interventions and interactions

Question 1

what is an intervention

Answer 1

• an act performed to prevent harm to a patient
• Recommendation initiated by a pharmacist
• Response to a drug‐related issue
• Refer to prescriber when necessary

Question 2

when can it occur

Answer 2

• Occurs in any phase of the dispensing process
• Can occur when responding to symptoms over the counter

Question 3

The role of the pharmacists in making simple interventions

Answer 3

• Ensure that our clinical check is robust
• Actively make interventions when an interaction/error is identified
• Ensure that our knowledge is up-to-date so that we are aware of solutions to any interactions/errors we find
• Be resourceful, by knowing where to find key information if we do not know it already

Question 4

types of intervention:

Answer 4

• Dose optimisation and synchronisation
• Allergies
• Formulation changes
• OTC interventions
• Identifying major drug interactions
• Suspected adverse drug reactions
• Public health – lifestyle interventions
• Non - adherence

Question 5

examples of interventions

Answer 5

• Double-checking doses prescribed for patients in ‘high risk’ groups
• Penicillin-allergic patient: query if penicillin-based drugs prescribed
• Some stroke patients: aspirin dispersible aspirin
• A laxative when a patient is taking an opiate medication
• Reviewing this and potentially suggesting an alternative
• Polypharmacy Over prescribing of medicines

Question 6

what interventions do we have to record:

Answer 6

• Prescription interventions
• Signposting interventions
• Public health advice offered
• Self – care advice
• Medication reviews

Question 7

where are these recorded interventions kept

Answer 7

on the PMR or use of an online template

Question 8

The role of pharmacist led interventions include…

Answer 8

• Reduction of the frequency of prescription and mediation monitoring errors
• Improvement of patient adherence and patient care.
• Cost savings to the NHS.
• Demonstrates the importance of community pharmacists
• Reduce drug interactions via prescription screening

Question 9

What is the meaning of drug interactions

Answer 9

When one drug alters the pharmacological effect of another drug. The pharmacological effect of one or both drugs may be increased or decreased, or a new and unanticipated adverse effect may be produced.

Question 10

Drug interactions may result from

Answer 10

pharmacokinetic interactions (absorption, distribution, metabolism, and excretion) or from interactions at drug receptors.

Question 11

interactions don’t just occur between drugs; what else can interfere

Answer 11

certain food, juices, and herbs can interact with medicines too

Question 12

What’s the plan after identifying a drug interaction?

Answer 12

1. Identity the drug interaction
2. Review the interaction, is it a common interaction?
3. If yes: seek alternatives or recommendations for the best course of action
4. If no: contact the prescriber to discuss your findings

Question 13

common drug – food interactions

Answer 13

• Grapefruit/juice and statins
  
  • Calcium channel blockers and Grapefruit
  • Vitamin k rich food and warfarin
  • Beta blockers and high K foods eg bananas, tomatoes, avocado and kale
  • Alcohol and beta blockers

Question 14

Key reference sources used in a pharmacist’s clinical decision-making process / how pharmacists identify the interactions:

Answer 14

https://www.notion.so/dispensing-and-prescriptions-1dd00bb3982d806aa330f48dd45bc7bc?pvs=4#1dd00bb3982d8093ac33ff3f09de7fca