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Chapter 3Dispensing of
Pharmacologic Agents
Chapter 3 Topics
• 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 Translation
ac before meals
bid twice a day
c with
cap capsule
DAW dispense as written
D/C discontinue
g gram
The Prescription
Abbreviation Translation
gr grain
gtt drop
hs at bedtime
IM intramuscular
IV intravenously
L liter
mcg microgram
The Prescription
Abbreviation Translation
mEq milliequivalent
mL milliliter
NKA no known allergy
NKDA no known drug allergy
npo nothing by mouth
pc after meals
PO by mouth
The Prescription
Abbreviation Translation
prn as needed
q every
qh every hour
q2h every two hours
qid four times a day
qs a sufficient quantity
stat immediately
The Prescription
Abbreviation Translation
tab tablet
tid three times daily
ud as directed
wk week
Problematic Abbreviations
Dangerous Abbreviation
Correct Form to Use
µg Microgram or mcg
qd every day
qod every other day
U units
MgSO4 magnesium sulfate
MSO4 morphine sulfate
.2 0.2
2.0 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 Patient
Right Drug
Right Strength
Right Time 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– Intravenous (vein)– Intra-arterial (artery)– Intracardiac (heart)– Subcutaneous (beneath the skin)– Intramuscular (muscle)
Dosage Forms and Routes of Administration
• Topical Dosage Route– 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 Formstablets, 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 Formsointments, 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
• AgePediatric patients and elderly patients may need a reduced dose because of smaller size or inability of liver to metabolize medication
• DiseaseSpecific diseases may hinder the pharmacokinetic process of some drugs
• Mental State, Genes, Gender
Considerations for Elderly Patients
Physiologic Function Changes– Optic
– Auditory
– Gastrointestinal
– Pulmonary
– Cardiovascular
– Urinary
– Hormonal
– Composition of the body
Considerations for Elderly Patients
• 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 immunityReceiving 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
• 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
– Endocrine system– Cardiovascular system– Gastrointestinal system– Pulmonary system– Inflammatory
Teaching Patients Medication Management
Goal: ComplianceA 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: – 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