How to Utilize Your Pharmacist In the Community Pharmacy Setting

Susie H. Park, Pharm.D., BCPP Assistant Professor USC School of Pharmacy [email protected]

NAMI

2007 Annual Convention June 22, 2007

Introduction

  The role of the community pharmacist The role of the patient or patient’s caretaker in the community setting  Record-keeping of medication documentation and history

The Role of the Community Pharmacist

 Medication evaluation – Drug interactions – Polypharmacy  Counseling of proper medication use  Communicating with prescribers and other health care professionals  Dispensing the correct medication, dose, quantity, and refills

Polypharmacy

 Is more than one medication prescribed to the same patient for the same thing? – –

Therapeutic

: Zoloft + Risperdal for OCD

Harmful

: Ambien + Klonopin for insomnia  Does the patient receive medications from more than one dispensing pharmacy?

– – Pharmacy A: Lithium 300mg one capsule twice daily #60 capsules dispensed Pharmacy B: Lithium 300mg one capsule three/day #90 capsules dispensed 3 weeks later

Medication Counseling

 Provide medication benefits and directions for use – What time of day to take certain medications  Assess how the medication is working – Have the symptoms been improving  Inform about any side effects – Discuss expectations and management  Inquire about other concomitant medications – Screen for drug interactions

Communicating With Other Healthcare Providers

 Clarify prescriptions with prescribers – Is Seroquel 300mg added to the existing Seroquel 400mg or replacing it?  Discuss potential for drug interactions with different prescribers – – Psychiatrist Dr. Mays prescribed lithium 900mg twice daily for the past 9 years Primary care physician Dr. Howe recently prescribed losartan 50mg daily

Patient/Patient’s Caretaker Responsibilities

     Know what the medication is being prescribed for Be familiar with the name(s) of medications Don’t leave the MD office until you can legibly read the written prescription – Have prescription called in directly Tell the pharmacist if more than one pharmacy fills prescriptions for the patient Tell the pharmacist about any new medications begin taken, including over-the-counter medications

Over-The-Counter Medications

      “OTC” = Non-prescription medications Pain medications can increase lithium levels – – Ibuprofen (Advil ® , Motrin ® , other combinations) Naproxen sodium (Aleve ® ) Bulk laxatives can interfere with medication absorption Heartburn medications can increase drug levels – Cimetidine (Tagamet ® ) Cold medicines can cause drug interactions – – Dextromethorphan (found in cough syrups) Phenylephrine (found in cold tablets and syrups) Herbal products can cause drug interactions

Medication Documentation

 Keep track of current medications – Prescription and OTC  Keep the list updated – Ask your pharmacist to keep the list updated and complete 

See attached form

– For an e-mailed copy of the form, send request to Susie Park: [email protected]

Conclusions

 Find a pharmacy you feel comfortable with  Stay with one filling pharmacy  Communicate with your pharmacist – Ask questions  Keep updated medication information