Monitors medication therapy regimens for contraindications, drug-drug interactions, drug-food interactions, drug-laboratory test interactions, allergies, appropriateness of drug and dose, indications and therapeutic duplications. Based on knowledge & expertise, develops, assists,implements, and executes all drug therapy management protocols including, but not limited to; pharmacokinetics, renal dose adjustments,anticoagulation dosing, IV to PO, pain management, antimicrobial stewardship, and pharmacy-directed dosing.