Positive/Negative Clinical intervention

[rxforlife2004]

I just went for a job interview last week and the pharm director asked me if i could explain in details about a positive/negative clinical intervention during hospital rotations...Boy, am i the only person here that hates these kinda questions? Or anyone knows how to handle such questions? Grr...i think i bombed it...

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[sdn1977]

I'd say you need to do some reading on outcomes management of clinical pharmacy interventions.

Just because you can get a dose to achieve a particular vancomycin trough does not necessarily mean you've done the pt any good - especially when you've not looked at the peak & kept that where it should be.

Sorry about the interview - but, this will give you something to work on for the next one.

 

[golf299]

Vanco is a time dependent drug, thus, time above MIC is what you need to worry about, not peak concentrations. Target a level of about 4-5x that of the MIC of the bug and keep it at that level for at least 50% of the time and you should be good.

 

[sdn1977]

Vanco is a time dependent drug, thus, time above MIC is what you need to worry about, not peak concentrations. Target a level of about 4-5x that of the MIC of the bug and keep it at that level for at least 50% of the time and you should be good.

Good job - but.....that was not the point.

The point was being able to discern a positive or negative clinical intervention. I just used vanco as an example of how it could be used either way.........

 

[dumediat]

Well, usually I'm a pretty good BSer, but those questions do throw me sometimes. For that particular question, though, I think it boils down to whether your intervention ultimately helped the patient in the long-run. If you ended up, say, giving a patient ampho B to treat sepsis, but the patient died 2 days later from ARF, then that's a negative clinical intervention. But, if you treated another patient with clindamycin for a life-threatening peritoneal B. fragillis infection, and you cured the infection but temporarily gave the patient CDAD, that would be a positive clinical intervention. Hopefully that helps a bit.