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. v > vy 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. This document is the property of PHINMA EDUCATIONPHINMA EDUCATION Course Code: PHA 070L ~ 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 This document is the property of PHINMA EDUCATIONCourse Code: PHA 070L 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: This document is the property of PHINMA EDUCATION