Artificial Intelligence
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Resources: Identifying Drug Related Problems - https://youtu.be/kwKBGig88_0 Therapeutic Monitoring – https://www.youtube.com/watch?v=csKhLXaD_JM Pharmaceutical Care – Introduction to Care Planning https://www.youtube.com/watch?v=etpng9Bjb-Q&t=68s


### 1. Identifying Drug Related Problems using PCNE Classification Using the PCNE (Pharmaceutical Care Network Europe) Classification, here are nine potential drug-related problems (DRPs) and their associated causes: 1. **Unnecessary Drug Therapy** - Cause: Overlapping therapy for similar indications (e.g., multiple antihypertensives). 2. **Needs Additional Drug Therapy** - Cause: Patient not on statin therapy despite having hyperlipidemia. 3. **Improper Drug Selection** - Cause: Allergy to a prescribed medication not acknowledged. 4. **Subtherapeutic Dosage** - Cause: Dosage not adjusted for renal impairment. 5. **Adverse Drug Reactions (ADRs)** - Cause: A known drug interaction not considered (e.g., warfarin and NSAIDs). 6. **Non-Adherence to Medication** - Cause: Complex dosing schedule or side effects discouraging adherence. 7. **Drug Interactions** - Cause: Polypharmacy in elderly patients. 8. **Therapeutic Duplication** - Cause: Prescribing multiple medications from the same class. 9. **Inadequate Monitoring of Drug Therapy** - Cause: Lack of follow-up appointments or lab tests to monitor therapeutic levels. ### 2. Suggested Appropriate Interventions Here are suggested interventions for each clinical problem, arranged by priority: 1. **Adverse Drug Reactions (ADRs)** - Intervention: Review patient medication records and conduct a thorough drug interaction check. Educate the patient on recognized side effects and possible alternatives. 2. **Non-Adherence to Medication** - Intervention: Simplify the medication regimen. Provide adherence aids (e.g., pill organizers) and educate the patient on the importance of medication adherence. 3. **Needs Additional Drug Therapy** - Intervention: Initiate statin therapy as per guidelines for the management of hyperlipidemia. Discuss the rationale with the patient. 4. **Unnecessary Drug Therapy** - Intervention: Assess and discontinue overlapping therapies where appropriate, or consider alternative treatment options. 5. **Improper Drug Selection** - Intervention: Document allergies and recommend alternative safe therapies. 6. **Subtherapeutic Dosage** - Intervention: Adjust dosages based on renal function tests and pharmacokinetic principles. 7. **Drug Interactions** - Intervention: Communicate with the healthcare team to adjust medications accordingly, and provide education about potential risks. 8. **Therapeutic Duplication** - Intervention: Review all medications and discontinue duplicate therapies. Counseling about necessity can be beneficial. 9. **Inadequate Monitoring of Drug Therapy** - Intervention: Schedule follow-ups for monitoring required lab tests and clinical endpoints based on the drugs' pharmacodynamics. ### 3. ADRs that can be life-threatening Testimonies from patients have noted that certain ADRs can lead to significant adverse effects, including: - **Anaphylaxis**: Allergic reactions to antibiotics or vaccines. - **Hemorrhage**: From anticoagulants such as warfarin when not properly monitored. - **Acute Kidney Injury**: Due to nephrotoxic agents (e.g., NSAIDs like ibuprofen). - **Respiratory Depression**: From opioids or benzodiazepines, especially when combined. ### 4. Pharmacotherapeutic Goal A **Pharmacotherapeutic Goal** is a specific, measurable outcome that healthcare providers aim to achieve through the administration of a particular pharmacotherapy. These goals take into account the patient's medical condition, the efficacy and safety of the treatment, and the patient's individual needs and preferences. A clear pharmacotherapeutic goal helps guide medication management and the evaluation of treatment efficacy. ### 5. If the Desired Endpoint of Therapeutic Monitoring is Unachievable If the desired endpoint of therapeutic monitoring is unachievable, a Clinical Pharmacist should: - Re-evaluate the patient's medication regimen and consider alternatives or adjustments. - Collaborate with the healthcare team to discuss additional interventions or referrals (e.g., to specialists). - Assess for any patient-specific factors that may influence the outcome (e.g., adherence, lifestyle factors). - Educate the patient about potential reasons for the unachieved endpoint and explore ways to improve outcomes. ### 6. Possible Factors Hindering Desired Endpoint for Monitoring As an intern, you may encounter several factors that can hinder the achievement of desired endpoints for monitoring, including: 1. **Lack of Patient Adherence**: Patients may not consistently take prescribed medications. 2. **Limited Access to Healthcare Resources**: Patients may face barriers such as cost, transportation, or availability of follow-up appointments. 3. **Incomplete Patient Information**: Lack of full medical histories or medication lists can lead to inadequate assessments. 4. **Complexity of Regimens**: Patients on multiple medications may experience confusion or difficulties. 5. **Underreporting of Symptoms**: Patients may not communicate all side effects or problems adequately. 6. **Variability in Patient Responses**: Different patients may respond differently to medications due to genetic, lifestyle, or co-morbid conditions. 7. **Time Constraints**: Busy workloads may reduce the time available for thorough monitoring and patient counseling. 8. **Drug Supply Issues**: Interruptions in the availability of medications can affect therapeutic continuity. These factors can significantly influence the success of therapeutic interventions and monitoring efforts in clinical practice.