Medicines information Centre Landspitali University Hospital Elin Ingibjrg

Medicines information Centre Landspitali University Hospital Elin Ingibjörg Jacobsen, pharmacist September 25 th 2017.

A typical day at Landspitali • • 600 inpatients 1. 300 day- and outpatient visits 75 new admissions 5. 300 laboratory tests 550 visits to physio- and occupational therapists 300 emergency unit visits 55 surgical procedures • • 9 babies born 40 visits at pediatric emergency unit 7 cardiac catheterizations 30 patients in dialysis 140 outpatient mental health visits 11 patients in intensive-care units 3. 700 employees at work 2 tons of waste

Medicines information Clinical pharmacy Hospital Pharmacy Dispensing to wards 05. 09. 2014 Dispensing to outpatients Aseptic

Medicines information centre • The service was formally introduced in february 2010 but had been in development since 2007. • Grants from the Ministry of Welfare, Landspitali quality fund and the Icelandic Pharmaceutical Associatiion • UKMi medicines information www. ukmi. nhs. uk • Enquiry answering guidelines used to produce SOPs for Landspitali • Mi. Databank www. midatabank. com • Training using the UKMi training Medicines learning portal and Mi. CAL (computer assisted learning) • Formal training of clinical pharmacists 2. 10. 2020 4

Medicines information service • Background information • Search strategies • Answering guidelines • Essential resource list • Mi. Databank • Training program

05. 09. 2014 6

05. 09. 2014 7

Clinical unit • 12 clinical pharmacists • Rotating into medicines information • Medicines information is also part of the clinical work, supporting pharmacists on wards • Poison centre • Pharmacovigilance - IMA • Drugs and therapeutics committee 05. 09. 2014

Column in the Icelandi Medical Journal 05. 09. 2014

Questions • A patient with a high-risk pregnancy experiencing allergic reactions to enoxaparin, what are the options? • Sulfa-allergy; is it safe to give furosemid? • Is olanzapin safe in pregnancy? • A patient with severe neutropenia due to clozapin, what are the options? • Evaluate the causality that kidney damage leading to death was due to atorvastatin interaction with amiodarone. • Clopidogrel allergy, what are the options? 05. 09. 2014

Recently • A young woman born 1982 is very ill in the intensive ward. • She has Garnder’s disease and has received treatment with sutinib. • She has now been diagnosed with sepsis and has multiple lesions on her skin. • Can any of her symptoms be adverse effects of sutinib and not sepsis. 05. 09. 2014

Evaluation of interactions 05. 09. 2014

Requests from nurses • Dilution and administration of i. v. medication • Administration of multiple i. v. medications centrally and periferally • Review of a patient´s medications for enteral feeding tubes • Crushing of tablets 05. 09. 2014

Problems • Time and resources to have a pharmacist totally dedicated in the work – recently resolved • Documentation is suffering due to lack of pharmacists and a growing demand of pharmacists‘ services on the wards. • Pharmacists are documenting everyting into the patient‘s chart so documentation in Mi. Databank i suffering. • Quality assurance, both internal and external 05. 09. 2014

Landspítali Hringbraut

Iceland today 05. 09. 2014

2. 10. 2020 17

Thank you! 05. 09. 2014