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| Date: | 05/16/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Describe any challenges during the encounter?: | The patient was unsure whether they needed a doctor's visit for allergies or if OTC medication was enough. |
| How did you/would you resolve these?: | I explained the criteria for self-care and why their case was appropriate. I reviewed red flag symptoms that would warrant medical evaluation. |
| How would you prevent such challenges in future encounters?: | Provide patients with a clear explanation of when OTC options are appropriate and use visual aids (like signage or printed handouts) to increase understanding. |
View| Date: | 05/09/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Were there any challenges during the encounter? And if so, how did you/would you resolve these?: | es, the patient was uncertain about which dose to take and had already started alternating between the two strengths, thinking it was acceptable. How I Resolved It: After confirming the correct dose with the physician, I contacted the patient to explain the correct 75 mcg daily dosing, advised them to stop using the 50 mcg tablets, and clarified the importance of taking the same dose consistently each day. I also ensured the outdated prescription was deactivated in the system to prevent future confusion. |
| What type of prescriber did you speak with (e.g. dentist, podiatrist, physician, nurse practitioner, physician assistant)?: | I spoke with a physician to clarify the duplicate Synthroid prescriptions and confirm the correct dosage |
| What was the issue?: | The patient had two active prescriptions for Synthroid (levothyroxine) at different strengths 50 mcg and 75 mcg both recently filled. This raised a concern for duplicate therapy, which could lead to incorrect dosing and thyroid imbalance. Clarification was needed to determine the correct dose and discontinue the outdated prescription |
| What was the provider's response?: | The physician acknowledged the error and confirmed that the intended dose was 75 mcg daily. They appreciated the clarification, authorized discontinuation of the 50 mcg prescription, and agreed that the patient should be counseled to use only the correct strength moving forward. |
| What were the recommendations?: | I recommended the prescriber discontinue the outdated 50 mcg Synthroid prescription and maintain only the 75 mcg daily dose as the active prescription. I also suggested that the patient be instructed to discard any remaining 50 mcg tablets to avoid confusion and ensure consistent, accurate dosing. |
| Date: | 05/08/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Were there any challenges during the encounter? And if so, how did you/would you resolve these?: | The main challenge was ensuring the urgency of the allergy concern was communicated clearly, especially since the patient was scheduled to receive the medication shortly. How I Resolved It: I clearly stated that the patient had a documented allergy to sulbactam and explained the potential risks if the medication were administered. I also came prepared with a safe alternative (ceftriaxone), which helped the physician make a quick, informed decision. Being concise and respectful helped facilitate a smooth and effective resolution. |
| What type of prescriber did you speak with (e.g. dentist, podiatrist, physician, nurse practitioner, physician assistant)?: | I spoke with a physician to clarify the prescription and address the patient's documented allergy to sulbactam. |
| What was the issue?: | A prescription was received for ampicillin/sulbactam (Unasyn), but the patient had a documented allergy to sulbactam, including symptoms of rash and facial swelling. This raised a safety concern that required clarification with the prescriber before the medication could be administered. |
| What was the provider's response?: | The physician was appreciative of the alert and agreed with the recommendation. They confirmed they were not aware of the sulbactam allergy and promptly changed the order to ceftriaxone to ensure patient safety. |
| What were the recommendations?: | I recommended discontinuing ampicillin/sulbactam due to the documented sulbactam allergy and suggested switching to an appropriate alternative that would provide similar coverage without risk such as ceftriaxone, depending on the infection being treated and the patient's clinical status. |
| Date: | 05/07/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Were there any challenges during the encounter? And if so, how did you/would you resolve these?: | Yes, there was a minor challenge in reaching the prescriber directly. I was initially placed on hold and had to speak with the front desk staff before being transferred to the nurse practitioner. How I Resolved It: I remained patient and professional, clearly explained the reason for the call, and emphasized the importance of ensuring the patient received the correct quantity. Once connected, I quickly summarized the issue, which helped the nurse practitioner provide a prompt and helpful response. |
| What type of prescriber did you speak with (e.g. dentist, podiatrist, physician, nurse practitioner, physician assistant)?: | I spoke with a nurse practitioner to clarify the prescription quantity. |
| What was the issue?: | The prescription for metformin 500 mg was written with directions to take 1 tablet twice daily, but the quantity prescribed was only 30 tablets, which is insufficient for a 30-day supply. Based on the directions, the correct quantity should have been 60 tablets. This discrepancy needed clarification before dispensing to avoid underdosing the patient |
| What was the provider's response?: | The nurse practitioner agreed with the recommendation and confirmed that the intended directions were 1 tablet twice daily. She verbally authorized updating the quantity to 60 tablets and appreciated the clarification to ensure the patient received the correct supply. |
| What were the recommendations?: | I recommended updating the prescription to reflect the correct 30-day supply, which would require 60 tablets based on the directions of 1 tablet twice daily. This adjustment ensures the patient receives the appropriate amount of medication for the prescribed duration. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| How do each of these positions work together to provide patient-centered care?: | Both the pharmacy manager and staff pharmacist are licensed pharmacists. The pharmacy manager handles leadership and operations, while still providing patient care. The staff pharmacist focuses more on daily clinical tasks. Together, they collaborate to ensure efficient workflow and high-quality, patient-centered care |
| List the different pharmacy positions at your community pharmacy practice site (e.g., pharmacist, pharmacist in charge, pharmacy technician) and briefly describe the roles and responsibilities of each position.: | Pharmacy Manager Staff Pharmacist |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| What specifically did you do to help the patient? (e.g. find a prescription discount card and provide it to the patient, discuss an alternative therapy with your preceptor/the patient's prescriber): | I first verified the rejection reason through the pharmacy system (e.g., refill too soon or non-formulary). Then, I consulted with my preceptor to determine the most appropriate action. Depending on the issue, I: For "too soon to refill": Explained the situation to the patient, reviewed when the medication would be eligible for refill, and discussed temporary options like splitting doses or using leftover supply if available and safe. For non-formulary or not covered: Helped identify a therapeutic alternative that was covered by the patient's insurance and discussed it with the prescriber for a possible switch. For prior authorization needed: Informed the patient about the insurance requirement and guided them to contact their provider's office to start the process, while also checking if a short-term supply or discount program could help in the meantime. |
| Why was the medication not covered by their insurance?: | It's too soon to refill based on the last fill date. The medication is not on the formulary (non-preferred or excluded). It is an over-the-counter (OTC) product not eligible for coverage. Prior authorization is required but not yet approved. The patient must try a lower-cost alternative first (step therapy). It exceeds quantity or frequency limits set by the plan |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Who has primary responsibility for this process?: | pharmacist-in-charge |
| Describe how medications are ordered and how inventory is maintained in the pharmacy department.: | Publix Pharmacy uses an automated system connected with Cardinal Health to manage medication ordering. The system tracks inventory in real time and automatically places orders when stock is low. Pharmacists can manually adjust orders as needed. Controlled substances are ordered separately using DEA-compliant systems like CSOS. Inventory is maintained through daily checks, regular cycle counts, and proper storage, including temperature monitoring for refrigerated items. Expired or damaged medications are returned through Cardinal's reverse distribution process. This system ensures accurate, efficient, and compliant medication management. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Were there any challenges during the encounter? And if so, how did you/would you resolve these?: | The main challenge was the unusual indication of gabapentin for cough, which required clarification. I addressed this by respectfully contacting the physician, who confirmed the off-label use for chronic refractory cough. We discussed starting at a low dose with close monitoring. The situation was resolved through professional communication, clinical reasoning, and thorough patient counseling. |
| What type of prescriber did you speak with (e.g. dentist, podiatrist, physician, nurse practitioner, physician assistant)?: | I spoke with a physician to clarify the prescription for gabapentin written with the indication "for cough." |
| What was the issue?: | A prescription was received for gabapentin with the indication noted as "for cough," which raised a clinical concern. |
| What was the provider's response?: | The physician acknowledged that the use of gabapentin for cough was off-label but explained that it was intentional and based on the patient's history of chronic refractory cough that had not responded to traditional therapies. He appreciated the pharmacist's diligence in verifying the indication and agreed with the recommendation to start at a low dose and monitor for side effects. The provider also confirmed that he would follow up with the patient in a few weeks to evaluate effectiveness and tolerability |
| What were the recommendations?: | Clarify Indication: Confirmed with the physician that gabapentin was being prescribed off-label for chronic refractory cough with a suspected neuropathic origin. Start at Low Dose: Recommended initiating gabapentin at a low dose (e.g., 100-300 mg at bedtime) to minimize side effects such as drowsiness and dizziness, especially in older adults or those with respiratory issues. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| Review the immunization form your site provides to each patient receiving an influenza immunization or other immunization. Counsel a patient receiving this immunization on this form (e.g. side effects, allergic reactions and associated risks) prior to them receiving the immunization. Describe your patient interactions below, including the side effects you counseled on.: | I counseled a 65-year-old male receiving the Shingrix vaccine for shingles prevention. I explained that it's a 2-dose vaccine series and reviewed common side effects such as injection site pain, fatigue, muscle aches, fever, and chills. I also discussed rare but serious allergic reactions, advised the patient to stay for 15 minutes of observation, and encouraged over-the-counter pain relief if needed. The patient had no contraindications, gave verbal consent, and was reminded to return for his second dose in 2-6 months |
| Shadow your preceptor while he/she administers the immunization. (Note: You are not able to vaccinate patients during IPPE. You must receive an APhA certification and training, which LU COP will provide during your P2 year, prior to APPE). Describe the process you observed, noting any particular use of technique or education provided to the patient (e.g. angle of injection, handling of hazardous waste).: | During my IPPE rotation at Publix Pharmacy, I observed my preceptor administer the Shingrix vaccine to an adult patient. He confirmed the patient's eligibility, reviewed the Vaccine Information Statement (VIS), and obtained informed consent. Using proper aseptic technique, he reconstituted the vaccine and administered it intramuscularly into the deltoid muscle at a 90-degree angle. After the injection, he safely disposed of the needle in a sharps container and provided post-vaccination counseling, including expected side effects and the importance of returning for the second dose. The patient remained in the pharmacy for 15 minutes of observation. This experience highlighted proper technique, patient communication, and safety practices in a community pharmacy setting. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| How does this database system alert a pharmacist to medication related problems?: | Drug-drug interaction alerts Allergy and contraindication warnings Duplicate therapy and dose range checks Drug-disease interactions Refill-too-soon notifications Age-specific safety alerts (e.g., for elderly or pediatric patients) |
| Provide an example of how a pharmacist resolved a medication related problem within this system.: | A patient at Publix Pharmacy was prescribed clarithromycin while already taking simvastatin. When the pharmacist entered the prescription into EnterpriseRx, the system generated a drug-drug interaction alert, warning of a risk for rhabdomyolysis due to CYP3A4 inhibition by clarithromycin. The pharmacist: Reviewed the interaction details in the system. Contacted the prescriber to discuss safer alternatives. Recommended switching to azithromycin, which does not inhibit CYP3A4. Documented the intervention in the system. The prescriber approved the change, and the patient received the safer antibiotic, avoiding potential harm. |
| What is the name of the database system your community pharmacy practice site uses to process prescription orders?: | Publix Pharmacy utilizes EnterpriseRx, a cloud-based pharmacy management system developed by McKesson, to process prescription orders. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| How does this database system alert a pharmacist to medication related problems?: | rug-drug interaction alerts Allergy and contraindication warnings Duplicate therapy and dose range checks Drug-disease interactions Refill-too-soon notifications Age-specific safety alerts (e.g., for elderly or pediatric patients) |
| Provide an example of how a pharmacist resolved a medication related problem within this system.: | A patient at Publix Pharmacy was prescribed clarithromycin while already taking simvastatin. When the pharmacist entered the prescription into EnterpriseRx, the system generated a drug-drug interaction alert, warning of a risk for rhabdomyolysis due to CYP3A4 inhibition by clarithromycin. The pharmacist: Reviewed the interaction details in the system. Contacted the prescriber to discuss safer alternatives. Recommended switching to azithromycin, which does not inhibit CYP3A4. Documented the intervention in the system. The prescriber approved the change, and the patient received the safer antibiotic, avoiding potential harm. |
| What is the name of the database system your community pharmacy practice site uses to process prescription orders?: | Publix Pharmacy utilizes EnterpriseRx, a cloud-based pharmacy management system developed by McKesson, to process prescription orders. |
| Date: | 05/10/2025 |
| Rotation Type: | IPPE Community |
| Comments: | ? |
| How does this database system alert a pharmacist to medication related problems?: | Drug-drug interaction alerts Allergy and contraindication warnings Duplicate therapy and dose range checks Drug-disease interactions Refill-too-soon notifications Age-specific safety alerts (e.g., for elderly or pediatric patients) |
| Provide an example of how a pharmacist resolved a medication related problem within this system.: | A patient at Publix Pharmacy was prescribed clarithromycin while already taking simvastatin. When the pharmacist entered the prescription into EnterpriseRx, the system generated a drug-drug interaction alert, warning of a risk for rhabdomyolysis due to CYP3A4 inhibition by clarithromycin. The pharmacist: Reviewed the interaction details in the system. Contacted the prescriber to discuss safer alternatives. Recommended switching to azithromycin, which does not inhibit CYP3A4. Documented the intervention in the system. The prescriber approved the change, and the patient received the safer antibiotic, avoiding potential harm. |
| What is the name of the database system your community pharmacy practice site uses to process prescription orders?: | Publix Pharmacy utilizes EnterpriseRx, a cloud-based pharmacy management system developed by McKesson, to process prescription orders. |
| Date: | 04/18/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | File attached. |
View| Date: | 04/18/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | File attached |
View| Date: | 04/18/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | ? |
View| Date: | 04/18/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | ? |
View| Date: | 04/16/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | ? |
| Select a particular medication related policy at your particular institution. Interview your preceptor and identify how the policy was created, approved, and implemented.: | Policy: Therapeutic Interchange for Proton Pump Inhibitors (PPIs) Institution: Larkin Community Hospital I interviewed my preceptor about the PPI Therapeutic Interchange Policy, which allows pharmacists to substitute non-formulary PPIs with formulary options (e.g., substituting pantoprazole with omeprazole) without needing a new physician order. Creation: The pharmacy team identified frequent non-formulary PPI use and proposed the policy based on cost savings and clinical equivalence. Approval: The draft policy was reviewed by the Pharmacy & Therapeutics (P&T) Committee, revised, and approved by hospital administration. Implementation: The EMR was updated, staff were educated, and pharmacists were trained to apply the policy and document substitutions. |
| Date: | 04/16/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | ? |
| Select a particular medication related policy at your particular institution. Interview your preceptor and identify how the policy was created, approved, and implemented.: |
Policy: Therapeutic Interchange for Proton Pump Inhibitors (PPIs) ?Institution: Larkin Community Hospital I interviewed my preceptor about the PPI Therapeutic Interchange Policy, which allows pharmacists to substitute non-formulary PPIs with formulary options (e.g., substituting pantoprazole with omeprazole) without needing a new physician order. Creation: The pharmacy team identified frequent non-formulary PPI use and proposed the policy based on cost savings and clinical equivalence. ?Approval: The draft policy was reviewed by the Pharmacy & Therapeutics (P&T) Committee, revised, and approved by hospital administration. ?Implementation: The EMR was updated, staff were educated, and pharmacists were trained to apply the policy and document substitutions. |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Pharmacy Positions in Institutional/Health System (SLO 1) |
| How do each of these positions work together to provide patient-centered care?: | At our institution, daily huddle meetings bring together all pharmacy team members to align on priorities and ensure safe, effective, and patient-focused care. |
| List the different pharmacy positions at your hospital pharmacy practice site (e.g., manager, pharmacist, specialty pharmacist, medication safety officer, director of pharmacy, pharmacy technician) and briefly describe the roles and responsibilities of each position.: | 1-Pharmacy Director - Oversees the entire pharmacy department, including staffing, budgeting, operations, and compliance with regulations. 2-Clinical Pharmacy Manager - Manages the clinical pharmacy services, oversees controlled substances, and ensures adherence to clinical protocols and safety standards. 3-Clinical Pharmacist Specialist - Reviews patient profiles, participates in interdisciplinary rounds, and provides consultations and therapeutic recommendations. 4-General Pharmacist - Reviews medication orders and dosages, verifies appropriateness, and ensures medications are safe and effective for dispensing. 5-Pharmacy Resident (PGY1) - Participates in rounds, reviews patients' medication regimens, adjusts dosages, and engages in educational activities like journal clubs. 6-Lead Pharmacy Technician - Supervises pharmacy technicians, manages schedules, coordinates workflow, and ensures daily operations run smoothly. 7-Compounding Pharmacy Technician - Prepares sterile and non-sterile compounded medications, following strict protocols for safety and accuracy. 8-Pharmacy Technician - Handles medication filling, inventory checks, answers phone calls, and delivers medications to the appropriate units. |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Pharmacy Positions in Institutional/Health System (SLO 1) |
| How do each of these positions work together to provide patient-centered care?: | At our institution, daily huddle meetings bring together all pharmacy team members to align on priorities and ensure safe, effective, and patient-focused care. |
| List the different pharmacy positions at your hospital pharmacy practice site (e.g., manager, pharmacist, specialty pharmacist, medication safety officer, director of pharmacy, pharmacy technician) and briefly describe the roles and responsibilities of each position.: |
1-Pharmacy Director - Oversees the entire pharmacy department, including staffing, budgeting, operations, and compliance with regulations. ?2-Clinical Pharmacy Manager - Manages the clinical pharmacy services, oversees controlled substances, and ensures adherence to clinical protocols and safety standards. ?3-Clinical Pharmacist Specialist - Reviews patient profiles, participates in interdisciplinary rounds, and provides consultations and therapeutic recommendations. ?4-General Pharmacist - Reviews medication orders and dosages, verifies appropriateness, and ensures medications are safe and effective for dispensing. ?5-Pharmacy Resident (PGY1) - Participates in rounds, reviews patients' medication regimens, adjusts dosages, and engages in educational activities like journal clubs. ?6-Lead Pharmacy Technician - Supervises pharmacy technicians, manages schedules, coordinates workflow, and ensures daily operations run smoothly. 7-Compounding Pharmacy Technician - Prepares sterile and non-sterile compounded medications, following strict protocols for safety and accuracy. 8-Pharmacy Technician - Handles medication filling, inventory checks, answers phone calls, and delivers medications to the appropriate units. |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Medication Process in an Institutional/Health System Setting ?(SLO 3) |
| Explain how a medication is verified, checked, and sorted for floor delivery.: | Pharmacy Technician - Locates the correct medication and dose as per the order - Checks the expiration date - Prepares and applies the appropriate label - Passes the medication to the pharmacist for verification Pharmacist - Reviews the order for accuracy and safety - Verifies the patient's information, medication name, dose, form, quantity, administration time, and date - Ensures the order is clinically appropriate and safe for the patient - Once verified, signs or initials the label - Returns the medication to the pharmacy technician Pharmacy Technician - Delivers the verified medication to the patient or the appropriate care unit |
| Explain the process of what happens to a medication once it leaves the pharmacy. How is the medication delivered to the floor, stored prior to administration (e.g. Pyxis, Omnicell), and ultimately administered to the patient.: | After the pharmacist verifies and signs off on the medication: The pharmacy technician ensures that patient information is kept confidential during transport, in compliance with HIPAA regulations. Upon arriving at the ward, the technician locates the nurse in charge of the patient. The medication is handed directly to the nurse, and the technician requests a signature on the delivery confirmation sheet to document that the medication was received. Alternatively, if applicable, the medication may be placed in the Pyxis system under the specific patient's profile for secure and documented storage until administration |
| What are the 5 Rights of drug administration?: | 1-Right Patient - Confirm the identity of the correct patient using at least two identifiers (e.g., name and date of birth). 2-Right Drug - Ensure the correct medication is being administered, matching the order exactly. 3-Right Dose - Verify the correct dosage based on the order, patient-specific factors, and clinical guidelines. 4-Right Route - Confirm the proper method of administration (e.g., oral, IV, IM, subcutaneous). 5-Right Time - Administer the medication at the correct time and frequency, considering scheduled dosing and clinical timing requirements |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Medication Process in an Institutional/Health System Setting ?(SLO 3) |
| Explain how a medication is verified, checked, and sorted for floor delivery.: | Pharmacy Technician - Locates the correct medication and dose as per the order - Checks the expiration date - Prepares and applies the appropriate label - Passes the medication to the pharmacist for verification Pharmacist - Reviews the order for accuracy and safety - Verifies the patient's information, medication name, dose, form, quantity, administration time, and date - Ensures the order is clinically appropriate and safe for the patient - Once verified, signs or initials the label - Returns the medication to the pharmacy technician Pharmacy Technician - Delivers the verified medication to the patient or the appropriate care unit |
| Explain the process of what happens to a medication once it leaves the pharmacy. How is the medication delivered to the floor, stored prior to administration (e.g. Pyxis, Omnicell), and ultimately administered to the patient.: | After the pharmacist verifies and signs off on the medication: The pharmacy technician ensures that patient information is kept confidential during transport, in compliance with HIPAA regulations. Upon arriving at the ward, the technician locates the nurse in charge of the patient. The medication is handed directly to the nurse, and the technician requests a signature on the delivery confirmation sheet to document that the medication was received. Alternatively, if applicable, the medication may be placed in the Pyxis system under the specific patient's profile for secure and documented storage until administration |
| What are the 5 Rights of drug administration?: | 1-Right Patient - Confirm the identity of the correct patient using at least two identifiers (e.g., name and date of birth). 2-Right Drug - Ensure the correct medication is being administered, matching the order exactly. 3-Right Dose - Verify the correct dosage based on the order, patient-specific factors, and clinical guidelines. 4-Right Route - Confirm the proper method of administration (e.g., oral, IV, IM, subcutaneous). 5-Right Time - Administer the medication at the correct time and frequency, considering scheduled dosing and clinical timing requirements |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | ? |
| Explain how a medication is verified, checked, and sorted for floor delivery.: | Pharmacy Technician - Locates the correct medication and dose as per the order - Checks the expiration date - Prepares and applies the appropriate label - Passes the medication to the pharmacist for verification Pharmacist - Reviews the order for accuracy and safety - Verifies the patient's information, medication name, dose, form, quantity, administration time, and date - Ensures the order is clinically appropriate and safe for the patient - Once verified, signs or initials the label - Returns the medication to the pharmacy technician Pharmacy Technician - Delivers the verified medication to the patient or the appropriate care unit |
| Explain the process of what happens to a medication once it leaves the pharmacy. How is the medication delivered to the floor, stored prior to administration (e.g. Pyxis, Omnicell), and ultimately administered to the patient.: | After the pharmacist verifies and signs off on the medication: The pharmacy technician ensures that patient information is kept confidential during transport, in compliance with HIPAA regulations. Upon arriving at the ward, the technician locates the nurse in charge of the patient. The medication is handed directly to the nurse, and the technician requests a signature on the delivery confirmation sheet to document that the medication was received. Alternatively, if applicable, the medication may be placed in the Pyxis system under the specific patient's profile for secure and documented storage until administration |
| What are the 5 Rights of drug administration?: | 1-Right Patient - Confirm the identity of the correct patient using at least two identifiers (e.g., name and date of birth). 2-Right Drug - Ensure the correct medication is being administered, matching the order exactly. 3-Right Dose - Verify the correct dosage based on the order, patient-specific factors, and clinical guidelines. 4-Right Route - Confirm the proper method of administration (e.g., oral, IV, IM, subcutaneous). 5-Right Time - Administer the medication at the correct time and frequency, considering scheduled dosing and clinical timing requirements |
| Date: | 04/09/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Medication Process in an Institutional/Health System Setting ?(SLO 3) |
| Explain how a medication is verified, checked, and sorted for floor delivery.: | Pharmacy Technician - Locates the correct medication and dose as per the order - Checks the expiration date - Prepares and applies the appropriate label - Passes the medication to the pharmacist for verification Pharmacist - Reviews the order for accuracy and safety - Verifies the patient's information, medication name, dose, form, quantity, administration time, and date - Ensures the order is clinically appropriate and safe for the patient - Once verified, signs or initials the label - Returns the medication to the pharmacy technician Pharmacy Technician - Delivers the verified medication to the patient or the appropriate care unit |
| Explain the process of what happens to a medication once it leaves the pharmacy. How is the medication delivered to the floor, stored prior to administration (e.g. Pyxis, Omnicell), and ultimately administered to the patient.: | After the pharmacist verifies and signs off on the medication: The pharmacy technician ensures that patient information is kept confidential during transport, in compliance with HIPAA regulations. Upon arriving at the ward, the technician locates the nurse in charge of the patient. The medication is handed directly to the nurse, and the technician requests a signature on the delivery confirmation sheet to document that the medication was received. Alternatively, if applicable, the medication may be placed in the Pyxis system under the specific patient's profile for secure and documented storage until administration |
| What are the 5 Rights of drug administration?: | 1-Right Patient - Confirm the identity of the correct patient using at least two identifiers (e.g., name and date of birth). 2-Right Drug - Ensure the correct medication is being administered, matching the order exactly. 3-Right Dose - Verify the correct dosage based on the order, patient-specific factors, and clinical guidelines. 4-Right Route - Confirm the proper method of administration (e.g., oral, IV, IM, subcutaneous). 5-Right Time - Administer the medication at the correct time and frequency, considering scheduled dosing and clinical timing requirements |
| Date: | 04/01/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Medication Information Sources (SLO 7) |
| Interview your preceptor and identify 3 medication resources that they use on a frequent basis. What are they?: | 1-Lexicomp 2-UpToDate 3-Epocrates |
| Where do you go to access each of these 3 resources at this institution?: | Internet Mobile App. |
| Date: | 04/01/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Medication Information Sources (SLO 7) |
| Interview your preceptor and identify 3 medication resources that they use on a frequent basis. What are they?: |
1-Lexicomp ?2-UpToDate ?3-Epocrates |
| Where do you go to access each of these 3 resources at this institution?: |
Internet ?Mobile App. |
| Date: | 04/01/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Interprofessional Exposure (SLO 6) Option 2 |
| Could this provider be benefited from a pharmacist's direct involvement? If so, how?: | Yes. For example, during rounds, the pharmacist identified that the patient's orthostatic hypotension was likely caused by one of the medications they were taking. This led to a timely adjustment in therapy, improving the patient's hemodynamic stability and preventing further complications. This illustrates how a pharmacist's direct involvement can enhance medication safety, support clinical decision-making, and contribute to better patient outcomes |
| How did these activities impact pharmacy?: | Improved Clinical Insight - Physicians and nurses provide essential updates that help pharmacists make safer, more accurate medication recommendations. Collaborative Decision-Making - Real-time discussion during rounds allows pharmacists to adjust or optimize therapy on the spot, reinforcing their role in patient care. Enhanced Interprofessional Communication - Clear communication from the team ensures pharmacy is aligned with the care plan, improving efficiency and patient outcomes. |
| List at least 3 activities the other health care professional performs that impact patient care.: | 1-Physician (Internist/Resident): - Formulates and updates the care plan based on physical exams, labs, and imaging; adjusts treatment accordingly to address acute issues and chronic disease management. 2-Nurse: - Provides real-time updates on the patient's condition, including vital signs, fluid balance, pain levels, and responses to medications-helping guide immediate clinical decisions. 3-Medical Student: - Presents thorough patient histories and assessments, contributing to differential diagnoses and offering evidence-based suggestions that enrich team discussions and planning. |
| What profession did you shadow?: | Clinical Pharmacist Specialist |
| Date: | 04/01/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Interprofessional Exposure (SLO 6) Option 1 |
| Describe how the pharmacist contributed to rounds. If a pharmacist is not part of the rounding team, describe how the team could have benefited from a pharmacist's direct involvement.: | The clinical pharmacist played a vital role during rounds by providing real-time input on medication management and patient safety. They reviewed each patient's active medication list, identified potential drug interactions and duplicative therapies, and made recommendations to optimize dosing, especially in the context of renal and hepatic function. Their involvement significantly enhanced medication reconciliation, promoted evidence-based therapy, and supported interdisciplinary decision-making. |
| List all professions who were part of the interprofessional rounding team. Is your preceptor involved?: |
-Attending Internist ?IM Chief Resident IM PGY-2 IM PGY-1 Clinical Pharmacist ?Pharmacist Intern ?Medical Student |
| List at least 3 activities that occurred during rounds which impacted the care of a patient.: |
1-Medication Adjustment Based on Lab Results - A patient's renal function was reviewed, leading to the adjustment of renally-cleared medications (e.g., lowering the dose of vancomycin or discontinuing metformin), minimizing the risk of toxicity. ?2-Discontinuation of Unnecessary Medications - Based on clinical improvement and pharmacist input, a proton pump inhibitor and an opioid were discontinued, reducing the risk of adverse effects such as C. difficile infection and constipation. ?3-Initiation of Targeted Therapy - After reviewing recent cultures and sensitivities, broad-spectrum antibiotics were de-escalated to targeted therapy, promoting antimicrobial stewardship and reducing resistance risk. |
| Date: | 04/01/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: | Interprofessional Exposure (SLO 6) Option 1 |
| Describe how the pharmacist contributed to rounds. If a pharmacist is not part of the rounding team, describe how the team could have benefited from a pharmacist's direct involvement.: | The clinical pharmacist played a vital role during rounds by providing real-time input on medication management and patient safety. They reviewed each patient's active medication list, identified potential drug interactions and duplicative therapies, and made recommendations to optimize dosing, especially in the context of renal and hepatic function. Their involvement significantly enhanced medication reconciliation, promoted evidence-based therapy, and supported interdisciplinary decision-making. |
| List all professions who were part of the interprofessional rounding team. Is your preceptor involved?: |
-Attending Internist IM Chief Resident ?IM PGY-2 IM PGY-1 Clinical Pharmacist ?Pharmacist Intern Medical Student |
| List at least 3 activities that occurred during rounds which impacted the care of a patient.: |
1-Medication Adjustment Based on Lab Results - A patient's renal function was reviewed, leading to the adjustment of renally-cleared medications (e.g., lowering the dose of vancomycin or discontinuing metformin), minimizing the risk of toxicity. 2-Discontinuation of Unnecessary Medications - Based on clinical improvement and pharmacist input, a proton pump inhibitor and an opioid were discontinued, reducing the risk of adverse effects such as C. difficile infection and constipation. ?3-Initiation of Targeted Therapy - After reviewing recent cultures and sensitivities, broad-spectrum antibiotics were de-escalated to targeted therapy, promoting antimicrobial stewardship and reducing resistance risk. |
| Date: | 04/04/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: |
Dear Dr. Perez, ?In this section, I will explain the patient's condition on the last day of their hospital admission. Best regards, Ali Afrand Pharmacist Intern |
| Dose: |
Active Medications: ?-Acetaminophen- 650mg -Zofran (ondansetron)- 4mg -Docusate sodium- 100mg ?-Lopressor (metoprolol tartrate)-50mg -Protonix (pantoprazole) - 40mg ?-Famotidine- 20mg ?-Lactated Ringer's IV- 1000ml at 100 ml/hr |
| Family History: | Not pertinent |
| Frequency: |
Active Medications: -Acetaminophen- 650mg- Q6HPRN ?-Zofran (ondansetron)- 4mg- BID PRN -Docusate sodium- 100mg - DAILY ?-Lopressor (metoprolol tartrate)-50mg- BID ?-Protonix (pantoprazole) - 40mg- DAILY ?-Famotidine- 20mg- QPM -Lactated Ringer's IV- 1000ml at 100 ml/hr- DAILY |
| Indication for Use in this patient*: |
Active Medications: -Acetaminophen- Pain relief, fever reduction -Zofran (ondansetron)- Nausea, vomiting prevention -Docusate sodium-Constipation relief ?-Lopressor (metoprolol tartrate)- Hypertension -Protonix (pantoprazole)- ulcer prevention, acid suppression -Famotidine- GERD, peptic ulcer, acid reflux ?-Lactated Ringer's IV fluid/electrolyte solution Hydration, electrolyte replenishment, volume support |
| Medication Name: |
Active Medications: -Acetaminophen ?-Zofran (ondansetron) ?-Docusate sodium -Lopressor (metoprolol tartrate) -Protonix (pantoprazole) -Famotidine -Lactated Ringer's IV |
| Past Medical History: | Hypertension (HTN) |
| Reason for Admission: | A 48-year-old female presented to the ED four days ago with a chief complaint of abdominal pain. She underwent evaluation and was admitted for further management. During her admission, significantly elevated pancreatic enzyme levels were noted, and she was diagnosed with acute pancreatitis. One notable risk factor identified was the use of Ozempic, which she had started approximately one month prior to symptom onset. Treatment for acute pancreatitis was initiated, and her symptoms, along with clinical findings and imaging results, have guided her ongoing care. She has been closely monitored throughout her hospital stay, and supportive treatment continues with follow-up from the appropriate specialty teams. |
| Recommended labs, vitals, and/or disease symptoms to monitor for this medication**: |
-On the last day of admission, all laboratory results were within normal limits. -The patient reports no pain or discomfort at this time. -It is strongly recommended that she discontinue Ozempic moving forward. ?-She should monitor her blood pressure regularly. -It is important that she maintains adequate hydration. ?-For follow-up care, she is advised to see her gastroenterologist (GI doctor) |
| Route: |
Active Medications: ?-Acetaminophen- 650mg- PO ?-Zofran (ondansetron)- 4mg- PO ?-Docusate sodium- 100mg- PO -Lopressor (metoprolol tartrate)-50mg- PO ?-Protonix (pantoprazole) - 40mg- IV -Famotidine- 20mg- PO ?-Lactated Ringer's IV- 1000ml at 100 ml/hr- IV |
| Social History: |
Smoking Status: Unknown if the patient has ever used tobacco Marital Status: Single Gender Identity: Female Sexual Orientation: Straight (heterosexual) |
| Date: | 04/04/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: |
Dear Dr. Perez, ?In this section, I will explain the patient's condition on the last day of their hospital admission. ?Best regards, ?Ali Afrand Pharmacist Intern |
| Dose: |
Active Medications: -Acetaminophen- 650mg? -Zofran (ondansetron)- 4mg -Docusate sodium- 100mg ?-Lopressor (metoprolol tartrate)-50mg ?-Protonix (pantoprazole) - 40mg -Famotidine- 20mg ?-Lactated Ringer's IV- 1000ml at 100 ml/hr |
| Family History: | Not pertinent |
| Frequency: |
Active Medications: ?-Acetaminophen- 650mg- Q6HPRN -Zofran (ondansetron)- 4mg- BID PRN ?-Docusate sodium- 100mg - DAILY ?-Lopressor (metoprolol tartrate)-50mg- BID ?-Protonix (pantoprazole) - 40mg- DAILY ?-Famotidine- 20mg- QPM -Lactated Ringer's IV- 1000ml at 100 ml/hr- DAILY |
| Indication for Use in this patient*: |
Active Medications: -Acetaminophen- Pain relief, fever reduction ?-Zofran (ondansetron)- Nausea, vomiting prevention -Docusate sodium-Constipation relief -Lopressor (metoprolol tartrate)- Hypertension -Protonix (pantoprazole)- ulcer prevention, acid suppression -Famotidine- GERD, peptic ulcer, acid reflux ?-Lactated Ringer's IV fluid/electrolyte solution Hydration, electrolyte replenishment, volume support |
| Medication Name: |
Active Medications: ?-Acetaminophen -Zofran (ondansetron) ?-Docusate sodium ?-Lopressor (metoprolol tartrate) -Protonix (pantoprazole) -Famotidine -Lactated Ringer's IV |
| Past Medical History: | Hypertension (HTN) |
| Reason for Admission: | A 48-year-old female presented to the ED four days ago with a chief complaint of abdominal pain. She underwent evaluation and was admitted for further management. During her admission, significantly elevated pancreatic enzyme levels were noted, and she was diagnosed with acute pancreatitis. One notable risk factor identified was the use of Ozempic, which she had started approximately one month prior to symptom onset. Treatment for acute pancreatitis was initiated, and her symptoms, along with clinical findings and imaging results, have guided her ongoing care. She has been closely monitored throughout her hospital stay, and supportive treatment continues with follow-up from the appropriate specialty teams. |
| Recommended labs, vitals, and/or disease symptoms to monitor for this medication**: |
-On the last day of admission, all laboratory results were within normal limits. ?-The patient reports no pain or discomfort at this time. -It is strongly recommended that she discontinue Ozempic moving forward. -She should monitor her blood pressure regularly. ?-It is important that she maintains adequate hydration. -For follow-up care, she is advised to see her gastroenterologist (GI doctor) |
| Route: |
Active Medications: -Acetaminophen- 650mg- PO ?-Zofran (ondansetron)- 4mg- PO -Docusate sodium- 100mg- PO -Lopressor (metoprolol tartrate)-50mg- PO -Protonix (pantoprazole) - 40mg- IV ?-Famotidine- 20mg- PO -Lactated Ringer's IV- 1000ml at 100 ml/hr- IV |
| Social History: |
Smoking Status: Unknown if the patient has ever used tobacco Marital Status: Single ?Gender Identity: Female ?Sexual Orientation: Straight (heterosexual) |
| Date: | 04/02/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: |
Dear Dr. Perez, ?In this part, I will explain the patient's second day of admission. Best regards, Ali Afrand Pharmacist Intern |
| Dose: |
Active Medications: -Simethicone chewable- 80 mg -Acetaminophen- 1000mg/100ml -Hydralazine- 20mg/ml ?-Tramadol- 50mg -Famotidine- 20mg -MiraLAX- 17 gr -Pantoprazole (Protonix)- 40mg -Metoprolol Tartrate (Lopressor)- 50mg ?-Lactated Ringer's - IV - 1000 mL at 100 mL/hr - for hydration and nutrition |
| Family History: | Not pertinent |
| Frequency: |
Active Medications: ?-Simethicone chewable- Q8H -Acetaminophen- ONE TIME ?-Hydralazine- ONE TIME -Tramadol- Q8HPRN ?-Famotidine- QPM ?-MiraLAX- BID -Pantoprazole (Protonix)- DAILY -Metoprolol Tartrate (Lopressor)- BID -Lactated Ringer's - IV - 1000 mL at 100 mL/hr - for hydration and nutrition |
| Indication for Use in this patient*: |
Active Medications: ?-Simethicone chewable - for gas relief -Acetaminophen - for pain or fever -Hydralazine - for blood pressure control ?-Tramadol - for pain management -Famotidine - for acid reduction -MiraLAX - for constipation ?-Pantoprazole (Protonix) - for acid suppression -Metoprolol Tartrate (Lopressor) - for blood pressure control -Lactated Ringer's - IV - 1000 mL at 100 mL/hr - for hydration and nutrition |
| Medication Name: |
Active Medications: ?-Simethicone chewable -Acetaminophen -Hydralazine ?-Tramadol ?-Famotidine ?-MiraLAX -Pantoprazole (Protonix) -Metoprolol Tartrate (Lopressor) -Lactated Ringers- Serum IV- 1000 ml- 100ml/HR |
| Past Medical History: | Essential Hypertension (HTN) |
| Reason for Admission: | A 48-year-old female presented to the ED with abdominal pain radiating to the back, Imaging and labs suggested gallstone pancreatitis, with elevated lipase levels. She was admitted to the internal medicine service, |
| Recommended labs, vitals, and/or disease symptoms to monitor for this medication**: |
Labs Ordered: ?CBC with Differential Pancreatic Enzymes Liver Enzymes Kidney Function Tests ?Electrolytes Blood Glucose Rationale: Due to the patient's symptoms suggestive of pancreatitis, it is important to evaluate pancreatic enzyme levels. Additionally, since the patient is experiencing constipation and requires IV fluid therapy, monitoring her electrolyte levels, such as sodium (Na) and potassium (K) is necessary. ?Note: All laboratory data and vital signs are attached. |
| Route: |
Active Medications: ?-Simethicone chewable- PO ?-Acetaminophen- IV -Hydralazine- IV -Tramadol- PO -Famotidine- PO -MiraLAX- PO -Pantoprazole (Protonix)- IV ?-Metoprolol Tartrate (Lopressor)- PO ?-Lactated Ringer's - IV - 1000 mL at 100 mL/hr - for hydration and nutrition |
| Social History: |
Smoking Status: Unknown if the patient has ever used tobacco Marital Status: Single Gender Identity: Female Sexual Orientation: Straight (heterosexual) |
| Date: | 03/30/2025 |
| Rotation Type: | IPPE Institutional/Hospital Practice |
| Comments: |
Dear Dr. Perez, For this assignment, I have chosen one patient and followed her from the first day of admission until her discharge from the hospital. In this part, I will provide information from her first day in the Emergency Department before she was transferred to the Internal Medicine floor. Best regards,? Ali Afrand Pharmacist Intern |
| Dose: |
-Home Medications: ?. Metoprolol Tartrate 50 mg PO daily - for BP control . Ozempic 0.25 mg SC weekly - for weight loss -----------------------------------------------------Medications Administered in the ED: . Famotidine 20 mg IV - for abdominal pain . (Toradol) 30 mg IV - for pain control (NSAID) ?. Metoprolol Tartrate 50 mg PO - for blood pressure control |
| Family History: | - Not pertinent |
| Frequency: |
-Home Medications: ?. Metoprolol Tartrate 50 mg PO daily - for BP control . Ozempic 0.25 mg SC weekly - for weight loss ------------------------------------------------------?- Medications Administered in the ED: ?. Famotidine 20 mg IV - for abdominal pain ?. Ketorolac (Toradol) 30 mg IV - for pain control (NSAID) ?. Metoprolol Tartrate 50 mg PO - for blood pressure control |
| Indication for Use in this patient*: |
-Home Medications: . Metoprolol Tartrate 50 mg PO daily - for BP control ?. Ozempic 0.25 mg SC weekly - for weight loss ?------------------------------------------------------?Medications Administered in the ED: ?. Famotidine 20 mg IV - for abdominal pain ?. Ketorolac (Toradol) 30 mg IV - for pain control (NSAID) ?. Metoprolol Tartrate 50 mg PO - for blood pressure control |
| Medication Name: |
-Home Medications: ?. Metoprolol Tartrate 50 mg PO daily - for BP control ?. Ozempic 0.25 mg SC weekly - for weight loss ------------------------------------------------------- Medications Administered in the ED: ?. Famotidine 20 mg IV - for abdominal pain . Ketorolac (Toradol) 30 mg IV - for pain control (NSAID) ?. Metoprolol Tartrate 50 mg PO - for blood pressure control |
| Past Medical History: | - Hypertension (HTN) |
| Reason for Admission: |
C.C.: Abdominal pain ?- A 48-year-old white female presents to the ED as a walk-in with complaints of epigastric abdominal pain that started four days ago. |
| Recommended labs, vitals, and/or disease symptoms to monitor for this medication**: |
- Keep patient NPO ?- Consult Gastroenterology (GI) ?- Discontinue Ozempic - Admit patient to the Internal Medicine (IM) ward for further assessment ?- Monitor blood pressure regularly - Provide patient with safety information during hospital stay |
| Route: |
-Home Medications: . Metoprolol Tartrate 50 mg PO daily - for BP control ?. Ozempic 0.25 mg SC weekly - for weight loss ?----------------------------------------------------- - Medications Administered in the ED: ?. Famotidine 20 mg IV - for abdominal pain ?. Ketorolac (Toradol) 30 mg IV - for pain control (NSAID) ?. Metoprolol Tartrate 50 mg PO - for blood pressure control |
| Social History: |
- Smoking Status: Unknown if the patient has ever used tobacco ?- Marital Status: Single ?-?Gender Identity: Female - Sexual Orientation: Straight (heterosexual) |
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