special handling and administration instructions

Modified release formulations (do not crush/chew)

Suffixes- EC (enteric coated), ER/XR/XL (extended release), SR (sustained release), LA (long acting), CR (controlled release)
Rationale- crushing releases entire dose at once leading to toxicity or destruction of drug by stomach acid.

hazardous drugs (USP <800>)

chemotherapy, methotrexate, finasteride, dutasteride, warfarin….
- must be counted on dedicated, labeled counting trays and spatulas cleaned with deactivating agents

• hazardous dosage forms must not be placed in automated counting machines

• pregnant pharmacy staff avoid

light and temperature sensitivity

refrigerated (2c-8c/36f-46f)- most insulins (unopened), vaccines, reconstituted oral antibiotics

protect from light- nitroglycerin, nitroprusside, doxycycline IV, furosemide

administration nuances

bisphosphonates- take first thing in morning on an empty stomach, patient remain upright
inhaled corticosteroids- patient rinse mouth with water and spit after use