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Pharmaceutical Care (Process (Types of drug related needs (Effective drug…

- - - - Types
        
        Improper drug selection: inappropriate drug prescribed eg drug that patient is allergic to or contraindicated drugs eg drugs that can cause fetal damage to pregnant women or prescription of more expensive drug when cheaper alternatives are available
        
        Drug interactions (eg genotype affecting carbamazepine efficacy i.e. Steven-Johnson syndrome) and Vit C rich diet affecting colorectal test results
        
        Untreated indication: medical condition to be treated by multiple drugs but not all prescribed eg diabetes & hypertension but only antihypertensives prescribed or drugs ineffective to manage the condition such that outcomes are attained eg reduction of blood pressure not attained by antihypertensives
        
        Subtherapeutical dosage: insufficient drug dose prescribed
        
        Medication use without indication: use of drugs without requirement/need to or excess drugs prescribed to patient (when there is no need to)
        
        Overdosage: too much of the drug prescribed, increasing risk for side effect
        
        Failure to receive a drug: failure for patient to receive a drug (cost too high) or failure to adherence to drug regimen (avoids taking drugs) due to psychological fear or drug can be prescribed but taken wrongly eg GTN taken orally (high hepatic first pass effect) or not to consume recommended dosage (sociological reason eg forgot to take med)
        
        Adverse drug reaction (side-effects)
      - Actual
        
        A drug therapy that has already occurred eg overdose of warfarin results in excessive bleeding. Vit K supplements (involved in production of clotting factors) & blood plasma to be administered immediately (treatment of drug therapy problem) or Steven-Johnson syndrome (a medical problem arising from drug therapy i.e. carbamazepine resulting in adverse drug reaction (susceptible to infections)
      - Potential
        
        Problems that haven't occurred yet but can be prevented through intervention eg hirsuitism arising from ciclosporin treatment for post-surgery/organ transplant and patient advised on regular shaving (intervention) or administering of alternative immunosuppressant (tacrolimus)/increased risk for development of oral thrush (bacterial infection in mouth) if patient does not rinse mouth after use of evohalers/inhalers (anti-histamine particles > 5uM will remain at back of throat & disrupt immunoglobin function of tonsils
  - - - Medical: weight, height, ethnicity, medical history, symptoms of disease, allergies & intolerance, lab results, diagnostic & surgical procedures
      - Behavioural lifestyle: diet, exercise, tobacco use, alcohol consumption, personality type (psychiatric cases for compliance), occupation, sexual history (for STIs), living arrangements, ethnicity, socio-economic background & financial/insurance/healthcare plans
      - Medication therapy: prescribed drugs, non-prescribed drugs (over-the-counter), medications used prior to admission, home remedies (eg TCM), health supplements, compliance with therapy