Questions And Answers
Drug Therapy Problem (DTP) - ANS A NORMAL part of care (Process) that should be
recognized & resolved.
They always involve the patient.
Some DTPs may not be serious, while others can be more serious leading to DRMs.
Another definition: Any circumstance that a competent professional would judge to be
inconsistent with achieving a therapeutic objective.
Drug Related Morbidity (DRM) - ANS An OUTCOME of a drug therapy problem.
Must be two things to be a DRM: An actual problem that is 1) severe, dangerous, injurious, or
disabling beyond the normal process of care and 2) is not correctable or requires additional
medical care to correct.
Has a scientifically plausible relationship to "drug therapy".
A therapeutic malfunction in which therapy A has produced an adverse or toxic effect and B has
failed to produce the desired effect with the reasonable period of time.
"Drug Therapy" - ANS Includes both therapy actually given and therapy that should have
been given, but wasn't.
What 4 requirements must be met for a DRM to be considered preventable? - ANS 1) The
DRM was preceded by a RECOGNIZABLE DTP.
2) The DRM was FORESEEABLE under the circumstances.
3) The causes of the resulting DRM was IDENTIFIABLE.
4) The identified cause of the DTP (& resulting DRM) was CONTROLLABLE within the context
of therapy.
How many deaths in U.S. Hospitals are due to adverse drug reactions (ADRs)? - ANS
76,000 > 100,000
Making it the 4th leading cause of death in the U.S. each year, with the lower estimate being the
6th leading cause.
What are the 4 objectives of beneficent care? (in order of priority) - ANS 1) Not to inflict
harm
,2) To prevent harm
3) To remove harm
4) To promote good
Preventable adverse drug events reflect how much of U.S. deaths annually? - ANS 1/6th
About what percentage of adverse drug therapy outcomes are preventable? - ANS 50%
Simplified medication use process (5 steps) - ANS Recognize patient problem → Clinical
impression (diagnosis) → Plan (prescribe medicine) → Implement plan (dispense & advise) →
Implement plan (administer/consume)
Latency - ANS Significant error that is not sufficient enough to injure a patient
What are the 7 DTP Categories? - ANS 1) Indication- unnecessary drug therapy
2) Indication- additional therapy needed
3) Effectiveness- ineffective drug therapy
4) Effectiveness- dose too low
5) Safety- adverse drug reaction
6) Safety- dose too high
7) Adherence- pt is not willing or able to take the drug therapy intended
What are the 5 elements of the Interpersonal Communication Model? - ANS 1) SENDER-
transmits message to another person
2) MESSAGE- the element that is transmitted from one person to another (thoughts, ideas,
emotions, info, etc.); can be verbal and nonverbal
3) RECEIVER- receives the message from the sender, then "decodes" the message and
assigns meaning to it
4) FEEDBACK- process whereby receivers communicate back to the senders their
understanding of the senders' message (being sensitive to others can strengthen our ability to
receive and provide useful feedback)
5) BARRIERS- affect the accuracy of the communication exchange (ex. vacuum cleaner,
telephones, hearing deficiency, etc.)
We tend to interpret messages based on our perception of what two things? - ANS 1) What
we believe the message says
2) The individual sending the message
Both treatment failure & adverse effects can lead to what? - ANS Drug-related death
, What is the difference between DTP and DRM? - ANS The distinction between the process
of medical care and the outcome of medical care.
Documentation of care is necessary for what 4 reasons? - ANS 1. Efficiency
2. Coordination
3. Cooperation
4. Quality management
What are the main concepts of a SOAP note? - ANS Keeps practitioner focused on the
patient & facilitates cooperation
What are the 5 steps to the Pharmacists' Patient Care Process? - ANS 1. Collect
2. Assess
3. Plan
4. Implement
5. Follow-up/Monitor & Evaluate
Literature indicates that there are 3 major causes of asthma death. What are they? - ANS
1. Delay in seeking or receiving appropriate care
2. Medication misuse; poor adherence → under-use of corticosteroids and over-use of
beta-agonists; interaction and toxicity
3. Inappropriate care: insufficient corticosteroids
In the UF COP study in Gainesville, what % of patients were picking up their albuterol way too
early? - ANS 40%
In the UF COP study in Gainesville, what % of patients were picking up their corticosteroids
(beclomethasone) way too late? - ANS 60%
Ideal of Pharmaceutical Care - ANS "Responsible, cooperative provision of drug therapy
for the purpose of achieving definite outcomes intended to improve a patient's quality of life."
Effective drug therapy requires what 3 overlapping functions? - ANS 1. Prescribing-
initiation of therapy based on medical problem assessment
2. Supervision- by a prescriber or co-therapist
3. Facilitation- actual administration of therapy by the pt or the patient's caregiver
Therapeutic Outcomes Monitoring Model (8 steps) - ANS Purpose→ for pharmacists'
function as co-therapists
1) Record & Interpret relevant patient info
2) Document therapeutic objectives