PHARMACY PRACTICE II LAB PHCY 380L

Spring 2016-17

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College of Pharmacy and Nursing

School of Pharmacy

PHARMACY PRACTICE II LAB

PHCY 380L

Lab Manual

Spring 2016/17

Faculty: Ms Beena Jimmy

Lecturer, Pharmacy Practice

Name:

Student Id:

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Learning Objectives:

Develop the skills to review prescriptions to identify the

indications for the use of specified drugs, identify drug

interactions, need for dosage adjustment in patients

with renal and hepatic dysfunction

Develop the skills to review prescriptions to evaluate

the safety of drug use in pregnancy and lactation and

make appropriate recommendations using appropriate

information resources

Develop the skills to evaluate patient case notes to

identify the drug related problems including adverse

drug reactions, drug interactions and rationality of

drug use

Develop the skills to retrieve, evaluate and synthesis

information and formulate reply in response to a drug

information query using modified systematic approach

Skills such as searching reference texts, searching web-

based databases, and providing medicine counseling to

patients are also an integral part of this course. These

skills are at the core of modern pharmacy practice

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Lab Instructions:

Various patient oriented pharmacy services for the

given prescriptions will be discussed

Utilize appropriate references to provide patient

oriented pharmacy services for the respective cases

Evaluate the prescription and provide your

recommendation for each prescription

Communicate with the health care professional

regarding your recommendation with reference.

Food and drink are forbidden in the Laboratory.

Cell phones are forbidden and will be confiscated if

found.

Please take care of Reference Books that are used in the

Lab and do not write on it. If observed to be writing on

these books, it may have to be replaced by the student.

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LAB EXERCISE -1

PRESCRIPTION/MEDICATION ORDER REVIEW

Task: Identifying the indication of the medicines and potential drug- drug interactions in

the given prescription

Review the given prescription and

a. Identify the indications of the prescribed medications

b. Evaluate the prescription for potential drug-drug interactions.

NIZWA Hospital

Nizwa

Name of the patient: Mr. Khamis Said Al Amri Hospital

No:11155672

Male,Omani,57year(s)

Department: Medicine Doctor: Dr: Abdul

Hakim

Physicians Name &

Reg.No: Dr. Abd Hak,

5789

Physicians Signature

& Stamp:

Dr. Abd Hak , 5789

Provisional Diagnosis: Heart Failure

Medicine Formulation Course

Lisinopril- 5 mg Tablets 5 mg/1 Tablet Oral OD for 14 days

Warfarin sodium- 3 mg Tablets 3 mg/1 Tablet Oral OD for 14 days

Aspirin- 75 mg Tablets 75 mg/1 Tablet Oral OD for 14 days

Date : 6 February 2017 Dispensed by: Ph Ahmed (1234)

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Finding: ---------------------------------------------------------------------------------------------------------

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Summary/Recommendations:------------------------------------------------------------------------------

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References:------------------------------------------------------------------------------------------------------

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LAB EXERCISE -2


Task: Identify the problems in the prescription and Review the appropriateness of the

patient’s treatment

Review the appropriateness of patient’s treatment and identify any drug related problem

NIZWA Hospital

Nizwa

Name: Abdulaziz Said Al Hattali Hospital No:1115522 Male,Omani,42year(s)

Department: Medicine Doctor: Dr: Hamed Physicians Name &

Reg.No: Dr. Hamed,

6061

Physicians Signature

& Stamp:

Dr. Hamed , 6061

Provisional Diagnosis: Diabetes Mellitus with Allergic Rhinitis


Montelukast- 4 mg Tablets 4 mg/1 Tablet Oral BD for 30 days

Cetirizine- 5 mg Tablets 10 mg/1 Tablet Oral OD for 30 days

Glibenclamide- 5 mg Tablets 5 mg/1 Tablet Oral OD for 30 days

Date : __ February 2017 Dispensed by: Ph ___________ (1234)

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LAB EXERCISE- 3


Task: Evaluate the prescription for safety of drug use during pregnancy

Dear Clinical/Ward Pharmacist/Pharmacist,

Please evaluate the safety of the medications in this patient considering her pregnancy status

NIZWA Hospital

Nizwa

Name: Huda Nasser Al Senaidi Hospital No:1115511 Female,Omani,24year(s)

Department: Medicine Doctor: Dr: Hilal Physicians Name &

Reg.No: Dr. Hilal,

6062

Physicians Signature &

Stamp:

Dr. Hilal , 6062

Provisional Diagnosis: Diabetes Mellitus with Hypothyroidsm

Additional Information: 34 Weeks of Gestation


Glimepride- 4 mg Tablets 4 mg/1 Tablet Oral OD for 14 days

Levothyroxine- 50 mcg Tablets 50 mcg/1 Tablet Oral OD for 14 days

Date : __ February 2017 Dispensed by: Ph ___________ (1234)

Please document your recommendations on the patient’s case note.

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Finding: ---------------------------------------------------------------------------------------------------------

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References:------------------------------------------------------------------------------------------------------

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LAB EXERCISE- 4


Task: Evaluate the prescription for safety of drug use during Lactation

Review the prescription considering the patients lactating status

NIZWA Hospital

Nizwa

Name: Shamna Ahmed Al Hajri Hospital No:141584

Age: 24 yrs Weight in Kg: 60 Sex: Female

Rx

Tetracycline 250 mg Tablet PO Q6H x 5 days

Ibuprofen 400 mg tablet 1-1-1 x 5 days

Additional information: Breast feeding; 4 months old infant

Diagnosis: Respiratory tract infection

Physicians Name & Reg.No: Dr.Ahmed, 254

Physicians Signature & Stamp:

Dr.Ah, 254

Date :__ March 2017 Dispensed by: Ph._______

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Finding: ---------------------------------------------------------------------------------------------------------

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LAB EXERCISE- 5


Task: Evaluating safety of drugs in patients with hepatic dysfunction

Evaluate the safety of the drugs considering the patients hepatic function

NIZWA Hospital

Nizwa

Name of the patient: Mr. Yakoob Salim Al Salmi Hospital No:56354

Age: 45yrs Weight in Kg:74 Sex: Male

Rx

1. Tab. Digoxin 125mcg PO 1-0-0

2. Tab. Pantoprazole 40 mg PO 1-0-1

3. Tab. Furosemide 20 mg PO 1-0-1

4. Tab. Metoprolol 100mg PO 1-0-1

Liver function tests: Altered liver function tests. Moderate hepatic failure

Diagnosis: Heart failure with hypertension

Physicians Name & Reg.No: Dr.Galila, 25472


Dr.Galila, 25472

Date :___March 2017 Dispensed by: Ph ________

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LAB EXERCISE - 6


Task: Evaluating safety of drugs in patients with renal dysfunction

Evaluate the safety of the drugs considering the patients renal function

Calculate the creatinine clearance and identify any need for dosage adjustment for the prescribed

drugs, considering the patients renal status

NIZWA Hospital

Nizwa

Name: Amani Salam Al Khalsi Hospital No:456891

Age: 38yrs Weight in Kg: 85 Sex: Male

Rx

Tab. Metformin 500 mg PO 1-0-1

Tab. Prazosin 500 mcg PO 1-1-1 x 3 weeks

Renal function tests: Scr:260 micromoles/L

Diagnosis: Diabetes with hypertension

Physicians Name & Reg.No:

Dr. Jamal, 24631


Dr.Jamal, 24631

Date ___ March 2017 Dispensed by: Ph. ________

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Finding: ---------------------------------------------------------------------------------------------------------

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LAB EXERCISE – 7

Drug Information

Answer the drug information from the health care professional

Dr. Abdul Satar, Professor, Department of Internal Medicine, Samail Hospital would like to have

the following information from the Drug Information Centre.

A 45 year old male patient, weighing 50 kgs is admitted to the hospital for treatment of

oropharyngeal candidiasis. Clinician plans to start Ketoconazole. The patient is alcoholic since

20 years. Based on the liver function tests, he is having moderate hepatic impairment. Clinician

would like to know the dose of Ketoconazole to be given in this patient. Further, he would like to

know whether the dose of Ketoconazole needs to be adjusted based on the liver function tests.

He would like to have the information within 1 hour.

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LAB EXERCISE – 8

SCENARIO

You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in

Nizwa.

A patient approaches your Pharmacy counter to fill his prescription.

Provide appropriate patient medication counseling.

NIZWA HEALTH CLINIC

FIRQ, Nizwa Name of the Patient: Ms. Amal Mustafa Al Salhi Hospital No: 1234567

Age: 45 years Weight in Kg: 70 Sex: Female

Rx

Glibenclamide 5 mg Tablet OD for 30 days

Metformin 500 mg Tablet BD for 30 days

Follow up after 30 days and FBS Test

Physicians Name & Reg. No:

Dr. Kamaluddin, 1054

Physician’s Signature & Stamp:


Date: __ April 2017

Dispensed By: Ph.X

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LAB EXERCISE – 9

SCENARIO

You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in

Nizwa.

A patient approaches your Pharmacy counter to fill his prescription.

Provide appropriate patient medication counseling.

NIZWA HEALTH CLINIC

FIRQ, Nizwa Name of the Patient: Ms. Amal Hospital No: 1234567

Age: 45 yrs Weight in Kg: 70 Sex: Female

Rx

Tab. Enalapril 5 mg 1-0-0 x 2 weeks

Tab. Atenolol 50mg 1-0-0 x 2 weeks

Follow up after 2 weeks

Physicians Name & Reg. No:


Physician’s Signature & Stamp:


Date: __ April 2017 Dispensed By: Ph.X

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Drug interactions are important to check for because they can:

Affect how your medication works by changing levels of the drug in your blood

Put you at risk for side effects and toxicity

Worsen a medical condition you may already have.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.

Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.

Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

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PHARMACY PRACTICE II LAB PHCY 380L