Hospital Pharmacy Lab 1 PDF, Mansoura National University

Hospital Pharmacy (PP-501) Third level - First semester (Clinical Pharmacy PharmD) 2024 – 2025 Clinical Pharmacy &Pharmacy...

Hospital Pharmacy (PP-501) Third level - First semester (Clinical Pharmacy PharmD) 2024 – 2025 Clinical Pharmacy &Pharmacy Practice Department- Faculty of Pharmacy – Mansoura National University Lab 1 Pharmaceutical and clinical calculations Hospital Pharmacy - Third Level-Clinical Pharmacy 1 &Pharmacy Practice Department  Pharmaceutical and Clinical Allegation Calculations Interpretation of Pharmaceutical Interpretation of Prescription compounding alternative & medication label Notations instructions equivalent Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 2 Department  Allegation High Average of the conc. individual strengths calculated as proportional parts. Input Output Allegation is a method that is useful when Low mixing two or more preparations of known conc. strengths to prepare a mixture of an intermediate desired strength. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 3 Department Why allegation?????? Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 4 Department We need to make a liter of D12.5W. We have D70W and D5W. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 5 Department  Example 1 Rx: Prepare 1 liter of 20 % alcohol solution using 90% and 10% alcohol solutions. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 6 Department  Example 2 How many milliliters of 50% dextrose solution should be added to 250 mL of 10% dextrose solution to yield a 12.5% dextrose solution. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 7 Department  Example 2 How many milliliters of 50% dextrose solution should be 2.5 𝑝𝑎𝑟𝑡𝑠 ? = 37.5 𝑝𝑎𝑟𝑡𝑠 250 𝑚𝑙 added to 250 mL of 10% 250 dextrose solution to yield a ?= 2.5 × 37.5 = 16.7 ml 12.5% dextrose solution. So we need 16.7 ml of 50 % solution Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 8 Department  Example 3 A physician prescribed an ophthalmic solution to contain 100 mg of cortisone acetate in 8 mL of NS. You have cortisone acetate 2.5 % stock solution. How many mLs of this stock should be taken during preparation of this order? Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 9 Department from % to Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 10 Department  Example 3 A physician prescribed an ophthalmic solution to contain 100 mg of cortisone acetate in 8 mL of 𝑇𝑜𝑡𝑎𝑙 = 1.25 + 1.25 = 2.5 NS. You have cortisone acetate 2.5 ∴ 𝑎𝑚𝑜𝑢𝑛𝑡 𝑜𝑓 𝑐𝑜𝑟𝑡𝑖𝑠𝑜𝑛𝑒 𝑠𝑡𝑜𝑐𝑘 = 𝑡𝑜 𝑡ℎ𝑒 𝑎𝑚𝑜𝑢𝑛𝑡 𝑜𝑓 𝑁𝑆. % stock solution. How many mLs As the total volume of this stock should be taken during required by physician is 8 ml so we will need 4 ml of preparation of this order? NS and 4 ml of cortisone Hospital Pharmacy - Third Level Clinical stock sol. Pharmacy & Pharmacy Practice 11 Department II. Interpretation of Prescription Notations four times a day Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 13 Department  First 2 𝐷𝑎𝑦𝑠 = 2 ሺ2 𝑡𝑎𝑏𝑙𝑒𝑡𝑠 Example 4 Rx: Prednisone 5 mg 10 mg qid for 2 days 10 mg tid for 2 days 10 mg bid for 2 days So total = 16 + 12 + 8 5 mg tid for 2 days Then stop. How + 6 = 42 many tablets should be dispensed? Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 14 Department III. Pharmaceutical alternative & equivalent Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 15 Department Pharmaceutical equivalent: Pharmaceutical equivalents are drug products that are: In identical dosage forms and route(s) of administration Contain identical amounts of the identical active drug ingredient, i.e., the same salt or ester of the same therapeutic moiety, or, in the case of modified-release dosage forms, deliver identical amounts of the active drug ingredient over the identical dosing period. Do not necessarily contain the same inactive ingredients They may differ in characteristics such as shape, scoring configuration, release mechanisms, packaging, excipients (including colors, flavors, preservatives), expiration date/time, and labeling. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 16 Department Pharmaceutical equivalent Cefotaxime sodium Paracetamol = ≠ Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 17 Department Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice Department 18 Pharmaceutical alternatives: Pharmaceutical alternatives are drug products that contain: The identical therapeutic moiety, or its precursor, but not necessarily in the same amount or dosage form, or the same salt or ester examples: (e.g., tetracycline hydrochloride, 250mg capsules vs. tetracycline phosphate complex, 250mg capsules; quinidine sulfate, 200mg tablets vs. quinidine sulfate, 200mg capsules). Different dosage forms and strengths within a product line by a single manufacturer are pharmaceutical alternatives, as are extended-release products when compared with immediate-release or of the same active ingredient. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 19 Department Pharmaceutical alternatives Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 20 Department Therapeutic Equivalents: Approved drug products are considered to be therapeutic equivalents if they are pharmaceutical equivalents for which bioequivalence has been demonstrated, and they can be expected to have the same clinical effect and safety profile when administered to patients under the conditions specified in the labeling. Bioequivalent products are drugs that exhibit comparable bioavailability, that is, similar rate and extent to which the active ingredient/moiety is absorbed from a drug product and becomes available at the site of action.( bioequivalent drugs list approved by FDA can be found in Orange book ) Hospital Pharmacy - Third Level Clinical 21 Pharmacy & Pharmacy Practice  Drug products evaluated as "therapeutically equivalent" can be expected to have equal effect and no difference when substituted for the brand name product. Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 22 Department IV. Medication labels Hospital Pharmacy - Third Level Clinical Pharmacy & Pharmacy Practice 23 Department  Interpretation of Medication Labels Medication labels can be confusing because of the vast amount of information they contain and the small print. The most important information on medication labels is as follows: 1. Name – generic (the first letter is usually lowercase) and proprietary, brand, or trade name (the first letter is usually capitalized) 2. Route of administration 3. Unit dose per millilitre, per tablet or per capsule. 4. Total amount of drug in the container 5. Instructions for preparation (if present) 6. Instructions for storage 7. Expiration date (stamped by firm after manufacture) 8. Batch number should be added. Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy Practice 24 Department Medication label examples ( Augmentin ) Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy Practice 25 Department Interpretation of the label: Generic name Amoxicillin/Clavulanate potassium Trade name Augmentin Route of administration Oral suspension Unit dose ( per millilitre ) 5 ml Total amount of the drug in the 75 ml after reconstitution. container Instructions for preparation Use only if inner seal is intact Tap the bottle until all powder flows freely then add approx. 2/3 of the total water for reconstitution ( total = 67 ml ), Shake vigorously to wet powder. Add the remaining water then shake again vigorously. Shake well before using. Instructions for storage Store dry powder at room temperature It must be refrigerated after reconstitution and discarded after 10 days. Expiration date …/……/…… Batch number ……….. Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy 26 Practice Department What is the generic name? What is the unit dose? What are the instructions for storage? Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy 27 Practice Department Interpretation of the label: Generic name Tetracycline Trade name Tetracycline Route of administration Oral route Unit dose Capsule Total amount of the drug in the container 100 capsules Instructions for preparation Absent Instructions for storage Stored at controlled room temperature(15- 30° C ) Expiration date …../…../……. Batch number ………… Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy 28 Practice Department You are asked to dispense the following by the next prescription, how many prefilled pens needed for this patient for 2 months’ supply? Rx Lantus Solostar 15 U/day Hospital Pharmacy - Third Level-Clinical Pharmacy &Pharmacy Practice 29 Department Interpretation of the label: Generic name Insulin Glargine ( rDNA origin ) Trade name Lantus Solostar Route of administration Subcutaneous injection Unit dose ( 0.15 ml ) according to the prescribed dose 15 U/ day Total amount of the drug in the container 3 ml Instructions for preparation Ascent with precaution do not mix with other insulins. Instructions for storage Use within 28 days after opening (available on the package) Store prefilled pens refrigerated at 2°C to 8°C until expiration date, or at room temperature