Hospital Pharmacist

Pharmacists working in acute and community hospitals are a crucial part of the healthcare team. They are involved in the provision of pharmaceutical services in the hospital.

Hospital Pharmacists regularly attend ward rounds with doctors and are involved in selecting and managing the pharmacotherapy of their patients, to produce optimal outcomes from their treatments. Aside from working on the wards, the hospital pharmacists are involved in the manufacturing of sterile medicines, such as injectable antibiotics, nutritional infusions and sterile eyedrops.

Other daily major responsibilities include dispensing of medications and providing medication counselling, providing information on medicines to the public and healthcare professionals and managing the purchase, distribution and inventory of medicines for the whole hospital. The hospital pharmacist also documents, reports and manages adverse drug reactions, evaluates the appropriateness of drug use and may be involved in the general management of the hospital as well.

Hospital Pharmacists also run disease management clinics in the hospitals such as the anticoagulation clinic, heart failure clinic and lipid clinic, in collaboration with doctors to optimise patient care. Other patient-oriented services provided by the pharmacists include medication management service to help patients organise their medication needs, and counselling programmes to improve knowledge and compliance of medications to prevent drug interactions and minimise drug-related complications.

Some hospital pharmacists are recognised as Specialist Pharmacists in areas of practice such as oncology, critical care, nutrition, infectious disease and psychiatry. They play a major role in the selection, optimisation and monitoring of the medications used in the treatment of diseases. They provide input to hospital committees and assist to formulate policies and recommendations to improve standards of patient care and best practices. These include representation at the hospital Pharmacy and Therapeutic committee, Antimicrobial Stewardship Programmes to rationalise the use of antibiotics within the hospital, and medication evaluation initiatives. Professional education and research are also core activities of a Hospital Pharmacist.

There is also a growing number of American Board-certified specialist pharmacists in clinical specialties as described below:

Oncology Pharmacist

Oncology Pharmacists review all drug orders for the cancer patient and ensure that the orders are accurate and complete, and in keeping with patient?s laboratory results. They oversee the compounding and administration of chemotherapy drugs, making sure that mixing is done in a bacteria-free area called a cleanroom.

Oncology pharmacists also ensure protection of healthcare staff and the environment in the use and disposal of chemotherapy preparations which are potent substances. Other daily routine of an oncology pharmacist includes tracking of drug dosages and toxicity, looking out for signs of hypersensitivity, counselling patients on unpleasant side-effects of chemotherapy drugs, advising nurses and other members of the oncology team on symptoms management and reviewing new study protocols. The oncology pharmacist also facilitates all research studies in the oncology unit making sure patients enrolled in clinical trials receive the accurate dose of the drug at specified times as outlined in trial protocols.

Critical Care Pharmacist

Critical Care Pharmacists are in the front line of acute medical care. They perform ward rounds with a multidisciplinary team of healthcare professionals, the major role being to optimise the use of critical medications in the intensive care units (ICUs) in the hospital. Critical Care Pharmacists advise on the selection of medications, appropriate dosing, identifying potential adverse effects and drug interactions and perform therapeutic drug monitoring.

As ICU patients usually require many different medications, the critical care pharmacists play a vital role in optimising the total medication regime. They also provide information to health professionals about the unique characteristics of medication dose response in critically ill patients and they are involved in teaching and research activities as well.

Psychiatric Pharmacist

Psychiatric Pharmacists play an essential role in the safe, quality and effective use of medications in improving mental wellness. They are part of the mental healthcare team and are instrumental in managing medication-related issues to complement the holistic care for patients with psychiatric conditions.

Psychiatric Pharmacists provide education to patients and caregivers on the safe and appropriate use of medications, counsel on medication compliance, monitor and manage medication side-effects, as well as screen for dangerous drug interactions.

The specialist pharmacist also reviews medication therapy for psychiatric and concurrent medical problems, and provide recommendations that would enhance treatment outcomes and facilitate the continuity of care of these patients into the community.