Pharmacy Orientation Lecture 9 PDF

Pharm PharmDDProgram Program (2024/2025) (2023/2024) Lecture No. (9)...

Pharm PharmDDProgram Program (2024/2025) (2023/2024) Lecture No. (9) Handling the Prescription Dr/ Doaa Helal Associate prof. of Pharmaceutics & Industrial Pharmacy ,Faculty of Pharmacy, Al-Arish Branch 2 December 2024 www.su.edu.eg 1  Pharm PharmDDProgram Program (2024/2025) (2023/2024) Course Objectives After completing this course, students should be able to: Describe the mission of pharmacy, role of pharmacist in society, the responsibility of pharmacist and the skills required to become a pharmacist. Compare between various pharmacy careers and educational requirements. Identify pharmaceutical dosage forms and routes of administration. Read the prescription and determine the medication errors. Perform accurate pharmaceutical calculations. Learn about prescription and its contents. Know the ancient Arabic pharmacists and their achievements in the fields of pharmacy. 2 December 2024 www.su.edu.eg 2  Pharm PharmDDProgram Program (2024/2025) (2023/2024) HOSPITAL MEDICATION ORDERS Medication orders for patients in hospitals are written by the physician on forms called the Physician's Order Sheet. The type of form used varies between institutions and even within the institution, depending on the unit rendering the care. MEDICATION ERRORS *Medication errors include: o inappropriate prescribing. o dispensing errors. o patient noncompliance (under use or overuse). o medication administration errors. 2 December 2024 www.su.edu.eg 3  Pharm PharmDDProgram Program (2024/2025) (2023/2024) **The risk of medication errors is greatest in: 1. The pediatric populations. 2. The geriatric populations. 3. Drug with narrow therapeutic indexes. ***The recommendations to reduce medication errors include: 1- Medication orders should be complete with regard to:  patient information  drug name  correct dosage. 2. Instructions should be written out rather than using abbreviations. 2 December 2024 www.su.edu.eg 4  Pharm PharmDDProgram Program (2024/2025) (2023/2024) 3. Exact nomenclature for drug names should be used. 4. A leading zero should always precede a decimal expression of less than one (e.g., 0.5 mL); conversely, a terminal zero should never be used (e.g., 5.0 mL), because failure to note the decimal would result in a tenfold error. 5. The word units (e.g., 10 units of regular insulin) should be spelled out rather than abbreviated with U, which could be misinterpreted as a zero (misinterpreted as 100 units rather than the 10 units intended). 2 December 2024 www.su.edu.eg 5  Pharm PharmDDProgram Program (2024/2025) (2023/2024) HANDLING THE PRESCRIPTION I. Checking the prescription for safety: i- DOSE CALCULATION Methods for calculating the dose for child or infant can be based on: 1- Age 2- Weight 3- Body surface area Based on age: For infants younger than 2 years: 1- FRIED'S RULE: Infant dose = (Age in month/150) x adult dose For children 2 years and older: 2- YOUNG'S RULE: Child dose= (age in years/ age in years + 12) x adult dose 2 December 2024 www.su.edu.eg 6  Pharm PharmDDProgram Program (2024/2025) (2023/2024) Based on weight: - Generally, heavy individuals can withstand larger dose, than a person with less weight. - The usual doses in considered for persons with 70 Kg. FOR WEIGHT IN POUNDS: Child's dose= (weight in pounds/150) x adult dose FOR WEIGHT IN KG: Child's dose= (weight in Kg/70) x adult dose Based on body surface area ''B.S.A.": - The average body surface area for adult is 1.7 m² - Child's dose= (B.S.A. in m² for child/ 1.7) x adult dose 2 December 2024 www.su.edu.eg 7  Pharm PharmDDProgram Program (2024/2025) (2023/2024) ii- ROUTE OF ADMINISTRATION - Drugs which are absorbed completely from G.I.T will have equal parental and oral dose. - Drugs which are poorly absorbed by the oral route will have smaller doses parentrally than orally. iii- PHARMACEUTICAL DOSAGE FORM - The vehicle of prescription affects the safety and the therapeutic effect of the prescription. e.g. polyethylene glycol ointment should contain ½ the concentration of benzoic acid and salicylic acid used in hydrocarbon base because they are more active in polyethylene glycol base. - The degree of subdivision of an active drug may affect therapeutic activity. e.g. if polysorbate 80 is mixed with coal tar prior to incorporation of coal tar into the ointment base, a lower concentration of coal tar must be prescribed. As the subdivision of the coal tar results in more pronounced action on the skin. 2 December 2024 www.su.edu.eg 8  Pharm PharmDDProgram Program (2024/2025) (2023/2024) Compounding of the prescription: 1) CALCULATION: Check any calculation for the quantity of medicine Example: Rx chloral hydrate 8 gm 15 13.28 Sod. Bromide 12 gm 20 gm Syrup of raspberry 22.5 ml 37.5ml Water to 60 ml Fiat: mixture Mitte: 100 Signa: 5 ml every 4 hours Calculation: For preparation of 100 ml F= Amount required/amount prescribed F=100/60= 1.66 Amount required= amount prescribed x 1.66 2 December 2024 www.su.edu.eg 9  Pharm PharmDDProgram Program (2024/2025) (2023/2024) CHECKING THE STORAGE REQUIREMENTS: - Many drugs are photosensitive (degraded in presence of light) therefore need amber containers. - Some drugs should be protected from atmospheric gases as Oxygen which support micro-organisms growth and CO2 which shifts pH. Therefore many need tightly closed containers SELECTING THE CONTAINER AND CLOSURE: Any pharmaceutical formulation must have suitable container such as: 1)Amber glass bottles: for photosensitive substances because they provide maximum protection against photochemical deterioration. 2)Eye dropper bottles: ear, nasal and eye drops. 3)Pots or collapsible tubes: ointment and creams. 4)Wide-mouth bottles: for bulk powders, and viscous liquids. - The closure ability to restrict entrance of moisture into the container is of prime importance; because moisture has a deteriorating effect on many dosage forms, for example, aspirin tablets are hydrolyzed in the presence of moisture into acetic acid and salicylic acid. - Safety closures which are too difficult to open by children (childproof) are used to reduce the number of accidental poisonings due to ingestion of medication by children. 2 December 2024 www.su.edu.eg 10  Pharm PharmDDProgram Program (2024/2025) (2023/2024) WRITING THE LABEL: - Direction for the use of medicine should be clear and written before dispensary on a suitable size label. - The prescription label must be written in an easy way that is clear for patients to read. - On the label the following should be written: 1) The prescription number. 2) Date of dispensing. 3) Patient name. 4) The prescriber's name. 5) The name, address and the telephone number of the pharmacy. Auxiliary labels: Are used to emphasize important aspects of the dispensed medication, including: 1- Its proper use, 2- Handling, storage, refill status, 3- Necessary warnings or precautions. 2 December 2024 www.su.edu.eg 11  Pharm PharmDDProgram Program (2024/2025) (2023/2024) References For any questions feel free Kevin M.G. Taylor, Michael E. Aulton editors. Aulton's Pharmaceutics: to contact me by mail [email protected] Design and Manufacture of Medicines. 6th Edition - May 14, 2021 Loyd V. Allen , Jr. Timothy B. McPherson. Ansel's pharmaceutical dosage forms and drug delivery systems. Lippincott Williams & Wilkins;. 12th Dr EMAN Edition EL WAHSH November 15, 2021 2 December 2024 www.su.edu.eg 12