Ppc hypertension activity-pharmacy activity
Institutional Medication Order
Patient JJ DOB: 2-14-55
MR: 0021668 ALL: NKA
DX: MI, Hypertension
Metoprolol IV in D5W
5 mg IV bolus every 2 minutes for 3 doses. Then, 15 minutes after the last IV dose, begin oral therapy
Electronically ordered and signed: Walter Maxwell, MD
COLLECT: Define the disease state, what else is it called?
How is the disease state diagnosed? What are risk factors?
ASSESS: Do we need to treat it pharmacologically? Can we treat it non pharmacologically in the acute phase? What happens if you do not treat it?
PLAN: Is this order appropriate (look up in Clinical Pharmacology) After the acute phase is over – what non-pharmacological treatments should the patient implement?
IMPLEMENT: What would be some counseling points (something the pharmacist would say to the patient to help them do well with the medicine)?
FOLLOW UP and MONITOR: What would be some monitoring parameters and when do you monitor for each? (what efficacy outcome or ADR should/would the patient, pharmacist or doctor monitor for efficacy and/ or toxicity)
(for the order for patient JJ above):
What is the concentration of Metoprol as supplied? What is the total dose of Metoprolol, what would be the total volume?
What does “bolus” mean? Do you need to compound a dose of Metoprolol?
What is the salt form of the Metoprolol injection? Are all oral formulations the same salt form? What’s the difference in the salt forms?
When you change the patient to oral form, what dose would you start at and what is the dosing frequency? (specify the salt formulation)
Why do you think the dose varies so much between injectable and oral?
Community Based Prescription
Institutional Medication Order
COLLECT: Define the disease state, what else is it called?
What is Stage 1? Any other stages?
How is the disease state diagnosed? What are risk factors?
ASSESS: Do we need to treat it pharmacologically? How does this medication work to help to treat High Blood Pressure? Does treatment differ between Stage 1 / other stage? What happens if you do not treat it?
PLAN: Is this RX appropriate (look up in Clinical Pharmacology)? Translate the SIG. What non-pharmacological treatments should the patient implement?
IMPLEMENT: What would be some counseling points (something the pharmacist would say to the patient to help them do well with the medicine)?
FOLLOW UP and MONITOR: When should the patient be back for a refill? When should they need a new RX if they are adhering to the therapy? What would be some monitoring parameters and when do you monitor for each?
Community Based Prescription
Institutional Medication Order
COLLECT: Define the disease state, what else is it called?
How is the disease state diagnosed? What are risk factors?
ASSESS: Do we need to treat it pharmacologically? How does this medication work to help to treat High Blood Pressure? What happens if you do not treat it?
PLAN: Is this RX appropriate (look up in Clinical Pharmacology)? Translate the SIG. What non-pharmacological treatments should the patient implement?
IMPLEMENT: What would be some counseling points (something the pharmacist would say to the patient to help them do well with the medicine)?
FOLLOW UP and MONITOR: When should the patient be back for a refill? When should they need a new RX if they are adhering to the therapy?
What would be some monitoring parameters and when do you monitor for each?
Institutional Medication Order
Patient CC DOB: 12-14-30
MR: 0021558 ALL: NKA
DX: angina, hypertension
Amlodipine Oral solution 1mg/1mL
5 mg po QD
Electronically ordered and signed: Walter Maxwell, MD
COLLECT: Define the disease state, what else is it called?
How is the disease state diagnosed? What are risk factors?
ASSESS: Do we need to treat it pharmacologically? How does is work to help to treat High Blood Pressure? Can we treat it non pharmacologically in the acute phase? What happens if you do not treat it?
PLAN: Is this order appropriate (look up in Clinical Pharmacology)? How many mL is one dose? After the acute phase is over – what non-pharmacological treatments should the patient implement?
IMPLEMENT: What would be some counseling points (something the pharmacist would say to the patient to help them do well with the medicine)?
FOLLOW UP and MONITOR: What would be some monitoring parameters and when do you monitor for each? (what efficacy outcome or ADR should/would the patient, pharmacist or doctor monitor for efficacy and/ or toxicity)
