1. Medicines information Centre
Landspitali University Hospital
Elin Ingibjörg Jacobsen, pharmacist
September 25th 2017.

2. A typical day at Landspitali
600 inpatients
1.300 day- and outpatient visits
75 new admissions
5.300 laboratory tests
550 visits to physio- and occupational therapists
300 emergency unit visits
55 surgical procedures
9 babies born
40 visits at pediatric emergency unit
7 cardiac catheterizations
30 patients in dialysis
140 outpatient mental health visits
11 patients in intensive-care units
employees at work
2 tons of waste

3. Medicines information
Dispensing to outpatients
Aseptic
Dispensing to wards
Clinical pharmacy
Hospital Pharmacy

4. Medicines information centre
The service was formally introduced in february 2010 but had been in development since 2007.
Grants from the Ministry of Welfare, Landspitali quality fund and the Icelandic Pharmaceutical Associatiion
UKMi medicines information
Enquiry answering guidelines used to produce SOPs for Landspitali
MiDatabank
Training using the UKMi training Medicines learning portal and MiCAL (computer assisted learning)
Formal training of clinical pharmacists

5. Medicines information service
Background information
Search strategies
Answering guidelines
Essential resource list
MiDatabank
Training program

8. Clinical unit 12 clinical pharmacists
Rotating into medicines information
Medicines information is also part of the clinical work, supporting pharmacists on wards
Poison centre
Pharmacovigilance - IMA
Drugs and therapeutics committee

9. Column in the Icelandi Medical Journal

10. Questions
A patient with a high-risk pregnancy experiencing allergic reactions to enoxaparin, what are the options?
Sulfa-allergy; is it safe to give furosemid?
Is olanzapin safe in pregnancy?
A patient with severe neutropenia due to clozapin, what are the options?
Evaluate the causality that kidney damage leading to death was due to atorvastatin interaction with amiodarone.
Clopidogrel allergy, what are the options?

11. Recently A young woman born 1982 is very ill in the intensive ward.
She has Garnder’s disease and has received treatment with sutinib.
She has now been diagnosed with sepsis and has multiple lesions on her skin.
Can any of her symptoms be adverse effects of sutinib and not sepsis.

12. Evaluation of interactions

13. Dilution and administration of i.v. medication
Requests from nurses
Dilution and administration of i.v. medication
Administration of multiple i.v. medications centrally and periferally
Review of a patient´s medications for enteral feeding tubes
Crushing of tablets

14. Quality assurance, both internal and external
Problems
Time and resources to have a pharmacist totally dedicated in the work – recently resolved
Documentation is suffering due to lack of pharmacists and a growing demand of pharmacists‘ services on the wards.
Pharmacists are documenting everyting into the patient‘s chart so documentation in MiDatabank i suffering.
Quality assurance, both internal and external

15. Landspítali Hringbraut

16. Iceland today

18. Thank you!