Patient drug history setting

The medical record is another source of medication and health-related information. Access to this record may be limited in certain practice settings however, it can be a valuable tool to review prior to conducting your patient drug history interview. Some practitioners use medical release forms to obtain medical record information such as laboratory data from other institutions required for drug therapy monitoring. 

Every Monday in your oncology outpatient department, you run a pharmacist/ nurse-led oral capecitabine clinic, where patients are referred to you by oncologists for pretreatment counselling, drug history-taking and supplementary chemotherapy prescribing (under set clinical management plans) for the adjuvant treatment of colon cancer or treatment of metastatic colorectal cancer. 

A patient receiving an antianxiety drug may be treated in the hospital or in an outpatient setting. Before starting therapy for the hospitalized patient, the nurse obtains a complete medical history, including mental status and anxiety level. In the case of mild anxiety, patients may (but sometimes may not) give a reliable history of their illness. 

In addition, if possible, die nurse obtains a history of any past drug or alcohol abuse. Individuals with a history of previous abuse are more likely to abuse odier drug s, such as the antianxiety drug s. Some patients, such as diose with mild anxiety or depression, do not necessarily require inpatient care. These patients are usually seen at periodic intervals in die primary health care provider s office or in a psychiatric outpatient setting. The preadministration assessments of the outpatient are the same as diose for the hospitalized patient. 

Although treatment is minimally effective if used for 7 days, 10-14 days of treatment is recommended. The antisecretory drug may be continued beyond antimicrobial treatment in patients with a history of complicated ulcer (e g., bleeding or in heavy smokers). In the setting of an active ulcer, acid suppression is added to hasten pain relief. 

Neurologic symptoms Motor weakness has been reported rarely. Most of these cases occurred in the setting of lactic acidosis. The evolution of motor weakness may mimic the clinical presentation of Guillain-Barre syndrome (including respiratory failure). Symptoms may continue or worsen following discontinuation of therapy. Stavudine therapy has been associated with peripheral neuropathy, which can be severe and is dose-related. Peripheral neuropathy has occurred more frequently in patients with advanced HIV disease, a history of neuropathy, or concurrent neurotoxic drug therapy, including didanosine (see Adverse Reactions). 

Finally, in some patients, seizures tend to be exacerbated by environmental stimuli such as lights and sound. In such patients, conducting the therapy session in a busy, noisy clinic may be sufficient to precipitate a seizure, especially if the epilepsy is poorly controlled by drug therapy. Also, certain patients may have a history of increased seizure activity at certain times of the day, which may be related to when the antiepileptic drug is administered. Consequently, certain patients may benefit if the therapy session is held in a relatively quiet setting at a time when the chance of a seizure is minimal. 

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. 

As mentioned previously, some infectious diseases pharmacists have established effective clinical practices in the outpatient setting. The most common example of this is the presence of a pharmacist in an HIV clinic. The myriad of antimicrobial drug interactions and adverse effects associated with antiretroviral therapy, the need to periodically assess antiretroviral efficacy, and the considerable potential for noncompliance literally necessitate the need for a pharmacist in any established HIV clinic. Infectious diseases pharmacists work with infectious diseases and/or immunology physicians. Pharmacists conduct medication histories and answer drug information questions. In some settings, they may act under protocol to assess patient response to antiretroviral therapy based on virologic and immunologic measures, and to make appropriate modifications in therapy. 

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