2. Dispensing of Pharmacologic Agents
Chapter 3
Dispensing of Pharmacologic Agents

3. 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

4. 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.

5. The Prescription

6. The Prescription Abbreviation Translation ac before meals bid
twice a day c
with
cap
capsule
DAW
dispense as written
D/C
discontinue g
gram

7. The Prescription Abbreviation Translation gr grain gtt drop hs
at bedtime IM
intramuscular IV
intravenously L
liter
mcg
microgram

8. 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

9. 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

10. The Prescription Abbreviation Translation tab tablet tid
three times daily ud
as directed wk
week

11. 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

12. Problematic Abbreviations
Institute for Safe Medication Practices (ISMP)
Lists dangerous abbreviations and other safety tips.
Check out the site at
Review Appendix B in the textbook for additional safety tips.

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

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

15. 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?
A pharmacy technician should check to see what other drugs the patient is taking, looking for possible drug interactions. The technician should also check for known drug allergies.

16. Mediation Label

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

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

19. 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

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

21. Dosage Forms and Routes of Administration
Parenteral Dosage Forms
Solutions
Suspensions

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

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

24. 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

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

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

27. 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.

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?

29. 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.

30. Immunization
What are the two types of immunity?

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

32. 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

33. Immunization Schedule

34. 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

35. 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)

36. Allergic Response

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

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

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

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

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

42. Discussion Answer: Methods of administration
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

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

44. Teaching Patients Medication Management

45. Teaching Patients Medication Management