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BreathlessPharmacy technician roles in helping clients

with respiratory conditions

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The views I am presenting today are my own from my experience and references I am able to supply to you if you are interested. They do not reflect the opinions of the Calgary Health Region and I do not work for the region or AHS.

I have accepted funding for speaking many times from different pharmaceutical manufacturers and organizations including, AstraZeneca, GSK, Nycomed, Anaphylaxis Canada and Pfizer

Disclaimer

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Asthma and allergies Chronic Obstructive Pulmonary Disease Croup, RSV, Infectious disease Sleep apnea Smoking

Common respiratory conditions

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Antibiotics for infections Inhalers for symptoms and prevention Devices used for inhaled medications Over the counter treatment Information on self care Medication reconciliation role of technicians

Medications are a mainstay

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The trouble all begins at the nose Sinuses add to the mix Move on down to the throat, larynx Lungs and airways Branching off to alveoli Problems can occur at all levels

Anatomy of the respiratory system

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We breathe in through the nose, which warms, humidifies and cleans the air.

Once it enters the lungs the blood flowing past the alveoli through the capillaries take the oxygen out of the air and dump the carbon dioxide into the lungs to be blown off as we breathe out.

Physiology

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Asthma is likely present in about 5 per cent of the population making it the most common chronic disease, it affects children and adults.

COPD incidence is rising dramatically , especially among women.

Allergies (allergic rhinitis especially) which can affect breathing are one of the most common causes of visits to MD

How common are respiratory diseases in the general population?

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Every person in Canada who has a respiratory condition, like asthma, will see pharmacy staff.

They are getting prescriptions filled or are looking for help in the OTC section for cough, allergies, chest congestion (phlegm or mucus)

They are looking for smoking cessation aids They are looking for allergy treatments They are looking for sleep aids

Why is pharmacy important to respiratory conditions?

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Be able to recognize people who have these conditions.

Know the treatments and how to use them Recognize problems in use of medications

either on the medication profile or in talking with clients about questions they have .

Some studies estimate that up to 80% of people are using metered dose inhalers incorrectly.

How can pharmacy staff help?

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This is a real team effort which starts with correct diagnosis by physician who orders treatment or further tests

The pharmacy staff can ensure safe and effective medication use while filling prescriptions, labeling, dispensing, educating clients and families on use of medication

Technicians need to know how devices work and what is appropriate for labeling

Whose problem is it to ensure correct use of medications?

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Information on profile must be correct so that it is loaded to electronic health records correctly. Include demographic info

Discuss with pharmacist if a person is asking for large amounts of medications. If they take too many short acting relievers, there is a problem.

Look back ---way back on profiles to see if there is medications indicating chronic conditions which are not being filled and make pharmacist aware.

PROFILES---Use them

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Make sure you have placebo devices for the pharmacist to demonstrate proper technique and to assess if clients are using it properly.

You can answer question about use and demonstrate in response to questions, but the pharmacist must go over the whole thing with clients.

Technicians are so important at starting the dialogue with clients about device technique

Hands on is best for client

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Placebo Print handouts Local resources Online resources Pharmaceutical industry resources Check the dates on your print material Order more and contact representatives of

manufacturers to get placebo devices if needed at your location

Demonstration needs

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SABA-Short acting bronchodilators Name 3 of them

LABA -Long acting bronchodilators Name 2 of them

Inhaled medications for asthma

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Preventers Name 4 of them

Combination medications Name 2

Add on medications

Case D Foot pro athlete

Inhaled medications continued

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Short acting bronchodilators Name 2 classes

Long acting bronchodilators As for asthma and ? ??

When to use combination inhalers Case P Zoski

Inhaled medications for COPD

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TOP 10 Problems with respiratory meds

What are problems our clients encounter with these medications

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MDI alone and with chamber Diskus Turbuhaler Suspension vs solution

Demonstration of devices

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How do we know if someone has asthma or COPD?

What is an exacerbation? How is it different for the 2 conditions?

What should be done for each? The role of the action plan for patient and

pharmacy staff

Difference between asthma and COPD

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Sinus nasal rinses and drops Nasal aspirator Nasal lubricant gels and sprays for allergies

and dry nasal membranes due to oxygen or CPAP

Oral moisturizers for dry mouth due to medications

And>>>>

Extra products we can carry

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Fortunately asthma deaths are decreasing. Unfortunately COPD incidence is increasing Lung Cancer is increasing

What triggers aggravate these conditions? What is number one preventable health

condition, the fifth vital sign. How does your pharmacy deal with it?

Prevention- don’t just push drugs

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Know where local public health clinics are Help pharmacists who can immunize to

have supplies and information to allow smooth efficient workflow

Proper storage. Accessing provincial supplies Immunization records

Prevention- Vaccinations

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www.anaphylaxis.ca (Allergic Living magazine)

www.lung.ca www.calgaryhealthregion.ca/ican has

animated story for prereaders, forms for parents and teachers, games for kids and demos of device use.

www.asthmainschools.com

Resources – Don’t just push drugs