Adv Ther Principles I

Question 1

What are the Components of a “Patient Assessment”?

Answer 1

1) Pt Hx, including:
- Health Hx (med conditiosn)
- Med Hx:
a) Home Meds
b) Hospital Meds
c) Disease specific meds (i.e. abx for pneumonia)

2) Sx Assesmsent (SCHOLARE)
3) Chronic disease assesmsent:
a) initial assesmsent- IESA
b) FU assessment: 2 CAs

4) Complete Med review
5) Other assesmnets: adverse rxns, ddis, allergies

Question 2

What are the components of DATA in a DAP note? (13)

Answer 2

• Pt ID: Name, DOB/age
• CC:
  -HPI:
• PMH
• Med Hx –> iESA
• Drug allergies
• Soc Hx
• Diet
• Fam Hx
• ROS
• PHysical Exam:
• LABS
• other investigations/diagnostic exam

Question 3

What is the CC

Give examples

Answer 3

• CC: the reason the pt is seeking medical care.

e.g.
- HB is a 58 yr old M who presents to the clinic today for refills of his antihypertensive medications.
- TS is a 53 yr old F who presented to the pharmacy today after feeling unwell from suspected uncontrolled diabetes.

Question 4

What is the HPI?

• what is the main component of HPI?
• as well as ______ data from what?

Answer 4

HPI: the HPI is a narrative that describes the story of the current problem:

• main component of HPI: scholare.
• describes specific sx
• how problem began or was first recognized
• the duration of sx
• test results from previous evluations for the same problems
• activites and treatments that ease and worsen the problem
• past experiences iwth the problem
  —> basically, SCHOLARE
• pertinent data from previous hospitalizations and interventison fro the same problem (dates of admision and discahrge, results of tests, dx procedures, meds used to treat the problem, and physl data.

Question 5

• what is the Physical Examination findings?

What are 5 components of the PHysical exam?

Answer 5

Begins with a short description of pt to help readers visualize pt. eg// pt is a cooperative 48 r old african american female in no apparent distress. OR Pt B is an unconscious white female of unknwon age.
–> this is where VITALS GO!!

• PHysical Exam:
  i) General:
  ii) vitals:
  iii) HEENT
  iv) Chest and Lungs
  v) CV
  vi) Abdomen
  vii) extremitieis
  viii) Neuro:
  ix) Genitalia

Question 6

what is the ROS?

Answer 6

it sumarizes all current pt complaints NOT INCLUDED IN THE HPI, following an organ system approach (head heart and lung), and includes pertinent findings.

For example, a
patient may have a chief complaint of cough and fever
but, when asked about other complaints or problems, may
identify chronic constipation. In this example the story of
the cough and fever is described in the HPI and the story of the chronic constipation is described in the ROS.

Question 7

What are the electrolyte labs?

Answer 7

Na, K, Cl

Question 8

What are the renal labs? (3)

Answer 8

BUN,albumin, creatinine (3)

Question 9

what are the CBC labs? 4

Answer 9

Hgb, HCT, WBC, platelets

Question 10

what are the liver labs?

Answer 10

ALT, AST, ALP

Question 11

what are the lipid panel labs?

Answer 11

Total Cholesteral, total triglyceriades, HDL, LDL

Question 12

what are the 2 glu labs?

Answer 12

random glu, A1c

Question 13

What are the 6 “categories” of lab values?

Answer 13

electrolyte, renal, liver, glu, lipids, CBC

Question 14

What are the 2 CAS?

Answer 14

control, complications, adherence, adverse rxns

Question 15

What are the 2 questions in efficacy of iesa?

Answer 15

• is drug OPTIMAL trx CHOICE?
• dose too low?

Question 16

What are the 5 assessments in Safety of IESA?

2 key comorbidities to asses in safety?

Answer 16

• dose too high?
• DDIs?
• ADRS
• allergies
• comorbidities (age, renal)

DDAAC

Question 17

• what are the 4 broad categories of drp?
• what are the 2 indication, efficacy and adherence DRP types?
• the 5 “safety” related drp types?

Answer 17

IESA

Indication:
- unnecessary drug
- additional drug therapy required.
**basically: prescribing or deprescribing.

Efficacy:
- ineffective drug - incorrect drug.
- dose TOO LOW (correct drug, wrong dose).

Adherence:
- non adherence
- over adherence

Safety: DDAAC
- dose too high
- ddi
- adr
- allergies
- comorbidiites (age, kidney fxn)

Question 18

What are the components of a DRP?

Answer 18

A correctly stated drug therapy problem includes:

(a) a description of the patient’s condition or problem,
(b) the drug therapy involved, and
(c) the specific association between the drug therapy and the patient’s condition.

https://accesspharmacy.mhmedical.com/content.aspx?bookid=491&sectionid=39674905#:~:text=A%20correctly%20stated%20drug%20therapy,therapy%20and%20the%20patient’s%20condition.

Question 19

how do you write a drug.

Answer 19

Name strengh roa frquency.

Amlodipine 5 mg PO daily.
Atorvastatin 40 mg PO TID.

Question 20

how would you write out the following OTC and herbals:

they take 1-2 tabs of tylenol regular strength every 6 hours as needed for headache

Answer 20

Acetminophen regular strengh (325 mg), 1-2 tabs q6h prn for headache

Question 21

What are the Components of a CARE PLAN?

Answer 21

1) Med conditions & med-related needs:
- List and prioiritize each medical conditikon first, followed by any DRPs identified for a given condition. Even if a medical condition doesnt have a DRP, a care plan is still necessary for ongoing pt monitoring.

2) Goals of Therapy for each medical condition and/or DRP + timelines.

3) REcommendations/Plan:
- select the best alterantive and provide rationale relative to other alternatives.

Question 22

what is the formula for CrCL?

Answer 22

1.2 *(140-age) * (weight in kg)/ Scr (umol/L)

• Multiply equation by 0.85 for females