Dosage Calculations Fifth Canadian Edition PDF

PowerPoint Slides to accompany Pickar/Pickar Abernethy/ Swart/Davis/O’Connell Dosage Calculations Fifth Canadian Edition  Chapter 7 Drug Labels Copyright © 2022 by Cengage Learning Canada, Inc. 7-2  Chapter Objectives 1. Differentiate between the trade and gener...

PowerPoint Slides to accompany Pickar/Pickar Abernethy/ Swart/Davis/O’Connell Dosage Calculations Fifth Canadian Edition  Chapter 7 Drug Labels Copyright © 2022 by Cengage Learning Canada, Inc. 7-2  Chapter Objectives 1. Differentiate between the trade and generic names of drugs. 2. Interpret the significant components of a drug label. 3. Recognize the significance of reading and following label instructions. 4. Interpret product label directions. Copyright © 2022 by Cengage Learning Canada, Inc. 7-3  Trade and Generic Names  Trade name = manufacturer’s name for drug  Usually most prominent on label  Ends with sign ®  Generic name: determined by international body  Appears under trade name  By law must be identified on all labels Copyright © 2022 by Cengage Learning Canada, Inc. 7-4  Trade and Generic Names  Drugs sold in Canada are approved by:  Health Canada’s Therapeutic Products Directorate (TPD) or Natural and Non-prescription Health Products Directorate (NNHPD)  Meet strict guidelines from Health Canada’s Food and Drug Act and Regulations  Generic equivalents can be ordered as substitutes  Nurses must carefully cross-check Copyright © 2022 by Cengage Learning Canada, Inc. 7-5  Dosage Strength  Refers to dosage weight or active portion of drug in a specific unit of measurement  E.g., gemfibrozil 600 mg per tablet Copyright © 2022 by Cengage Learning Canada, Inc. 7-6  Form  Identifies structure and composition of drug  Solid (tablets, capsules)  Powdered, granular  Some can be combined with food or beverages for administration or reconstituted and measured in liquid volume (mL or drops)  Crystalloid (clear solution) Copyright © 2022 by Cengage Learning Canada, Inc. 7-7  Form  Suspension: solid particles in liquid that separate when held in a container  Injectable: either solution or powder form for reconstitution  Many other forms (e.g., suppositories, inhalers, creams, patches) Copyright © 2022 by Cengage Learning Canada, Inc. 7-8  Form Copyright © 2022 by Cengage Learning Canada, Inc. 7-9  Time-Release Medications  Newer modes can control rate a drug is released, or location in body where released, or both  Time-release medications  Sustained-release, long-acting, extended- release  intended to maintain therapeutic window for prolonged periods of time  Delayed release  targets different sites of GI tract  Controlled-release/controlled-delivery  Prolongs action of the drug and maintains levels to avoid peaks (controls rate and site) Copyright © 2022 by Cengage Learning Canada, Inc. 7-10 Time-Release Medications  Time-release drugs must never be cut, chewed, crushed, dissolved  Damages timed- release mechanism Copyright © 2022 by Cengage Learning Canada, Inc. 7-11  Supply Dosage  Refers to both dosage strength and form  “X measured units per some quantity” Solid X measured forms units/tablet Liquid X measured forms units/mL Copyright © 2022 by Cengage Learning Canada, Inc. 7-12 Supply Dosage Copyright © 2022 by Cengage Learning Canada, Inc. 7-13  Total Volume or Quantity  Full quantity contained in package, bottle, or vial Tablets and other solid Total number of individual items medications Liquids Total fluid volume  Not used when calculating dosages—Total volume or total quantity is not strength or concentration Copyright © 2022 by Cengage Learning Canada, Inc. 7-14 Total Volume or Quantity Copyright © 2022 by Cengage Learning Canada, Inc. 7-15 Total Volume or Quantity Copyright © 2022 by Cengage Learning Canada, Inc. 7-16  Administration Route  Site of body or method of drug delivery into patient  Examples: oral, enteral, sublingual, injection, otic, optic, topical, rectal, vaginal, and others  Unless specified otherwise, tablets, capsules, caplets are for oral use Copyright © 2022 by Cengage Learning Canada, Inc. 7-17 Administration Route Copyright © 2022 by Cengage Learning Canada, Inc. 7-18  Directions for Mixing or Reconstituting  Drugs dispensed in powder form must be reconstituted for use Copyright © 2022 by Cengage Learning Canada, Inc. 7-19  Special Instructions  Manufacturers “Refrigerate at all times” may print special “Keep in a dry place” instructions on the “Replace cap and close packaging tightly before storing”  Specific alerts may “Protect from light” be added by the “Shake well before using” pharmacy prior to dispensing Copyright © 2022 by Cengage Learning Canada, Inc. 7-20 Special Instructions Copyright © 2022 by Cengage Learning Canada, Inc. 7-21  Name of the Manufacturer  Required on all labels Copyright © 2022 by Cengage Learning Canada, Inc. 7-22  Expiry Date  Medication should be used, discarded, or returned to pharmacy by expiry date  Observe special instructions for expiry date on label for reconstituted solutions Copyright © 2022 by Cengage Learning Canada, Inc. 7-23  Lot or Control Number  All medication packages must be labelled with lot or control number  Assigned by company, allows it to identify exact time and date batch made  Important for recall Copyright © 2022 by Cengage Learning Canada, Inc. 7-24  Drug Identification Number (DIN)  Eight-digit computer-generated number assigned by TPD of Health Canada  Indicates product has been evaluated and meets safety and health benefit expectations, and is approved for sale  Includes over-the-counter drugs as well  DIN identifies manufacturer, product name, active ingredient(s), strength(s) of active ingredient(s), form, route of administration Copyright © 2022 by Cengage Learning Canada, Inc. 7-25 Drug Identification Number (DIN) Copyright © 2022 by Cengage Learning Canada, Inc. 7-26  Natural Product Number (NPN)  Natural Health Products (NHPs) must also be approved and licensed  Approval and NPNs provided by Natural and Non- prescription Health Products Directorate  Ensures safe, effective, high quality products  All NHPs must have product licence and meet requirements for labelling Copyright © 2022 by Cengage Learning Canada, Inc. 7-27  Bar Code Symbols  Global bar code standard for pharmaceutical products adopted by Health Canada  Ensure accurate medication verification and documentation accuracy  Intended to increase medication safety and reduce errors Copyright © 2022 by Cengage Learning Canada, Inc. 7-28 Bar Code Symbols Copyright © 2022 by Cengage Learning Canada, Inc. 7-29  Unit- or Single-Dose Labels  Most oral medications in hospital setting available as unit doses in a blister pack  Pharmacy provides 24-hour supply of each drug for a patient  Quantity is one tablet or capsule  Dosage strength is per one  Injectable medications can also be packaged as single-dose preparations Copyright © 2022 by Cengage Learning Canada, Inc. 7-30 Unit- or Single-Dose Labels Copyright © 2022 by Cengage Learning Canada, Inc. 7-31  Combination Drugs  Two or more drugs combined in one form  Usually prescribed by number of tablets, capsules, millilitres, rather than strength  Percocet contains 5 mg oxycodone hydrochloride and 325 mg acetaminophen Copyright © 2022 by Cengage Learning Canada, Inc. 7-32 Supply Dosage Expressed as Ratio  Ratio solutions express number of grams of drug per total millilitres of solution  Epinephrine 1:1000 contains 1 g pure  1 g:1000 mL drug per 1000 mL  =1000 mg:1000 mL solution  = 1mg:1mL Copyright © 2022 by Cengage Learning Canada, Inc. 7-33  Supply Dosage Expressed as Percentage  Percentage solutions express number of grams of drug per 100 millilitres of solution  Lidocaine  2 g/100 mL hydrochloride 2%  =2000 mg/100 mL contains 2 g pure  =100 mg/5 mL drug per 100 mL  =20 mg/mL solution Copyright © 2022 by Cengage Learning Canada, Inc. 7-34 Supply Dosage as Ratios, Percents  Supply dosage can still be determined with these labels  Many labels will have supply dosage as well as ratio or percentage  Epinephrine: ratio is 1:1000, so supply dosage is 1 mg/mL  Lidocaine: percentage is 2%, so supply dosage is 20 mg/mL Copyright © 2022 by Cengage Learning Canada, Inc. 7-35  Checking Labels Right Right Right Right Right Right Right Right site patient drug reason dose route time frequency Copyright © 2022 by Cengage Learning Canada, Inc. 7-36 Check Labels Three Times Against the MAR Before preparing drug After preparing and before administering Copyright © 2022 by Cengage Learning Canada, Inc. 7-37