Pharmaceutical Care u The direct responsible provision of

Pharmaceutical Care u The direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.

Hospital Pharmacy Services u Distribution u Clinical Pharmacy Service

Distribution Service u Daily u Unit u IV order processing dose system admixture service

Clinical Pharmacy Services u General services u Specialized services u Services by specialty area – inpatient – outpatient – home care u Services by medication categories (Drug therapy protocol management)

General Services u medication history u drug therapy monitoring u patient education u drug information u Drug Use Evaluation (DUE) u ADR monitoring u medical/nursing in-services u participation in CPR

Specialized Services u Pharmacokinetic service u Nutritional support service u Drug information service u Poison center u Investigational drug/clinical research

Drug Therapy Protocol Management u Aminoglycosides u Digoxin u Vancomycin u Antiepileptics u Antibiotics u Pain u Heparin u Warfarin u Theophylline management u Insulin u Addiction treatment

Services by Specialty Areas (Inpatient Services) u Critical care u Pediatrics u Geriatrics u Surgery u Oncology u Internal medicine u Cardiology u Endocrinology u Nephrology u Neurology u Infectious diseases u Ob-gyn u Psychiatry u Family practice u Transplantation u Operating room

Services by Specialty Areas (Outpatient Services) u Oncology clinic u Anticoagulation clinic u Diabetes clinic u Hypertension clinic u Lipid clinic u Asthma clinic u Pain service u Neurology clinic u AIDS clinic u General medicine clinic u Refill clinic

Clinical Pharmacy Services

Routine Clinical Practice u Medical rounds/medical records review u Drug therapy monitoring u Protocol based drug consults u CPR participation u TDM service u TPN service u Drug information u Medical/nursing inservice u Documentation in medical record

Drug Therapy Protocol Management u Prescribing/ordering u Order of drugs/TPN necessary labs u Order necessary nursing measures u Document in progress note u Communicate with physician

Drug Therapy Protocol Management