How to Utilize Your Pharmacist In the Community Pharmacy Setting

1
How to Utilize Your PharmacistIn the Community
Pharmacy Setting

• Susie H. Park, Pharm.D., BCPP
• Assistant Professor
• USC School of Pharmacy
• susiepar_at_usc.edu

NAMI 2007 Annual Convention June 22, 2007
2
Introduction

• The role of the community pharmacist
• The role of the patient or patients caretaker in
  the community setting
• Record-keeping of medication documentation and
  history

3
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

4
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

5
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

6
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

7
Patient/Patients Caretaker Responsibilities

• Know what the medication is being prescribed for
  
• Be familiar with the name(s) of medications
• Dont 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

8
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

9
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 susiepar_at_usc.edu

10
Conclusions

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