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State and Federal Statutes and Regulations Concerning Patient Counseling
Published in Harvey M. Rappaport, Kelly S. Straker, Tracy S. Hunter, Joseph F. Roy, The Guidebook for Patient Counseling, 2020
Harvey M. Rappaport, Kelly S. Straker, Tracy S. Hunter, Joseph F. Roy
Prospective DUR consists of a point-of-sale/distribution review of drug therapy before each prescription is filled or delivered, the maintenance of patient profiles and patient counseling. The review must include screening to identify potential drug therapy problems due to therapeutic duplication, drug-disease contraindication, adverse drug-drug interaction (including serious interactions with nonprescription or over-the-counter drugs), incorrect drug dosage, incorrect duration of drug treatment, drug-allergy interaction and clinical abuse/misuse.
The Drug Use Process
Published in William N. Kelly, Pharmacy, 2018
Reviewing Patient Therapy: The following are areas for drug therapy problems that the pharmacist must screen: Therapeutic duplicationDrug–disease contraindicationsDrug–drug interactionsIncorrect drug dosageIncorrect duration of treatmentDrug–allergy interactionsClinical abuse/misuse of medication
Ethambutol-induced optic neuropathy in diabetic patients with tuberculosis
Published in Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty, Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
M. Djunaedi, U. Athiyah, Y. Priyandani, S.A.S. Sulaiman
Evaluation of drug-related problems and/or drug therapy problems: The patient has diabetes comorbidity. He is <60 years old, and therefore, he needed controlled hypertension medication according to JNC 7th Guideline, such as blood pressure 140/90 mmHg. The first-line treatment is with thiazide-type diuretic agent or ACEI, ARB, CCB, or combination. (James et al. 2014).Occasionally, outside food was consumed without confirmation with a dietician or health provider. A patient undergoing diabetic therapy should adhere to the nutritional needs that nutritionists have provided in hospitals. Nutritionists have taken into account the proper nutrition for the patient. Therefore, blood sugar levels will be controlled to avoid the risk of hyper- or hypoglycemia while taking antidiabetic drugs (Evert et al. 2013).Awareness about therapeutic duplication or polypharmacy.Drug–drug; drug–disease, drug–food, or drug– herbal should be closely monitored. Rifampicin is a strong inducer of hepatic microsomal enzyme system, which interacts with most drugs. It lowers the serum level of sulfonyl urea and biguanide. Isoniazid–ethambutol interaction does not increase the level of isoniazid, but does magnify the optic neuropathy of ethambutol likely due to the concurrent use of isoniazid (Kansal et al. 2005).Concomitant use of isoniazid–rifampicin was evidence of the incidence of hepatotoxicity. Rifampicin might alter the metabolism of isoniazid to form hydrazine, which is a proven hepatotoxicity agent (Nanta 2014). Again, ethambutol–isoniazid was found to cause visual function impairment (Ayanniyi & Ayanniyi 2011). Peripheral neuropathy and neurological complication are common in tuberculosis patients with DM and HIV (Mafukidze et al. 2016). Ethambutol-related adverse effects may cause permanent vision loss due to involvement of the optic nerve (Lim 2016).Barrier to adherence/compliance is a problem of drug therapy that is suggested to be considered in achieving therapeutic efficacy (Lim 2016).
Medication management for complex patients in primary care: application of a remote, asynchronous clinical pharmacist model
Published in Postgraduate Medicine, 2021
Mark Benson, David Murphy, Lindsey Hall, Philip Vande Kamp, David J Cook
Drug therapy problems involve the use of unnecessary or ineffective medication, the absence of indicated medications, adverse drug reactions (ADRs), and/or medication non-adherence [7]. Polypharmacy (the use of five or more medications) increases the likelihood of poor patient outcomes [1–3,8,9]. An estimated 39% of adults aged 65+ take 5 or more medications [4]. These risks are compounded by healthcare service fragmentation. Emergency department (ED) utilization patterns highlight the impact of drug therapy problems in a disjointed care system, as approximately 1 in 9 ED visits are due to adverse drug reactions and 68% of adverse drug reactions resulting in ED visits are preventable [10].