PRESCRIPTION SCREENING MADE ARY SARASMITA, S.FARM, M.FARM.KLIN, APT Paradigm Change from Manufacture Pharmaceutical Care COMPOUNDING & DISPENSING What is Compounding ? What is Dispensing ? THE BIG QUESTION, WHAT ARE YOU DOING IN COMPOUNDING & DISPENSING ?? AND WHAT FOR ??? Pharmacist roles ambulatory care, can include : Dispensing and compounding medications Counseling patients Minimizing medication errors Enhancing patient compliance Monitoring drug therapy Minimizing drug expenditures. CHEMISTRY PHARMACY FORENSIC PHARMACOLOGY DISPENSING PHARMACEUTICAL TECHNOLOGY MICROBIOLOGY The medication error usually happens because of breakdown in the systems that have been developed for handling and processing drugs, from prescribing and ordering to distribution and administration. IOM estimates that in the USA there is 1 med error per hospitalized patient/day. 1,5 million preventable adverse drug events per year 7.000 deaths per year from medication error in hospital. The drug therapy problems most frequently associated with ADEs: inadequate monitoring (45.4%), patient nonadherence (36.6%), and dosing/frequency errors (26.8%). Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc 2001;41:192-9. US Office of the Actuary National Health Expenditure Data. 2000 Institute of Medicine (IOM). (2007). Preventing medication errors: Quality chasm series. P. Aspden, J. Wolcott, J. L. Bootman, & L. R. Cronenwett (Eds.). Washington, DC: The National Academies Press. Thomsen, L.A., A. G. Winterstein, B. Sondergaard, et al. 2007. “Systematic Review of the Incidence and Characteristics of Preventable Adverse Drug Events in Office-Based Care.” Annals of Pharmacotherapy 41:1411-1426. Philips J et al. Retrospective analysis of mortalities associated with medication errors. Am J Health Syst Pharm. 2001 Oct MEDICAL SERVICES & CARE PHARMACEUTICAL SERVICE & CARE PATIEN T NURSING OR MIDWIFE SERVICE & CARE NUTRITION SERVICE & CARE SERVICE BY HEART Teamwork Cooperation + Coordination + Communication Resep Screening Administrasi Legalitas Farmasetis Klinis Inkompatibilitas Suspensi PGA/PGS/CMC Maximal Dose Sediaan Lazim Spesialite Sinonim Alergi, Interaksi, Indikasi Pemberian Harga Penyiapan Recek / cek ulang Penimbangan Peracikan Pemberian Etiket Penyerahan Informasi Skrining Administratif Skrining Farmasetis Skrining Klinis / Farmakologis Berdasarkan Keputusan Menteri Kesehatan Republik Indonesia No.1027/Menkes/ SK/IX/2004 tentang Standar Pelayanan Kefarmasian di Apotek, dinyatakan bahwa skrining resep yang dilakukan oleh apoteker meliputi: Persyaratan administratif : Nama, SIP, dan alamat dokter Tanggal penulisan resep Tanda tangan/paraf dokter penulis resep Nama, alamat, umur, jenis kelamin, dan berat badan pasien Nama obat, potensi, dosis, dan jumlah yang diminta Cara pemakaian yang jelas Informasi lainnya Kesesuaian farmasetik: bentuk sediaan, dosis, potensi, stabilitas, inkompatibilitas, cara, dan lama pemberian. Pertimbangan klinis: adanya alergi, efek samping, interaksi, kesesuaian (dosis, durasi, jumlah obat dan lain-lain). Nama Dokter Alamat Rumah Alamat Praktek SIP Tanggal Kota ,tanggal Superscriptio R/ Inscriptio/Pr escriptio R.Cardinale R.Adjuvan Corrigen rasa, bau, warna Vehiculum Subscriptio Perintah pembuatan m f l a------ Signatura S.Aturan pemakaian obat Dosis (mg,ml) Dosis (mg,ml) Jumlah obat Paraf/tanda tangan Nama pasien Alamat