Skill Medication Manager: Удобный помощник по приему лекарств

--- name: medication-manager description: "Comprehensive medication management skill for tracking prescriptions, monitoring adherence, checking drug interactions, managing refills, and providing medication education. Supports chronic medications, PRN/as-needed drugs, and complex multi-drug regimens. Triggers on: medication, prescription, drug, medicine, pill reminder, refill, interaction, side effect, my meds, when to take, dosage." allowed-tools: [bash, glob, read] version: "1.0.0" --- # Medication Manager — Your Personal Pharmacy Assistant Comprehensive medication management skill to help you take the right medications at the right time, avoid dangerous interactions, and stay on top of refills. ## Core Capabilities ### 💊 **Medication Tracking** - Current prescriptions and dosages - PRN (as-needed) medication logs - Over-the-counter supplements - Allergy medications and emergency meds ### ⏰ **Adherence Monitoring** - Daily medication schedule - Adherence rate calculation - Missed dose tracking - Pattern analysis (e.g., weekend effect) ### ⚠️ **Safety Checks** - Drug-drug interaction screening - Drug-allergy cross-check - Contraindication alerts - Side effect monitoring ### 📦 **Supply Management** - Refill reminders - Days supply tracking - Prescription expiration alerts - Pharmacy coordination ## Medication Categories I Track ### By Schedule | Type | Description | Examples | |------|-------------|----------| | **Scheduled** | Taken at specific times | Daily BP meds, twice-daily diabetes meds | | **PRN (As-Needed)** | Taken when symptoms occur | Pain relievers, rescue inhaler | | **Cyclic** | Based on cycles or phases | Hormonal contraceptives, fertility meds | | **Tapering** | Gradually changing dose | Steroid tapers, antidepressant discontinuation | | **Single Course** | Short-term treatment | Antibiotics (usually 7-14 days) | ### By Purpose - **Chronic disease management** (ongoing) - **Symptom relief** (PRN) - **Preventive** (vaccines, prophylaxis) - **Supplements** (vitamins, minerals, herbs) ## Data Structure ### medication-registry.json ```json { "active_medications": [ { "id": "med_001", "name": "Lisinopril", "generic_name": "lisinopril", "brand_names": ["Prinivil", "Zestril"], "drug_class": "ACE Inhibitor", "purpose": "hypertension", "prescribed_by": "Dr. Smith", "prescribed_date": "2025-08-10", "dosage": { "strength": "10", "unit": "mg", "form": "tablet" }, "schedule": { "type": "fixed_time", "frequency": "daily", "times": ["08:00"], "with_food": false, "instructions": "Take in the morning" }, "supply": { "quantity_dispensed": 90, "quantity_remaining": 45, "days_supply": 90, "days_remaining": 45, "refills_left": 2, "refill_due": "2026-04-15", "pharmacy": "CVS Pharmacy #1234" }, "adherence_log": [ {"date": "2026-03-20", "taken": true, "time": "08:05", "notes": ""} ], "side_effects": ["dry_cough"], "allergies_related": false, "status": "active" } ], "discontinued_medications": [...], "adherence_summary": { "overall_30day": 0.94, "overall_7day": 1.0, "by_medication": { "med_001": 0.95, "med_002": 0.93 } } } ``` ### prn-medication-log.json ```json { "medications": [ { "name": "Acetaminophen", "max_daily_dose": "4000mg", "usage": [ { "date": "2026-03-19", "time": "14:30", "dose": "500mg", "reason": "headache", "effective": true } ], "monthly_usage": { "march_2026": 6 } } ] } ``` ## Universal Drug Interaction Check ### Severity Levels | Level | Description | Action Required | |-------|-------------|-----------------| | **Contraindicated** | Never combine | Absolute avoidance | | **Major** | May be life-threatening | Usually avoid combination | | **Moderate** | Significant concern | Monitor closely, may need dose adjustment | | **Minor** | Minimally significant | Monitor, usually manageable | ### Common Major Interactions to Watch | Drug 1 | Drug 2 | Effect | Management | |--------|--------|--------|------------| | Warfarin | Aspirin/NSAIDs | Increased bleeding | Avoid or monitor INR closely | | ACE-I/ARB | Potassium supplements | Hyperkalemia | Avoid combination | | Statins | Clarithromycin | Myopathy/rhabdomyolysis | Use azithromycin instead | | Metformin | Contrast dye | Lactic acidosis | Hold metformin 48h before/after | | MAOIs | Tyramine foods | Hypertensive crisis | Strict dietary restrictions | ## Adherence Tracking ### Adherence Calculation ``` Adherence Rate = (Doses Taken / Doses Prescribed) × 100 Example: - Prescribed: 1 tablet daily × 30 days = 30 doses - Taken: 28 doses - Adherence: (28/30) × 100 = 93.3% ``` ### Adherence Interpretation | Rate | Category | Action | |------|----------|--------| | ≥95% | Excellent | Maintain current regimen | | 85-94% | Good | Monitor for barriers | | 75-84% | Fair | Identify and address barriers | | <75% | Poor | Immediate intervention needed | ### Common Barriers to Adherence 1. **Forgetfulness** → Reminder systems, pill organizers 2. **Complex regimen** → Simplify if possible, combination pills 3. **Side effects** → Discuss alternatives with doctor 4. **Cost** → Generic alternatives, patient assistance programs 5. **Lack of understanding** → Education about condition/medication 6. **Cultural beliefs** → Address concerns respectfully ## Refill Management ### Refill Timeline | Days Remaining | Action | |----------------|--------| | 7-10 days | Request refill | | 3-5 days | Urgent refill needed | | <3 days | Contact pharmacy immediately | | 0 days | Emergency supply may be needed | ### Automatic Refill Criteria - Chronic maintenance medications - Stable dosing for >3 months - No recent changes - Good adherence history ## Special Medication Protocols ### Warfarin Management - **INR monitoring**: Weekly when starting, then per protocol - **Target INR**: Usually 2.0-3.0 (individualized) - **Diet**: Consistent vitamin K intake - **Interactions**: Many drugs affect INR ### Insulin Management - **Types**: Rapid, short, intermediate, long-acting - **Timing**: Critical for meal-time insulin - **Storage**: Refrigerate unopened; room temp for in-use - **Monitoring**: Blood glucose before each dose ### Opioid Management - **Risk assessment**: Opioid risk tool at initiation - **Monitoring**: Pain scores, functional improvement - **Naloxone**: Recommended for high doses or risk factors - **Disposal**: Safe disposal of unused medication ### Biologics - **Storage**: Refrigeration critical - **Timing**: Precise intervals - **Missed dose**: Specific protocols per drug - **Infection risk**: Screen for TB, hepatitis ## Output Report Format ```markdown # Medication Management Report — March 20, 2026 ## 💊 Current Medications (4 Active) ### Morning Medications (8:00 AM) | Medication | Dose | Purpose | Days Left | Refills | Adherence | |------------|------|---------|-----------|---------|-----------| | ✅ Lisinopril | 10mg | BP | 45 | 2 | 95% | | ✅ Metformin | 1000mg | Diabetes | 30 | 1 | 93% | | ✅ Atorvastatin | 20mg | Cholesterol | 60 | 3 | 100% | ### Evening Medications (8:00 PM) | Medication | Dose | Purpose | Days Left | Refills | Adherence | |------------|------|---------|-----------|---------|-----------| | ✅ Metformin | 1000mg | Diabetes | 30 | 1 | 93% | | ✅ Aspirin | 81mg | Heart | 90 | 5 | 98% | --- ## 📊 Adherence Summary ### Overall Adherence (Last 30 Days) | Period | Rate | Status | |--------|------|--------| | Overall | 94.2% | ✅ Good | | Last 7 days | 100% | ✅ Excellent | | Last 30 days | 94.2% | ✅ Good | ### By Medication | Medication | 7-Day | 30-Day | Pattern | |------------|-------|--------|---------| | Lisinopril | 100% | 95% | Consistent | | Metformin AM | 100% | 93% | Missed weekends | | Metformin PM | 100% | 93% | Missed weekends | | Atorvastatin | 100% | 100% | Perfect | | Aspirin | 100% | 98% | Very good | **Insight**: Weekend adherence drops for Metformin. Consider linking to consistent daily activity. --- ## ⚠️ Safety Checks ### Drug Interactions **Status**: ✅ No major interactions detected **Minor Interactions to Monitor**: - Metformin + Lisinopril: Potential for kidney function changes - Action: Ensure regular kidney function tests ### Allergy Cross-Check **Status**: ✅ No conflicts with known allergies Known Allergies: Penicillin (anaphylaxis), Sulfa (rash) ### Contraindications **Status**: ✅ No contraindications for your conditions ### Side Effect Tracking | Medication | Reported Side Effects | Severity | Action | |------------|----------------------|----------|--------| | Lisinopril | Dry cough | Mild | Monitor, may need alternative | | Metformin | GI upset (initial) | Resolved | — | | Atorvastatin | None | — | — | --- ## 📦 Refill Status ### Upcoming Refills | Medication | Current Supply | Refill Due | Refills Left | Action | |------------|---------------|------------|--------------|--------| | Lisinopril | 45 days | Apr 15 | 2 | Schedule in 2 weeks | | Metformin | 30 days | Apr 5 | 1 | Schedule now | | Atorvastatin | 60 days | May 10 | 3 | No action needed | | Aspirin | 90 days | Jun 15 | 5 | No action needed | ### Prescription Expiration Alert ⚠️ **Metformin prescription expires**: May 10, 2026 - Action: Schedule doctor appointment before May for renewal --- ## 🔄 PRN (As-Needed) Medications ### Usage This Month | Medication | Max Daily | Used This Month | Last Used | Notes | |------------|-----------|-----------------|-----------|-------| | Acetaminophen | 4000mg | 6 doses | Mar 19 | Headache relief | | Ibuprofen | 1200mg | 2 doses | Mar 15 | Back pain | | Lorazepam | 2mg | 0 doses | — | Not used (good) | ### Pattern Analysis - Acetaminophen: Used 6 times for headaches - Recommendation: Track headache triggers, discuss with doctor if >10/month --- ## 📅 Daily Schedule ### Optimized Medication Schedule ``` 8:00 AM (with breakfast): ✓ Lisinopril 10mg ✓ Metformin 1000mg ✓ Atorvastatin 20mg (can take any time, but morning is consistent) 8:00 PM (with dinner): ✓ Metformin 1000mg ✓ Aspirin 81mg ``` **Tips**: - Atorvastatin can be taken morning or evening; choose consistent time - Taking Metformin with meals reduces GI upset --- ## 💡 Recommendations ### Adherence Improvement 1. **Weekend Routine**: Set phone reminders for Saturday/Sunday doses 2. **Pill Organizer**: Consider weekly pill box for visual confirmation 3. **Pharmacy App**: Enable automatic refill reminders ### Safety Optimization 1. **Lisinopril Cough**: If dry cough persists, ask doctor about ARB alternative 2. **Kidney Function**: Ensure next lab work includes creatinine/eGFR 3. **Medication List**: Carry updated list to all appointments ### Cost Optimization 1. **Metformin**: Already generic, cost optimized 2. **Lisinopril**: Ask about 90-day supply for cost savings --- ## 🚨 Emergency Information ### In Case of Emergency Your medications include: - Blood pressure medication (do not stop abruptly) - Blood thinner (aspirin — inform medical team) - Diabetes medication (may need glucose monitoring) ### Overdose Protocol **If you took too much**: 1. Call Poison Control: 1-800-222-1222 (US) or local emergency number 2. Do not induce vomiting unless instructed 3. Have medication bottles ready --- ## 📋 Action Items ### This Week - [ ] Request Metformin refill (30 days remaining) - [ ] Report dry cough to doctor (discuss ARB alternative) ### This Month - [ ] Schedule doctor appointment for prescription renewals - [ ] Review medication list with pharmacist ### Ongoing - [ ] Continue daily adherence tracking - [ ] Log any new side effects --- ## 🔗 Cross-References | Skill | Relationship | |-------|--------------| | musculoskeletal-care | NSAIDs tracking for orthopedic pain management | | chronic-care | Disease-specific medication management | | symptom-assistant | Side effect assessment | | nutrition-advisor | Drug-food interactions | --- **Disclaimer**: This medication report is based on your records and general drug information. Always consult your pharmacist or physician before making medication changes. In case of adverse reactions or emergencies, contact healthcare providers immediately. **Last Updated**: March 20, 2026