Intervention Date
Pharmacist
Hagel, H
Smith, J
Med Rec No.
Prescriber
ABELE BRUCE, MD
AIGNER, SCOTT W, MD
ALEXANDER, TERENCE A, MD
ANDERSON, THADDEUS L, MD
Age
- none selected -
Less than 18 Years
18-44 years
44-65 years
Greater than 65 years
Problem ID
- none selected -
Order processing
Pharmaceutical care
Target drug review
ADE program
Drug therapy monitoring
Kinetic service
Nurse inquiry
MD Inquiry
Patient inquiry
Other
Gender
- none selected -
Male
Female
Time Est. (min)
Current Drug
ADDERALL XR CAP 10mg 100
AMOXICIL CAP 250 mg
ACYCLOVIR 500 mg /10 ml vial
Dose in mg
Doses per day
New Drug
ADDERALL XR CAP 10mg 100
AMOXICIL CAP 250 mg
ACYCLOVIR 500 mg /10 ml vial
Dose in mg
Doses per day
Problem Class
- none selected -
Unnecessary Drug
Dose Too Low
Low Dosage
Adverse Drug Reaction
Dosage Too High
Inappropriate Compliance
Needs Drug Therapy
Problem Type
- none selected -
Actual
Potential
Recommendation
- none selected -
Change dose
Add medication
Stop medication
Dosage form change
Duration change
Educate patient
Medication change
Non-drug therapy
Obtain lab results
Route change
Continue unchanged
Patient Risk
- none selected -
None
Low
Moderate
Serious
Intervention
- none selected -
Consult Prescriber
Phone Prescriber
Note to Prescriber
Educate Patient
Monitor Patient
Notify Payer
Refer Patient
Sent Report
Other
Result
- none selected -
Accepted Recomm
Not Accepted Recomm
Unknown Result
Other
Note:
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