- Review and validate medication orders for appropriateness, dose, route, frequency, interactions, contraindications, and duplications.
- Participate in medication reconciliation at admission, transfer, and discharge.
- Monitor patients' medication therapy and identify drug-related problems.
- Provide evidence-based recommendations to physicians and other healthcare professionals.
- Monitor therapeutic drug levels where applicable and recommend dose adjustments.
- Monitor and document adverse drug reactions and medication errors.
- Provide drug information and counseling to patients, caregivers, doctors, and nursing staff.
- Support antimicrobial stewardship activities and promote rational antibiotic use.
- Participate in clinical rounds with multidisciplinary healthcare teams.
- Review renal and hepatic function when assessing medication dosing.
- Assist in developing and updating hospital drug protocols, formularies, and medication-use guidelines.
- Promote secure medication practices and compliance with hospital policies.
- Support pharmacovigilance and reporting of adverse drug reactions.
- Provide patient counseling regarding medication use, adherence, precautions, and possible adverse effects.
- Maintain accurate clinical documentation and intervention records.
- Participate in pharmacy audits, quality-improvement initiatives, and medication-safety programs.