Pharmacoeconomics and Safe Medication Use

Learning Objectives

Apply the principles of pharmacoeconomics to

patient care.

adverse drug event (ADE), a preventable ADE, and

an adverse drug reaction (ADR).

Design an ADE reporting program, including com-

mittee structure, committee reporting mechanisms,

and methods of detecting, reporting, and managing

ADEs.

Provide recommendations for improving medication

use safety using the 2017 SCCM Safe Medication

Use Guidelines for the ICU.

Provide safety measures for drug interaction detec-

tion and prevention.

Develop a drug formulary proposal.

Adverse drug event

CDS

Clinical decision support

EHR

Electronic health record

P&T

Pharmacy and therapeutics (committee)

Self-Assessment Questions

Answers and explanations to these questions may be

found at the end of this chapter.

Questions 1 and 2 pertain to the following case.

Your institution wants to evaluate the addition of coagu-

lation factor Xa (recombinant), inactivated-zhzo to your

formulary for reversal of direct oral anticoagulants.

Which best describes the type of cost this medica-

tion would have?

data to evaluate the impact of this medication on

neurologic disability and cost compared with pro-

thrombin complex concentrate. Which analysis

would be best to find in the literature?

A 60-year-old patient is admitted to the surgical ICU

with a documented history of cefuroxime allergy

(shortness of breath). The patient is administered

ceftriaxone and develops a life-threatening anaphy-

lactic reaction. Which best describes this patient’s

reaction to ceftriaxone?

A 50-year-old patient is admitted to the neurology

ICU from the medical floor for the management of

an apixaban-induced cerebral hemorrhage. Which

medication would best have been used as an effec-

tive tracer medication to help detect this ADE?

Questions 5 and 6 pertain to the following case.

As a new pharmacist in the medical ICU at your insti-

tution, you have been tasked with improving the safety

of medication use in the ICU. You have read the 2017

SCCM Guidelines for Safe Medication Use in the ICU

and are prepared to provide recommendations to the

interdisciplinary critical care committee regarding your

suggestions.

According to the grading system of the guideline

recommendations, which is the best initial recom-

mendation to improve medication use safety, given

the strength of recommendation?

health record (EHR) systems to improve

communication.