Tiêu đề 1. DEFINITIONS, DEVELOPMENT AND SCOPE OF CLINICAL PHARMACY.pdf ✅

PHARMD GURU Page 1 Clinical Pharmacy: Clinical pharmacy is defined as, the service provided by the pharmacist, to promote the rational drug therapy that is safe, appropriate and cost-effective. Clinical pharmacists often work in collaboration with physicians, nurse practitioners, and other healthcare professionals. Pharmaceutical Care: Pharmaceutical care is defined as “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient‟s quality of life”. Ward Pharmacy: It is defined as “the system where a pharmacist visits wards regularly to monitor for completeness & accuracy of prescription, is available for consultation by medical and nursing staff & ensures that the drug distribution system is operating correctly. AIM OF CLINICAL PHARMACY: The aim of the clinical pharmacy is to ensure the patient' maximum well-being and to play a meaningful role in the safe and rational use of drugs. The main goals of clinical pharmacy are: 1. To assist the physician in doing a better job of prescribing and monitoring drug therapy for the patient. 2. To assist medical and para-medical staff and documenting medication incidents correctly. 3. To maximize the patient's compliance in drug use process. DEFINITIONS, DEVELOPMENT AND SCOPE OF CLINICAL PHARMACY
PHARMD GURU Page 2 QUALITIES OF CLINICAL PHARMACIST: 1. Communication Skill: The clinical pharmacist should have good communication skills, in order to communicate with the patient and co-professionals freely and effectively. 2. Clinical Skills: The clinical pharmacist should have thorough knowledge about etiology of a disease, signs. symptoms. pathophysiology, laboratory tests, pharmacokinetics, etc. He should be clinically trained for providing information on rational drug use, related drug therapy, and for reviewing drug doses. 3. Professional Relationship: He should be able to understand and appreciate the role of medical and para-medical staff wherever possible. He must accompany physician on medical rounds to assist him by providing drug information. The physician, pharmacists and nurses should develop an inter-professional relationship with each other to enhance the quality of patient care. 4. Empathy: Clinical pharmacist should possess a deep sense of shared responsibility towards medical care of patients. It will help him in taking medication history and gaining patient‟s confidence. 5. Monitoring Drug Therapy: Clinical pharmacist must help in monitoring drug therapy because it is an on-going process and keeps on changing depending upon patient's conditions. DEVELOPMENT OF CLINICAL PHARMACY 1. The term clinical pharmacy was first used in 1953. 2. In 1960‟s, clinical pharmacy became widely used among pharmacists. 3. Clinical pharmacy as a separate discipline emerges first as „Clinical pharmacology‟. 4. The concept of clinical pharmacology started with two incidents: (a) The thalidomide tragedy in 1962. (b)Phenytoin toxicity in 1968 (in Australia).
PHARMD GURU Page 3 In the same year i.e. 1968, higher digoxin levels associated with digitalis toxicity (ventricular arrhythmias) were reported in USA, which again was due to use of different formulations. 5. Hence, it was realized that studies must be done to investigate bioavailability, pharmacokinetics & toxicity of different formulations. 6. Hence it was realized that a pharmacist is needed there. 7. A pharmacist has expertise in analytical methods, knowledge about advancement of modern analytical techniques, new drug delivery systems & formulation of drugs. 8. A series of studies performed in united states & other countries on the occurrence of medical errors in hospital received considerable attention both among health professionals & in the public. 9. According to these studies, the average patient was given 6-7 doses of medicines with an estimated error rate of 6-15% and hence, each patient have the risk of being exposed to an average of one medication error per day. 10.The recognition of this medication error problem resulted in two important developments. (a) It brought nurses, pharmacists and physicians together to discuss ways of preventing the errors. (b)It initiates a newer & safe drug distribution system called “unit dose system”. 11.The pharmacist also began to understand the need to work more closely with other health professionals in the interest of the patient. 12.The unit dose system then gradually evolved in number of clinics. It became the necessary platform where pharmacists met with nurses & physicians in a professional coordinated co-operation. 13.Thus a new avenue opened for the pharmacists & that is “Clinical Pharmacy”.
PHARMD GURU Page 4 SCOPE OF CLINICAL PHARMACY 1. Preparation of patient medication histories: • Any hypersensitivity's or allergies to specific drugs observed in the past, any particular drug or food habits, drug dependence or intoxication with chemicals due to occupational hazards, all of which are likely to interfere with the therapy. • This will help in saving physicians time and efforts and thus will result in faster and more accurate selection of drug therapy. 2. Rational prescription: The clinical pharmacist can suggest the physician and help him in selecting the right drug. Some of the examples of irrational combinations identified by pharmacist are: E.g.:-Haloperidol + Diazepam + Amitriptyline, Reserpine + Sintamil. 3. Bioequivalence and generic equivalence of pharmaceutical formulations: Number of factors influences the bioavailability of drugs from the dosage forms. Selection of proper drug therapy based on bioequivalence studies on different dosage forms of the same drug moiety. 4. Patient monitoring: Observes the signs and symptoms of that indicate the need for reaction to drugs. Clinical pharmacist who knows correct route of administration, the signs and symptoms of over dosages, contraindications, desired effects, undesired effects and side effects can help in monitoring the drug therapy for safety and efficiency, a necessity with the increasing applications of potent and toxic chemicals and drugs. Drugs with narrow therapeutic index, or When drugs administered in patients, who are critically ill or suffering from chronic diseases. 5. Adverse drug reactions and drug interaction: The clinical pharmacist: • Can compile and process data using computers and make it available to the