A Review of The Therapeutic Monitoring Techniques Used By Pharmacists

The Therapeutic Monitoring Techniques

To keep the concentration of medication in the blood reasonably constant, therapeutic drug monitoring involves measuring certain medicines and/or the byproducts of their breakdown,also known as metabolites, at predetermined intervals. The proportion between the hazardous and therapeutic or effective dose of medicine is known as the “therapeutic index”, and it can be quite narrow for certain pharmaceuticals.

Different systems begin to remove medication from the body as soon as it enters. The half-life of a drug is the length of time that it takes the body to lower the concentration of the medication to half of its starting value. A medication is typically eliminated from the body fully within five half-lives.

In general, a pharmacological dose needs to be administered to a person on a frequent basis in order to maintain the therapeutic or effective concentration of the medication in the body. For certain medications, maintaining this constant state requires more effort than just administering the prescribed amount.

Depending on the patient’s age, general health and genetic makeup, each person will absorb, metabolize, use and remove medicines at differing rates. In addition to the drug that needs to be evaluated, other drugs you are taking may interact and increase or reduce the amount of medicine in the body. This is sometimes referred to as a drug-drug interaction.

This interaction can be complicated and requires specialized medical help from pharmacists, as they are the most skilled individuals in this regard. Pharmacists study all therapeutic and non-therapeutic drugs in detail, so they are able to explain crucial information about various drugs to patients. They also play a key role in drug monitoring.

The role of pharmacists in drug monitoring

Clinical pharmacokinetic monitoring, according to the American Society of Health-System Pharmacists (ASHP), is a core duty of all pharmacists who provide pharmaceutical treatment.

For some individuals who have been carefully chosen based on their unique pharmacotherapy, illness states, associated variables, and treatment objectives, clinical pharmacokinetic monitoring is a crucial part of pharmacological care. According to the ASHP, attaining favorable outcomes for these patients along the whole continuum of treatment and in all practice contexts of health systems depends on clinical pharmacokinetic monitoring.

Examples of the results include lower mortality, reduced treatment duration, reduced hospital stays, decreased morbidity including either a reduction in illness symptoms or improved recovery and a reduction in drug-related side effects.

Responsibilities of pharmacists in drug monitoring

  • Creating patient-specific drug administration regimens based on the goals of therapy with drugs to improve the safety and effectiveness of medication therapy and promote successful treatments for patients.
  • Suggesting or organizing evaluations of drug levels in biofluids or tissues to make it simpler to evaluate dosage regimens.
  • Keeping track of and modifying dose schedules based on pharmacologic responses and other considerations.
  • Examining unexpected patient pharmacokinetic and pharmacologic reactions to medication treatment for potential causes.
  • Delivering oral and written patient-specific medication therapy information to doctors, nurses and other healthcare professionals, as well as to patients and recording this in the patient’s medical file.
  • Teaching medical professionals, such as chemists, medical professionals and nurses, the foundations of pharmacokinetics and the appropriate circumstances for clinical pharmacological monitoring, including the cost-effective use of drug dosage data.
  • Using clinical pharmacokinetic monitoring makes it possible to document improved patient outcomes and financial advantages.

Highlighted above are some of the basic responsibilities of a pharmacist in a healthcare environment. There may be additional duties that a pharmacist may need to perform based on the level of their qualification. To gain access to higher-paying pharmacist opportunities, a pharmacist must possess a Doctor in Pharmacy (D. Pharm) degree, earned through an institution such as the University of Findlay. The University of Findlay’s online Doctor of Pharmacy program allows students to earn an accredited degree over four years through a combination of synchronous and asynchronous online courses, experiential learning and on-campus immersions. Dual degree options are also available, including earning either an MBA or Master of Science in Health Informatics.

Therapeutic monitoring techniques used by pharmacists

Medication chart review

This is among the fundamental roles of a pharmacist. A medication chart review is a technique that involves a detailed and systematic analysis of a patient’s drug therapy to make sure that the medicines prescribed to the patient are correct for them. This technique involves assessment of all the medication orders that the patient has been put on currently or recently, including OTC medicines, herbal medicines and any prescriptions.

The primary goal of a medication chart review is to make sure that all five rights of medication prescription and administration are being fulfilled, which highlights that the right patient must be given the right medication, in the right dosage, through the right route, at the right time.

Daily review

The purpose of this technique is to assess the response of the patient to therapy. This helps healthcare professionals determine whether the therapy provided is working for the patient or not. Additionally, it helps in determining the safety of the drug for the patient depending on whether the patient develops any side effects. At the end of such monitoring, healthcare professionals are able to decide whether they want to move forward with the same therapy or change their initial plan of treatment.

Adverse drug reactions (ADR) identification and management

Improper management of a drug can significantly increase the risk of morbidity and mortality among patients, so a pharmacist must identify and manage any drug-related side effects as soon as possible.

Pharmacists must evaluate patient review charts and medical histories to identify those that are at an increased risk for developing ADRs. Medical state authorities have asked chemists to create a formal process for logging and reporting ADRs. ADRs and medication mistakes must be reported right away to the doctor who prescribed the medicine. The patient’s chart and the pharmacy’s records should both include the episode record.

Final thoughts

Pharmacists employ a variety of therapeutic monitoring techniques throughout the course of their work. Some of these techniques include medication chart reviews, daily reviews and ADR identification and management. With the help of these techniques, pharmacists help to improve the efficacy and safety of medications for all patients.