Identifying Drug-Related Problems in Pharmaceutical Care
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Pharmaceutical Care
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Prepared by
Refaa AlAjmi
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Drug Therapy Problem Category:
Safety
Sub Category:
Dose was too high.
Statement:
The patient has developed drug
toxicity, appearing as bradycardia and second
degree heart block, because the dose of digoxin
is too high.
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L. G. came to her physician for her anemia follow up
appointment to check the results of her labs, but the
Iron and hemoglobin level was still low. Although L. G.
is compliant to her medication, when the pharmacist
asked her: she said I take my iron and calcium pills
after lunch.
Drug Therapy Problem Category:
Effectiveness
Sub Category:
Drug-drug interaction.
Statement:
The patient is taking iron orally at the same
time as oral calcium. She is not exhibiting increased iron
and hemoglobin levels, because the interaction of iron
with calcium is leading to decreased iron effectiveness.
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H.Y is a 49 years old female presented in the family
medicine clinic for follow-up of her osteoporosis,
her BMD T score was found to be -2.8, last
appointment it was Tscore = -2.6 . When asked
about her medications, she states that she takes
Alendronate 70 mg one tablet at morning once a
month.
contains two drug related problems
(i)
Drug Therapy Problem Category:
Effectiveness
Sub Category:
Dosage too low; frequency inappropriate
(i)
Drug Therapy Problem Category: Compliance
Sub Category:
Directions not understood
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H.Y is a 49 years old female presented in the family
medicine clinic for follow-up of her osteoporosis, her
BMD T score was found to be -2.8, last appointment it
was Tscore = -2.6 . When asked about her medications,
she states that she takes Alendronate 70 mg one tablet at
morning once a month.
Statement
H.Y’s BMD has not improved as she is not
taking her medication according to instructions
(noncompliance) which led to inappropriate
frequency of administration and low dose of
medication ; decrease effectiveness
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1)
Pt. F.A is a 60 y.o female, a diabetic and suffering from
osteoporosis and dyslipidemia comes to the outpatient pharmacy
for refill of her chronic medications which include
Alendronate 70 mg one tablet at morning every week
Calcium carbonate 600 mg PO BID
Cholecalciferol 800 units tablet, one tablet PO OD
Metformin 500 mg PO TID
Glibenclamide 10 mg PO BID before meals
Drug Therapy Problem Category:
Indication
Sub Category:
Needs additional therapy, untreated condition
Statement:
FA is a 60 years old with dyslipidemia not currently on
medication to lower cholesterol. She needs additional therapy to address
this untreated indication
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1)
S.N is a 32 years old male with history of asthma, & mild heartburn. He
came to the clinic today for refill and review, his medications include
Ventolin inhaler two puffs PO q4-6hr prn.
Symbicort turbuhaler (80/4.5 mcg) two inhalations twice daily.
The patient takes Zantac 150 mg tablet BID, Gaviscone (Extra Strength) two
tablets PO QID prn & Maalox 1-2 tablets PO after meals and at bed time prn
to relive his heartburn which he feels occasionally.
Drug Therapy Problem Category:
Indication
Sub Category:
Unnecessary Drug therapy, duplicate therapy
(Multiple drug products are being used for a condition that requires
single drug therapy).
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The content discusses various drug-related problems encountered in pharmaceutical care scenarios, highlighting issues such as dose toxicity, drug-drug interactions, dosage effectiveness, and compliance. Real-life cases are presented to illustrate these challenges and emphasize the importance of addressing them for patient safety and optimal treatment outcomes.
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Presentation Transcript
05 Pharmaceutical Care Drug Related Problems Prepared by Refaa AlAjmi Identify the drug related problem in the following case
Drug Therapy Problems WINTER Template The patient developed bradycardia and second degree heart block resulting from a 0.5 mg daily dose of digoxin used for congestive heart failure. Drug Therapy Problem Category: Safety Sub Category: Dose was too high. Statement: The patient has developed drug toxicity, appearing as bradycardia and second degree heart block, because the dose of digoxin is too high.
Drug Therapy Problems L. G. came to her physician for her anemia follow up appointment to check the results of her labs, but the Iron and hemoglobin level was still low. Although L. G. is compliant to her medication, when the pharmacist asked her: she said I take my iron and calcium pills after lunch. Drug Therapy Problem Category: Effectiveness Sub Category: Drug-drug interaction. Statement: The patient is taking iron orally at the same time as oral calcium. She is not exhibiting increased iron and hemoglobin levels, because the interaction of iron with calcium is leading to decreased iron effectiveness.
Drug Therapy Problems H.Y is a 49 years old female presented in the family medicine clinic for follow-up of her osteoporosis, her BMD T score was found to be -2.8, last appointment it was Tscore = -2.6 . When asked about her medications, she states that she takes Alendronate 70 mg one tablet at morning once a month. contains two drug related problems (i) Drug Therapy Problem Category: Effectiveness Sub Category: Dosage too low; frequency inappropriate (i) Drug Therapy Problem Category: Compliance Sub Category: Directions not understood
Drug Therapy Problems H.Y is a 49 years old female presented in the family medicine clinic for follow-up of her osteoporosis, her BMD T score was found to be -2.8, last appointment it was Tscore = -2.6 . When asked about her medications, she states that she takes Alendronate 70 mg one tablet at morning once a month. Statement H.Y s BMD has not improved as she is not taking her medication according to instructions (noncompliance) which led to inappropriate frequency of administration and low dose of medication ; decrease effectiveness
Drug Therapy Problems 1) Pt. F.A is a 60 y.o female, a diabetic and suffering from osteoporosis and dyslipidemia comes to the outpatient pharmacy for refill of her chronic medications which include Alendronate 70 mg one tablet at morning every week Calcium carbonate 600 mg PO BID Cholecalciferol 800 units tablet, one tablet PO OD Metformin 500 mg PO TID Glibenclamide 10 mg PO BID before meals Drug Therapy Problem Category: Indication Sub Category: Needs additional therapy, untreated condition Statement: FA is a 60 years old with dyslipidemia not currently on medication to lower cholesterol. She needs additional therapy to address this untreated indication
Drug Therapy Problems 1) S.N is a 32 years old male with history of asthma, & mild heartburn. He came to the clinic today for refill and review, his medications include Ventolin inhaler two puffs PO q4-6hr prn. Symbicort turbuhaler (80/4.5 mcg) two inhalations twice daily. The patient takes Zantac 150 mg tablet BID, Gaviscone (Extra Strength) two tablets PO QID prn & Maalox 1-2 tablets PO after meals and at bed time prn to relive his heartburn which he feels occasionally. Drug Therapy Problem Category: Indication Sub Category: Unnecessary Drug therapy, duplicate therapy (Multiple drug products are being used for a condition that requires single drug therapy). Statement: The patient is taking multiple drug products to relieve his heartburn, his condition is suitably treated with one of the three medications he is taking.
05 Thank You
