Clinical Pharmacist

Pharmacist Duties

Clinical 1) The pharmacist provides appropriate selection of drug therapy based upon the pharmaceutical principles of pharmacokinetics and pharmacodynamics; monitoring for efficacy, side effects and clinical outcome; and advises prescribers as appropriate. 2) Provides patient-specific therapeutic drug monitoring and communicates relevant findings and/or recommendations to other health care providers in charge of the patient both orally and in writing. Monitoring will include prospective review and intervention in: a. Therapeutic appropriateness of a patient's drug regimen b. Therapeutic duplication in the patient's drug regimen c. Appropriateness of the route and method of administration d. Degree of patient compliance with the prescribed drug regimen e. Drug-drug, drug-food, drug-laboratory, or drug disease interactions f. Clinical and pharmacokinetic laboratory data to evaluate the efficacy of drug therapy and to anticipate side effects, toxicity, or adverse effects g. Physical signs and clinical symptoms relevant to the patient's drug therapy 3) Performs continuous evaluation of prescribed medications to ensure optimal drug therapy. 4) Provides medication counseling to patients. 5) Completes medication histories including patient interviews. 6) Serves as a drug information resource by providing up-to-date drug information to prescribers, other health care professionals, patients and caregivers. 7) Participates in patient care rounds, review charts, evaluates pertinent laboratory data, drug-drug and drug-nutrient interactions, monitors for adverse drug effects, and screens for allergies. 8) May performs medication reconciliation at all transitions of care, including updating the medication profile to reflect an accurate, active list of VA and non-VA medications. This may include adding non-VA medications or discontinuing duplicate medications or those the patient is not taking. 9) Assesses drug safety and efficacy, including evaluation of physical symptoms. 10) May reports adverse drug events (ADE), near misses, and medication errors in alignment with VA ADERS reporting program. 11) Participates in the medical center medication utilization evaluation (MUE) program.

Work Schedule : Tuesday-Friday 10:30am - 9:00PM Telework: Ad-hoc Virtual: This is not a virtual position. Functional Statement #: 59895F Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized

US Department of Veterans Affairs