Medication Error Types and Labeling PDF

# **Types of Medication Error** | Medication Error Type | Type of Error Definition | Sub-Category | |---|---|---| | Prescription | Interactions | Drug Interactions | | | Drug Choice Problem | Inappropriate Route or Dose | | | | Inappropriate Repeat of Same Family Drug | | | | Contraindications...

# **Types of Medication Error** | Medication Error Type | Type of Error Definition | Sub-Category | |---|---|---| | Prescription | Interactions | Drug Interactions | | | Drug Choice Problem | Inappropriate Route or Dose | | | | Inappropriate Repeat of Same Family Drug | | | | Contraindications | | | | Lack of Obvious Indications | | | | No Drug Prescription Despite Existence of Indication | | | Dosing Problem | Low Drug Dose or Frequency | | | | High Drug Dose or Frequency | | | | Short Treatment Time | | | | Long Treatment Time (Not Able to Follow Due to Short Stay of Patients at Hospital) | | Transcription/ Administration | Drug Use Problem | Ordered Drug Not Given (Omission Error) | | | | Given Drug Not Ordered (Unauthorized Drug) | | | Others | Incorrect Drug Dilution | | | | Incorrect Drug Storage | ## **Prescription Parts See Your Lectures** # **Objectives** * To estimate the types and prevalence of medication errors during transcription. # **Material and Methods** * Review and the analysis of given prescription for determining the different types of errors in writing a prescription using joined sheet. # **Results and Discussion (Your Comment)??!!** * Write your comment in given sheet # **General Conclusion** * There is a need to critically address the legibility of prescription, correct spelling of drugs, authorized abbreviations and all other informations of a prescription concerned with patient, prescriber and drugs to minimize the occurrence of medication errors. # **Points to Remember** * Keep good records of medications prescribed, dates written, length of treatment, concentration of medication and your diagnosis of the condition. * Explain specifically to the patient how to use the medication and why it should be used. * When possible, explain dosage, diagnosis and the reason for the treatment to the available caregiver of the patient (husband, parent, child, friend, nurse). * Give written instructions to the patient in the office when the dosage schedule is complicated, when multiple medications are prescribed and tapering of dosage is needed. Written instructions are especially important to achieve compliance. * Illiteracy is the forgotten reason for non-compliance. If you suspect the patient cannot read or may not be able to understand written instructions, check for understanding by having the patient repeat the instructions verbally after you have explained how to use the medication. If possible, explain the dosage and treatment plan to a family member. * **Refill Data:** Provide the number of refills the patient should need to complete the cycle of drug treatment. Most antibiotic and steroid prescriptions need no refills or one refill. Glaucoma medications usually have three refills, which allows the patient enough medication for 3 to 6 months, depending on the size of the bottles dispensed. * **Substitution Permitted:** Marking “Yes” allows the pharmacist to substitute a generic form of the medication prescribed. Some health plans request that the generic drug be used to save money. When writing the drug names remember that generic names are not capitalized and brand names are capitalized: Pred Forte (Allergan) or prednisolone acetate 1%. * **Signature:** Signature and degree finalize the legal document. A signature stamp can be used for non-controlled substances. Prescriptions for controlled drugs require a handwritten signature and DEA number. # **Prescriptions Abbreviations** | Abbreviation | Definition | Abbreviation | Definition | |---|---|---|---| | p.o | orally | q.d. | once a day | | I.M. | intramuscularly | b.i.d. | twice a day | | Subq. | subcutaneous | t.i.d. | three times a day | | Rectally | rectally | q.i.d. | four times a day | | I.V. | intravenous | q.h.s | before bed | | O.D. | in the right eye | 5X a day | five times a day | | O.S | in the left eye | q.4h | every four hours | | O.U | in both eyes | q.6h | every six hours | | q.o.d | every other day | prn | as needed | | | One | q.t.t | drop | | | Two | a.c. | before meals | | | Three | p.c | after meals | | | Four | | | # **Labeling of Prescribed Medicines** ## **Learning Objectives** By the end of this lab, the student should be able to: * Define label * Identify importance of labeling * Recognize types of labels (manufacturing versus dispensing labeling) * Identify legal requirements ## **Define Label** * Label means a display of written, printed or graphic matter upon immediate container or the wrapper of drug package. * The label states the name of preparation, percentage content of drug of a liquid preparation, the amount of active ingredient of a dry preparation, the route of administration, a statement of storage condition and expiry date. * A label must indicate the name of manufacturer or distributors and carry an identifying lot number. ## **Importance of Labeling** 1. To describe the medicine and identify it. 2. To contribute to optimal therapeutic outcome and to avoid medicines errors. This is achieved by ensuring that patient have clear, legible and concise information. 3. To achieve appropriate handling and storage. 4. To let the product to be traced if there are problems with either the manufacturing, prescribing or dispensing process. ## **Types of Labels** * **Manufacturer label:** A label which contains drug information for the use of medical practioners, pharmacists, or nurses supplied by the manufacturer, packer, or distributor of the drug (FDA). * **Dispensing label:** It includes the drug name and quantity, patient name, prescription number, phone number, instruction for use, and pharmacy name and address. ## **Legal Requirements of a Manufacturer Label** 1. The name of preparation. 2. Strength and dosage form. 3. Quantity. 4. Instructions for the use. 5. Precautions & warnings. 6. Registration number. 7. Batch number. 8. Manufacturing & Expiry date. 9. Price 10. The name and address of pharmaceutical in. ## **Legal Requirements of a Manufacturer Label : Instructions for Use** Shake well before use: * Necessary on all disperse systems: * Emulsions * Suspensions * E.g. Liniments, lotions and tinctures. ## **Legal Requirements of a Manufacturer Label : Warning and Precautions** * Keep out of reach of children * Protect from light * Storage conditions * For external use only * Inflammables: when the preparation contains 50% or more alcohol or any other inflammable solvents * Not to be taken: * Liquid preparation that are not administered by mouth. * For nasal drops, enemas and nasal sprays. * Unit dosage forms e.g., pessaries and rectal suppositories. * Help to administer drugs safely. ## **Legal Requirements of a Manufacturer Label : Registration Number** A number given to a specific drug when it is registered according to specific rules by registration board set up by federal government. ## **Legal Requirements of a Manufacturer Label : Batch Number** A designation printed on label of a drug that identifies the batch and permits the production history of the batch including all stages of manufacturer and control to be traced and are viewed. ## **Legal Requirements of a Manufacturer Label : Manufacturing date** Date stated on the label of a drug after which a drug is not expected to retain its claimed efficacy, safety, quantity or potency or after which it is not permissible to sell the drug. Ibuprofen=Motrin ## **Legal Requirements of a Manufacturer Label : License Number** * Biological products are approved for marketing under the provisions of the public health service (PHS) Act. * A Product License Number (or PL code) is a unique identifier on the pakaging of medicines to uniquely identify the product, this code will normally remain the same despite the varying marketing and branding of the company's selling it. ## **Legal Requirements of a Manufacturer Label : Barcodes** It is an optical machine readable representation of date, which shows data about the object to which it attaches. ## **Dispensing Label** It includes: * Drug name and quantity * Patient name * Prescription number * Phone number * Instruction for use * Pharmacy name and address ## **Dispensing Label : Instructions for Use** * For ear drops: for external use only. * Aerosols inhalation: keep away from heat source, shake before use and do not exceed the prescribed dose. * Creams: for external use only and store in cool place. ## **Dispensing Label : Interactions** * Certain drugs have serious reactions when taken with specific food e.g. * amine containing food (tyrosine) with monoamine oxidase inhibitors → hypertensive crises * tetracycline with milk