Pharmaceuticals

Core Generalist#

Knowledge#

CG.K.1#

Describe pharmacology basic science, including:

  • mechanism of drugs at the receptor and intracellular level
  • principles of absorption, distribution, metabolism and excretion of drugs
  • effect of ageing, pregnancy and lactation on pharmacokinetics
  • importance of genetic alterations in drug metabolism
  • effect of climate and storage conditions
  • pharmacological basis of drug interactions, and
  • impact of organ dysfunction on pharmacokinetics and dose modification

CG.K.2#

Explain the principles of prescribing pharmaceuticals:

  • patient factors impacting on prescribing – allergy, age, pregnancy, over the counter (OTC) medications and nutraceuticals (eg fish oil, turmeric, glucosamine, vitamins etc)
  • appropriate dose adjustments in disease, ageing, pregnancy and other medications
  • categories of drug safety in pregnancy and impact on prescribing
  • principles of dose titration, and
  • legislation regarding prescribing and controlled and restricted drugs

CG.K.3#

Identify adverse reactions and interactions:

  • common and life-threatening drug interactions and common presentations of drug-induced disease, adverse drug reactions, and
  • common interactions between prescription and non-prescription and complementary therapies

CG.K.4#

Discuss the quality use of medicines:

  • factors affecting adherence
  • factors increasing risk of medication error
  • techniques for enhancing medication safety
  • factors predisposing to polypharmacy (therapeutic cascade) and reasons for over prescribing, and
  • delivery techniques for specific medicines
  • delivery devices e.g. pumps, syringe drivers
  • remember the recommendation to prescribe generically where possible
  • consider working with pharmacist eg Webster packing, medication reviews, and medication use or prescribing clinical audits re quality outcomes

CG.K.5#

Discuss the range of treatment modalities patients may seek including complementary therapies

Skills#

CG.S.1#

Prescribe appropriately with reference to specific patient factors including organ dysfunction, allergies adverse effects and slow acetylators

CG.S.2#

Consider the cost, storage, safety issues, access to refrigeration and the socioeconomic status of the patient

CG.S.3#

Calculate loading doses and maintenance doses

CG.S.4#

Take a complete drug history including history of use of non-western medical options, complementary therapies and over the counter medicines

CG.S.5#

Consult pharmacist/MIMS/similar databases to obtain medication information

CG.S.6#

Use locally appropriate guidelines for prescribing

CG.S.7#

Write clear and unambiguous prescriptions: private, Pharmaceutical Benefits Scheme (PBS), Department of Veterans Affairs (DVA), Authority S8, hospital

CG.S.8#

Identify presence of, or potential for, adverse drug reaction and drug interactions and treat appropriately

CG.S.9#

Monitor for development of common adverse drug reactions, including selection of appropriate laboratory investigations (e.g. monitoring of renal or hepatic function)

CG.S.10#

Monitor drug levels and effects, when appropriate and respond accordingly to results

CG.S.11#

Conduct regular medication review with appropriate adjustment of treatment and avoidance of polypharmacy

CG.S.12#

Cease medications where proven ineffective or no longer indicated

CG.S.13#

Identify medication errors and take appropriate action

CG.S.14#

Engage patient in decision making, explaining drug therapy and monitoring and following up verbal with written information where appropriate

CG.S.15#

Teach device use technique and assess patient’s use of delivery devices

CG.S.16#

Use a range of strategies to enhance patient adherence

Attributes#

At.2#

Adaptability

At.17#

Resourcefulness

At.1#

Accountability

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