Pharmacy Practice and Pharmaceutical Care
Core concepts
Pharmaceutical care is patient-centred: identify, resolve, and prevent drug-related problems (DRPs). Know the pharmaceutical care process - assessment, care plan, monitoring, follow-up. Understand medication reconciliation, medication review, adherence assessment, and the pharmacist's role in chronic disease management (hypertension, diabetes, asthma). Familiarise yourself with complementary roles: patient counselling (teach-back), health screening, immunisation, and referral. Recognise high-risk situations: polypharmacy, renal/hepatic impairment, pregnancy, paediatrics, elderly (Beers criteria).
Traps
Distinguish compliance (following instructions) from adherence (agreement and persistence) and concordance (shared decision-making). DRPs include indication, effectiveness, safety, and adherence categories - classify correctly. Do not confuse a side effect with an adverse drug reaction or an interaction. When asked about monitoring parameters, match the drug: warfarin → INR; ACE inhibitor → potassium and creatinine; metformin → renal function; aminoglycosides → levels and renal function.
Worked example
A patient on warfarin started on an antibiotic: the antibiotic may raise INR (interaction) and the patient's diet or illness may alter it. The care plan should include INR monitoring, patient education on bleeding signs, and follow-up - not simply stopping the drug.
Exam strategy
Frame every scenario using the DRP categories and the monitoring parameter specific to the drug.