Pharmacy Clinic
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Clinical Pharmacy Common Terms
GLOSSARY
Pharmaceutical care: is "the responsible provision of drug therapy for the purpose of achieving
definite outcomes that improve the patient's quality of life. As defined by Hepler and Strand
Adverse drug event: An injury resulting from medical intervention related to a drug. (Source:
Bates DW, Boyle, DL,Vander Vilet M et al. Relationship between medication errors and adverse
drug events. J Gen Intern Med. 1995; 10:199-205.)
Significant adverse drug reaction: Any unexpected, unintended, undesired, or excessive
response to a drug that
1. Requires discontinuing the drug (therapeutic or diagnostic),
2. Requires changing the drug therapy,
3. Requires modifying the dosage (except for minor dosage adjustments),
4. Necessitates admission to a hospital,
5. Prolongs a stay in a health care facility,
6. Necessitates supportive treatment,
7. Significantly complicates the diagnosis,
8. Negatively affects the prognosis, or
9. Results in temporary or permanent harm, disability, or death.
(Source: ASHP guidelines on adverse-drug-reaction monitoring and reporting. Am J Health-Syst
Pharm. 1995; 52:417-9.)
High-alert medications: Medications with a high potential for a serious
adverse drug event, either as a result of a narrow therapeutic range or a high rate of reported
serious errors in the past.
Medication error: Any preventable event that may cause or lead to inappropriate medication use
or patient harm while the medication is in the control of the health care professional, patient, or
consumer. Such events may be related to professional practice, health care products,
procedures, and systems, including prescribing; order communication; product labeling,
packaging, and nomenclature; compounding; dispensing; distribution; administration;
education; monitoring; and use. (Source: National Coordinating Council for Medication Error
Reporting and Prevention; 1995 Sep 21.)
Multiple medications: Five or more medications.
Practice change: A change in the practice model, or, within the practitioner’s model of practice, a
significant change in how tasks are performed, the addition of tasks, or the deletion of tasks.
(Source: Holland RW, Nimmo CM. Transitions, part 1: beyond pharmaceutical care. Am J Health-
Syst Pharm. 1999; 56:1758-64.)
Practice model: The overriding framework within which a health care professional approaches his
or her practice. The choice of model answers the following questions:
1. What are my appropriate job responsibilities?
2. To whom am I ultimately responsible in my work?
3. What social values do I serve in my work?
4. What relationship should I maintain with other health care providers?
5. What relationship should I maintain with patients?
6. What responsibility do I have to my profession?
An individual may change the performance of tasks in a practice model without changing the
model. Examples of pharmacy practice models include the distributive, drug information, clinical
pharmacy, self-care, and pharmaceutical care models. (Source: Holland RW, Nimmo CM.
Transitions, part 1: beyond pharmaceutical care. Am J Health-Syst Pharm. 1999; 56:1758-64.)
Drug use evaluation: check if at minimum drug use patterns are analyzed and results are
reported to hospital committee.
In-service education: pharmacist presents continuing education to fellow employees (M.D., R.N.,
R.Ph., etc.) on a scheduled basis at least 4 times/year.
Drug information: provided only if a formal drug information service with specifically assigned
pharmacist(s) is available for questions. Does not require a physical location called drug
information center.
Poison information: provided only if a pharmacist is available to answer toxicity and overdose
questions on a routine basis with appropriate resources.
Clinical research: performed by pharmacists either as a principal investigator or co investigator,
or pharmacist is likely to be (co)author of a published paper. Do not check if activity is limited to
investigational drug distribution or record keeping.
ADR management: pharmacist evaluates potential adverse drug reaction while the patient is
hospitalized and appropriately follows through with physicians.
Pharmacokinetic consultation: provided only if at a minimum the drug regimen, serum levels,
and patient's medical record are reviewed and verbal or written follow-up is provided when
necessary.
Drug therapy monitoring: provided only if a patient's medical record is reviewed and verbal or
written follow-up is provided when necessary. Monitoring is continuing and repeated, often on
daily basis. Do not check if only drug orders are reviewed. Does not include Pharmacokinetic
consults, TPN team, rounds, ADR management, or drug therapy protocol management.
Drug protocol management: pharmacist, under the order of a prescriber, requests laboratory
tests as necessary and initiates or adjusts drug dosage to obtain the desired therapeutic
outcome (e.g., aminoglycoside or heparin dosing per pharmacy).
TPN team participation: pharmacist at a minimum reviews medical records and/or provides
written or verbal follow-up if required.
Drug counseling: pharmacist provides counseling on drugs either during hospitalizations or at
discharge. Do not check if counseling involves solely review of label directions.
CPR team participation: pharmacist is an active member of the CPR team, attending most
arrests when present in the hospital.
Medical rounds participation: pharmacist rounds with medical team at least 3 days/week actively
providing specific input.
Admission drug histories: pharmacist provides admission histories.
DUR (drug utilization review):
Drug Formulary System: An ongoing process whereby a health care organization, through its
physicians, pharmacists, and other health care professionals, establishes policies on the use of
drug products and therapies, and identifies drug products and therapies that are the most
medically appropriate and cost effective to best serve the health interests of a given patient
population.
Drug Formulary: A continually updated list of medications and related information, representing
the clinical judgement of physicians, pharmacists, and other experts in the diagnosis and/or
treatment of disease and promotion of health.
Pharmacy & Therapeutics (P&T) Committee: An advisory committee that is responsible for
developing, managing, updating, and administering the drug formulary system.
Generic Substitution: The substitution of drug products that contain the same active ingredient
(s) and are chemically identical in strength, concentration, dosage form, and route of
administration to the drug product prescribed.
Therapeutic Alternates: Drug products with different chemical structures but which are of the
same pharmacolog- ical and/or therapeutic class, and usually can be expected to have similar
therapeutic effects and adverse reaction profiles when administered to patients in
therapeutically equivalent doses.
Therapeutic Interchange: Authorized exchange of therapeutic alternates in accordance with
previously established and approved written guidelines or protocols within a formulary system.
Therapeutic Substitution: The act of dispensing a therapeutic alternate for the drug product
prescribed without
prior authorization of the prescriber. This is an illegal act because only the prescriber may
authorize an exchange of therapeutic alternates.
Drug Utilization Review (Drug Use Review, DUR, and Drug Use Evaluation): Process used to
assess the appropriateness of drug therapy by engaging in the evaluation of data on drug use
in a given health care environment against predetermined criteria and standards.
Pharmaceutical care: is "the responsible provision of drug therapy for the purpose of achieving
definite outcomes that improve the patient's quality of life. As defined by Hepler and Strand
Adverse drug event: An injury resulting from medical intervention related to a drug. (Source:
Bates DW, Boyle, DL,Vander Vilet M et al. Relationship between medication errors and adverse
drug events. J Gen Intern Med. 1995; 10:199-205.)
Significant adverse drug reaction: Any unexpected, unintended, undesired, or excessive
response to a drug that
1. Requires discontinuing the drug (therapeutic or diagnostic),
2. Requires changing the drug therapy,
3. Requires modifying the dosage (except for minor dosage adjustments),
4. Necessitates admission to a hospital,
5. Prolongs a stay in a health care facility,
6. Necessitates supportive treatment,
7. Significantly complicates the diagnosis,
8. Negatively affects the prognosis, or
9. Results in temporary or permanent harm, disability, or death.
(Source: ASHP guidelines on adverse-drug-reaction monitoring and reporting. Am J Health-Syst
Pharm. 1995; 52:417-9.)
High-alert medications: Medications with a high potential for a serious
adverse drug event, either as a result of a narrow therapeutic range or a high rate of reported
serious errors in the past.
Medication error: Any preventable event that may cause or lead to inappropriate medication use
or patient harm while the medication is in the control of the health care professional, patient, or
consumer. Such events may be related to professional practice, health care products,
procedures, and systems, including prescribing; order communication; product labeling,
packaging, and nomenclature; compounding; dispensing; distribution; administration;
education; monitoring; and use. (Source: National Coordinating Council for Medication Error
Reporting and Prevention; 1995 Sep 21.)
Multiple medications: Five or more medications.
Practice change: A change in the practice model, or, within the practitioner’s model of practice, a
significant change in how tasks are performed, the addition of tasks, or the deletion of tasks.
(Source: Holland RW, Nimmo CM. Transitions, part 1: beyond pharmaceutical care. Am J Health-
Syst Pharm. 1999; 56:1758-64.)
Practice model: The overriding framework within which a health care professional approaches his
or her practice. The choice of model answers the following questions:
1. What are my appropriate job responsibilities?
2. To whom am I ultimately responsible in my work?
3. What social values do I serve in my work?
4. What relationship should I maintain with other health care providers?
5. What relationship should I maintain with patients?
6. What responsibility do I have to my profession?
An individual may change the performance of tasks in a practice model without changing the
model. Examples of pharmacy practice models include the distributive, drug information, clinical
pharmacy, self-care, and pharmaceutical care models. (Source: Holland RW, Nimmo CM.
Transitions, part 1: beyond pharmaceutical care. Am J Health-Syst Pharm. 1999; 56:1758-64.)
Drug use evaluation: check if at minimum drug use patterns are analyzed and results are
reported to hospital committee.
In-service education: pharmacist presents continuing education to fellow employees (M.D., R.N.,
R.Ph., etc.) on a scheduled basis at least 4 times/year.
Drug information: provided only if a formal drug information service with specifically assigned
pharmacist(s) is available for questions. Does not require a physical location called drug
information center.
Poison information: provided only if a pharmacist is available to answer toxicity and overdose
questions on a routine basis with appropriate resources.
Clinical research: performed by pharmacists either as a principal investigator or co investigator,
or pharmacist is likely to be (co)author of a published paper. Do not check if activity is limited to
investigational drug distribution or record keeping.
ADR management: pharmacist evaluates potential adverse drug reaction while the patient is
hospitalized and appropriately follows through with physicians.
Pharmacokinetic consultation: provided only if at a minimum the drug regimen, serum levels,
and patient's medical record are reviewed and verbal or written follow-up is provided when
necessary.
Drug therapy monitoring: provided only if a patient's medical record is reviewed and verbal or
written follow-up is provided when necessary. Monitoring is continuing and repeated, often on
daily basis. Do not check if only drug orders are reviewed. Does not include Pharmacokinetic
consults, TPN team, rounds, ADR management, or drug therapy protocol management.
Drug protocol management: pharmacist, under the order of a prescriber, requests laboratory
tests as necessary and initiates or adjusts drug dosage to obtain the desired therapeutic
outcome (e.g., aminoglycoside or heparin dosing per pharmacy).
TPN team participation: pharmacist at a minimum reviews medical records and/or provides
written or verbal follow-up if required.
Drug counseling: pharmacist provides counseling on drugs either during hospitalizations or at
discharge. Do not check if counseling involves solely review of label directions.
CPR team participation: pharmacist is an active member of the CPR team, attending most
arrests when present in the hospital.
Medical rounds participation: pharmacist rounds with medical team at least 3 days/week actively
providing specific input.
Admission drug histories: pharmacist provides admission histories.
DUR (drug utilization review):
Drug Formulary System: An ongoing process whereby a health care organization, through its
physicians, pharmacists, and other health care professionals, establishes policies on the use of
drug products and therapies, and identifies drug products and therapies that are the most
medically appropriate and cost effective to best serve the health interests of a given patient
population.
Drug Formulary: A continually updated list of medications and related information, representing
the clinical judgement of physicians, pharmacists, and other experts in the diagnosis and/or
treatment of disease and promotion of health.
Pharmacy & Therapeutics (P&T) Committee: An advisory committee that is responsible for
developing, managing, updating, and administering the drug formulary system.
Generic Substitution: The substitution of drug products that contain the same active ingredient
(s) and are chemically identical in strength, concentration, dosage form, and route of
administration to the drug product prescribed.
Therapeutic Alternates: Drug products with different chemical structures but which are of the
same pharmacolog- ical and/or therapeutic class, and usually can be expected to have similar
therapeutic effects and adverse reaction profiles when administered to patients in
therapeutically equivalent doses.
Therapeutic Interchange: Authorized exchange of therapeutic alternates in accordance with
previously established and approved written guidelines or protocols within a formulary system.
Therapeutic Substitution: The act of dispensing a therapeutic alternate for the drug product
prescribed without
prior authorization of the prescriber. This is an illegal act because only the prescriber may
authorize an exchange of therapeutic alternates.
Drug Utilization Review (Drug Use Review, DUR, and Drug Use Evaluation): Process used to
assess the appropriateness of drug therapy by engaging in the evaluation of data on drug use
in a given health care environment against predetermined criteria and standards.