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Chapter 3

Chapter 3. Dispensing 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

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Chapter 3

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  1. Chapter 3 Dispensing of Pharmacologic Agents

  2. 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

  3. 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.

  4. The Prescription

  5. The Prescription

  6. The Prescription

  7. The Prescription

  8. The Prescription

  9. The Prescription

  10. Problematic Abbreviations

  11. 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.

  12. Discussion What makes an abbreviation dangerous? What is the role of the pharmacy technician when a prescription arrives with a dangerous abbreviation?

  13. “Rights” for Drug Administration Right Drug Right Strength Right Patient Right Time Right Route

  14. 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?

  15. Mediation Label

  16. Dosage Forms and Routes of Administration • Peroral (PO, by mouth) Dosage Route • Oral (swallowed) • Sublingual (under the tongue) • Buccal (dissolves in the check)

  17. Dosage Forms and Routes of Administration • Parenteral Dosage Route • Intravenous (vein) • Intra-arterial (artery) • Intracardiac (heart) • Subcutaneous (beneath the skin) • Intramuscular (muscle)

  18. 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

  19. Dosage Forms and Routes of Administration • Peroral (PO, by mouth) Dosage Forms tablets, capsules, solutions, syrups, elixers, suspensions, magmas, gels, powders, trouches/lozenges

  20. Dosage Forms and Routes of Administration • Parenteral Dosage Forms • Solutions • Suspensions

  21. Dosage Forms and Routes of Administration • Topical Dosage Forms ointments, creams, pastes, powders, aerosols, lotions, transdermal patches, sprays, inhalants, suppositories, enemas, emulsions, sponges, gels

  22. Factors that Influence Drug Action • Review:What are the four phases of the pharmacokinetic process? Absorption Distribution Metabolism Elimination

  23. 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

  24. Considerations for Elderly Patients Physiologic Function Changes • Optic • Auditory • Gastrointestinal • Pulmonary • Cardiovascular • Urinary • Hormonal • Composition of the body

  25. Considerations for Elderly Patients • Altered Drug Responses • Adverse Drug Reactions (ADRs) • Polypharmacy • Noncompliance

  26. 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.

  27. 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?

  28. 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.

  29. Immunization What are the two types of immunity?

  30. Immunization What are the two types of immunity? • Active immunity • Passive immunity

  31. 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

  32. Immunization Schedule

  33. 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

  34. 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)

  35. Allergic Response

  36. Allergic Diseases • Allergic rhinitis • Hay fever • Allergic dermatitis, eczema • Contact dermatitis • Urticaria (hives)

  37. Drug Therapy for Allergies • Free environment of allergens (if possible) • Corticosteroids • Short-term relief of symptoms with antihistamines • Long-term desensitization programs

  38. Prostaglandins • Mediators of several physiologic processes • Include PGA, PGB, PGE, and PGF • Actions • Endocrine system • Cardiovascular system • Gastrointestinal system • Pulmonary system • Inflammatory

  39. Teaching Patients Medication Management Goal: Compliance A patients’ adherence to the dose schedule and other particular requirements of the specific drug regimen

  40. Discussion What kinds of information help improve patient compliance?

  41. 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

  42. Discussion What can the pharmacy technician do to help patients manage their medications properly?

  43. Teaching Patients Medication Management

  44. Teaching Patients Medication Management

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