August Rotation - Advanced Hospital (@ Mission Hospital)
I started my Advanced Hospital rotation this week. This rotation essentially exposes us to the inter-workings of the hospital, and allows us to learn about most of the roles of a pharmacist in the hospital. I say most only because there are so many areas that a pharmacist can work in, and we simply don’t have enough time to see it all! Most of this rotation is the “non-patient care” part of pharmacy – not to say we aren’t taking care of patients, but we have less face time with patients, and it’s more of the background work. Some of my experiences include kinetics dosing, core pharmacy, metabolic support, cancer center, pharmacy informatics, management, operating room, emergency department and off-site filling facility. Some other experiences that are offered on this rotation that I will not be doing is pediatrics (I have a rotation in this in March, I’m SO excited!), pharmacogenomics, psychology, etc. My preceptor’s name is Jordan. She got her PharmD at UNC, and did her Residency at Mission Hospital!
My first day was awesome! I think part of it was finally doing something real. Not to say my past three months have been a waste, but I haven’t truly put my pharmacy knowledge into good use. I’m spending the first two weeks in the CTC, where I’ll be doing pharmacokinetics dosing. The last two and a half weeks I’ll spend on those mini-rotations.
Pharmacokinetics. What is it? It’s “the clinical application of the principles of drug absorption, distribution, metabolism and excretion to the safe and effective therapeutic management of drugs in an individual patient.” We use patient characteristics (such as age, weight, and lab values) to calculate personalized doses for patients. I’m focusing on dosing aminoglycosides (a class of antibiotics), vancomycin (an antibiotic), warfarin (anticoagulant aka blood thinner), phenytoin (a seizure medication), vitamin D, and occasionally adjusting medications based a patient’s renal function (how well the kidney is doing!). A lot of times doctors will prescribe these medications, and will call in pharmacy to “consult” on them. Then we’ll calculate a dose if it’s a new start, or adjust based on changes if the patient has been on the medication. See, there’s more to a pharmacist than what most people think! We’re doing some hard work in the background :P See above for an example of what some of my notes look like while calculating doses.