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Dr. Nelson T.

Tubon

Exercise 11

Generic Dispensing

Key Terms
 Generic Names is the identification of

drugs and medicines by their scientifically and internationally recognized active ingredients or by their official generic names  Chemical Names is the description of the chemical structure of the drug or medicine and serves as the complete identification of a compound.

Key Terms
 Drug Establishment is any organization or

company involved in the manufacture, importation, repacking and/or distribution of drugs or medicines  Essential Drug List is a list of drugs prepared and periodically updated by the DOH on the basis of health conditions obtained in the Philippines, as well as on internationally accepted criteria

Key Terms
 Complementary List is a list of alternative

drugs used when there is no response to the core essential drug or when there is a hypersensitivity reactions to the core essential drug or when, for one reason or another, the core essential drug cannot be given  Active Ingredient is the chemical component responsible for the claimed therapeutic effect of the pharmaceutical product.

Key Terms
 Drug Product is the finished product form

that contains the active ingredients, generally but not necessarily in association with inactive ingredients.  Drug outlets means drugstores, pharmacies, and any other business establishments which sell drugs or medicines

KEY TERMS
 Core list is a list of drugs that meet the

health care needs of the majority of the population  Brand Name is the proprietary name given by the manufacturer to distinguish its production from those of competitors

Generic Dispensing Flow Chart OVER THE COUNTER DRUGS


Patient/Customer asks for a drug
Present the list of drugs with the generic equivalents as the asked drug with their corresponding prices to the patient

Dispense the chosen drug with the same generic as the originally prescribed drug. And give the necessary information and direction for its use

Allow the patient to choose based on his preferences

Generic Dispensing Flow Chart PRESCRIPTION DRUGS


Patient/Customer presents the Prescription

Check if the drug written on the Prescription has a generic name of the active ingredient, dose level, dosage form and delivery mode
Present the list of drugs with the same generic name, dose level, dosage form and delivery mode as the prescribed drug with their corresponding prices to the patient Dispense the chosen generic equivalent and give necessary directions for its use. Keep the prescription for filing.

Allow the patient to choose based on his preferences IS IT FULLY FILLED?

Dispense the chosen generic equivalent with the desired quantity and give necessary directions for its use. Record the date, quantity served and balance of the prescription in the prescription book and prescription itself. Return the prescription to the patient.

Question:
1. What are the penalties for violating the rules and regulations of Generic Dispensing? First conviction shall suffer the penalty of reprimand which shall be officially recorded in the appropriate books of the Professional Regulation Commission (PRC) Second conviction fine of NLT P2,000.00 but NMT P5,000.00 Third conviction fine NLT P5,000.00 but NMT P10,000.00 and suspension of license to practice his profession Fourth and subsequent convictions fine NLT P10,000.00 and suspension of his license

Question:
2. How can you detect whether a certain prescription is violative, erroneous, impossible, or not? A. Violative prescription 1. where generic name is not written 2. where the generic name is not legible and a brand name which is legible is written 3. where the brand name is indicated and instructions added (such as the phrase no substitution) which tend to obstruct, hinder or prevent proper generic dispensing

B. Erroneous prescription  1. where the brand name precedes the generic name  2. where the generic name is the one in parenthesis  3. where the brand name is not in parenthesis  4. where more than one drug product is prescribed on one prescription form

C. Impossible prescription  1. when only the generic is written but it is not legible  2. when the generic name does not correspond to the brand name  3. when both the generic and the brand name are not legible  4. when the drug product prescribed is not registered with the BFAD

3. What actions may be taken if the prescription is violative, erroneous, or impossible prescription?

A. For violative prescription Violative prescription shall not be filled. They shall be kept and reported by the pharmacist of the drug outlet or any other interested party to the nearest DOH Office for appropriate action. The pharmacist shall advise the prescriber of the problem and/or instruct the customer to get the proper prescription

B. For erroneous prescription Erroneous prescriptions shall be filled. Such prescription shall also be kept and reported by the pharmacist of the drug outlet or any interested party to the nearest DOH Office for appropriate action

C. For impossible prescription Prescriptions mentioned shall not be filled. They shall be kept and reported by the pharmacist of the drug outlet or any other interested party to the nearest DOH Office for appropriate action. The pharmacist shall advise the prescriber of the problem and/or instruct the patient to get the proper prescr

4. In tabulated form, enumerate at least 10 Generic names with their corresponding Trade Name and Company, Category or Use, and Dosage Form and Strength.
Generic Names Acetylsalicylic acid Trade Name and Company Aspirin - Bayer Category or Use Antitrombotics prophylaxis of thromboembolic disorders Cardiac drugs Astringent, protectant Antidiarrheal Atibacterial 0.3mg, 0.4mg, 0.6 mg Analgesic, antiinflammatory Antihistamine, antiemetic, sedative Treatment for acne vulgaris Counteract gastric hyperacidity Dosage and Strength 1 tab daily Tab 100 mg 750-1500ug rapid oral loading 250-750 slow oral loading and others 40% usual strength 2 mg 250mg,500mg Antianginal

Digoxin

Lanoxin Glaxo SmithKline Desitin - Pfizer Imodium -Janssen Keflex-Dista Nitrostat ParkeDavis Indocin SR Capsule Merck Phenergan WyethAyerst Cleocin T topical Upjohn Maalox Suspension Novartis

Zinc oxide Loperamide Cephalexin Nitroglycerin Indomethacin Promethazine HCl Clindamycin phosphate Magnesia and alumina

12.5 mg, 25 mg, 50 mg 15 solution 225 mg aluminum hydroxide 200mg/5 mL magnesium hydroxide

Exercise No. 12

Information Basic To Dispensing Drugs

KEY TERMS
Generic name is the official name given a drug. Dosage and Route this refers to how much drug is given and how the drug is to be given. Indications information gives the reasons for using the drug. This information aids in observing for expected effects and therapeutic response, as well as indicating what side and adverse effects might occur.

KEY TERMS
 Contraindications and Precautions These

refers to condition in which a drug should be given with caution or not given at all.  Classification The drug class is a quick reference to the therapeutic action, use, and adverse effect of a drug.

KEY TERMS


Action Information explains how the drug is known or believed to act to produce a therapeutic effect. This knowledge aids in understanding whether a drug should be taken with food or between meals, with other drugs or alone, orally or parenterally. Side and adverse effects Side effects are nontherapeutic reactions to a drug that are transient. Adverse effects are nontherapeutic effects that may be harmful to the patient and that require lowering the dosage or discontinuing the drug.

A. Kinds of information the pharmacist need to know to give drugs safely.

        

1. 2. 3. 4. 5. 6. 7. 8. 9.

Generic name/trade name Action of the drug Use of the drug Side/adverse effects of the drug Contraindications/Precautions Interactions/Incompatibilities Nursing implications Evaluation effectiveness Patient counseling

B. Pregnancy categories used to identify the safety of drugs


1.

No risk to fetus

2. No adverse effects in animals, but no human studies 3. Animals show adverse effects, calculated risk to fetus 4. Fetal risk exists 5. Absolute fetal abnormality

C. Positive actions to avoid liability


       

1. 2. 3. 4. 5. 6. 7. 8.

Know policies and practices of the establishment Research unfamiliar drugs Do not leave medicines at the bedside Chart carefully Listen to the patients complaints Check yourself (read labels carefully) Label anything you reconstituted/diluted Keep up to date

D. Ethical principles in the drug therapy


1. 2. 3. 4. 5. 6. 7. Autonomy : freedom to decide based on knowledge with no constraint Truthfulness: truth telling that can create a dilemma. It is absolute or is there a beneficient deceit? Beneficence: obligation to help others Nonmaleficence: do no harm Confidentiality: keep secrets Justice: rights of an individual Fidelity: keep promises

QUESTIONS

1. The primary reason patients should have individual eye medication is to To prevent cross contamination

2. How should each of the following be applied to a patients skin? A. Powders Sprinkle on gloved hands and apply; use sparingly to prevent caking B. Lotions Pat on lightly with gloved hand or gauze pad C. Creams Rub into skin while wearing gloves D. Ointments Use gloved hand to apply an even coat and cover with dressing

3. How should a vaginal applicator be inserted? Back and up 5. How should the skin be prepared for an injection? Rub the skin with alcohol pad in a circular motion from the center of site out

6. List three reasons for administering medication by injection a. The drug would be destroyed orally b. A rapid effect is desired c. The patient is unable to take the drug orally 7. What is the difference between administering ear drops to an adult and a 2 year-old-child? In the adult, pull the ear back and up. In a 2 year old child full the ear back and down.

4. Identify administration procedures as clean or sterile.

A. SC injection sterile B. Nitroglycerin ointment clean

C. SL tablet clean D. Urethral suppository sterile E. Vaginal suppository clean F. Nasogastric route clean

G. Nose drops clean H. Intradermal sterile I. J. IM injection sterile Rectal suppository clean

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