Exam (elaborations)
PHM 552 EXAM II
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Exam of 16 pages for the course MN 552 at MN 552 (PHM 552 EXAM II)
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PHM 552 EXAM IImedicationsmanagement
-keystosmedicationsmanagementsinsashospitalsissthes*formularyssystem*s-
sDescribessthesprocesssusedstosassures*safesandseffective*susesofsdrugssinsascostsconscio
ussmanner
drugsformularys-
s•sAs*continuallysupdatedslistsofsmedications*sestablishedsbysthesPharmacysandsTherapeu
ticss(P&T)sCommittee
•sSupportedsbys*currentsevidence-
basedsmedicine*,sjudgmentsofsphysicians,spharmacistssandsothersexpertssinsthesdiagnosi
ssandstreatmentsofsdiseasesandspreservationsofshealth
•sThesprimaryspurposesisstosencouragesthesusesofs*safe,seffective,sandsmostsaffordablesm
edications*
closedsformularys-
s•sListsofsmedicationsswhichslimitssaccesssofsasprescriberstoscertainsmedications
•sLimitedsselections-->s↓scost
•sAscommonspracticesinstheshospitalssetting
opensformularys-
sAslistsofsmedicationssinswhichsprescribersshavesnosrestrictionssonsordering/prescribingsm
edications
•sBroadersselections-->↑scosts
RESTRICTEDsformularysmedications
-usuallystosminimizessideseffectssandscostss-
sCertainsmedicationssonsthesformularysareslimitedsorsrestrictedstosspecificsphysicians,spati
entscaresareas,sorsdiseasesstatessviasformularysrestrictions
•sExample:sCertainsantibioticsscansonlysbesorderedsbysInfectioussDiseases(ID)sphysicians
-Asnon-formularysmedicationswillsgosthroughsans*approvalsprocess*sifsitsis
needed
-ManysCPOEssystemssgivesansalertstosthesprescribersthatsthesmedicationsissnon-formulary
,-
Thesphysicianswills*needstospresentsevidence*sthatsthesmedicationsissappropriatesforsthesp
atient
----Typically,sthespatientshasstriedsothersmedications,sorsthesalternativesissnotsappropriate
(Analogousstosfillingsoutsaspriorsauthorizationsinsthesout-patientssetting)s-
sWHATsHAPPENSsWHENsAsNON-
FORMULARYsMEDICATIONsISsORDEREDsINsAsCLOSEDsFORMULARYsHOSPITAL?
"isstheresastherapeuticsinterchange?"
"arestheresanyscontraindications?
ETC.s-sWhatsquestionsswouldsyousasksthesprescribersifshe/shesorderssasnon-
formularysantibiotic?
PharmacysandsTherapeuticss(P&T)s-s-
Composedsofsrepresentativessfroms*medicalsstaff,sadministration,spharmacy,sandsnursing
*
-Ascommitteeswithsoversightsforsmedicationsmanagementsincludingsthesdrugsformulary
-
*Reviewssthesmedicationslist*sandsguidelinessonsasregularsbasisstosassuresthatsitsisscurrent
sandsmeetssthesneedssofsthesmedicalsstaffsandspatients
P&TsCommittees-s•sEstablishessands*maintainssthesformulary*
•sPreventssandsmonitorss*adversesdrugsreactions*sandsmedication
errors
•s*Educates*shealthsprofessionalsstosthesoptimalsusesofsmedications
•sDevelopssofs*protocolssandsprocedures*sforsmedicationssonsthesformulary
-DURs(drugsutilizationsreview)
-MUEs(medicationsusesevaluation)s-sHowsaresformularysdrugssevaluated?
DrugsUtilizationsReviews(DUR)sakasDUEs(evaluation)s-
sAssystemsofsongoing,ssystematic,scriteria-
basedsevaluationsofsdrugsusesthatswills*helpsensuresthatsmedicinessaresusedsAPPROPRIA
TELY*sgenerallysinstermssofsprescribing
•sIfstherapysissdeemedstosbesinappropriate,sinterventionsswithsproviderssorspatientsswillsbes
necessarystosoptimizesdrugstherapy
•sExamplessincludes*inappropriatesusesorsincorrectsdosessofsasmedication*
, *medicationsusesevaluations(MUE)*
-similarstosDURsbutsbroader
*didsthespatient'ssconditionsimprove*s-
semphasizessimprovingspatients*outcomessandsindividualsqualitysofslife*
•sDependentsonsas*multidisciplinarysapproach*sinvolvingsallsprofessionalssdealingswithsdru
gstherapy
•sExamplessinclude:sinfectionscuresrates,sdecreasedslipidslevels,sUsesofstigecyclinesforsap
propriatesinfections
•sDidsthesphysiciansprescribestigecyclinesappropriately?
s•sDidsthespatient'ssconditionsimprove?
*developsdrugsmonograph*
•sPharmacistsshavesthesopportunitystosassumesasleadershipsrolesinsintroducingsnewsmedic
ationsstosthesformulary
•sPharmacistsswillspresentsthesdrugsmonographstosthesP&TsCommittees-
sHOW sAREsNEW sDRUGSsADDEDsTOsTHEsFORMULARY?
drugsmonographs-
sAswritten,s*unbiasedsevaluationsofsspecificsmedication*swithsthesfollowingscomponents...
-Drugsname
-Pharmacology
-Indicationssforsuse
-Summarysofsclinicalstrials
-Pharmacokinetics/dynamics
-Adverseseffectssandsdrugsinteractions
-Comparativescosts,sefficacy,sandssafetysprofileswithsdrugssinsthessamesclass
•sWhysissthissdrugsbettersthansothersdrugs?sIssthescostsworthsit?s-
sCOMPONENTSsOFsDRUGsMONOGRAPH
A.sHowsdoessthissdrugscomparesins*efficacy*stosothersdrugssinsthessame/similarsclass?
B.sHowsdoessthissdrugscomparesins*cost*stosothersdrugssinsthessame/similarsclass?
C.sHowsdoessthissdrugscomparesins*toxicity*stosothersdrugssinsthessame/similarsclass?s-
sYousaresthesclinicalspharmacistsonsthesP&TsCommittee.sAsclinicalspharmacistsisstryingstos
getsasnewsantibioticsonsthesformulary.sWhatsaressomesquestionssyouswouldsasksthesclinica
lspharmacistswhosisstryingstosgetsthesnewsantibioticsonsthesformulary?
*managedscare*
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