Pharmacists detection

Tisdale JE. Arrhythmias. In Tisdale JE, Miller DA, eds. Drug-Induced Diseases. Prevention, Detection and Management. Bethesda, MD American Society of Health-Systems Pharmacists 2005 289-327. 

Certain drugs cannot be used in animals produced for human consumption, including chloramphenicol, clenbuterol, diethylstilbestrol (DES), dimetridazole, ipronidazole, furazolidine, and vancomycin. Severe legal penalties could be incurred if the pharmacist were to provide any of these drugs for use in food-producing animals and subsequent residues were detected in animal tissue. 

Pharmacists have an opportunity to extend their activities in patient care as the emphasis continues to shift from inpatient care to ambulatory care. The latter situation generally encourages a team approach to health improvement, prevention, health maintenance, risk assessment, early detection, management, curative therapy, and rehabilitation [12]. Ambulatory care offers a variety of opportunities for individualizing patient care through pharmaceutical compounding. In fact, it is the area where most compounding pharmacists practice. 

In the reported error, a physieian used the abbreviation IL-ll when ordering oprelvekin for a patient. Unfortimately, the order was misinterpreted to be interleukin-2 (i.e., the number eleven was pereeived to be the Roman numeral two). Five or more health eare professionals, ineluding pharmacists and nurses, mistook the order to be aldesleukin. The error was not detected for four days, until it was noted that the inventory of aldesleukin was nearly depleted. 

Part two of the plan calls for establishing an error-reporting system. The report suggests a two-prong approach in which a national program is first implemented at the state level to detect the most serious errors. Then, a voluntary, confidential system is established to encourage individuals to report near misses. Pharmacists can participate in both activities to provide their expertise and help create such systems in their institutions. 

Some individuals go to more than one physician, and it is common for a patient to be treated by one or more specialists in addition to a family physician. Some patients are also seeing other health professionals (e.g., dentists, podiatrists, etc.), who may prescribe medication. It is frequently difficult for one prescriber to become aware of all the medications that have been prescribed by others for a particular patient, and many difficulties arise from such situations. For example, one physician may prescribe an antihistamine having sedative properties for a patient for whom another physician has prescribed an antianxiety agent, with the possible consequence of an excessive depressant effect. Even though the patient is seeing different prescribers, he will often have the prescriptions dispensed at the same pharmacy. Therefore, the pharmacist, by maintaining patient medication records, plays an important role in the detection and prevention of drug-related problems. 

It was commonly thought by those in authority that if mithridatum or theriac did not produce the desired cure, this was due to incorrect preparation (perhaps with adulterated or poor-quality materials) or to incorrect storage after use. As the only cause for therapeutic failure therefore lay with the pharmacist who compounded the mixture, the remedy lay in careful scrutiny of manufacture, which should be in public. Any misdemeanor should then be detected and immediately punished. 

Interviewing patients to detect nonadherence is most effective when indirect probes are used. For instance, the probe Most people have trouble remembering to take their medications. Do you have any trouble remembering to take yours will solicit more reliable information than asking Are you taking your medications as prescribed Table 2 gives examples of specific probes that the pharmacist can use to assess whether a patient has been or is likely to be adherent. 

The physician in charge of the patient considers whether he/she will be a candidate for home care according to the clinical assessment described in the previously defined protocol. In the detection of patient candidates, the pharmacist and the nurse who are working in the home care team can also participate. 

Drug dispensing/distribution is one of the m.ain clinical activities of Spanish hospital pharmacists. Many studies have shown that the unit-dose distribution system has reduced drug errors, and it is one of the main contributions of the hospital pharmacy to patient care. Pharmacist participation in medical rounds and presence at the time of prescription can result in even better patient care and a prompter detection of treatment failures. - " Such clinical pharmacy activity is being conducted with some groups of patients in some Spanish hospitals - and is becoming more frequent. 

Other infectious diseases pharmacists work full time as consultants. Usually, they are employees of larger consulting firms that are hired by hospitals or other health care institutions to detect inefficiencies in process and to improve financial success. 

Much of the knowledge developed about medication errors and ADEs has depended on the ability of individual pharmacists to detect problems and take an active part in resolving them. The increasing use of complex medication regimens has drawn attention to the number of iatrogenic medication errors and ADEs, as well as their associated costs. Pharmacists must work to reduce predisposing factors so that safety can be enhanced and costs reduced. A new practice model as an adjunct to evidence-based medicine practices must be created to prevent medication errors and ADEs, and to let others outside the pharmacy know that we are ready to lend our expertise and energy to this critical endeavor. 

Prospective review takes place before medication use, and thus, its usual focus is on patient assessment and prescribing. This approach to evaluation can detect and resolve potential problems in individual patients before they occur. Pharmacists routinely perform prospective reviews when assessing new medication orders for possible drug interactions, accurate dosing, or duplicate therapy. Data collection occurs at only one point in time and can easily be integrated with daily pharmacist care activities. However, while data collection for a single pa-... 

Art. 1 Enumerates the functions and duties of pharmacists working in pharmacy offices, which include information and follow-up of pharmacological treatment of patients collaboration on the control of individualized use of drugs to detect any possible adverse reactions and inform the relevant pharmacovigilance bodies. ... 

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