What does an inpatient pharmacist do?

Each day nearly 200 pharmacists around MD Anderson dispense an average of 23,000 drug doses. That’s 8.4 million doses a year, one of the highest volumes of any cancer care center in the U.S.

Inpatients receiving cancer treatment receive the vast majority of that medication – almost 7 million doses a year. And that’s a challenge that requires the expertise of top-notch pharmacists.

Expertise and experience required

MD Anderson treats more than 400 types of cancer, and many cases are highly complex, so expertise in rare cancers and the complications of treatment is critical.

As inpatient pharmacists on our Central Pharmacy team, Mariamma (Leni) Varghese, Pharm.D., and Ifeoma Okafor, Pharm.D., have that expertise and are experienced collaborators as well.

Okafor and Varghese, who rotate on surgical floors, interact with physicians and advanced practice providers like physician assistants every day. Their combined knowledge of drug interactions and specific drugs for specific conditions reduces the potential for errors.

Even so, as an MD Anderson pharmacist for 19 years, Okafor appreciates the backstop of new technology that can draw attention to mistakes before they happen.

“We’re grateful for our electronic health record system,’’ she says. “The new system flags issues regarding dosage, drug interactions and drug allergies.”

There’s another set of eyes locked on to each prescription as well. Pharmacists and technicians in Central Pharmacy on the first floor of the hospital are working to ensure that medications are safely prepared, checked and delivered to the floors above.

The inpatient pharmacists see themselves as collaborators with patients, too.

Varghese, who began her pharmacy career in the drug industry, came to MD Anderson 12 years ago after realizing how much she missed interacting with patients.

“It’s such a dynamic job,’’ Varghese says. “I meet people from all over the world, and I’m always learning from the patients and their families. It’s an amazing opportunity.”

Playing a part in cancer treatment with patient-tailored drug therapy

In addition to staff pharmacists from the Central Pharmacy, more than 80 clinical pharmacy specialists work in several inpatient and outpatient areas.

Jeffrey Bruno, Pharm.D., is one of 10 clinical pharmacy specialists responsible for ICU patients. He’s worked at MD Anderson since 2005, after completing our second-year residency program in critical care and nutrition support.

“We’re fortunate to be considered core members of the health care teams here at MD Anderson,” Bruno says. “Participating in patient care rounds offers us the opportunity to work alongside the multidisciplinary staff, providing general drug information as well as patient-specific recommendations to help ensure optimal and safe medication therapy.’’

He’s proud of the high level of responsibility our clinical pharmacy specialists have to tailor and monitor medication regimens in collaboration with physicians and advanced practice providers.

“We get to really dive deep into the acute as well as the chronic issues our patients face to provide patient-tailored therapy,’’ Bruno says. “Particularly in the ICU, the ability to help someone in that heightened, vulnerable moment and to see so many patients get over their critical illnesses – that challenges me and also makes me excited to come to work every day.”

An eye to the future

MD Anderson is looking ahead to ensure we have the expertise our pharmacists need going forward. Our Pharmacy residency programs offer training in general pharmacy practice as well as oncology, critical care, infectious diseases and health systems administration specialties.

The residency program provides a pipeline for the future, as nearly 40% of our clinical pharmacy specialists completed residencies at MD Anderson.

Pharmacy residents are attracted to MD Anderson’s emphasis on direct patient care as well as its dedication to training and mentoring, says Bruno, director of Pharmacy’s Critical Care residency program.

“At MD Anderson, we practice at the pinnacle of what we can do as a clinical pharmacist,” he says. “We have good systems, processes and management support, and we feel fortunate that we have a voice at the table. We’re empowered to help guide the patient regimen.”

A longer version of this story originally appeared in Messenger, MD Anderson’s quarterly publication for employees, volunteers, retirees and their families. 

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