1. Week 2 Medication Orders/Rx’s chapter 5 Measurement Systems chapter 7 Pharmacology HS140 *** Jenny Hayes 1

2. Overview of Unit 2 Readings: Readings: Chapter 5: Reading and interpreting medication labels, orders, and doc Chapter 5: Reading and interpreting medication labels, orders, and doc Chapter 7: Measurement systems and their equivalents Chapter 7: Measurement systems and their equivalents Discussion Question Discussion Question Quiz Quiz Seminar Seminar Please have textbook available for discussion Please have textbook available for discussion 2

3. Case study A patient call you at the office to report that he is out of his refills for his medication. He asks you to call in the prescription refills to the pharmacist. How would you handle this situation? A patient call you at the office to report that he is out of his refills for his medication. He asks you to call in the prescription refills to the pharmacist. How would you handle this situation? 3

4. Page 87 What are the 6 components of a prescription? What are the 6 components of a prescription? 4

5. 6 parts of a Medication-Order 5 DATE PATIENT NAME (D.O.B. recommended!) DRUG NAME DOSAGE or AMOUNT of medication ROUTE of administration (po, IV, etc) TIME or FREQUENCY of administration (B.I.D., T.I.D., q4h, q12h, etc)

6. Written Prescriptions (Rx)  For out-patient use  legal document given by MD directly to the patient, or is called/faxed to pharmacy  Patient can take this to the ‘Drug Store’  Single-line (only 1 drug per prescription)  Multiple-line (more than 1 drug written on the same prescription-blank) 6

7. Page 87 7  Most prescriptions need to be filled within _______ months.

8. Controlled-Substance ‘schedule’  There are 5 schedules (aka ‘classes’)  Labeled with a ‘C’ and Roman-numeral (example ‘C-III’ = a schedule-3 drug)  ‘Schedule’ determined by a drug’s potential for dependency & abuse.  The lower the number the higher the potential for dependency and abuse.  Good examples on pg 83 in your text. 8

9. 9  What are some differences you need to consider when prescribing scheduled medications?

10. Understanding labels Active learner Active learner know your resources know your resources Class activity: Chapter 5 Class activity: Chapter 5 Page 92 Page 92 10

11. What is a ‘standing order’ and give an example when you would use it. What is a ‘standing order’ and give an example when you would use it. 11

12. Class activity 12 Page 88 Figure 5-11 Review parts of a prescription

13. Common Medical Abbreviations: Route  IM=intramuscular (into muscle) Example: Depo-Provera ® 150 mg/mL, # 1mL 150 mg IM q 3 months  SC=subcutaneous (under skin) Example: Lantus 100 units/mL, # 1 vial Inject 10 units SC q hs 13

14. Common Medical Abbreviations: Route  SL =sublingual (under the tongue) Example: nitroglycerin 0.4 mg SL tabs, #25 i tab SL q 5 min x 3 doses prn chest pain  PO =by mouth Example: atenolol 25 mg, # 30 i tab po q am 14

15. Route abbreviations cont.  pr = ‘per rectum’ (insert rectally) RX example: Insert I suppository pr q6h prn Instructing the patient to… “Insert 1 suppository per rectum every 6 hours as needed”  pv = ‘per vagina’ (insert vaginally) RX example: Insert 1-gram pv qhs x 7 doses instructing this patient to… “Insert 1-gram per vagina (or ‘vaginally’) at bedtime for 7 doses” 15

16. EYE (opthalmics)/EAR (otics)  for Eye-drops, eye- ointments … OD = Right-eye OS = Left-eye OU = both eyes, or ‘each’ eye  For Ear-drops … AD = Right-ear AS = Left-ear AU = both ears, or ‘each’ ear 16

17. JCAHO (Joint Commission on Accreditation of Healthcare Organizations) 17 Created an Official “Do Not Use” List  Why?  easily misinterpreted abbreviations increased risk of errors compromised patient safety What are some examples on this list?

18. Common Medical Abbreviations: Frequency: what do they mean? prn hs Stat q2h b.i.d. t.i.d 18

19. Patient compliance 19  Why is it important to encourage patients to fill all prescriptions at one pharmacy?  How might financial issues be a barrier to compliance?  How might you assist patients with remembering to take their meds?

20. Patient compliance 20  Provide written instructions  Ensure patient/caregiver thoroughly understands instructions  Make a list of meds to carry with  Encourage one pharmacy to fill all Rx  Confirm patients understand WHY they are taking a medication  Take time to answer questions.

21. generic and Trade Names 21 The generic is drug’s ‘official name’ in the USP. Brand(Trade) drugs have a U.S. patent and have the ‘®’ attached (example … Motrin® is the Brand-name, ibuprofen is generic-name) Brand-names --- are always Capitalized ! generic-names --- always in lower-case, and drugs in the same therapeutic class almost always end with the same ‘suffix’ (amoxicillin, penicillin, ampicillin …or lovastatin, simvastatin, etc)

22. WEEK 2 SEMINAR MEASUREMENT SYSTEMS AND THEIR EQUIVALENTS 22

23. Household System 23 Volume  1 cup (c) = 8 oz  1 pint (pt) = 2 c = 16 oz  1 quart (qt) = 2 pt = 4 c =32 oz  1 gallon (gal)= 4 qt= 8 pt = 16c = 128oz Weight or mass  1 pound = 16 oz Length  1 foot = 12 in  1 yard = 3ft = 36in

24. Metric System 24 Based on the decimal system the international standard for scientific and industrial measurements Used in more than 90% of developed countries

25. Three Basic Units of Measure in the Metric system 25 Weight – gram (g, gm) Volume – liter (L) Length – meter (m)

26. Common Prefixes 26 Deci = 0.1 (one-tenth of one unit) Centi = 0.01 (one-hundredth of a unit) Milli = 0.001 (one-thousandth of a unit) Micro = (one-millionth of one unit) Kilo = 1000 units

27. Metric Rules Zero ALWAYS placed before decimal ex: 0.78 (not.78) Zero NEVER added to the end ex: 1.01 (not 1.0100)

28. What is the ‘Base’ for:  Weight?  Volume/liquid?  Length? 28

29. Page 133 in textbook:Mnemonic  King Henry Died By Drinking Chocolate Milk _ _ (Micro) 29

30. Length Measurement 30 1 Meter = 39.37 inches 2.5 cm = 1 inch 1 m = 1000 mm 1 m = 100 cm 1 cm = 10 mm

31. Liter the metric unit of volume 31 1 Liter = 1L = 1,000 milliliters = 100 centiliters =10 deciliters =0.1 dekaliter =0.01 hectoliter =0.001 kiloliter

32. Volume Measurement 32 1 mL = 1cc 1 teaspoonful=5mL or 5cc’s 1 tablespoon=3 tsp = 15mL or 15cc’s 1 L = 32 ounces (approx) 1L = 1000 mL=1000cc 1L = 1qt (approx)

33. GRAM - Metric Measure of Weight 33 1 gram = (1g) = 1000 mg = 100 centigrams = 10 decigrams = 0.1 dekagram = 0.01 hectogram = 0.001 kilogram

34. Most Common GRAM-based units 34 Milligram (mg) Gram (g) Kilogram (kg) 1000 mg =1 g 1000 gm = 1 kilogram (kg or kilo)

35. Weight Measurement 35 1 kg = 2.2 pounds 1 kg = 1000 g 1 mg = 0.001g 1 mg = 1000 mcg or µg