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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5497_Библиотеки_им_академика_М_И_Перельмана.pdf
Pharmacy Practice128
b. Secondary sources: Pharmacopoeias and formularies are the
books of standards for drug and related articles with
descriptions, tests, and formula for preparing the same,
selected by some recognized authorities.
c. Tertiary sources: The following fall under the sources of
drug information:
i. The chemist and druggist directory
ii. Indian pharmaceutical guide
• Nowadays computers are used in pharmaceutical
industries, hospitals and in various departments for drug
information, education, evaluation, analysis, medication
history and for maintenance of financial record, etc. Some
important functions are:
a. Maintenance of records
b. Inventory control: Generally there are two systems for
inventory control.
i. Periodic inventory control: In this system stock levels are
checked manually and the amount of inventory in
hand is compared with minimum and maximum stock
maintained in the computers
ii. Perpetual system: In this system computer tells us about
the present position of the drugs, i.e current stock
c. Medication monitoring
d. Drug information services
e. Storage data retrieval
f. Marketing and distribution
g. Pharmaceutical industry
h. Hospital pharmacy and retail pharmacy: Following are
the application in hospital and retail pharmacy
i. Calculation of monthly gross income
ii. Generating salary slip
iii. Updating the employee information
iv. Placement of supply order
Drug Information Service 129
PRAPRA
PRAPRA
PRA
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONS
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1. What do you mean by drug information services?
2. Define PIC.
3. Give two examples of primary sources for drug information.
4. Give some examples of tertiary sources for drug
information.
5. What is the importance of poison information centre.
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1. Define drug information. Write the source of drug
information.
2. Write a note on establishment of drug information center.
3. Write a note on poison information center.
4. Explain in detail about drug information bulletin.
5. Write the sources of drug information services.
6. Write the steps involved in answering a drug query.
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1. Define drug information. Write the steps involved in ans-
wering a drug information query.
2. Write a detailed note on drug information services/centre.
3. Discuss the use of computers in business and healthcare
software.
4. Define DIC. What are the objectives of DIC?. What are the
qualification criteria for a pharmacist to run DIC?
Objective TObjective T
Objective TObjective T
Objective T
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1. Which of the following is not a source of drug information?
A. Primary source
B. Secondary source
C. Zero source
D. Tertiary source
2. PIC stands for:
A. Prescription input center
B. Placental information center
C. Poison information center
D. None of these
Pharmacy Practice130
3. Secondary sources of information include:
A. Commercial periodicals
B. Primary and secondary periodicals
C. Scientific periodicals
D. Formulary and pharmacopoeias
4.
is a computer program that can predict pharma-
cokinetic parameter very easily.
5. National library of medicine created computerized medical
information retrieval system (MEDLAR) in the year:
A. 1960 B. 1966
C. 1965 D. 1963
AnswersAnswers
AnswersAnswers
Answers
1. C 2. C 3. D 4. Nonlin 5. A
“Patient counseling refers to the process of providing
information, advice and assistance to help patients use their
medications appropriately. According to USP, medication
counseling is an approach that focuses on enhancing the
problem solving skills of the patients for the purpose of
improving or maintaining the quality of health and quality of
life”.
Counseling patients regarding their medication are an
important responsibility for pharmacists and an excellent
learning opportunity for students. Pharmacists are often the
only healthcare providers focusing patient education on
medication, how to take it, what to expect, and side effects and
drug interactions. Many pharmacists have been trained to use
a counseling method developed by the Indian Health Service
(IHS). The IHS model has been promoted as an effective
strategy for patient counseling because it utilizes open-ended
questions (3 prime questions) and feedback (final verification)
strategies, which make communication between the pharmacist
and patient more efficient and engaging.
Safe and effective drug therapy depends on patients being
well informed about their medication. Most pharmacists in
community pharmacies and hospitals have not been educated
and trained for counseling and have largely remained as
prescription fillers or dispensers. As a result many patients do
not get enough information about use of their medication,
including how and when to take the medication, how long to
Patient Counseling
13
Pharmacy Practice132
take it, what to do if side effects occur or a dose is missed. Lack
of information may lead to the therapeutic failure, adverse
effects, additional expenditure on investigations and treatment
or even hospitalization.
The information is usually given verbally, but may be
supplemented with written materials. During counseling, the
pharmacist should assess the patients understandings about
his or her illness and treatment, and provide individualized
advice and information which will assist the patient to take
their medication in the most safe and effective manner. To
provide accurate advice and information, the pharmacist
should be familiar with the pathophysiology and therapeutics
of the patients disease.
Patient counseling is a growing need in chronic illness.
Unlike acute illness where the patient get himself treated at an
ambulatory care center or admits himself for a short period
in the hospital, the chronic illness requires hospital stay,
self-monitoring, follow-up, lifelong drug therapy, non-
pharmacological measures and several lifestyle modifications.
It is well known that the most prevalent chronic illnesses are
strongly linked to specific behaviors such as smoking, diet,
sedentary lifestyle, intravenous drug abuse, etc. Prevention and
effective treatment of these illnesses require behavior changes.
Pharmacists familiarize themselves with recent developments
in the scientific study of the behavior change. Moreover, chronic
illness in many cases is lifelong. It damages the patients'
“biography” and self-image and usually has a more severe
impact than acute illness on quality of life. When providing
medication counseling to patients with chronic illnesses,
pharmacists must be sensitive to the broad array of challenges
the patients face. For the patients with chronic diseases, home
is the central site of managing illness and these patients also
require more knowledge on the management of their illness.
Since chronic illnesses move through different phases and these
phases of illness require different kinds of managing strategies.
These patients are primarily concerned with quality of life.
Some of the commonly seen chronic illnesses where pharmacists
can play an active role through counseling.
Patient Counseling 133
STEPS INVSTEPS INV
STEPS INVSTEPS INV
STEPS INV
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TIENT COUNSELINGTIENT COUNSELING
TIENT COUNSELINGTIENT COUNSELING
TIENT COUNSELING
The following are the steps to be followed during patient
counseling:
1. Preparing for the session
2. Opening of the session
3. Counseling content
4. Closing the session
1. Preparing for the session: The pharmacist should tell the
purpose and expected length of the sessions, and obtain the
patient's agreement to participate. Determine the patient's
primary spoken language. Assess the patient's knowledge
about his or her health problems and medications, physical
and mental capability to use the medications appropriately
and attitude toward the health problems and medications.
2. Opening the session: At start of session, focus on infor-
mation gathering from patient:
i. Introduction from pharmacist, make the patient
comfortable
ii. State objective of meeting
iii. Seek information from patient regarding his medication,
understanding of his disease and other supplementary
information such as previous allergies, past medications,
smoking, alcohol history, etc.
iv. It also includes the open-ended questions which help in
patient understanding of disease like:
• What symptoms patient is experiencing?
• What did the doctor tell patient about the disease?
• Q on patient understanding of his/her medication.
• What did the doctor tell patient about this medication?
3. Counseling content: It is the main part of session. In this
session pharmacist speaks about medication and lifestyle
changes like:
i. Name/strength of drug
ii. How long, how to be taken
iii. Expected benefits, timeframe
iv. Possible side effects and interactions
v. What to do if missed dose is missed and special storage
conditions requirements.
Pharmacy Practice134
vi. Pharmacist speaks about medication and lifestyle
changes.
vii. Counseling in simple language and also advising the
family members.
4. Closing the session: This usually done by asking simple
questions. Before ending, important to know patients
understanding of his/her medication. This usually done by
asking simple questions. Example: What is the drug, how
many times in a day drug was taken, which one after meal,
which one empty stomach, etc.?
SPECIAL CASES REQUIRING PHARMASPECIAL CASES REQUIRING PHARMA
SPECIAL CASES REQUIRING PHARMASPECIAL CASES REQUIRING PHARMA
SPECIAL CASES REQUIRING PHARMA
CISTCIST
CISTCIST
CIST
Unlike acute illness where the patient get himself treated at an
ambulatory care center or admits himself for a short period in
the hospital, the chronic illness require hospital stay, self-
monitoring, follow-up, lifelong drug therapy.
The chronic diseases are strongly linked to specific behaviors
such as smoking, diet, sedentary lifestyle, intravenous drug
abuse, etc. Pharmacist helps in prevention and effective
treatment of these diseases.
Hypertension if uncontrolled can lead to a huge adverse
impact on quality of life. The management of hypertension
requires non-pharmacological as well as pharmacological
methods. A pharmacist can counsel the patients regarding
weight loss and regular exercise, sodium and calorie restriction,
restriction of alcohol intake, stopping smoking, self-monitoring
of blood pressure, etc.
Diabetes is a chronic disease with altered carbohydrate, lipid
and protein metabolism which affect the quality of life of
diabetic patients. Various factors like understanding of the
patients about their disease, socioeconomic factors, dietary
regulation, self-monitoring of blood glucose are known to play
a vital role in diabetes management. The pharmacist can
educate the patients about the proper use of medications, drug
interactions. The pharmacist can give an overview of diabetes,
stress and psychosocial adjustment, family involvement and
social support, nutrition, exercise and activity, monitoring and
use of results, relationship between nutrition, exercise,
medication, and blood glucose level.
Patient Counseling 135
Coronary heart disease is also a chronic disease in which
pharmacist can play an active role in the management of this
chronic illness in several ways. Non-pharmacological measures
like education regarding diet, smoking, and exercise and
encouraging the patients to maintain a diary on anginal attacks,
pain symptoms, etc. Pharmacological measures like educating
the patients on the use of nitrates in case of an acute anginal
attack.
Asthma is a chronic condition requiring lifelong drug
therapy. Pharmacist can play an active role in counseling the
patient regarding self-monitoring of drug therapy, other life-
style modifications and usage of specialized dosage forms such
as metered dose inhalers, dry powder inhalers, spacers, etc.
Non-pharmacological measures include safety measures while
traveling, prophylactic use of drugs before exercise, avoidance
of allergens, stopping cigarette smoking, etc.
ISOLISOL
ISOLISOL
ISOL
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A
TED KEY POINTSTED KEY POINTS
TED KEY POINTSTED KEY POINTS
TED KEY POINTS
• “Patient counseling refers to the process of providing
information, advice and assistance to help patients use their
medications appropriately.
• Safe and effective drug therapy depends on patients being
well informed about their medication.
• Patient counseling is a growing need in chronic illness.
• Steps involved in patient counseling are:
i. Preparing for the session
ii. Opening of the session
iii. Counseling content
iv. Closing the session
• Preparing for the session: The pharmacist should tell the
purpose and expected length of the sessions, and obtain the
patient’s agreement to participate.
• Opening the session: At start of session, focus on some
information gathering from patient like:
i. State objective of meeting
ii. Seek information from patient regarding his medication,
understanding of his disease and other supplementary
information such as previous allergies, past medications,
smoking, alcohol history, etc.
Pharmacy Practice136
• Counseling content: It is the main part of session. In this
session pharmacist speaks about medication and lifestyle
changes like:
i. Name/strength of drug
ii. How long, how to be taken?
• Closing the session: Done by asking simple questions.
Example: What is the drug, how many times in a day drug
was taken, which one after meal, which one empty stomach,
etc.?
• Special cases requiring pharmacist: The chronic illness
requires hospital stay, self-monitoring, follow-up, lifelong
drug therapy.
• The chronic diseases are strongly linked to specific behaviors
such as smoking, diet, sedentary lifestyle, intravenous drug
abuse, etc.
PRAPRA
PRAPRA
PRA
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONS
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1. What do you understand by the term patient counseling?
2. Give the objectives of patient counseling.
3. Enumerate the importance of patient counseling.
4. Enlist the barriers in patient counseling.
5. Discuss patient counseling points for TB patients.
6. Enlist the qualities of a patient counselor.
7. What are the benefits of patient counseling?
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1. Write steps involved in patient counseling.
2. What are the communication skills required for a better
patient counseling?
3. Enlist various patient counseling aids.
4. Enumerate the counseling points for asthma.
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1. Define patient counseling. Explain in detail steps involved
in patient counseling.
2. Enlist the various counseling points to be provided for a
diabetes and hypertension patient.
Patient Counseling 137
Objective TObjective T
Objective TObjective T
Objective T
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1. Patient counseling is a growing need in:
A. Acute illness B. Surgery
C. Chronic illness D. None of these
2. Steps involved in patient counseling are:
A. Preparing for session B. Opening of session
C. Counseling content D. All of the above
3. Which is the main part of patient counseling
A. Preparing for the session
B. Opening of session
C. Counseling content
D. Closing the session
4. _________ are strongly linked to behaviours such as
smoking, diet, sedentary lifestyle, IV drug abuse, etc.
5. Non-pharmacological measures in coronary heart disease
include education regarding _____, _______ and _______.
AnswersAnswers
AnswersAnswers
Answers
1. C 2. D 3. C 4. Chronic disease
5. Diet, smoking and exercise