PHARMACIST’S CARE PLAN

HEALTH PHARMACOTHERAPEU RECOMMENDATIO MONITORING DESIRED FREQUENC

CARE NEED TIC GOAL NS & PARAMETERS ENDPOINT Y
INTERVENTION
FOR THERAPY

Respectfully suggest to
comply:
NAC 600mg/tab diisolved in
½ glass of water OD Cough with phlegm (-)occurrence Daily
Salbutamol + Ambroxol 2cc Monitor for
Management for To eradicate the infection caused neb q6h RR;insomnia RR- 120to 20 Daily
VAP-MDRO by k. pneumonia and P. aeroginos breaths/min Daily
Chlorhexidine TID (-) insomnia
Doxofylline 100mg/5mL Infection
TID Gum bleeding (-)infection
Daily
(-)bleeding
Daily
-VITAMIN C 1g 2 tabs BID
for the immune system Monitor liver
function ALT/AST 30-65u/L ALT
Respectfully suggest to add 15-37U/L AST Before and after
Carbapenems for the VAP treatment
and suggest to have culture
and sensitivity testing prior to
initiating therapy

Respectfully suggest to
Management for To help stop the harmful antibodies comply:
GBS (AMSAN damaging the nerves and to provide IMMUNEGLOBULIN IV Monitor for BP BP 120/80 mmHg
Daily
TYPE) further recovery from GBS 7doses

HYDROCORTISONE Monitor for serum SGlucose3.9-6.1

50mg q6H IV glucose and mmol/L Before, during
electrolytes and Electrolytes- normal and after therapy
presence of (-)infection; WBC
infection( WBC) 4-11x10/L
 To prevent increase risk in having a Respectfully suggest to Monitor for Na 140-148 mmol/L Every month
low sodium in the body comply: Electrolytes Na, K K 3.6-5.2 mmol/L
(hyponatremia-common electrolyte NaCl 1 tab TID concentration
abnormality of GBS)
Respectfully suggest to
Discontinue Tolvaptan 15mg
¼ tab OD

To treat constipation and diarrhea Respectfulyy suggest to

(s/s of GBS) comply :
LACTULOSE 30cc HS Monitor for bowel
Management for movement patterns 1 to 3 times Daily
GBS (AMSAN LACTOBACILLUS TID
TYPE) (YAKULT) to manage
diarrhea

To manage the neuropathic Respectfully suggest to

conditions characterized by comply : Daily
progressive weakness URIDINE + VITAMIN B Monitor for mild (-) occurrence
COMPLEX 1 tab OD upset stomach of
flushing
VITAMIN B COMLEX 1
TAB TID FOR
NUTRITIONAL
SUPPLEMENT

For stress ulcer prophylaxis Respectfully suggest to Monitor for (-)occurence During treatment
comply : Dizziness
OMEPRAZOLE 40 mg 1
tab OD

To manage insomnia Respectfully suggest to Monitor for sedation, (-)occurence During therapy
comply : confusion
CLONAZEPAM 2mg ½ tab
HS
 Management for Respectfully suggest to
Hypertension Stage To control BP pressure within comply : <140/90mmHg Daily
Blood Pressure
II normal range <140/90mmHg LOSARTAN 100mg/tab 60-100bpm
Heart Rate
(uncontrolled) OD
AMLODIPINE 10mg tab
OD

To relieve symptoms of angina Respectfully suggest to

pectoris such as chest pain and comply : Monitor for Chest (-)chest pain Daily
reduce complications such as ISMN 30mg /tab 1 tab BID pain
stroke, MI for chest pain

Respectfully suggest to Monitor for bleeding

comply: Anti Factor Xa (-)bleeding Daily
0.5-1.2IU/mL After the dosing
FISH OIL BID

Management for To prevent blood clotting and to Respectfulyy suggest to

CVD INFARCT prevent complications comply : -Monitor for 1) 1)RBC 4-
-ENOXAPARIN 0.6 cc SC RBC,Hgb, Hct, 6X10^12/L 1)Before, during
OD platelet count; HGB 120-180g/L and after
2)Bleeding PLT 150- treatment;
Respectfulyy suggest to add : 450X10^9/L; 2)During
PROTAMINE SULFATE 2) (-)BLEEDING treatment
IF BLEEDING IS
SUSPECTED