Geoup 2° CF
PHINMA EDUCATION Course Code: PHA 070L
Student's Guide #2
Symptoms of MRP:
Changes in speech
Confusion Oy.
Depression
Delirium Tte)23
Insomnia MONA UVR Mea
Parkinson’s-like symptoms
Incontinence
Weakness or lethargy
Loss of appetite :
Falls
VVVVVYVVYY
Reasons MRPs are not address:
> The patient has been taking this medication for many years without a problem
‘One provider did not prescribe all of the medications the patient is taking.
Patients and prescribers are concemed that the risk of discontinuing the medication is greater than the
benefit,
Patients often resist changes in their drug therapy (a stereotype).
The problems the patient is experiencing are not usually seen with this medication.
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>
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MRPs are primarily caused by the patient's behavior in one way or another, while “medication errors”
(which will be discussed on the next topic) generally are due to faults committed by health professionals,
although there is a gray area and a lack of a full consensus among practitioners and researchers. Pharmacists
are in @ unique position to identify, correct and prevent the occurrence of patients’ drug therapy problems
because of their pharmacotherapeutic training and regular contact with patients. In a patient-oriented role, they
could, therefore, enhance drug therapy outcomes before they lead to morbidity and mortality.
EXPERIMENT 1: TYPE of Medication Related Problem
Direction: Identify the type of medication related problem the scenario presented and the specific name of
‘symptoms of MRPs observed. Answer NIA if the scenario doesn't fall under the categories of MRP and
symptom.
1. An infection was developed on untreated knife out of patient C.K. . His physician prescribed him an antibiotic
Co-Amoxiclav 625mg to be taken 3 times a day for 7 days. The cost of medication per tablet is 45 pesos
however Patient C.K. decided not to take the medication since it caused too much for him and says he will Just
buy the money for his lunch and jayabas leaves to treat his infection.
‘Type of MRP: foi receine medication
Symptom: N/A
2. Prescription of patient X.0. says, take one tablet of 50mog Diphenhydramine at bed time. The Pharmacy
doesn't have the dose but have the 25mog, the Pharmacy assistant choose to give the available dose doubling
the quantity of the said medication. Upon the dispensing of medication, the PA forgot to inform the patient
about the decision she made and caused the patient to take one tablet. The patient struggling in sleeping and
feeling irritated due to his allergy.
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~ Student's Guide #2
Type of MRP: _POFE rotou.
Symptom: _\ASOMANG oe
3. An 18 months old patient was prescribed with Biogesic tablet every four hours as needed for his fever. After
taking the second dose of medication, the patient felt tired, abdominal pain and nausea.
Type of MRP: _Dore too
Symptom: _Wenluneer_or_keAnorys,—
4, The patient is taking tetracycline (an antibiotic) for her infection. Right after taking it, she remembers that she
needs to take her daily mineral supplements (iron,magnecium and calcium). Three days have passed with the
correct dosage regimen and no changes in her nutritional contents intake but she noticed no improvement with
her condition. She wonders and concluded that her medicine tetracyciine is ineffective and her doctor was a
quack doctor for prescribing her a wrong medication.
Type of MRP: _DIMg \Wernetion,
Sirpton: 3h)
5. The patient was prescribed to apply Nizoral® ointment for her fungal infection.Her physician advised her to
apply itn the affected area two times a day (morning and night). After 7 days, her condition become better and
decided to discontinue the medication without informing her physician
Type of MRP: __NO_HAP
‘Symptom: Nik
EXPERIMENT 2: Case Scenario
Direction: Answer the questions after each case scenario.
Case 1:
Patient J.L., a 57 years old woman, is a regular customer at your pharmacy. Patient J.L. visit your
pharmacy to get a first refill of her medication metoprolol (Toprol-XL@) tablets 200 mg as a treatment
for her hypertension. Her medication was prescribed by the new, young doctor at her health care
center. She thinks however that they are hard to swallow but tells you that she used to split them in
half and then chew them carefully. Since years, patient J.L. also takes beclomethasone (Easyhaler®)
200 meg twice daily. As well as salmeterol (Diskus®) 50 meg, of which she wants another refill, a
couple of weeks earlier than expected.
(eos eeaneeateunssntenne ht emmene na ee LEO
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Student's Guide #2
Questions:
1. Are there any MRP present on the scenario presented on the above case? If so, identify the type of
MRP. Justify your answer.
Answer:
es, The MRP present ore Dose tno highGad daug interactions, Mehyoruiol Cfopro\ -L6) Jettets 200
rivets, Ate
sama, wren
FOE) ENT Pa SS ae
sidceingWy raking merwriol (Toprol). these, Adbieds shoutd ork be chened ur cred
nia dal is Aaing ‘alich_iiteraet
Answer,
=fotiend Sa ic
Case 2:
Patient M.H., a 20 years of age female, comes to your pharmacy and presents a prescription of
‘metronidazole tablets 500 mg, to be taken 3x a day for a week to treat a dental infection. M.H. also asks
for a refill of her contraceptive pill and is worried that her antibiotic may decrease the effect of her pill
and asks you if that's true. She happily tells you about the birthday party she will go to Saturday night
together with your daughter and a number of friends in common.
Questions:
1. Are the! eeu present on the scenario presented on the above case? If so, identify the type of
MBP- Justify your answer.
2. What intervention you can make to optimize drug therapy of patient M.H.?
Answer:
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