DISPENSING LEC FINALE

• Brand name precedes generic name
• Generic name is in parenthesis
• Brand is not in parenthesis

Erroneous prescription (3 signs)

• Only generic name is written but not legible
• Generic name does not match with brand name • Both written - both not legible
• Drug is not registered with DOH

Impossible prescription (4 signs)

Dangerous Drugs

it refers to either prohibited drugs or regulated drugs which require a special prescription form, the use of which is monitored

prohibited drug

TYPE OF DRUG that includes "opium and the active components and derivatives such as heroin and morphine: coca leaf and its derivatives, principally cocaine, alpha and beta Eucaine,hallucinogenic drugs such as masculine, lvsergic acid diethylamide (LSD) and other substances producing similar effects: Indian hemp and its derivatives; all preparations made derivatives; all preparation made from any of the foregoing; and other drugs, whether natural or synthetic, with the physiological effects of a narcotic drug

regulated drug

TYPE OF DRUG that includes sleep-inducing sedatives, such as secobarbital, Phenobarbital, barbital amobarbital and other drugs which contain a salt or derivative of a salt of barbituric acid; any salt, isomer or salt of an isomer, of amphetamine, such as Benzedrine or denadrine and hypnotic drugs such as, or other compound producing similar pharmacologic effects

ana; of each

latin and meaning of aa.

ad; up to or to make

latin and meaning of ad.

dispensatur; dispense

latin and meaning of disp.

dentur tales doses; give such doses

latin and meaning of d.t.d.

fiat; make

latin and meaning of ft.

mice; mix

latin and meaning of M.

numero; number

latin and meaning of No.

non repatatur; do not repeat

latin and meaning of non rep or NR

quantum sufficit; a sufficient quantity

latin and meaning of q.s.

quantum sufficit ad; a sufficient quantity to make

latin and meaning of q.s. ad

ante cibos; before meals

latin and meaning of a.c.

ad libitum; at pleasure, freely

latin and meaning of ad lib.

administer

meaning of admin.

ante meridem

latin of am

cum; with

latin and meaning of c.

die; day

latin and meaning of d.

hora somni

latin and meaning of h.s.

non per os; non by mouth

latin and meaning of NPO

post cibos; after meals

latin and meaning of p.c.

post meridem; afternoon or evening

latin and meaning of pm

per os; by mouth

latin and meaning of p.o.

pro re nata; as needed

latin and meaning of p.r.n.

every number

latin and meaning of q4h q8h etc.

sine; without

latin and meaning of s,

stamina ; immediately

latin and meaning of stat.

• Generic name is not written
• Generic name is not legible but brand name is legible
• Both are written but with word "NO SUBSTITUTION"

Violative prescription (3 signs)

dividatur; divide

latin and meaning of div.

signa; write directions on the label

latin and meaning of sig.

around the clock (24 hours)

meaning of the abbreviation ATC

bis in die; twice a day

latin and meaning of b.i.d.

hora

latin of hr.

ut dictum; as directed

latin and meaning of ut dict,

patient's information leaflet

drug with special instructions can be checked on ________________

tablet cutter/ razor

what is used for cutting tablets

Absorption, Drug Instability, Failure to reach site of action, Produce irritant effect, Occupational Health and Safety issue, unpalatable taste

consequence of crushing opening or chewing oral medication

powdered aerosolization

crushing carcinogenic or teratogenic can expose health risk such as _______________

HRT
corticosteroid
dexamethasone
Finasteride
Mycophenolate

drugs that should not be crushed; that may cause harm upon exposure. (5)

dehydronifedipine, dehydronitrosonifedipine (inactive)

photodegradation of nifedipine into ___________________ which can further more degrade to __________________

suppository

substitution for enteric coated drugs

uncomfortable gastric spasms

if Dulcolax is chewed what happens?

Bradycardia or Tachycardia

if Digoxin is crushed what can happen?

Increase in the amount that can be absorbed

If Pradaxa is crushed what can happen?

gastric irritation

If Diclofenac sodium is crushed what could happen?

mucosal ulceration/ irritation

If Alendronate is crushed or chewed what could happen?

unpleasant taste

If Ibuprofen and quinine are crushed what could happen?

Verapamil MR
Propanolol
Felodipine
Diclofinac
Omeprazole

drugs that utilizes Multi Unit Pellet System (5)

pharmacodynamic, Pharmacokinetic and Pharmaceutical composition that can cause ADR.

Drug- food Interaction can alter (3)

hepatotoxicity

Paracetamol taken with alcohol can increase __________

Bioavailability

High protein, Fatty, Fiber diets can interfere with

Bioavailability

is the ability of a drug or substance to be absorbed and used by the body.

reduced bioavailability

risk that happens when a patient is at a fed state

purpura associated cilostazol and aspirin

Grapefruit + Aspirin + cilostazol can cause _____________

not be taken with food

Lovastatin should be taken with food however, Rosuvastatin should ______________

mg or ca

Avoid co administration antibiotics with food that is rich in ________ or ________

not taken would be food normally

Paracetamol should not or be taken with food ?

should be taken normally

NSAIDS should not or be taken with food?

hour, 2 hours

medicines should be taken on an empty stomach should be taken about an ________ before a meals or ______ after a meal

Name and address of the pharmacy
patient name
name and strength of medication
Direction for use
Manufacturer lot number
Expiration date
Name and initial of the pharmacy

Important information in a label (5)

Sound Alike Look Alike Drugs

SALAD meaning

quantity of the drug names
generic/ brand name of the drug
spelling errors
combination products
different formulation of the same drug
illegible writing

Factors affecting SALAD

Double Check
Read the Label
Emphasize
Set Apart
Spread awareness

what to do with SALADs

High Alert Medication

HAM meaning

Insulin
Opiates and Narcotics
Injectable Potassium Chloride (orPhosphate) concentrate
Intravenous Anticoagulants
Sodium Chloride above 0.9%

5 HAM medication

Separate
Pull out
Identify
Compare and Confirm
Ensure

what to do with HAM

Drug interaction

an interaction wherein an effect of a drug can be altered.

what is that drug for.
What is the precautions
how the patient should take that medication

the patient should know

Fed state

is when you are digesting the food and absorbing nutrients

Chelation

the drug is not absorb in the amount that is intended to induce a therapeutic effect

increase or decrease

increased gastric secretion may _____ or _______ absorption

should not be taken with food

Antibiotics should not or be taken with food

medicine/drug

a compound or preparation used for the treatment or prevention of disease.

Drug-Food interaction

interaction that pharmacist recognize that some food and drugs when taken simultaneously alters the body’s ability to utilize a particular food or drug.

Pharmaceutical, Pharmacokinetic and pharmacodynamic or ADRs

Drug food interaction can alter (3)

Drug interaction

a situation where a substance affect the ability of a drug

protein, fatty, fiber

classification of foods

high Protein, Fatty, Fiber foods

alteration of absorption by what food types

Bioavailability

is the ability of a drug or other substances to be absorbed and used by the body

Fed state

your body is digesting the food in absorbing the nutrient.

lower bioavailability

the drug is not absorbed in the amount that is intended in fed state results into

Therapeutic Incompatibility

undesirable pharmacological interaction between two or more ingredients.

Improper Doses

Synergistic and Antagonistic combination

Wrong Drug

Contraindicated drug

Formation of toxic compounds

Reduction or Delay in therapeutic Effectiveness

Manifestations of Therapeutic Incompatibility

Drug interaction

A situation in which the effects of one drug are altered by prior or concurrent administration of another drug, of food, of laboratory test, presence of disease and influence of environmental chemicals and smoking

Precipitant

component of DI which initiates the interaction

Object

component which is affected in the interaction

Multiple pharmacological effects

Multiple prescribers

Use of nonprescription drugs

patient noncompliance

Drug abuse

Factors leading to DI (5)

Age

Genetic factors

Disease states

Renal function

Hepatic function

patient variables leading to DI’s

DRUG-DRUG, DRUG-FOOD, DRUG-LAB

3 classifications of DI

a. Pharmaceutic Interaction

b. Pharmacokinetic Interaction

c. Pharmacodynamic Interaction

3 interactions DRUG-DRUG

Pharmaceutic interaction

Caused by a chemical or physical incompatibility when two or more drugs are mixed together. Occurs when drugs are mixed inappropriately in syringes or infusion fluids prior to administration

precipitate

Phenytoin Na will _________ in acidic pH

epinephrine

Aminophylline (basic pH) should not be mixed with_________ which decomposes at alkaline pH

pharmacokinetic interactions

“What the body does to the drug?” are interactions in which the precipitant alters the ADME of the object drug. Accompanied by a change in plasma concentration of the object

sig: drug metabolism

least: drug distribution

most significant and least significant pharmacokinetic interactions

Alteration in ADME

Manifestation in pharmacokinetic interactions

Physiologic absorption

Rate and extent of disappearance of drug from the site of administration