Patient drug history communication

In many developing countries of the world, there is still a major reliance on crude drug preparation of plants used in traditional medicines for their primary health care. Pharmacognosists employed in the different institutions are aware of the changing trends of herbal medications and a number of useful texts on the analysis, uses, and potential toxicities of herbal remedies have appeared recently, which serves as useful guides in pharmacy practice. The history of medicine includes many ludicrous therapies. Nevertheless, ancient wisdom has been the basis of modem medicine and will remain as one important source of future medicine and therapeutics. The future of natural products drug discovery will be more holistic, personahzed and involve the wise use of ancient and modem therapeutic skills in a complementary manner so that maximum benefits can be accmed to the patients and the community. 

This group investigated patients presenting with acute schizophrenic symptoms who underwent a drug-free washout period, received lithium only initially, and then antipsychotics later (374). Lithium was ineffective for classic schizophrenia, but some patients who met criteria for schizophreniform disorder did respond to lithium. Whether schizophreniform illness is a variant of mood disorders (a reasonable hypothesis in view of their lithium response) or a separate entity that is lithium-sensitive is still unclear. It is known that these patients have family histories that include mood-disordered as well as schizophrenic relatives. In a small pilot study, physostigmine (a drug with possible antimanic but no antipsychotic properties) benefited schizophreniform patients who responded to lithium, but had no effect in those who did not (Carver DL, personal communication). 

What comes to mind when the word pharmacy is mentioned Depending on your age, hometown size and location, personal health history, and experiences shared by family and friends, a number of examples might appear. While the descriptions would vary regarding the name and even the practice setting, many would envision a privately owned business that not only filled prescriptions but also took care of patients and their families. This type of pharmacy has been described in many ways a mom and pop shop, a drug store, a chemist s shop, an apothecary, a prescription shop, or hundreds of brand names ranging from Abe s Drug to Zimmerman s Pharmacy. The business that is described by most is an independent community pharmacy. 

Among the cycloplegics most frequently used are cycfopentolate and atropine. Because of their potential side effects, a careful history and assessment of the anterior chamber angle are necessary before use. Selection of the appropriate agent is also important (see Chapter 21). If there is a risk of angle closme, this risk must be communicated to patients, and informed consent should be obtained before the drug is administered. 

Documentation of patient care is essential to the defense of legal claims. If pharmaceutical agents are used, clinicians should ensure that the patient record includes an adequate history, a description of drugs used, any warnings communicated to the patient, required recall appointments (including no show appointments), and... 

In 1993, the Royal Pharmaceutical Society of Great Britain created checklists for pharmacists that served as a guide to the types of communication that should occur between hospital and community pharmacists regarding patients medication and pharmaceutical needs. These checklists contained information that should be completed by the community pharmacist to the hospital pharmacist on hospital admission of a patient, such as the medication history and domiciliary circumstances and known adverse drug reactions (ADRs),... 

Nervous system In a case-control analysis nested within a cohort of 26157 community-dwelling patients (mean age 76 years) with at least one antipsychotic drug prescription in the Netherlands, there were 518 hospital admissions for cerebrovascular adverse events [23 ]. For each case, four randomly selected controls, matched by sex and age, were sampled from the cohort. Current and recent exposure to antipsychotic drugs was associated with an increased risk of cerebrovascular adverse events compared with non-users (OR=1.7 95% CI=1.4, 2.2). The OR for a history of use less than a week was 9.9 (5.7,17). The risk fell with time and was comparable to the risk in on-users after 3 months (OR 1.0 95% Cl=0.7,1.3). 

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