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CLINICAL PHARMACY AND THERAPEUTICS HERFINDAL PDF

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Clinical pharmacy and therapeutics. Fourth Ed. By Eric T. Herfindal, Dick R. Gourley, and Linda Lloyd Hart. William & Wilkins: Baltimore, MD. xiv + Eric T. Herfindal, Dick R. Gourley, and Linda Lloyd Hart. Williams and Wilkins: Clinical Pharmacy and Therapeutics is a well-established therapeutics textbook. Clinical pharmacy and therapeutics. Fourth Edition. Edited by Eric T. Herfindal, Dick R. Gourley, and Linda Lloyd Hart. Williams and Wilkins: Baltimore.


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Clinical pharmacy and therapeutics by Eric T. Herfindal, , Williams & Wilkins edition, in English. Professor of Clinical Pharmacology at King's College London School of Medicine , The fifth edition of A Textbook of Clinical Pharmacology and Therapeutics is. Available in the National Library of Australia collection. Author: Herfindal, Eric T; Format: Book; xviii, p. illus. 26 cm.

Although the learning process is repetitious and passive, it assures that students will be primed with basic knowledge and under- When asked, this reviewer characterizes himself as a standing in clinical medicine. In this context, collaboration, or attempts a more challenging and dynamic situation, in which students at such, with toxicologists has been inevitable.

Although assemble acquired basic clinical skills with communication personal relations have developed, there remains, on occa- skills to solve the problems confronting the patient and other sion, a scientific tongue-in-cheek antagonism.

The experi- health professionals. Information comes from all health team ence of other pharmacokineticists has been similar. The medical library zyxwvut Having said the above, this reviewer read this book with zyxwv zyxw interest.

First of all, the slimness of the volume should not preclude a judgment as to the relevance, and thus the value, of the contents. Although written by "toxicologists", the volume is a clear indication that in these authors' experience, toxicology cannot be a recitation of what has occurred:that is, "feed them and bleed them and count the dead". One author writes that "toxicologyis a science without a scientificunderpinning". This is not to say it has no value, but that an understanding as to why animal toxicology has occurred is necessary in order to obtain a "window" as to what may be relevant to man.

Guidelines and laws of clinical practice taught in school are stretched to the limit in some cases; the experience is overwhelming but leaves students with a wealth of clinical knowledge that no textbook or professor can instill.

Through the Looking-Glass

Those who continue to experience this learning process are truly clinical pharma- cists, no matter what degrees or titles follow their names. As for Clinical Pharmacy and Therapeutics, the book follows the same approach as previous editions, except on a slightly broader scale.

This edition has fifteen sections, ninety-four contributors, and sixty-six chapters. The tables Although the volume contains much specific information and illustrations presented in each chapter are helpful and that addresses the topic contained in the title, the authors summarize data adequately.

The information is presented in clearly bring to the foreground the fact that, in spite of a long a straightforward manner, with basic concepts of pathophys- history of toxicity studies, much information and understand- iology, pharmacology, and an overview of therapeutics.

If the address matches an existing account you will receive an email with instructions to retrieve your username. Journal of Pharmaceutical Sciences Volume 81, Issue 3.

First published: March Tools Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access.

Please review our Terms and Conditions of Use and check box below to share full-text version of article. In Scotland, of items monitored interventions were highlighted [ 49 ] whilst in South Africa [ 50 ] it was found that prescriptions prescribed for the elderly required most interventions. Worldwide, therefore, the intervention rate is fairly consistent. In general the intervention rate is less than one item for each prescribed and of these less than half have the potential to cause a hospital admission or harm.

This is much lower than the reports that have indicated that adverse effects are responsible for up to Nevertheless they highlight the need for a community pharmacy based pharmaceutical care service which could extend into disease management and thus ensure that prescribing is safe and effective at all times rather than only at the time of dispensing a presciption.

It will also ensure that the chosen drugs are obtained at the best price. Clinical pharmacy outside the retail pharmacy environment In a working party report by the Royal Pharmaceutical Society of Great Britain [ 51 ] focused on the provision of a community pharmacy domiciliary visiting service. The type of advice that can be offered during a domiciliary visit by a Pharmacist has been reported [ 52 ] with 7 out of 31 patients visited advised to see their GP. Following training of 12 volunteer community pharmacists almost one third of the patients visited were experiencing adverse effects because of their medication [ 53 ].

Similar results have been reported in a study of 50 housebound patients [ 54 ]. An independent multidisciplinary panel evaluated the data of these interventions and decided that five could have prevented an admission to hospital whilst for 22 other patients the likelihood of harm or side effects may have been prevented.

They also decided that 31 other interventions may have been beneficial in that they were most likely to improve clinical control. Each visit took an average of 2.

3 pathology and therapeutics for pharmacists a basis

In another study [ 55 ] 39 patients were visited by 16 community pharmacists. The study identified 9 interventions to prevent adverse drug effects.

Other reports have indicated some value of a pharmaceutical domiciliary visiting service [ 56 — 72 ]. The value of a pharmacy domiciliary service, to deliver pharmaceutical care, has also been shown when patients are visited soon after they are discharged from hospital.

Cochrane et al.

Providing a clinical pharmacy domiciliary visit to 53 patients within 7—10 days of discharge revealed that an intervention with the GP was necessary for 31 The medication of one patient was different from that of discharge and their GP had made intentional changes. All these were restored to that of discharge.

These interventions were put to an independent clinical panel who decided that 7 The admitting physician had indicated why they thought the patient had been admitted to hospital in the first instance. Pharmaceutical care can also be provided in the primary healthcare sector during a visit to a residential or nursing home.

Advice on the correct methods of administration for each medicine can also be provided. Recently an audit of patients residing in registered nursing or residential homes [ 78 ] has highlighted the potential cost savings to the drug budget. A preliminary report of a major study soon to be submitted for publication has highlighted the drug review process by a pharmacist visiting residential and nursing homes.

Other studies on providing a similar pharmaceutical visiting service have shown that 12 interventions were made to 80 residents in residential homes [ 77 ] and 44 out of 60 patients in a nursing home [ 78 ]. Thus the provision of a domiciliary pharmaceutical care service to those in residential and nursing homes could have significant benefits in terms of healthcare and prescribing costs.

Conclusion The studies described above have highlighted the potential of pharmaceutical care in the primary care sector. With appropriate funds disease management protocols could be implemented with the emphasis on controlling repeat prescriptions. A stock control policy together with pharmaceutical care services minimises costs in hospitals and thus a similar service, in the primary care sector, should provide benefits to patient outcomes and control drug costs. However for this type of approach to be effective a primary healthcare multidisciplinary team will be necessary.

In the future community pharmacy will take one of two models. In the first model the pharmacist would become more involved with retailing and their healthcare delivery would be related to selling non-prescription only medicines or referral to the GP following the presentation of symptoms by a customer. Their involvement with the dispensing process may be restricted to accurate supply or this may be replaced by other methods.

However the above literature reveals that GPs require more pharmaceutical help than they receive at present. In the second model community pharmacists would become part of an integrated, patient-centred system of healthcare and be proactive in all aspects from decision making on which medicines to prescribe through to administration by the patient. If community pharmacists are to become part of an active system of patient-centred pharmaceutical care then the services described in the above studies need to be developed now.

However community pharmacy may not develop in future to become an integral part of the healthcare system without changes to the remuneration. In addition there is a flat rate dispensing fee of 94p per item. Furthermore if an intervention is made and the result is that the prescribed item is not dispensed then, in the UK, no remuneration is received. The indications in the literature above highlight the need for a pharmaceutical care service to assist the GP. Instead of a remuneration structure based on volume dispensing, the Global Sums i.

A remuneration process by which community pharmacy receives more of a salaried structure could enable the development of pharmaceutical care in the community sector as described in this review.

3 pathology and therapeutics for pharmacists a basis

If new services are identified and there is real evidence for their value, eg pharmaceutical domiciliary visits, then these should be remunerated out of the budget from where the savings can be made. This is how it successfully occurs in hospital pharmacy.

If hospital pharmacy had been remunerated by the same processes as their colleagues in the community then the development of clinical pharmacy, and more recently pharmaceutical care, during the past 25 years may not have occurred. In the new NHS, as proposed by the current Government, the money to develop and implement pharmaceutical care may be available from the budget of the primary care groups.

Some GPs are already contracting community pharmacists to provide prescribing advice to control drug costs. Other pharmacists have extended into more clinical pharmacy orientated services such as warafarin clinics.

It is important to collect extensive outcome data from these to show their real value such that evidence based practice is available. References 1. Drug-related emergency department visits and hospital admissions. J Am Hosp Pharm. Drug-related admissions to medical wards: a population based survey.

Br J Clin Phamacol. Adverse drug reactions. Br Med J.

Introduction

Schneider PJ, Gift M. Cost of medication errors. Int Pharm J. Einarson TR. Drug-related hospital admissions. Ann Pharmacother. A classification of prescription errors. J Roy Coll Gen Pract. Zermansky A. Who controls repeats? Br J Gen Pract.

Harris CM. The scale of repeat prescribing. Am J Pharm Ed. Hepler CD. The third wave in pharmaceutical education and the clinical movement.

Opportunities and responsibilities in Pharmaceutical Care. Am J Hosp Pharm.Choudhari Quintessence of Medical pharmacology Central.

Clinical pharmacy in primary care

The development of a computerised quality assurance system for clinical pharmacy. Gourley, and Linda Lloyd Hart.

Pharmaceutical Care: The future for Community Pharmacy. Tools Export citation Add to favorites Track citation.

Part I. Rupp MT. Outrage, cold and deep, filled than before his eyes a naked about on top, then noticed the shallow drawer slung underneath.

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