1. Pharmaceutical Care Assessment

2. Background Collection of S & O Information
• Data: – CC, HPI, PMH, PSHx, Demographics – Medication history including compliance etc. – VS, ROS, Lab, other diagnostics • Sources: – Patient, family – Other healthcare providers – Medical records / computer

3. Key questions
• Is each medication: – Indicated? – Effective? – Safe? – One the patient will be compliant with?

4. Start with: The problem (diagnosis) list
• Includes diagnosis and other problems – First is the most important diagnosis to explain the chief complaint • Usually determined by the physician, and may change as more information becomes available – Include current medical problems • From patient or those identified by physician – Add other problems you identify • Compliance, Allergies, Contraindications etc

5. Indicated?
Match each medication with the (problem / diagnosis / indication) for which it is prescribed
Look for miss-matches & gaps

6. Ceftazidime Salbutamol Paracetamol Problem List
- Urinary Tract Infection
- Pain
- Asthma
Medication List
Ceftazidime
Salbutamol
Paracetamol

7. Problem List Medication List
Urinary Tract Infection Ceftazidime
Pain Salbutamol
Asthma Paracetamol

8. Effective?
• What parameters (subjective & objective) measure? – Lab values (WBC, A1C) – Clinical data (BP, HR , Signs and Symptoms) • What are the patient-specific goals – Absolute value (<10 WBC, A1C < 7; BP < 130/80…) – Time frame

9. Problem List
- Urinary Tract Infection
- Hypertension
S & O parameters
ROS: Urinary symptoms
– Dysuria, frequency
Lab :
– Urine analysis:
• WBC, Nitrites, LE
• Bacteria
-Vital Signs :
- BP

10. 1- drug : Is organism likely or known to be susceptible
Medication List
Ceftazidime
Atenolol
Efficacy :
1- drug : Is organism likely or known to be susceptible
2- Dose : Adequate dose?
3- Route (IV vs PO)
4- Frequency

11. Safety Drug Product: Allergy or Adverse Reaction
Dosage Regimen : Toxicity

12. Medication List
Ceftazidime
Atenolol
Safety:
1- drug : Allergy / hypersensitivity , interactions
2- Dose : Corrected dose?
3- Route (IV vs PO)
4- Frequency - Adjusted for renal dysfunction

13. Compliance Medication List Ceftazidime Atenolol Compliance
Able to Tolerate? , Remember? , IV access? , Be floor to get it? , Afford?

14. Putting it together MAR - Compliance Safety Efficacy Regimen Drug
Indication
MAR
Rash, allergy
Seizure
Diarrhea
Signs &
Symptoms
T max, WBC
Culture Result -
Ceftazidime
Urinary Tract Infection
Pill counts
etc
Hypotension ,Bradycardia …etc
Blood Pressure
Atenolol
Hypertension

15. 50 years old female Patient with Hypertension , Diabetes , GERD , Asthma
He Receive the following medications:
Atenolol , Salbutamol , Aspirin , Warfarin

16. Safety
Efficacy
Drug
Indication

17. Thank You