Prescriptions & Medication Orders PDF

PHAR 641 Ziyaur Rahman, Ph.D. Professor Department of Pharmaceutical Sciences Texas A&M University College Station, TX 2 PHAR 641 Learning objectives:...

PHAR 641 Ziyaur Rahman, Ph.D. Professor Department of Pharmaceutical Sciences Texas A&M University College Station, TX 2 PHAR 641 Learning objectives: Recognize types of prescriptions Identify components of prescriptions and medication orders Interpret symbols and abbreviations on prescriptions Recognize error-prone notations Perform calculations related to prescribed medications Keywords: Superscription, Subscription Inscription, Transcription Required & recommended materials: Textbook- Prescriptions & Medication Orders (Chapter 2) Khan & Reddy (Chapters 3) Ansel & Stocklosa (Chapter 4) Calculator  3 PHAR 641 4 PHAR 641 PRESCRIPTIONS MEDICATION ORDERS 5 PHAR 641 Written in an outpatient setting 6 PHAR 641 New (Original): Filled for the first time Refill: Repeat filling of an original prescription Compounded: Requires mixing of two or more ingredients Non-compounded: Drug products requiring only simple preparation (pre-manufactured) Generic: Drug identified by generic name Brand: Drug identified by its trademark or manufacturer’s name Controlled: For drugs from Schedule II, III, IV, or V 7 PHAR 641 Prescriber information and signature Patient’s information Date The Superscription: The symbol Rx that stands for “you take” or “recipe” The Inscription: Name, strength, and the type of dosage form of the medications The Subscription: Instruction for the pharmacist The Transcription: Signa or Sig- Direction for patients Refill information Special components: Must comply with the state specific law, e.g., DAW, DEA number etc.  8 PHAR 641 9 PHAR 641 Legal requirement Pharmacist is responsible for accuracy. State-specific requirements Components: Date of dispensing Name, address, phone # of pharmacy Prescription number Prescriber’s name Name and address of patient Directions for use Optional: - Refill directions - Name and strength of medication 10 PHAR 641 Written in an institutional setting 11 PHAR 641 Aka- Drug Order, Physician’s Order Components: - Patient information - Date and time - Drug information - Route of administration - Administration schedule - Prescriber’s signature - Transcriber’s information - Provisions for notes - Auxiliary information 12 PHAR 641 Categories: Patient instructions Quantities Filling directions Medication names Dosage forms/vehicles Clinical terms Routes of administration 13 PHAR 641 ABBRV. MEANING ABBRV. MEANING ac Before meals qid Four times a day pc After meals qod Every other day hs At bedtime wk Week prn As needed biw Twice a week stat Immediately tiw Three times a week q Every ud As directed qh Every hour utd As directed qd Every day ut dict As directed bid Twice a day gtt A drop tid Three times a day ss One half 14 PHAR 641 ABBRV. MEANING ABBRV. MEANING ft Make ad Right ear m Mix as Left ear sig Write au Each ear disp Dispense od Right eye div Divide os Left eye dil Dilute ou Each eye dtd Give of such doses po By mouth aud Apply as directed sc/sq Subcutaneous dc Discontinue medication pr Rectally c With sl Sublingual 15 PHAR 641 ABBRV. MEANING ABBRV. MEANING amp Ampoule aa Of each ung Ointment t Temperature pulv Powder (bulk) bm Bowel movement supp Suppository bp Blood pressure ns Normal saline bs Blood sugar tsp Teaspoonful ht Hypertension tbsp Tablespoonful iop Intraocular pressure qs A sufficient quantity n&v Nausea and vomiting ad Up to uti Urinary tract infection qs ad A sufficient quantity uri Upper respiratory tract to make infection  16 PHAR 641  17 PHAR 641 18 PHAR 641 Resources for error-prone notations: Institute for Safe Medication Practices (ISMP)- www.ismp.org/tools/abbreviations FDA- www.fda.gov 19 PHAR 641 NOTATION MISTAKEN FOR INSTEAD USE IU IV, 10 International Unit QD QID Daily QOD QID, QD Every other day 5.0 mg 50 mg 5 mg.5 mg 5 mg 0.5 mg MS Magnesium sulfate Morphine sulfate d/c Discontinued or Discharged  20 PHAR 641  21 PHAR 641 22 PHAR 641 Original/Refill? Inscription? Subscription? Transcription? 23 PHAR 641 Compounded/ Non-compounded? Inscription? Subscription? Transcription? 24 PHAR 641 Brand/Generic? Inscription? Subscription? Transcription? 25 PHAR 641 On a prescription, the directions to the patient are: “ten units subcutaneously twice a day in the morning and evening before meals”. The abbreviation for this is ____________________. a) 10 units SC bid, am & pm ac b) 10 units SC tid, am & pm ac c) 10 units SC bid, am & pm pc d) 10 units IV bid, am & pm ac e) 10 units SC bid, am & pm ud 26 PHAR 641 Rx Amoxicillin 125 mg/ 5 ml Sig. 2 teaspoons TID for 7 days What is the daily dose (in mg)? 27 PHAR 641 Rx Humulin® N 100 units/ml 3 ml vials Sig. 0.8 unit/kg/day sc Based on the prescription, how many vials should be dispensed for 30 days’ supply if the patient’s body weight is 125 kg? 28 PHAR 641 Rx Lisinopril HCTZ aa 10 mg Calcium phosphate 40 mg Lactose qs ad 300 mg M ft cap 1 dtd #30 Sig. 1 cap AM ac How many mg of lactose is required? 29 PHAR 641 Rx Lisinopril HCTZ aa 300 mg Calcium phosphate 1.2 g Lactose qs ad 9 g M div cap #30 Sig. 1 cap AM ac How many mg of lactose is required? 30 PHAR 641 Azithromycin suspension powder for reconstitution is available in the following different forms: 100 mg/5 ml (15 ml bottle) 200 mg/5 ml (15 ml bottle) 200 mg/5 ml (22.5 ml bottle) 200 mg/5 ml (30 ml bottle). If there are plenty of bottles in stock for all these products, what would you dispense to a 44 lb patient if the dose is 15 mg/kg body weight on the first day followed by 10 mg/kg on the second day, and finally 5 mg/kg body weight for 6 more days? End of the chapter