Monday, October 4, 2010

Rotation 2: Arrhythmias, Heart Failure, CAD, Hypertension and the list goes on!

Posted by Omo at Monday, October 04, 2010

After going through my cardiology rotation, I can gladly and proudly say that I learned a great deal within the short time span of a month. My rotation was at the University of Michigan Hospital. My typical day involved me waking up at about 5am to work-up my patients then head off to the hospital for early morning rounds. After rounds, we would meet with our preceptor to discuss all the patients that we rounded on, usually focusing on their drug therapy and medication plans. It took me a while to blog about this rotation because I have so much to share so I tried to condense it as best as I could. Feel free to contact me for more info/questions.
Here are a few pertinent things I learned.

1. In dealing with patients, focus on drug therapy!
When rounding with a medical team, it is easy to get sucked into all their recommendations for patients with regards to their drug therapy. Most times, the medical team is right about choosing medications for a patient but they do not always choose the best medication for a specific patient. We are pharmacists in the making and our job is to make sure that every patient is on the best medication for their disease state. These include accounting for drug interactions, therapeutic duplications and disease state. While on my cardiology rotation, I learned to look at each patient’s condition and ensure that they were on all the right medications without being influenced by the medical team’s decision.

2. Don’t sleep on Evidenced Based Medicine (EBM) and Keeping up with Literature!
This rotation provided the opportunity to go through over 100 important journal articles/reviews in cardiology. I was able to connect groundbreaking studies with recommendations for drug therapy. For example, according the 4S Lancet trial, we know that any patient with coronary artery disease (CAD) should be on a statin. I would go through patient’s profile and ensure that they were on a statin and I found myself making an intervention/suggesting a statin to the medical group on more than one occasion. Additionally, if a patient had A-fib, I will be checking to make sure he or she was on warfarin and also ensuring that he or she was followed by an anticoagulation clinic as an outpatient to monitor their INR. These are a few of the interventions I made on a daily basis.

3. Science is always evolving!
Like many other sciences, pharmacy and therapeutics are always changing. To be the best pharmacist you can be to a patient, it is therefore important to stay up-to-date with literature and drug-related issues. My preceptor was a very good role model because he was very current with pharmacy and drug related issues not only pertaining to the field of cardiology. One advice he gave that resonates with me all the time is to continuously educate myself even after graduating from pharmacy school. It is very easy to say that we would try to stay current with the information but when we get out to the work force and have other responsibilities, it is easy to get swamped and forget to keep up with continuous education. This is something I am going to be very conscious of and I advice my fellow students to be conscious of this too!

Overall, the rotation was awesome. I learned a great deal and I am very happy I had it early on in the year because I feel more prepared for my other rotations!!!


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