Skip to 0 minutes and 14 secondsOkay then look at drug interactions. For drug interaction, the patient's age disease state kidney and liver function may be attribute to on drug interactions and cause more severe clinical interactions. So and also the length of the therapy with each drug are very important to assess if there is such kind of drug interaction run happened. And then for drug identification and you know a lot of time there are medication with imprint code but sometimes there is no imprint code. Especially for generic drugs. So if there is very difficult to identify the medication, I will actually encourage you not to provide the answer that not very sure.

Skip to 1 minute and 14 secondsAnd also forward drug interference with laboratory tests and this kind of question that's very important to know the medication dosage duration of the therapy and when the specimen was strong and also other medication that use at the same time and they are all very important to determine if there is a such kind of drug interaction and also there are very often pharmacists are requested to help Pharmacokinetic calculation or therapeutic drug monitoring and that kind of question you have to know on the drug correct dosing and the patient's age weight height liver and kidney function and therapeutic use and what kind of route of the medication has been given and so those questions are lots can be included into this category.

Skip to 2 minutes and 28 secondsFor example dosage adjustment according to liver or renal impairment and also dosage conversion and also if for the medications really achieve our goal of a therapeutic level and also we want pobably be requested what's the best time what is the best time to draw the blood ? and also when the medication is actually reaching as a steady state and we can serve to draw the blood and the duration of drug therapy is also very important. So then we go to the other category about teratogenicity and if he medication is existed in breast milk. And this category we have actually know many references. So let's very need to be very careful to interpret what you have on your hand.

Skip to 3 minutes and 37 secondsbecause a lot of time, it happened to such kind of situation a patient may come and find out she just get positive on the pregnant test results but she may actually worry about a few weeks a few days ago and she has been taking some medication for cold or some other some other symptoms. and it's kind of very worried. about the lady if that's actually hurt the baby. So, you know in such kind of a situation and there are very limited study because actually no IRB will approve such kind into a randomized control trial. So you only actually rely on some cases that just unintentionally taking of medication in pregnancy duration.

Skip to 4 minutes and 48 secondsSo they are very limited results and all sometimes we realize on animal studies. So we have to give a very balanced answer to this kind of situation. So we need to actually assess when the medication is actually initiated and at what gestational age or the route the duration and how about the total dose and then when we present the results to the patient or healthcare providers. We need to be very careful just providing an unbiased data.

Categorization of questions from requesters 2

In this video, Prof. Shawn Chen elaborates on another 5 categorization of the questions from requesters.

As a pharmacist, we need to know the background information required in drug interactions, drug identifications, drug interference with laboratory tests, pharmacokinetic calculation or TDM, and finally teratogenicity from excretion in breast milk.

Besides, there is limited study for the cases who are pregnant. The reason is that no IRB will approve such randomized control trials. Therefore, we need to be very careful to interpret the literature.

Have you ever struggled on pregnant cases in your clinical work? Please share your experience below.

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This video is from the free online course:

Evidence-Based Medicine in Clinical Pharmacy Practice

Taipei Medical University