Indication
Drug therapy is unnecessary because patient does not have a clinical indication at this time
Indication
Additional drug therapy is required to treat or prevent a medical condition in the patient
Effectiveness
Drug product is not being effective at producing the desired response in the patient
Effectiveness
Dosage is too low to produce the desired response in the patient
Safety
Drug is causing an adverse drug reaction in the patient
Safety
Dosage is too high, resulting in undesirable effects experienced by the patient
Adherence
Patient is not able or willing to take the drug therapy as needed
Unnecessary drug therapy
(INDICATION)
- duplicate therapy: multiple drug products are being used for a condition that requires only a single drug therapy
- No medical indication at this time: there is no valid medical indication requiring drug therapy at this time
- Nondrug therapy more appropriate: the medical indication is more appropriately treated with nondrug therapy
- Addiction/recreational drug use: drug abuse, alcohol use, or smoking causing the problem
- Treating avoidable adverse reaction: drug therapy is being taken to treat an avoidable ADR associated with another medication
Needs additional therapy
(INDICATION)
- Preventative therapy: preventative drug therapy is required to reduce the risk of developing a new condition
- Untreated condition: a medical condition requires the initiation of drug therapy (i.e prescribing daily Ca2+ and Vit D supplements to slow bone loss in women)
- Synergistic therapy: a medical condition requires additional pharmacotherapy to attain synergistic or additive effects
Ineffective drug
(EFFECTIVENESS)
- More effective drug available: the drug is not the most effective for the medical condition and a different drug is needed
- Condition refractory to drug: the medical condition is refractory to the drug product and a different drug is needed
- Dosage form inappropriate: the dosage form of the drug product is inappropriate
- Contraindication present: the drug product is contraindicated in this patient
- Drug not indicated for condition: the drug product is not an effective product for the indication being treated
Dosage too low
(EFFECTIVENESS)
- ineffective dose: the dose is too low to produce the desired response
- frequency inappropriate: the dosage interval form of the drug is inappropriate
- Incorrect administration: the drug product was not administered b y the appropriate route or method
- Drug interaction: a drug interaction reduces the amount of active drug available resulting in a lack of effectiveness in this patient
- Incorrect storage: the drug product was stored incorrectly and lost potency
- Duration inappropriate: the duration of the drug therapy is too short to produce the desired response
- Needs additional monitoring: clinical or laboratory parameters are required to determine if the dosage is too low in the patient
Adverse drug reaction
(SAFETY)
- Undesirable effect: the drug product causes undesirable reaction that is not dose-related
- Unsafe drug for the patient: a safer drug product is required due to patient risk factors
- Drug interaction: a drug interaction cause an undesirable reaction that is not dose- related
- Incorrect administration: the drug product was administered by the incorrect route or method resulting in ADR
- Allergic reaction: the drug product caused an allergic reaction
- Dosage increase/decrease too fast: the drug dosage was administered or escalated too rapidly resulting in an ADR
Dosage too high
(SAFETY)
- Dosed of the drug is too high for the patient, resulting in toxicity
- Dosing frequency is too short for this patient
- Duration of the drug therapy is too long for the patient
- Drug interaction increases increases the amount of active drug available resulting in toxicity in this patient
- Needs additional monitoring: clinical or laboratory parameters are required to determine if the dosage is too high for the patient
Adherence
(ADHERENCE)
- Does not understand instructions: the patient does not understand how to properly take or use the drug product and dosage regimen leading to the underuse of the medication
- Patient prefers not to take: the patient prefers not to take the drug therapy as instructed
- Patient forgets to take: the patient does not remember to take sufficient doses of the medication and/or forgets to pick up refills
- Patient is worried about side effects
- Drug product is not available: sufficient supply of the drug product is not available to the patient
- Cannot swallow/ administer drug: the patient is not able to swallow or administer the drug therapy as intended
- Substituting self-medication for prescribed medication or altering the use of prescribed medication in other ways due to complementary use of self medication
- Cannot afford drug product: the patient cannot afford the drug therapy recommended or prescribed
asthma
a difficulty in exhalation, leaving residual “spent” air in the lungs. Its root cause is “reactive airways,” where bronchoconstriction, bronchial inflammation, swelling, and mucus production, combine to reduce bronchiolar diameter making it difficult to breathe
MDI
Metered-dose inhalers
Norfloxacin
antibiotic that is especially useful for urinary tract infections (UTI) because it is excreted unchanged (i.e., concentrated) in the urine. Unfortunately, norfloxacin is chemically bound by aluminum, calcium and magnesium salts, so it cannot be absorbed well (and thus will not work as well) if given with common antacids that contain these salts. Typically, symptoms of urinary tract infection resolve in a few days with norfloxacin or other antibiotics, if the causative organism is sensitive to the antibiotic
Lovastatin
a cholesterol-lowering drug and belongs to the class of statins. Statins are the most potent drugs to treat hyperlipidemia and are usually well tolerated. Alcohol should be avoided when using this medication because it raises the risk of liver disease. As with all statin drugs, Lovastatin can lead to myopathy (muscle soreness) (one case per 4933 patent sat 20-40mg/day and 4 of 1649 patients at 80mg/day) and rhabdomyolysis, a condition in which damaged skeletal muscle tissue breaks down rapidly that leads to the release of muscle fiber contents into the blood, which can be harmful to the kidney. In this case, statin therapy needs to be discontinued immediately
NSAIDS
Non-steroidal anti-inflammatory drug e.g., ibuprofen, may cause gastrointestinal bleeding which may be severe or even fatal if undetected
Epipens
for people who have a history of life-threatening allergic reactions (anaphylaxis) to things like bee stings, peanuts or seafood, or are at increased risk for a severe allergic reaction. Epipens contain epinephrine (first-line treatment for life-threatening allergic reactions) in self-injectable devices (auto-injectors) that are used to inject the drug into a thigh. Knowing how to correctly use an Epipen is crucial for the patient, especially in emergency situations
