藥學(xué)專業(yè)英語視聽說教程 課件 上篇Lecture 8 Clinical Pharmacy

Lecture8ClinicalPharmacylabelinginsurancepharmacistrefillregimen“Label”vs.“Labeling”(藥品標簽vs.藥品標識)Label(FDA)Labelisadisplayofwritten,printed,orgraphicmatterupontheimmediatecontainerofanyarticle.Labeling(FDA)Labelingmeansalllabelsandotherwritten,printed,orgraphicmatter(1)uponanyarticleoranyofitscontainersorwrappers,or(2)accompanyingsucharticle.Druglabelonaprescriptionbottlecriticalcareconsultationreferraladherenceparamedicclinicsfacilitiesmedicalhistoriesdruginteractionsregimensresponsediagnosticconsultationsmulti-disciplinarycriticalcareTFFTTFattherighttimeandintherightwayforgetfulnessifthemedicationisdoinganythingfeelingbetterbothersomesideeffectsorinfearofsideeffectshighcostofmedicationsUseamedicationremainderAPPonthephoneStoremedicationproperlysothattheycanbeeasilyfoundadaptingpatients’medicationregimentobestsuittheirlifestylesimplifyingpatients’medicationregimenifitistooburdensomeswitchingtoamoreappropriatedalternative1.Whendodruginteractionsusuallyhappen?cholesterolmedication+grapefruitjuiceacetaminophen+alcoholbloodthinningmedication+aspirinkidneyfailureliverdamageinternalbleedingDruginteractionsoccurwhenacombinationofadrugwithanothersubstancecausesdifferenteffectsthaneitherwouldindividually.2.Whatarethetwomaincategoriesofdruginteractions?Onetypeoccurswhentwosubstances’effectsinfluenceeachotherdirectly,andtheotheroccurswhenonesubstanceaffectshowthebodyprocessesanother.3.Pleaseexplainpossiblemechanismsofthefollowingthreeexamplesofdruginteractions:1)Aspirin+bloodthinnerThetwodrugshavesimilareffectstopreventbloodclotsfromforming2)statins+grapefruitjuiceGrapefruitbindstothesameenzymeasstatins,makinglessofthatenzymeavailabletobreakdownstatins.3)paracetamol+alcoholAlcoholcanalterthefunctionoftheenzymethatbreaksdownacetaminophen.AlcoholandparacetamolarecompetitivesubstratesforCYP2E1,whichreducestheproductionofthereactiveNAPQIspeciesgeneratedinparacetamolmetabolism;asaresult,acutealcoholingestionmayinfactactasaprotectivemechanismagainstparacetamolhepatotoxicity.Ontheotherhand,paracetamolhepatotoxicityisaugmentedwithchronicalcoholconsumptionthroughtheup-regulationandincreasedsynthesisandactivityofCYP2E1aswellasthedecreasedproductionofglutathione.OneisAIprogramsthatcanpredictthesideeffectsofdruginteractionsbeforetheyoccur,andtheotherissupercomputersthatcanbeusedtofindthepotentialinteractionswhilethesedrugsarestillindevelopment.4.Whatarethetwonewlydevelopedtechnologiestotrackdruginteractions?13commonailments:hayfever,oralthrush,dermatitis,pinkeye,menstrualcramps,acidreflux,hemorrhoids,coldsoresandimpetigo,insectbitesandhives,tickbites,sprainsandstrains,andurinarytractinfections1.WhatwasthePharmacistPrescriptionTrialabout?AndwhatwasthebackgroundforthegovernmentofNorthQueenslandinAustraliatostarttheTrial?ThePharmacistPrescriptionTrialwasaboutallowingpharmaciststoprescribedrugsthatnormallyrequireadoctor'sprescription.

ThenumberofGPsinAustraliawasfalling,andregionalandruralareaswereworstaffected.InNorthQueensland,theshortageofGPshadledtolongwaittimesforpatients,promptingthegovernmenttoconsideralternativesolutionstoimproveaccesstohealthcare.Allowingpharmaciststoprescribecertaindrugswasonesuchsolution,aimedatensuringthatpatientscouldaccesstimelyhealthcare.2.Whydiddoctorshaveferociousbacklashagainstthispilotscheme?----Doctorsbelievedthatallowingpharmaciststoprescribedrugs,evenafterundergoingaminimumof120hoursofsupervisedtraining,wasnotasuitablesolutiontotheshortageofGPs.----Theyarguedthatpatientsdeservedtobetreatedbydoctorsandthattheproposalputpatients'healthatriskbyexperimentingwiththeircare.----Additionally,therewasconcernaboutapotentialconflictofinterest,aspharmacistswhoprescribeddrugsmightalsosellthem,whichcouldcompromisetheirobjectivityinprescribingthebestpossibletreatmentforpatients.3.Whatwastheattitudeofpharmaciststowardsthispilotscheme?----Theattitudeofpharmaciststowardsthispilotscheme,asrepresentedbyKateWhalen,isgenerallypositiveandexpectant.ShebelievesthatthepublicwillembracethechangeandthatpharmacistscanprovidetimelyrelieftopatientswhoarestrugglingtoseetheirGPs.----It'salsoworthnotingthattheschemeisnotwithoutitscritics,includingsomeGPsandothermedicalprofessionalswhoareskepticalofpharmacists'abilitytoreplacedoctorswithoutpropertraining.4.Doyouthinkpharmacistsshouldbegivenmorepowerofprescription?Whyorwhynot?Supportingarguments----EnhancedAccessibilityandConvenience:Grantingpharmacistsmoreprescriptionpowercouldsignificantlyimprovepatientaccesstomedications.Thiswouldbeparticularlybeneficialforpatientswithchronicconditionswhorequireongoingmedicationmanagement,asitwouldreducetheneedformultipleappointmentswithaphysician.----AlleviationofPhysicianWorkload:Bydelegatingsomeprescriptiontaskstopharmacists,theworkloadofphysicianscouldbereduced,allowingthemtofocusonmorecomplexcasesandpatientcare.Thiscouldleadtomoreefficientuseofhealthcareresourcesandpotentiallyshorterwaittimesforpatients.----Pharmacists'ExpertiseinMedication:Pharmacistsarehighlytrainedprofessionalswithextensiveknowledgeofmedications,theirinteractions,andpotentialsideeffects.Givingthemmoreprescriptionpowercouldleveragethisexpertisetoimprovepatientoutcomesandreducemedicationerrors.Opposingarguments----PotentialforMisuseandOverprescription:Increasingpharmacists'prescriptionpowerraisesconcernsaboutmisuseandoverprescription.Withoutthecomprehensivemedicaltrainingofaphysician,pharmacistsmaynothavethenecessaryskillstoassessapatient'soverallhealthandmakeinformeddecisionsaboutmedication.----DisruptionofDoctor-PatientRelationship:Thedoctor-patientrelationshipisacrucialaspectofhealthcare,involvingtrust,communication,andpersonalizedcare.Allowingpharmaciststoprescribecouldweakenthisr