Medication Therapy MonitoringEnsures 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.Adjusts regimens based on approved protocols and consultation with the interdisciplinary team.Completion 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.Potential drug-drug, disease-drug, food-drug interactions, or contraindications.Adherence with Sharp Pharmacy and Therapeutics Committee approved medication use guidelines/protocols.Targeted or therapeutic drug monitoring and pharmacokinetics, and adjustment of drug regimens if necessary.Review documented adverse drug reactions/allergies and report new occurrences.Review for disease progression and resolution of symptoms (e.g., pain).Communication of necessary information to pertinent health care providers, patients, caregivers, and encourage health promotion and prevention. As applicable, understands investigational drug protocols and procedures for investigational drug research studies, implementation, administration, and record keepingParticipates in cost management initiatives including managing appropriate inventory levels to decrease staleness & wastage and keep Inventories low; reduce waste attempts to reduce expired meds and use short-dated items before they expire, etc.Oversees pharmacy operations and provides direction to Pharmacist Residents, Pharmacist Interns, Pharmacy Technicians, and other non-licensed personnel.