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M3 Pharmacy Cheat Sheet by

Dispensing, HOSPITAL Pharmacy, ADR

MEDICATION ERROR category

A
potential for error
Ala pa naman
B
error did not reach patient
Buti di umabot
C
error but no harm
Char wala lang pala
D
error with monitoring
Dapat i-monitor
E
error with Temporary reversible harm
temporarE / Eenter­vention
F
error & hospit­ali­zation
hosFital
G
error with Permanent injury
Grabe permanent
H
error with near death
nagHingalo
I
error with death
Iyak

Clinical Trials

Phase I
is it safe? Goal:s­afety
25-50 healthy people (non-b­linded)
Phase II
does it work? Goal: safety, efficacy
10-200 with disease (singl­e-b­linded)
Phase III
is it better? Goal: safety, efficacy
200-1000 with disease (doubl­e-b­linded)
Phase IV Post-m­ark­eting survei­llance (Pharm­aco­vig­ilance)

Types of ADR

A - augmented
predic­table, dose-d­epe­ndent, extension effect
B - bizarre
Unpred­ict­able, dose-i­nde­pen­den­t,h­ype­rse­nsi­tivity rxns, idiosy­ncratic rxns
C - continuous
long term effect related to drug, chronic use
D - delayed
manifested long after the exposure, carcin­oge­nicity, terato­gen­icity
 
PREGNANCY RATINGS:
 
A - safe: human & animal
 
B - safe (human), unsafe (animal)
 
C - no studies (human), unsafe (animal)
 
D - unsafe (human): beneif­its­>>>­>risk (can use)
 
E - unsafe (human): risk>>­>> benefits (cant use)
E - end of use
From sudden termin­ation, abruptly discon­tinued
F - failure of therapy
resist­ance, inappr­opriate use, patient tolerance, AMR

Waist hip ratio

MEN
WOMEN
Risk
MT 40 inches
MT 35 inches
Cardio­vas­cular & Metabolic disease
LT 0.85
LT 0.75
Excellent, less risk
1 or higher
1 or higher
increased risk

Body MASSAGE Index

Wt(kg)­/ht(m) X 2
wt(lbs­)x703 / ht(in)x2
Underw­eight
<18.5
Normal weight
18.5 - 24.9
Overweight
25 - 29.9
Class I obesity
30 - 34.9
Class II obesity
35 - 39.9
Class III
MT 40

Blood Pressure

 
Systolic
diastolic
Normal
<120
<80
Pre-HTN
120-139
80-89
Stage 1 HTN
140-159
90-99
Stage 2 HTN
MT 160
MT 100

DD book

S1
retail dealer o exemp dd
S2
prescriber in prescr­ibing dd
S3
retail dealer of da & excempt da prepar­ations
S4
wholesaler dealer of dd
S5I
Importer of da & exempt da prepar­ations
S5C
compou­nder, producer, & manufa­cturer of da & excempt da prepar­ations
S5E
Exporter of da & excempt da prepar­ations

Terminal Steril­ization

Moist heat
Protein coagul­ation
autoclave (121 C, 15 psi, 15-30mins)
Dry heat
Oxidation
Oven (160 C, 2-4hrs)
Membrane Filtration
physical separation
0.2 micron filter (for heat sensitive)
Gas
alkylation
ethylene Oxide (Carbo­xide, 10% EtO + 90% CO2)
Ionizing Radiation
DNA mutation
Gamma rays

LAWS

RA 5921 / 10918 Pharmacy Law
RA 6675 Generics Act of 1988
RA 3720 Food, Drugs & Cosmetics Act
RA 8203 Special Law on Counte­rfeit Drugs
RA 6425 Dangerous Drugs Act of 1972
RA 4226 Hospital Licensure Act
RA 9165 Compre­hensive Dangrous Drugs Act of 2002
RA 9275 Expanded Senior Citizens Act of 2003
AO 90 s. 1990 allowed more than 1 medication written in given prescr­iption except Dangerous Drug prescr­iption
AO 62 s. 1989 rules and regula­tions to implement PRESCRIBED requir­ements under RA 6675
AO 2012 - 0012 classi­fic­ati­ons­/types of hospitals
RA 4226
PHILIP­PINES Hospital Licensure Act
EO 49 s. 1993 Govt Hospital Procur­ement must follow only vol 1 of PNDF
AO 63 s. 1989 dispensing requir­ements under RA 6675
AO 55 labeling requir­ements under RA 6675

Record & Filing

Prescr­iption record Book
keep for 2 years
Dangerous drugs record Book
keep for 1 yr
Poison Book
keep for 5 years
Normal Prescr­iption
valid for 1 month
 
keep in file for 1 yr
DD Prescr­iption
limit for 1 month
 
antiCA limit for 3 months (ex: Morphine supply)
 
Yellow - kept by RPh
 
White - kept by physician
 
Green - kept by patient

Essential Drugs List of National Drug Formulary

list of altern­ative drugs prepared & period­ically updated by the DOH on the basis of health conditions obtaining in the Philip­pines, as well as on the intern­ati­onally accepted criteria
Core List
list of drug that meets the needs of majority of population
Comple­mentary List
list of altern­ative drugs used when no response to the core list

Hospital

organized structure pools together all healthcare profes­sio­nals, the diagnostic & therap­eutic facili­ties, equipment & supplies & the physical facilities into a coordi­nated system for delivering healthcare to the public
Public Health
preven­tion, mitigation of disease in the community
 
primordial - goes before the patient, changes soceity
 
Primary - prevent disease, no disease yet
 
secondary - early detection, treatment
 
tertiary - limit disabi­lity, rehab
Hospital Pharmacy
practice of pharmacy in hospital setting
 

Dispensing

Prepar­ation & Delivery of a drug or device
PRESCR­IPTION: written order & instru­ction from licensed prescriber to the pharmacist for specific patient
Valid for 1 month (28 days); keep in file for 1 yr
Supers­cri­ption
Rx, recipe
Inscri­ption
Drug and dosage
Subscr­iption
direction to the RPh
Transc­ription
signa, direction to the patient

ADVERSE drug effect

Any untoward occurence during use of a drug, without without correl­ation
ADR
noxious and uninte­nded, doses normally used
S/Es
Unintended effect at normal doses, related to pcol properties
Toxicity
noxious and unintended or intended, dose is higher than normal
ME
preven­table but lead to cause harm while in control of a profes­sional, patient

Study Designs

Case - conrol
retros­pective study, info collected from the past
 
inexpe­nsive, recall bias
Cohort
prospe­cti­ve/­lon­git­udinal study, no interv­ention
 
time consuming, expensive, less recall bias
Cross - sectional
survey at a single point in time
 
new + on-going cases
Randomized controlled
clinical trials, GOLD standard, experi­mental study, 2 or more treatments and placebo
 
costly,, time consuming, ethical consid­era­tions

Evidence Based Medicine

consci­ent­ious, explicit & judicious use of concurrent best evidence in making decisions about the care of indivi­duals

Drug Management Cycle

Essential Drugs
satisfies healthcare needs of majority

Prescr­iption vs. OTC drugs

Prescr­iption / Ethical Drugs
dispense ONLY upon writtn order
 
For management or treatment of a condition or disease
Non-pr­esc­ription / OTC Drugs
dispensed without written order
 
only for sympto­matic relief at minor self-l­imiting ailments

Incorrect Prescr­iption

Erroneous
Violative
Impossible
brand nme precedes genric name
generic name is not indicated
generic name is written but NOT legible
X - (generic name)
generic name is NOT legible but brand name is legible
generic name does not correspond to brand name
brand name not in ()
Brand name is only indicated "NO SUBSTI­TUT­ION­"
both generic and brand name are NOT legible
"­Shall be filled­"
"­Shall not be filled­"
product is not registered to FDA
dispense, report
don't dipense, report
"­Shall not be filled­"
   
don't dispense, report
 

Physical Assessment

Respir­atory rate
12-20 breath­e/min
 
Number of breaths in 15 secs x 4
Heart Rate
60-100 BPM
 
number of pulse in 15 secs x 4
Temper­ature
37 C / 98.6 F
 
F = C (9/5) + 32
 
C = F-32 (5/9)

Dangerous Drugs

PROHIBITED drugs
opium & its deriva­tives
Heroin & Morphine
coca leaf & its deriva­tives
Cocaine
 
a & b Eucaine
 
Halluc­ino­genic drugs (Mesca­line, Lysergic acid diethy­lamide)
Indian Hemp & its deriva­tives
other drugs (natural or synthetic) with physio­logical effects of narcotic drug
REGULATED drugs
Sleep-­ind­ucing sedatives
barbitals
any salt, isomer, or salt of isomer of Amphet­amine
Benzedrine or Dexedrine
Hypnotic drugs
Metheq­ualone
 

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  • Published: 27th August, 2022

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