Prescription Analysis (PDF)

 Analysis of Prescription and Medication Orders Janelyn V. Rojas Associate Professor 5 [email protected] COLLEGE OF HEALTH SCIENCES Department of Pharmacy  Outline Prescription Common Special an...

 Analysis of Prescription and Medication Orders Janelyn V. Rojas Associate Professor 5 [email protected] COLLEGE OF HEALTH SCIENCES Department of Pharmacy  Outline Prescription Common Special and Errors and Latin Terms Instructions/ Medication Omissions and Order Abbreviations Precautions COLLEGE OF HEALTH SCIENCES Department of Pharmacy Prescription and Medication Order Prescription An order for medication issued by a physician, dentist, or other properly licensed medical practitioner. Designates a specific medication and dosage to be prepared by a pharmacist and administered to a particular patient. Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins.; Khan, M.A., & Reddy, I.K. (2000). Pharmaceutical and Clinical Calculations. London: CRC Press. Prescription Ansel, H. (2010). Pharmaceutical Calculations. New pinterest.ph https://rxistsource.blogspot.com/2013/04/samp York: Lippincott William & Wilkins. le-prescription.html Categories of Prescription Include the chemical or Single component nonproprietary/generic name of the or prefabricated substance with or without the manufacturer’s brand or trademark name. product More than 1 single component and Contain the quantities of each requires component required. compounding Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins.  Categories of Prescription https://www.coursehero.com/tutors- Ansel, H. (2010). Pharmaceutical problems/Nursing/26852896-Consider- Calculations. New York: Lippincott the-scenario-that-you-already-gave-the- William & Wilkins. medication-to-the-pati/ Medication Order Drug order Physician’s order Used in hospitals and other institutions. For institution (admitted) patients. Medication Order https://www.christushealth.org/ Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins. Pharmacist’s Responsibility Prescription and medication order received is correct in its form and content Order is appropriate for the patient Order is filled, labeled, dispensed, and administered accurately Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins. Case in Point The doctor prescribes a combination of amoxicillin and clavulanate and mentions the dose as take 5ml twice a day. It is available as Which one to Amoxicillin 125mg+ Clavulanic acid 31.25mg dispense? and Amoxicillin 200mg+ Clavulanic acid 28.5mg.  Case in Point The prescription reads ‘Glibenclamide 5mg tablets p.o per day for 3 months’ for a chronic patient who has been taking the medicine since 3 years ago. On May 15, 2024, and the stock available of Glibenclamide in the pharmacy has an expiry date of July 2024, and no fresh stock is available. What to do? Is there a way to dispense for him all stocks? Errors and Omissions Errors and Omissions Error Omission Leaving out or Mistakes or neglecting inaccuracies something Failure to Incorrect identify medication allergies Error of Omission Not taking the necessary Taking the action or wrong action omitting to or performing Error of Commission include an action important improperly. information or steps.  Pharmacist Should Check: Prescriber’s Date of the Patient Drug information order information prescribed Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins.  Pharmacist Should Check: Abbreviations, Directions Refill/generic Special symbols, units for use substitution labeling Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins.  Pharmacist Should Check: Listing of components Calculations Labels and quantities Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins.  Check the Label Name of Drug Name of Auxiliary Refills Patient Name Pharmacist labels Common Latin terms & Abbreviations Terms Related to Quantities aa ana of each q.s. quantum sufficiat sufficient quantity ad lib. ad libitum freely, at pleasure qt quart gal gallon m minim gr grain Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Terms Related to Administration Time qd quaque die once daily bid bis in die twice daily tid ter in die three times daily qid quarter in die four times daily am ante meridum in the morning pm post meridum in the evening Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Terms Related to Administration Time h.s. hora somni at bedtime a.c. ante cibos before meals p.c. post cibos after meals i.c. inter cibos between meals om omne mane every morning Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC  Terms Related to Preparations or Remedies mist. mistura mixture neb. nebula nebulizer pil. pilula pill pulv pulvis powder suppos suppositorium suppository troch trochiscus lozenge Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Instruction for Preparations div divide divide ft fiat let it be made m.ft misce fiat mix to make d.t.d. dentur tales doses such doses be given e.m.p. ex modo prescriptio in the manner prescribed s sine without Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Method of Application a.l/AL aurio laeva left ear e.m.p. ex modo prescriptio as directed u.d ut dictum as directed dext dexter right Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Miscellaneous AA apply to affected area AUD apply as directed ASA acetyl salicylic acid APAP acetaminophen BCP birth control pills BIW twice a week Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Miscellaneous BM bowel movement BP blood pressure BS blood sugar BSA body surface area CHF congestive heart failure DSS doccusate Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Miscellaneous et and TPN total parenteral nutrition UTI urinary tract infection Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Vehicles aq. bull boiling water DW/or aq. dist distilled water D5W dextrose 5% in water NS or NSS Normal saline 1/2 NS Half strength of normal saline RL Ringer's lactate Khan M., Reddy, I. (2000). Pharmaceutical and Clinical Calculations (2nd ed). USA: CRC Press LLC Special Instructions/ Precautions Drug Safety in Pregnancy Controlled studies in women fail to demonstrate a risk to the fetus in 1st trimester Category A Possibility of fetal harm remains remote Either animal-reproduction studies have not demonstrated a fetal risk Category B No controlled studies in pregnant women or animal- reproduction studies have shown an adverse effect www.mims.com Drug Safety in Pregnancy Either studies in animals have revealed adverse effects on the fetus. Category C No controlled studies in women or studies in women and animals are not available. There is positive evidence of human fetal risk. Use in pregnant women may be acceptable despite the Category D risk if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective. www.mims.com Drug Safety in Pregnancy Studies in animals or human beings have demonstrated fetal abnormalities. Category X The drug is contraindicated in women who are or may become pregnant. www.mims.com Pre & Post-Prandial Advice Special Instructions Take each dose with a large glass of water. Do not drink alcohol while being treated with this medicine. Special Instructions Do not stop taking this medicine without consulting your doctor. Do not take indigestion remedies, iron or calcium within two hours of taking this medicine. Special Instructions Used with caution in patients with renal or hepatic impairment and bronchial asthma Sulfonamides Given with caution to patients with allergies Pregnancy category C Contraindicated in patients with a history of hypersensitivity to penicillin or the cephalosporins Penicillin Used cautiously in patients with renal disease. Pregnancy category C Beggs, S., et.al. (2007). Introductory Clinical Pharmacology (7th ed). New York : Lippincott Williams & Wilkins  Special Instructions Used cautiously in patients with renal or hepatic impairment. Cephalosporins Use cautiously in patients with bleeding disorders. Pregnancy Category B. Used cautiously in patients with renal function Tetracyclines impairment. Highly toxic to the kidneys after degradation. Beggs, S., et.al. (2007). Introductory Clinical Pharmacology (7th ed). New York : Lippincott Williams & Wilkins Special Instructions Contraindicated in patients with a history of hypersensitivity. Fluoroquinolones Contraindicated in children younger than 18 years. Precautions regarding photosensitivity. Contraindicated in individuals who are allergic to the drug or other NSAIDs, who have hypertension, who Ibuprofen have peptic ulceration, or who are lactating. Used cautiously in patients with renal or liver dysfunction. Beggs, S., et.al. (2007). Introductory Clinical Pharmacology (7th ed). New York : Lippincott Williams & Wilkins References Ansel, H. (2010). Pharmaceutical Calculations. New York: Lippincott William & Wilkins. Beggs, S., et.al. (2007). Introductory Clinical Pharmacology (7th ed). New York: Lippincott Williams & Wilkins Khan, M.A., & Reddy, I.K. (2000). Pharmaceutical and Clinical Calculations. London: CRC Press. www.mims.com Comprehension Check  MEDICATION ABBREVIATION Match the correct abbreviation into the correct box that correlates with its name. ___ is the abbreviation for aspirin APAP OC ___ is the abbreviation for acetaminophen NTG ___ is the abbreviation for hydrocholorothiazide ___ is the abbreviation for oral contraceptive ASA MTX ___ is the abbreviation for methotrexate HCTZ ___ is the abbreviation for nitroglycerin  LATIN ABBREVIATION Match the correct Latin abbreviation into the correct box that correlates with its interpretation. agit. gtt. mix and make right eye a drop left eye o.l. M ft. intravenous push as directed around the clock aq. ad IVP shake, stir ut dict; u.d. atc water up to o.d.  LATIN ABBREVIATION Match the correct Latin abbreviation into the correct box that correlates with its meaning. prn ad as needed every other hour twice daily with food, with meals bid hs up to ac at bedtime cc before meals alt. h. Which of the following is a potential consequence of illegible handwriting on a prescription? increased medication adherence improved patient safety medication errors faster prescription processing Which of the following information is typically included in a medication order? Patient’s social security number Pharmacy’s operating hours Medication expiration date Dosage and frequency of administration Which of the following is an example of a “tapering” medication schedule? Taking a medication twice a day at regular intervals. Gradually reducing the dosage of a medication over time. Taking a medication only when symptoms are present. Taking a higher dosage of a medication during initial treatment. Get in Touch With Us Send us a message or visit us City of Batac, Ilocos Norte, Philippines (63) 77-600-0459 [email protected] Follow us for updates facebook.com/MMSUofficial www.mmsu.edu.ph