Pharmacy Practice and Incompatibilities Flashcards

Vocabulary flashcards generated from the provided lecture transcript on pharmacy practice, drug interactions, incompatibilities, legal requirements, and dosage calculations.

Auxiliary Label

A label that supplements the main dispensing label with essential instructions or warnings such as 'Shake well,' 'For external use only,' or storage precautions to help ensure proper medication use, storage, and compliance.

Pharmaceutical Incompatibility

An undesirable reaction occurring before or during administration when ingredients interact physically, chemically, or therapeutically in an undesirable way, causing reduced potency or possible harm.

Three Traditional Types of Pharmaceutical Incompatibility

The conventional compounding classification consisting of physical, chemical, and therapeutic incompatibility.

Immiscibility

A condition where liquids do not form a uniform mixture (such as oil mixed with water without an emulsifier) and require an emulsifying agent to disperse into a stable emulsion.

Calcium Gluconate and Sodium Bicarbonate Reaction

A reaction where calcium ions react with carbonate species to form a visible precipitate of poorly soluble calcium carbonate, signaling incompatibility.

Republic Act No. 9502

The Universally Accessible Cheaper and Quality Medicines Act of 2008, a Philippine law that improves access to cheaper and quality medicines.

Clinical Pharmacist's Primary Role

Medication management, which includes optimizing medication selection, dosing, monitoring, safety, adherence, and outcomes in collaboration with patients and the healthcare team.

Medication Order

An inpatient or institutional written instruction that directs staff to prepare and administer a specific medication to a patient.

Praescriptio

The Latin origin of the word prescription, meaning 'a writing before' or something written beforehand.

Essential Elements of a Medication Order

The drug name, dose, route, and frequency, which specify what medicine is to be administered and how it should be given.

Dangerous Drugs

A drug classification subject to special licensing, strict monitoring, regulation, and controlled dispensing.

Medical Consultation (Direct Patient-Care)

A diagnosis-centered service ordinarily performed by a physician rather than a pharmacist, though pharmacists conduct medication consultations.

Prescription Date

An important prescription element for determining validity, refill timing, and preventing inappropriate refilling.

Inscription

The part of a prescription that lists the medication or ingredients to be supplied, prepared, or compounded, including drug name, strength, dosage form, and quantities.

Dosage Regimen Evaluation Data

The patient's biometric parameters, estimated renal and hepatic function, and specific indication for therapy used during prospective clinical review to calculate and verify an individualized dose.

PDEA S2 License

The PDEA registration associated with a practitioner authorized to prescribe dangerous drugs.

PDEA S3 License

The PDEA registration associated with a retail pharmacy authorized to sell or dispense dangerous drugs.

MDRP

Maximum Drug Retail Price; the legally set ceiling price at which a covered medicine may be sold at retail.

Pharmacokinetic Interaction

An interaction occurring when one drug alters the absorption, distribution, metabolism, or excretion (ADME) of another drug, changing drug exposure.

Light-Exposed Nitroglycerin Color Change

A visual indication of photochemical degradation and chemical decomposition resulting from exposure to light.

Cloudiness in Amphotericin B Admixture

A sign of physical incompatibility with precipitation or aggregation occurring immediately after mixing with an unverified diluent, requiring the preparation to be withheld.

Emulsion Phase Separation Factor

Temperature variation, which can alter viscosity, interfacial films, or droplet behavior and promote cracking or phase separation in emulsions.

Administrative Order No. 62

The Philippine administrative order that implements prescribing requirements under the Generics Act (RA 6675).

Administrative Order No. 63

The Philippine administrative order that implements generic dispensing requirements and related duties of pharmacists and drug outlets.

Generic Name Before Brand Name Format

The correct writing format required under the Generics Act, where the generic name is written before the brand name.

Salbutamol and Lagundi Interaction

A pharmacodynamic interaction where both agents influence respiratory symptoms at the level of drug effect to achieve a similar respiratory therapeutic effect.

Cetirizine and Alcohol Interaction

An interaction where alcohol adds to drowsiness and psychomotor impairment caused by sedating antihistamines.

Penicillin Allergic Reaction Classification

Type B (bizarre) adverse drug reaction, which is unpredictable and not an extension of the drug's usual dose-related pharmacology.

Opioid Agonist and Naloxone Interaction

Antagonism, where naloxone competitively blocks opioid receptors and reverses opioid effects.

Warfarin and Aspirin Interaction Risk

Substantially increased bleeding risk due to combined clotting-factor reduction by warfarin and platelet aggregation inhibition by aspirin.

Brand Name Above Generic Name Classification

Violative prescription format under traditional Generics Act teaching, because placing the brand before the generic name fails the required generic-first format.

Pharmacist Action on a Violative Prescription

Do not dispense and refer the patient back to the prescriber for correction, explaining the issue professionally without independently rewriting the order.

Prescription Book Retention Period

Two years from the last entry, as commonly taught under Philippine pharmacy regulations.

Warfarin and Ginseng Interaction

Reduced anticoagulant effect and possible thrombotic risk caused by certain ginseng products lowering warfarin efficacy.

Sulfisoxazole in Late Pregnancy

A drug that can displace bilirubin from albumin when given near term, increasing the risk of kernicterus in a neonate.

Cimetidine and Theophylline Interaction

Inhibition of theophylline metabolism by cimetidine, leading to increased theophylline concentration, reduced clearance, and possible toxicity.

Chloramphenicol-Induced Aplastic Anemia

A rare, unpredictable, non-dose-related Type B adverse reaction that is not an extension of chloramphenicol's usual pharmacology.

Red Man Syndrome

A condition associated with rapid vancomycin infusion, characterized by histamine-mediated flushing, erythema, pruritus, and hypotension.

Eutexia

The phenomenon where solid substances (such as camphor and menthol) liquefy when mixed at room temperature because the mixture has a melting point below room temperature.

Epinephrine Solution Pink Discoloration

A signal of chemical decomposition via oxidation into colored degradation products, accelerated by light, oxygen, heat, and alkaline conditions.

Acacia and Iron-Salt Solution Incompatibility

A physical incompatibility characterized by the formation of a gel-like mass and loss of acceptable texture.

Deliquescence

The property of a substance (such as KOH pellets) to absorb enough atmospheric moisture to dissolve completely in the absorbed water.

Type I Hypersensitivity

An IgE-mediated immediate or anaphylactic reaction involving mast-cell activation, which may cause urticaria, bronchospasm, angioedema, or anaphylaxis.

NCC MERP Category E

A medication error category where an error reached the patient and contributed to temporary harm requiring treatment or intervention, but not hospitalization.

NCC MERP Category B

A medication error category where an error occurred but was detected before reaching the patient.

NCC MERP Category C

A medication error category where an error reached the patient but caused no harm and required no monitoring.

NCC MERP Category D

A medication error category where an error reached the patient without causing harm, but required monitoring or intervention to confirm or preclude harm.

Griseofulvin Administration Advice

Taking the medication with a high-fat meal to improve oral absorption and increase systemic exposure.

Physiological Antagonism Example

Epinephrine and histamine, which act at different receptors to produce opposing physiological effects.

'Gaviscon 1 tablet tid pc and hs' Interpretation

One tablet three times daily after meals (pc) and at bedtime (hs).

Gray Baby Syndrome Pathway Immaturity

Immature UDP-glucuronosyltransferase activity (glucuronidation pathway) in neonates, reducing chloramphenicol clearance and causing toxic accumulation.

St. John's Wort and Digoxin Interaction

Induction of transport and metabolic pathways by St. John's wort, reducing digoxin concentration and potentially leading to therapeutic failure.

Pharmacodynamic Antagonism Example

Naloxone and morphine, where naloxone directly blocks opioid receptors and opposes morphine's effects without altering drug exposure.

Phenytoin Induction on Warfarin

Enzyme induction that increases warfarin metabolism, leading to a reduced anticoagulant effect and possible clotting risk over time.

Type IV Delayed Hypersensitivity Example

Contact dermatitis from poison ivy, which is a T-cell mediated reaction typically developing hours to days after exposure.

Yellow Copy (Triplicate Prescriptions)

The patient's copy in the traditional triplicate dangerous-drug prescription system taught in Philippine pharmacy law.

'NO SUBSTITUTION' Prescription Classification

A violative instruction that conflicts with the patient's right to choose generic equivalents under generic substitution rules.

Poison Book Retention Period

Five years, as commonly taught under Philippine pharmacy regulations.

Sucrose Unsuitability in Acarbose-Treated Hypoglycemia

Acarbose inhibits alpha-glucosidase required to split sucrose, preventing its rapid digestion; oral glucose or dextrose must be used instead.

Spironolactone and High-Potassium Foods Interaction

A risk of dangerous hyperkalemia because spironolactone reduces renal potassium excretion, compounding potassium intake from high-potassium foods.

Triple Whammy Renal Risk

Acute kidney injury caused by combining an NSAID (e.g., ibuprofen), a renin-angiotensin blocker (e.g., losartan), and a diuretic (e.g., hydrochlorothiazide).

Mefenamic Acid and Amlodipine Interaction

Reduced blood-pressure control caused by NSAID-induced sodium retention blunting the antihypertensive effect of amlodipine.

Subscription

The traditional part of a prescription containing directions to the pharmacist, including the dosage form, quantity to prepare, or amount to dispense (e.g., 'Dispense 120 mL').

Oral Suspension Auxiliary Instruction

'Shake well before use,' which redistributes settled particles to ensure a uniform drug concentration in each measured dose.

Dose Calculation: 250 mg from 125 mg/5 mL

A volume of $10\,\text{mL}$ required, calculated as $\frac{250\,\text{mg} \times 5\,\text{mL}}{125\,\text{mg}} = 10\,\text{mL}$.

Dose Calculation: 1 Capsule BID for 7 Days

A total of $14\,\text{capsules}$ needed, calculated as $2\,\text{capsules/day} \times 7\,\text{days} = 14\,\text{capsules}$.

Eutectic Powder Preparation Method

Triturating each ingredient separately with an inert absorbent before combining to reduce direct contact and absorb liquid.

Ionic Solution Precipitation Cause

A double-displacement reaction that produces a poorly soluble salt whose solubility limit is exceeded.

Efflorescence

A physical instability where a hydrated salt loses its water of crystallization when exposed to dry air, becoming powdery.