Pharmacy specialists

[Robotjim]

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Whats all in a day's work as a ID pharmacist ? I like pharmacy but I would like to be more involved with patient care and have more patient contact in my career. I have recently been made aware that many pharmacists complete residencies and decide to work in clinical settings...This is obviously quite appealing to me and I would love to learn more...

Do clinical pharmacists order and interpret lab test? do h/p? prescribe meds? Do they just discuss meds with the docs?

Thanks in advance for your help.

 

[Priapism321]

Start here:

http://www.journals.uchicago.edu/doi/pdf/10.1086/510393?cookieSet=1

Look at the key components/members of an effective team.

Here is a trial showing a pharmacist's utility on an antimicrobial management team.

http://www.journals.uchicago.edu/doi/pdf/10.1086/321880

Here is another one, though centered around what pharmacists are doing in the U.K. I think I have read this and it is relatively similar:

http://jac.oxfordjournals.org/cgi/reprint/54/2/295

 

[Priapism321]

Whats all in a day's work as a ID pharmacist ? I like pharmacy but I would like to be more involved with patient care and have more patient contact in my career. I have recently been made aware that many pharmacists complete residencies and decide to work in clinical settings...This is obviously quite appealing to me and I would love to learn more...

Do clinical pharmacists order and interpret lab test? do h/p? prescribe meds? Do they just discuss meds with the docs?

Thanks in advance for your help.

The day to day activities of an infectious diseases pharmacist will vary quite a bit depending on where one practices and what one was hired to do. I have been at an institution where the pharmacists primarily were committed to stewardship activities, and they basically told physicians who weren't ID physicians what they couldn't have (or told ID physicians what they shouldn't want to have and why) all day every day (prospective approval for all restricted antimicrobials [our list was long]). Tough job, but our antibiogram looked good compared to most, and patients rarely even dreamed of receiving a carbapenem or extended spectrum beta-lactam/beta-lactamase inhibitor. This also translates into much less use of expensive, often unnecessary medications.

Conversely, I know an ID pharmacist who primarily serves as a member of the ID Consult service, and she meets with an Attending and Fellow every day, sees the patients with them, makes recommendations about therapeutic strategies, helps with follow up, etc.

Then there are ID pharmacists who fit into a hybrid of the two distinct job descriptions that were elaborated on above. If you were well trained and at a good VA or an Academic Medical Center with a strong Pharmacy Department, ID pharmacists are certainly able to be given order (drugs/labs) writing ability. These individuals also sit on relevant committees that are in charge of setting most drug use policies regarding antimicrobials in an institution.

 

[ItsOverZyvox]

The day to day activities of an infectious diseases pharmacist varies quite a bit depending on where one practices and what one was hired to do. I have been at an institution where the pharmacists primarily were committed to stewardship activities, and they basically told physicians who weren't ID physicians what they couldn't have all day every day (prospective approval for all restricted antimicrobials [our list was long]). Tough job, but our antibiogram looked good compared to most, and patients rarely even dreamed of receiving a carbapenem or extended spectrum beta-lactam/beta-lactamase inhibitors. This also translates into much less use of expensive, often unnecessary medications.

Conversely, I know an ID pharmacist who primarily serves as a member of the ID Consult service, and she meets with an Attending and Fellow every day, sees the patients with them, makes recommendations about therapeutic strategies, helps with follow up, etc. Then there are ID pharmacists who fit into a hybrid of the two distinct job descriptions that were elaborated on above.

If you were well trained and at a good VA or an Academic Medical Center with a strong Pharmacy Department, ID pharmacists are certainly able to be given order (drugs/labs) writing ability. These individuals also sit on relevant committees that are in charge of setting most drug use policies regarding antimicrobials in an institution.

Couldn't wait for you... I made the hire after 6+ months of searching.. well published, very attractive, and all the credentials.. I'll probably end up working for her..

 

[RxWildcat]

You should do a search on clinical pharmacy and you'll find lots of info already here in the forums.

 

[Priapism321]

Couldn't wait for you... I made the hire after 6+ months of searching.. well published, very attractive, and all the credentials.. I'll probably end up working for her..

Seems like you made the right decision.......for now.

Just read an article on PNA FISH detecting resistant enterococcal bacteremia much faster than the conventional methods published by a group from the University of Maryland.

 

[ItsOverZyvox]

Seems like you made the right decision.......for now.

Just read an article on PNA FISH detecting resistant enterococcal bacteremia much faster than the conventional methods published by a group from the University of Maryland.

ehhhh...I thought I emailed you that study....
PNA FISH differentiates faecalis to feacium in 90 minutes... so it lets us know Ampi... or Ampi/vanc/Zyvox..

 

[Priapism321]

ehhhh...I thought I emailed you that study....
PNA FISH differentiates faecalis to feacium in 90 minutes... so it lets us know Ampi... or Ampi/vanc/Zyvox..

You probably emailed me a study on enterococcus, but I believe this one was just e-published ahead of print in AAC...

 

[Priapism321]

Is this new? There are a couple female pharmacists on this study, one may even be your new hire.....who knows?

http://aac.asm.org/cgi/content/abstract/AAC.00283-08v1

 

[ItsOverZyvox]

Is this new? There are a couple female pharmacists on this study, one may even be your new hire.....who knows?

http://aac.asm.org/cgi/content/abstract/AAC.00283-08v1

I stand corrected dude... I had their Poster. This is the real thing. I'm going to get it printed.

 

[SpirivaSunrise]

Is this new? There are a couple female pharmacists on this study, one may even be your new hire.....who knows?

http://aac.asm.org/cgi/content/abstract/AAC.00283-08v1

Small world! I know some of them!

 

[Priapism321]

Small world! I know some of them!

Very interesting.......the druggists on the paper are Weekes and Toombs no? I think it says Weekes is now in Colorado.

 

[SpirivaSunrise]

And I may be jumping ship...switching to hospital pharmacy. We'll see what happens in the next few weeks...

 

[Priapism321]

And I may be jumping ship...switching to hospital pharmacy. We'll see what happens in the next few weeks...

Even more interesting......back to Florida, somewhere new, or is that also up in the air???

 

[SpirivaSunrise]

Even more interesting......back to Florida, somewhere new, or is that also up in the air???

Yeah, that's also up in the air. There are a lot of changes happening and I'm not very happy with the direction things are going at my location. Nuclear's got a special place in my heart though, and I feel like I have a lot to bring to the table. So, we'll see.

I miss the inpatient side of things though...

 

[njac]

the ID docs at current rotation aren't buying into the PNA fish hype.

but I think the lab dude is mostly talking about staph at the moment.

 

[ItsOverZyvox]

the ID docs at current rotation aren't buying into the PNA fish hype.

but I think the lab dude is mostly talking about staph at the moment.

You know why? Because it wasn't their idea... and it changes their practice. Many ID docs who see patients get paid everyday they are there to see the patient... and if LOS suddenly drops by 2 to 3 days...that's that much less they make. Also, with PNA-FISH, non-ID physicians can suddenly know how they are going to treat some infections..

Institutional ID physicians may welcome PNA-FISH...but private ID physicians may not be too crazy about it. Certainly, many of them aren't fully aware of how PNA FISH works. There are other microbio technology out there fore rapid identification also.