미 국 에 서 의 병 원 약 사 의 역 할 서 옥 경, Pharm.D. 서울대학교 약학대학

Pharmaceutical Care u The direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.

Hospital Pharmacy Services u Distribution u Clinical Pharmacy Service

Distribution Service u Daily order processing u Unit dose system u IV admixture service

Clinical Pharmacy Services u General services u Specialized services u Services by specialty area –inpatient –outpatient –home care u Services by medication categories (Drug therapy protocol management)

General Services u medication history u drug therapy monitoring u patient education u drug information u Drug Use Evaluation (DUE) u ADR monitoring u medical/nursing in-services u participation in CPR

Specialized Services u Pharmacokinetic service u Nutritional support service u Drug information service u Poison center u Investigational drug/clinical research

Drug Therapy Protocol Management u Aminoglycosides u Vancomycin u Antibiotics u Heparin u Warfarin u Theophylline u Digoxin u Antiepileptics u Pain management u Insulin u Addiction treatment

Services by Specialty Areas (Inpatient Services) u Critical care u Pediatrics u Geriatrics u Surgery u Oncology u Internal medicine u Cardiology u Endocrinology u Nephrology u Neurology u Infectious diseases u Ob-gyn u Psychiatry u Family practice u Transplantation u Operating room

Services by Specialty Areas (Outpatient Services) u Oncology clinic u Anticoagulation clinic u Diabetes clinic u Hypertension clinic u Lipid clinic u Asthma clinic u Pain service u Neurology clinic u AIDS clinic u General medicine clinic u Refill clinic

Clinical Pharmacy Services

Routine Clinical Practice u Medical rounds/medical records review u Drug therapy monitoring u Protocol based drug consults u CPR participation u TDM service u TPN service u Drug information u Medical/nursing inservice u Documentation in medical record

Drug Therapy Protocol Management u Prescribing/ordering of drugs/TPN u Order necessary labs u Order necessary nursing measures u Document in progress note u Communicate with physician

Drug Therapy Protocol Management

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