Drug File Associated Files Urban Health Programs August 2010

Section Objectives Describe and Manage files associated with the Drug File –Standard Schedule –Medication Route –Medication Instruction –Dosage Form Demonstrate proper set up Describe how these files relate to EHR use

Pharmacy Data Management Menu Options Dosages... Drug Enter/Edit Drug Interaction Management... Electrolyte File (IV) Lookup into Dispense Drug File Medication Instruction File Add/Edit Medication Route File Enter/Edit Orderable Item Management... Orderable Item Report Drug Text Enter/Edit Drug Text File Report Pharmacy System Parameters Edit Standard Schedule Edit Synonym Enter/Edit

Standard Schedule Select Pharmacy Data Management Option: standard Schedule Edit Select ADMINISTRATION SCHEDULE: ?? Choose from: (5) TIMES/DAY PM 1500 AC AC BID AC TID AC&HS ACCU-CHEK AC&HS BB 0700 BDA BID BID (DIURETIC) BID (HYPOGLYCEMIC) BID (INSULIN) BIW BL 1100 BS 1630 DAILY 1000

Standard Schedule, cont. NAME: TID//  the “shortcut” abbreviation OUTPATIENT EXPANSION: THREE TIMES A DAY//  how it looks in the Rx OTHER LANGUAGE EXPANSION:  LEAVE BLANK! TYPE OF SCHEDULE: CONTINUOUS//  Cont, day of week, or one-time STANDARD ADMINISTRATION TIMES: //  not needed if not inpatient at your facility FREQUENCY (IN MINUTES): 480//  minutes between doses, calculated as if split evenly through a 24 hour day Select WARD:  not needed if not inpatient at your facility NAME: WEDNESDAY// OUTPATIENT EXPANSION: EVERY WEDNESDAY// OTHER LANGUAGE EXPANSION: TYPE OF SCHEDULE: DAY OF THE WEEK// STANDARD ADMINISTRATION TIMES: 1000// Select WARD: NAME: ONCE// OUTPATIENT EXPANSION: ONCE// OTHER LANGUAGE EXPANSION: TYPE OF SCHEDULE: ONE-TIME//

Medication Routes Select MEDICATION ROUTES NAME: ?? Choose from: BLOOD TEST BUCCAL BUCC BUCCAL DENTAL INFILTRATION BUCCDENTIF BUCCAL ORAL BUCCORAL BUCCAL SUBLINGUAL BUCCSL BY MOUTH BYMO CATHETER CAUDAL BLOCK CAUD CAUDAL EPIDURAL CAUDED CAUDAL EPIDURAL MISCELLANEOUS CAUDED MISC CAUDAL SUBCUTANEOUS INFILTRATI CAUDSC IF CHEW CHEW DEEP IM DENTAL DENT DENTAL INFILTRATION DENTIF DENTAL INTRAMUSCULAR DENTALIM DENTAL ORAL DENTORAL DENTAL ORAL TOPICAL DENTORALTOP DENTAL SUBCUTANEOUS DENTSC

Medication Routes, cont. NAME: ORAL//  full name ABBREVIATION: PO//  abbreviation used in prescriptions PACKAGE USE: ALL PACKAGES//  ”National Drug File Only” will hide it from use locally OUTPATIENT EXPANSION: BY MOUTH//  include preposition, will show on label OTHER LANGUAGE EXPANSION:  LEAVE BLANK! IV FLAG:  mark “yes” if will process in the IV Package in RPMS NAME: TOPICAL// ABBREVIATION: TOP// PACKAGE USE: ALL PACKAGES// OUTPATIENT EXPANSION: TO AFFECTED AREA// OTHER LANGUAGE EXPANSION: IV FLAG: NAME: OPHTHALMIC// ABBREVIATION: OPH// PACKAGE USE: ALL PACKAGES// OUTPATIENT EXPANSION: INTO AFFECTED EYE(S) Replace OTHER LANGUAGE EXPANSION: IV FLAG:

Medication Instruction Select MEDICATION INSTRUCTION NAME: ?? Choose from: (M) (MUST SEE PROVIDER FOR MORE REFILLS) A/A **AVOID ALCOHOL** AH **AVOID ALCOHOL** AOOH AT ONSET OF HEADACHE DD **DOSE DECREASED** DIN **DOSE INCREASED** FALL FOR ALLERGIES FAN FOR ANXIETY FAR FOR ARTHRITIS FAS FOR ASTHMA FAX FOR ANXIETY FBC FOR BIRTH CONTROL FBP FOR HIGH BLOOD PRESSURE FBR FOR BREATHING FCA FOR CALCIUM FCH FOR CHOLESTEROL CONTROL FCIRC FOR CIRCULATION Generally for patient instructions Not for schedules (BID, Q12H, etc) –Those go in standard schedules

Medication Instruction, cont. NAME: FFL//  the abbreviation you will use SYNONYM:  if you want more than one abbreviation EXPANSION: FOR FLUID//  how it will look on labels and reports PLURAL:  not usually used INTENDED USE: OUTPATIENT ONLY//  Inpatient, Outpatient, or both FREQUENCY (IN MINUTES):  no longer needed NAME: AH// SYNONYM: EXPANSION: **AVOID ALCOHOL**// PLURAL: INTENDED USE: OUTPATIENT ONLY// FREQUENCY (IN MINUTES): NAME: WF// SYNONYM: WFM// EXPANSION: WITH FOOD OR MILK// PLURAL: INTENDED USE: IN & OUTPATIENT// FREQUENCY (IN MINUTES):

Dosage Form Need to go into “Dosages” Menu to find it Edits here affect EVERY drug with that dosage form! Can associate one or more ROUTES Can change the VERB Must remove the PREPOSITIONs Can edit the NOUNS

Dosage Form, cont. NAME: TAB  comes from matching, do not edit Select MED ROUTE FOR DOSAGE FORM: ORAL//  can have more than one here VERB: TAKE//  this will be on the label, so should be patient friendly OTHER LANGUAGE VERB:  LEAVE BLANK! PREPOSITION:  LEAVE BLANK! OTHER LANGUAGE PREPOSITION:  LEAVE BLANK! Select NOUN: TABLET(S)//  can have more than one, will have doses of 1 and 2 of every noun here created NOUN: TABLET(S)// OTHER LANGUAGE NOUN:  LEAVE BLANK! PACKAGE: Both//  usually both Select NOUN: CONJUNCTION:  not usually used, but might be for topicals that have a %strength

Dosage Form, cont. NAME: INHL,ORAL Select MED ROUTE FOR DOSAGE FORM: ORAL// VERB: INHALE// OTHER LANGUAGE VERB: PREPOSITION: OTHER LANGUAGE PREPOSITION: Select NOUN: PUFF(S)// NOUN: PUFF(S)// OTHER LANGUAGE NOUN: PACKAGE: Both// Select NOUN: CONJUNCTION:

Dosage Form, cont. NAME: OPHTHALMIC,CRC Select MED ROUTE FOR DOSAGE FORM: IN BOTH EYES// VERB: PLACE// OTHER LANGUAGE VERB: PREPOSITION: OTHER LANGUAGE PREPOSITION: Select NOUN: CONJUNCTION:

Putting it all together With drug file entry, creates a prescription and (if using) a label So…where are the nouns, verbs, and routes seen?

Dosage Form Routes: Only routes you have linked to the dosage form show here Standard Schedules Medication Instructions, shows expanded in EHR Verb (in the dosage form file) Noun (in the dosage form file)

DEMO,PATIENT INFANT TAKE ONE (1) CAPSULE BY MOUTH THREE TIMES A DAY FOR INFECTION TREATMENT; TAKE UNTIL FINISHED MRx0 AMOXICILLIN 250MG CAP #30 CAP Rx MAMN PROVIDER,M CHM Verb (from Dosage form file) Noun (from Dosage form file) Route (note preposition in the route expansion, not in the field “preposition”) Standard schedule, expanded