication that is generally considered appropriate for the indication, but the desired therapeutic outcome is not achieved. PATIENT C R E

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PATIENT C R E Improper duration of therapy: The duration for which the drug has been prescribed is either less or more than the needed. Improper dosage form and route: Dosage form is not suitable for the patient. And is given through wrong Route. Improper administration: The drug is not administered properly.

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PATIENT C R E Therapeutic duplication: Two drugs from the same therapeutic category have been prescribed Simultaneously. The patient is allergic to prescribed medication: Previously the patient was allergic to a medication but again this Medicine is included in regimen. Patient non-compliance: Every thing is proper but the patient is not understanding and following the recommendations.

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PATIENT C R E Incomplete immunization: The patient has not received all of the required vaccines.

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Developing a pharmaceutical care plan STEP NO. 1 Gathering Information and Creating Patient Database PATIENT C R E

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PATIENT C R E a) Personal Data: It should include name, age, sex, body weight, height, Body surface area, Body mass Index, occupation, location, contact number, education, physician name and contact. b) Present diagnosis and past medical history: It should include what is the present diagnosis? And from which diseases the patient had been suffered in the past?

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PATIENT C R E c) Present medications and medication history: Pharmacist should gather an accurate medication history, including both prescription and nonprescription medications and the reasons due to which medications were prescribed or taken. And as well as gather the record of current medications. d) Medication allergies: Information regarding medication allergies or hypersensitive reactions should be asked.

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PATIENT C R E e) Drug use: Pharmacist should ask the patient about smoking, alcohol use, tea or coffee, tranquilizers, narcotics etc. f) Laboratory exam results: It should include gathering all diagnostic tests data.

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PATIENT C R E g. Renal and liver functions: The pharmacist should determine that whether the renal and liver functions are normal or not. h. Blood Pressure and Heart Rate: The pharmacist should also measure the B.P and heart rate and ask for previous B.P record if needed.

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PATIENT C R E i) Objective findings: Note the objective findings such as coughing, edema, discomfort, tiredness etc.

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Developing a pharmaceutical care plan STEP NO. 2 Identification and Assessment of drug related problems PATIENT C R E

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PATIENT C R E Assess the patient’s profile for presence of drug-related problems: Pharmacist evaluates that whether there is any present drug related problem or not. b) Determine whether drug-related problems are being treated: If there is any drug related problem present has it been treated or not? c) Determine whether additional drug therapy is needed: Pharmacist should determine is any additional drug needed for better outcomes?

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Developing a pharmaceutical care plan STEP NO. 3 Taking part actively to solve these problems PATIENT C R E

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PATIENT C R E a) Contact Prescriber: The pharmacist should contact prescriber if any thing wrong had done on the prescriber end or in the cases when any suggestion has to be given for better therapeutic outcomes. b) Contact Nursing staff: The pharmacist should contact to the nursing staff in the cases if any thing found wrong with the drug administration or if useful suggestions are to be given for better therapeutic results.

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PATIENT C R E c) Counsel the patient: The pharmacist should tell the patient about Proper use of medication Minor side effects of the drugs In case of severe ADRs what measures should be taken Whatever discussed with the physician and nursing staff Laboratory tests to be performed.

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Developing a pharmaceutical care plan STEP NO. 4 Specifying monitoring parameters and establishing therapeutic goals PATIENT C R E

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In Specifying the monitoring parameters, the pharmacist will select abnormal parameters of the body which will be checked every time when the patient comes for next visits. And correction of those parameters will be the therapeutic goal. PATIENT C R E

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EXAMPLES OF DIFFERENT PARAMETERS Physiology of organs ( BLOOD PRESSURE AND HEART RATE) Progression of disease ( CANCEROUS MASS) Symptoms (FEVER, HEADACH, PAIN etc.) Adverse effects. ( ANTIBIOTIC INDUCED DIARRHOEA) PATIENT C R E

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EXAMPLES OF THERAPEUTIC GOALS Approach normal physiology Slow progression of disease Alleviate symptoms Prevent adverse effects Control medication costs Educate the patient about his or her medication PATIENT C R E

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Economical Effective Logical Pharmaceutical care plan should be