Always review Pt medications for the following:

• Allergies, ADRs, toxi0city, and potential drug or food interactions.
• Contraindications or improper drug selection.
• Efficacy or medication being used without an indication.
• Overdose or subtherapeutic dose (consider age, renal/hepatic impairment) and appropriate duration of therapy.
• Medication duplication.
• Weight changes requiring dosage adjustments.
• Appropriate duration of therapy.
• Adherence with prescribed medication therapy.