Final answer:
Pharmacists may perform therapeutic substitution when it is legal and clinically suitable, such as medication unavailability, side effects, or to opt for cost-effective generics, but always with the prescriber's agreement.
Step-by-step explanation:
A pharmacist may exercise therapeutic substitution under specific circumstances where it is legally permissible and deemed clinically appropriate. For instance, if the original medication prescribed is not available, if a patient is experiencing harmful side effects or inadequate therapeutic benefit from the current medication, or if a cheaper generic equivalent is available that has the same clinical effect, a pharmacist might substitute the medication. However, therapeutic substitution should always be done with the consent and cooperation of the prescribing healthcare provider. It is important to note that the practices of plateauing, alternating, or substituting with another steroid to avoid tolerance are not supported by scientific evidence to reduce the harmful effects of these drugs. Moreover, a woman consulting with a pharmacist symbolizes the collaboration between patients and healthcare professionals to ensure optimal medication therapy.