• Advise health care providers on matters pertaining to drug selection while assessing for optimal drug therapy, dosage regimen, effective administration and drug therapy monitoring. Works independently responsible to exercise due care in the dispensing of pharmaceuticals.
• Conduct medication reconciliation: Identify the most complete and accurate list of medications a patient is taking and using this list to provide correct medications for the patient anywhere within the organization upon admission or transition of care.
• Participate in the multidisciplinary ward rounds/meeting.
• Assess current medication therapy; patient\xe2\x80\x99s medical record should be reviewed in conjunction with the medication administration record and medication history obtained. Recent consultations, pathology results and investigations, treatment plan and daily progress should be taken into account when determining the appropriateness of current medication therapy and when planning patient care.
• Prevent, detect, and resolve medication-related problems, make appropriate evidence-based, patient-centered medication therapy recommendations as part of the interdisciplinary team.
• Recommend appropriate therapy for individual patients where evidence is not available, controversial evidence exists or other professionals may challenge advice.
• Provide advice on the pharmaceutical and pharmacodynamics properties of drugs including alterations of these parameters in \xe2\x80\x98special groups\xe2\x80\x99 of patients.
• Contribute to the organizations wider antimicrobial surveillance program, implement local programs ensuring appropriate antimicrobial prescribing within general practice.
• Attend Consultant/GP white board/MDT meetings to actively facilitate and provide advice on the treatment of patients.
• Undertake medication reviews with patients to support optimum therapy and adherence.
• Perform on shift and is expected to be on call for emergencies as required.
• Direct and guide Assistant Pharmacists, and related staff.
• Evaluate response to drug therapy using patient\xe2\x80\x99s existing parameters.
• Therapeutic Drug Monitoring (TDM): interpretation, monitoring, and communication of measured drug concentrations in body fluids to optimize medication efficacy and minimize toxicity.
• Interpret each prescription before filling to ascertain if strength and dosage prescribed are within patient tolerance.
• Review patient profiles to check for: Drug vs Drug Interaction; Drug vs Patient Allergies; and Drug vs Patient Diet Restriction and dosage suitability.
• Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients and healthcare providers
• Provide medication counseling throughout patient\xe2\x80\x99s journey.
• Resolve discrepancy within the shift and make report, of not resolved refer the problem to the Supervisor.
• Management of medication errors and adverse drug reactions.

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