Medication Therapy MonitoringÂEnsures that drug regimen is consistent with all Sharp medication use guidelines and policies (or other evidence-based guidelines in the absence of Sharp-specific guidelines) which includes but is not limited to antimicrobial use guidelines, intravenous to oral, renal dosing, and serum drug concentration protocols.ÂAdjusts regimens based on approved protocols and consultation with the interdisciplinary team.ÂCompletion of a daily profile review for each patient consisting of the following elements:* Age, sex, height, weight, and renal/hepatic function* Pregnancy and lactation status* Appropriateness of the dose, route, rate, timing and frequency of administration, indication, and therapeutic duplication of all medications* Available laboratory values and microbiology resultsAppropriateness of antimicrobial therapy regimens which may include anticipated/planned stopped dates.ÂPotential drug-drug, disease-drug, food-drug interactions, or contraindications.ÂAdherence with Sharp Pharmacy and Therapeutics Committee approved medication use guidelines/protocols.ÂTargeted or therapeutic drug monitoring and pharmacokinetics, and adjustment of drug regimens if necessary.ÂReview documented adverse drug reactions/allergies and report new occurrences.ÂReview for disease progression and resolution of symptoms (e.g., pain).ÂCommunication of necessary information to pertinent health care providers, patients, caregivers, and encourage health promotion and prevention.ÂAssesses the patient’s progression to achieving desired medication treatment goals.ÂAt applicable entities, demonstrates knowledge and competency of chemotherapy dosing, monitoring, and established guidelines. ÂWhen faced with complex situations, has knowledge of and applies the appropriate policies and procedures including but not limited to Chain of Command escalation.ÂEffectively evaluates ongoing workflow issues and directs daily workload to achieve efficiency and maximize resource utilization as business needs require.ÂAttends and participates in staff meetings or reviews staff meeting communications.ÂReads work related email at a minimum on assigned workdays, responding in a professional and reasonable timeframe.