Dispensing and Adverse Drug Reactions (ADR) Flashcards

Vocabulary flashcards covering dispensing guidelines, prescription components, drug incompatibilities, drug interactions, and adverse drug reaction (ADR) classifications based on Module 3.

Dispensing (AO 63 s.1989)

The act by a validly registered pharmacist of filling a prescription or order.

Good Pharmacy Practice (GPP)

The practice of pharmacy that responds to the needs of the people who use the pharmacists' services to provide optimal, evidence-based care (FIP/WHO).

Prescription (AO 63 s.1989)

A written order and instruction of a validly registered physician, dentist, or veterinarian for the use of a specific drug product or medical device for a specific patient.

Prescription Parts Diagram

A sample prescription layout illustrating the 8 required components: prescriber info (1), date (2), patient info (3), superscription Rx (4), inscription (5), subscription (6), transcription/sig (7), and prescriber signature with license numbers (8).

Dangerous Drugs Prescription

A yellow-triplicate prescription form issued by PDEA requiring an S2 license, where partial filling is allowed but refills are prohibited.

S2 License Number Format

A code structure displaying permanent number, year issued, transaction status ($N$=New, $R$=Renewal, $E$=Exempt), practitioner type ($M$=Physician, $D$=Dentist, $V$=Veterinarian), region paid, loss status, and control number.

Erroneous Prescribing Offense

A generic prescribing offense where the brand name precedes the generic name, generic name is in parentheses, or brand name is not in parentheses; the drug is dispensed and reported.

Violative Prescribing Offense

A generic prescribing offense where only the brand name is written, brand name is more prominent than generic name, or instructions prevent substitution; the drug is not dispensed and reported.

Impossible Prescribing Offense

A generic prescribing offense where generic/brand names are illegible, generic name does not match brand name, or drug is unregistered with Philippine FDA; the drug is not dispensed and reported.

Tall-Man Lettering

A practice recommended by US FDA and ISMP that uses capitalized letters to differentiate look-alike sound-alike (SALAD) drug names, such as acetaZOLAMIDE vs. acetoHEXAMIDE.

Terminal Sterilization Methods

Sterilization techniques including moist heat (autoclave at $121^\text{o}\text{C}$, $15\text{ psi}$, $15\text{--}30\text{ mins}$), dry heat (oven at $160^\text{o}\text{C}$, $2\text{--}4\text{ hrs}$), membrane filtration ($0.2\text{-micron}$ filter), gas (ethylene oxide), and ionizing radiation (gamma rays).

Physicochemical Incompatibility

A drug incompatibility occurring outside the body that is directly observable, manifested by precipitate formation, color/odor change, gas evolution, or physical state changes.

Deliquescent

The property of a substance that absorbs atmospheric moisture and dissolves in it, such as $NaOH$, $KOH$, or $NH_4Cl$.

Efflorescent

The property of a hydrated substance that releases moisture into the surrounding air, such as $CuSO_4 \times H_2O$, $Na_2CO_3 \times 10H_2O$, or $CaSO_4 \times 2H_2O$.

Eutexia

Melting point depression leading to liquefaction when two solid substances (such as camphor and menthol) are mixed together.

Syneresis

The loss of water or liquid exuding from a gel dosage form due to shrinkage.

Precipitant Drug

In a drug interaction, the drug that causes the interaction or alters the effect of another drug.

Object Drug

In a drug interaction, the drug whose action, concentration, or effect is altered by the precipitant drug.

Enzyme Inhibitors and Inducers

Hepatic metabolic modulators summarized by mnemonics: inhibitors SICKFACES.COM GQ (e.g., Sodium valproate, Cimetidine, Ketoconazole) decrease metabolism; inducers CRAPGPT S (e.g., Carbamazepine, Rifampicin, Phenytoin) increase metabolism.

Pharmacodynamic Addition

A pharmacodynamic interaction where the combined response of two drugs equals the sum of their individual effects ($1 + 1 = 2$).

Pharmacodynamic Synergism

A pharmacodynamic interaction where the combined effect of two drugs is greater than the sum of their individual effects ($1 + 1 > 2$), such as sulfamethoxazole and trimethoprim.

Pharmacodynamic Potentiation

A pharmacodynamic interaction where a drug with no direct effect increases the activity of another drug ($1 + 0 = 2$), such as amoxicillin combined with clavulanic acid.

Pharmacodynamic Antagonism

A pharmacodynamic interaction where the effect of one drug reduces or cancels the effect of another drug ($1 + 1 = 0$), which can be pharmacologic or physiologic.

Adverse Drug Event (ADE)

Any untoward medical occurrence during treatment with a drug, which does not necessarily have a causal relationship with the drug.

Adverse Drug Reaction (ADR)

Any response to a drug that is noxious and unintended, occurring at doses normally used in humans for prophylaxis, diagnosis, or therapy.

Side Effect

Any unintended effect of a drug occurring at normal doses that is related to its pharmacological properties.

Toxicity

Any noxious and unintended or intended response to a drug occurring at doses higher than normally used in humans.

Medication Error

A preventable event that may lead to inappropriate medication use or patient harm while the medication is under the control of the health care professional, patient, or consumer.

Pharmacovigilance

The science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems (WHO).

Type A ADR (Augmented)

An adverse drug reaction that is common, predictable, dose-dependent, and related to the drug's pharmacology, including side effects and toxicity.

Type B ADR (Bizarre)

An unpredictable, dose-independent, and uncommon idiosyncratic reaction categorized into Type I (IgE-mediated), Type II (cytotoxic), Type III (immune complex), and Type IV (T-cell mediated).

Type C ADR (Continuous)

An adverse drug reaction related to cumulative dose and duration of drug use, such as adrenal suppression from steroids or nitrate tolerance.

Type D ADR (Delayed)

An adverse drug reaction that manifests long after exposure, such as teratogenicity (e.g., phocomelia from thalidomide, spina bifida from valproic acid) or carcinogenicity.

Pregnancy Safety Categories

Classification system for drug safety in pregnancy ranging from Category A (safe) and Category B (e.g., paracetamol, amoxicillin) to Category D (benefits > risk) and Category E/X (unsafe, contra-indicated, e.g., thalidomide, isotretinoin).

Type E ADR (End of Use)

An adverse drug reaction occurring upon sudden termination or discontinuation of therapy, managed by dose tapering (e.g., opioid withdrawal, rebound hypertension from clonidine).

Type F ADR (Failure of Therapy)

An adverse drug reaction characterized by an unexpected loss of drug efficacy, primarily caused by antimicrobial resistance (AMR).