Download rights of correct drug administration

Chapter 3
Dispensing of
Pharmacologic Agents
Chapter 3 Topics
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The Prescription
“Rights” for Correct Drug Administration
Dosage Forms and Routes of Administration
Factors that Influence Drug Action
Endogenous Chemicals that Affect Drug Action
and Response
• Teaching Patients Medication Management
Learning Objectives
• Know the components of the prescription, including the
commonly used abbreviations.
• Understand the rights of correct drug administration.
• Recognize common dosage forms.
• Know the routes of administration.
• Recognize factors that influence the effects of drugs,
particularly in the elderly and pediatric populations.
• Know the effects natural chemicals have on drug action
and response.
• Understand the immunization process.
The Prescription
The Prescription
Abbreviation
ac
bid
c
cap
DAW
D/C
g
Translation
before meals
twice a day
with
capsule
dispense as written
discontinue
gram
The Prescription
Abbreviation
gr
gtt
hs
IM
IV
L
mcg
Translation
grain
drop
at bedtime
intramuscular
intravenously
liter
microgram
The Prescription
Abbreviation
mEq
mL
NKA
NKDA
npo
pc
PO
Translation
milliequivalent
milliliter
no known allergy
no known drug
allergy
nothing by mouth
after meals
by mouth
The Prescription
Abbreviation
prn
q
qh
q2h
qid
qs
stat
Translation
as needed
every
every hour
every two hours
four times a day
a sufficient quantity
immediately
The Prescription
Abbreviation
tab
tid
ud
wk
Translation
tablet
three times daily
as directed
week
Problematic Abbreviations
Dangerous
Abbreviation
µg
qd
qod
U
MgSO4
MSO4
.2
2.0
Correct Form to Use
Microgram or mcg
every day
every other day
units
magnesium sulfate
morphine sulfate
0.2
2
Problematic Abbreviations
• Institute for Safe Medication Practices
(ISMP)
– Lists dangerous abbreviations and other safety
tips.
– Check out the site at www.ismp.org.
– Review Appendix B in the textbook for
additional safety tips.
Discussion
What makes an abbreviation
dangerous?
What is the role of the pharmacy
technician when a prescription arrives
with a dangerous abbreviation?
“Rights” for Drug Administration
Right Drug
Right Patient
Right Time
Right Strength
Right Route
Discussion
How do the “rights” for correct drug
administration help avoid dispensing
errors?
What other things should a pharmacy
technician check when dispensing a
medication?
Mediation Label
Dosage Forms and Routes of
Administration
• Peroral (PO, by mouth) Dosage Route
– Oral (swallowed)
– Sublingual (under the tongue)
– Buccal (dissolves in the check)
Dosage Forms and Routes of
Administration
• Parenteral Dosage Route
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Intravenous (vein)
Intra-arterial (artery)
Intracardiac (heart)
Subcutaneous (beneath the skin)
Intramuscular (muscle)
Dosage Forms and Routes of
Administration
• Topical Dosage Route
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Transdermal (skin surface)
Conjunctival (conjunctiva) or Intraocular (eye)
Intranasal (nose)
Aural (ear)
Intrarespiratory (lung)
Rectal
Vaginal
Urethral
Dosage Forms and Routes of
Administration
• Peroral (PO, by mouth) Dosage Forms
tablets, capsules, solutions, syrups, elixers,
suspensions, magmas, gels, powders,
trouches/lozenges
Dosage Forms and Routes of
Administration
• Parenteral Dosage Forms
– Solutions
– Suspensions
Dosage Forms and Routes of
Administration
• Topical Dosage Forms
ointments, creams, pastes, powders, aerosols,
lotions, transdermal patches, sprays, inhalants,
suppositories, enemas, emulsions, sponges, gels
Factors that Influence Drug Action
• Review: What are the four phases of the
pharmacokinetic process?
Absorption
Distribution
Metabolism
Elimination
Factors that Influence Drug Action
• Age
Pediatric patients and elderly patients may need a
reduced dose because of smaller size or inability
of liver to metabolize medication
• Disease
Specific diseases may hinder the pharmacokinetic
process of some drugs
• Mental State, Genes, Gender
Considerations for Elderly Patients
Physiologic Function Changes
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Optic
Auditory
Gastrointestinal
Pulmonary
Cardiovascular
Urinary
Hormonal
Composition of the body
Considerations for Elderly Patients
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Altered Drug Responses
Adverse Drug Reactions (ADRs)
Polypharmacy
Noncompliance
Considerations for Pediatric Patients
• Wide variation between age and degree of
organ-system development
• Reevaluate all doses at regular intervals.
• Be sure the dosage is appropriate for the
child’s age.
• Always double-check all computations.
Discussion
What should a pharmacy technician
do when a parent is struggling to
determine the best dose of an OTC
medication for a pediatric patient?
Discussion
What should a pharmacy technician do when a
parent is struggling to determine the best dose of
an OTC medication for a pediatric patient?
Answer: Ask the pharmacist to
determine the child’s dose for the
caretaker if the dose information is
not provided.
Immunization
What are the two types of immunity?
Immunization
What are the two types of immunity?
– Active immunity
– Passive immunity
Immunization
What are the two types of immunity?
– Active immunity
Coming in contact with an infectious agent or
an inactivated part of an infectious agent
through a vaccine
– Passive immunity
Receiving antibodies that were formed by
another person or animal that developed them
in response to being infected
Immunization Schedule
Endogenous Chemicals that Affect
Drug Action and Response
Two types of receptors that histamine acts on:
– H1 receptors mediate the contraction of smooth
muscle of the bronchi and intestine
– H2 receptors mediate the action of histamine on
gastric secretion and cardiac acceleration
Endogenous Chemicals that Affect
Drug Action and Response
Two types of drugs that block the histamine
receptors:
– Antihistamines block H1 receptors
– H2 blockers
• cimetidine (Tagamet)
• ranitidine (Zantac)
• famotidine (Pepcid)
• nizatidine (Axid)
Allergic Response
Allergic Diseases
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Allergic rhinitis
Hay fever
Allergic dermatitis, eczema
Contact dermatitis
Urticaria (hives)
Drug Therapy for Allergies
• Free environment of allergens (if possible)
• Corticosteroids
• Short-term relief of symptoms with
antihistamines
• Long-term desensitization programs
Prostaglandins
• Mediators of several physiologic processes
• Include PGA, PGB, PGE, and PGF
• Actions
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Endocrine system
Cardiovascular system
Gastrointestinal system
Pulmonary system
Inflammatory
Teaching Patients Medication
Management
Goal: Compliance
A patients’ adherence to the dose schedule and
other particular requirements of the specific drug
regimen
Discussion
What kinds of information help
improve patient compliance?
Discussion
What kinds of information help improve patient compliance?
Answer:
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Methods of administration
How to make swallowing easier
Times and time intervals for administration
If medication should be taken with food or
not
– Possible side effects
– How long the medication should be taken
Discussion
What can the pharmacy technician do
to help patients manage their
medications properly?
Teaching Patients Medication
Management
Teaching Patients Medication
Management