Transcript Document

Ch.5: Reading and
Interpreting Medical
Labels and Orders
and Documents
Appropriately
By Dr. Kevin Perrino
Background Assessment
Q. What are the advantages of using the same pharmacy
for all of your medication needs?
Background Assessment
A: If you use the same pharmacy for all the prescriptions
you need filled, all of your medications will be on file at
that pharmacy. That way the pharmacist can monitor
for medication interactions. The pharmacist also keeps
track of all your allergies to food or previously taken
medications.
Labels for Stock Medications
 Parts of the stock
medication label
• A. Trade (proprietary, brand)
name
• B. ??????????
• C. Drug strength or weight
• D. ??????????
• E. ??????????
• F. Amount of medication in
container
Labels for Stock Medications
B. Generic name
D. Form of Medication
E. Route of administration
Labels for Stock Medications
•
•
•
•
•
•
G. ????????????????
H. ????????????????
I. Manufacturer’s name
J. Expiration date
K. ????????????????
L. Auxiliary Labels
NDC 0777-2321-97
What do these numbers represent?
Labels for Stock Medications
G. Directions for
reconstitution
H. National Drug Code
K. Label for controlled
drugs
NDC 0777-2321-97
What do these numbers represent?
Common Abbreviations Used in
Medication Orders/Prescriptions




Abbreviations come from Greek and Latin
Shorthand for writing medical orders
Use only standard abbreviations
TJC “Do Not Use List”
Medical orders vs. Prescription
 What is the difference between medical orders and a
prescription?
Medical orders
 Should be written but may be verbal
 Used in in-patient facilities for medication
administration
 Are not given to patients for dispensing
 May be
• Standing order
• Standard protocol
Medical orders
 What are the six components of medication orders?
Medical orders
Prescription
 A prescription is a written order for a medication for a
particular patient by a person licensed to prescribe
medications.
 Prescriptions may be written for therapy (physical,
occupational, speech) and ultrasound.
 Those licensed to prescribe medications vary from
state to state
What is the purpose of prescription?
Prescriptions
 Order written for:
• compounding or mixing of medications
• dispensing of medication
• dedication administration
 Use blue or black permanent ink for filling out
prescriptions.
 A physician must sign a computer-generated
prescription.
 Single- or multiple-line forms may be used for
prescriptions.
Multiple-Line Prescription
 What would make this prescription complete?
Prescription Components
B: Patient heading
Date determines when prescription is no longer valid.
Most prescriptions must be filled within ____ months of writing.
Some prescriptions may be refilled for ____ months after initial
filing.
Schedule III, IV, V substances must be within what time frame?
Prescription Components
B: Patient heading
Date determines when prescription is no longer valid.
Most prescriptions must be filled within 12 months of writing.
Some prescriptions may be refilled for 12 months after initial filing.
Schedule III, IV, V substances must be within what time frame?
6 months
Prescription Components (cont’d.)
E: What is “E” and what does it stand for?
Prescription Components (cont’d.)
E: What is “E” and what does it stand for?
Directions should include instructions on when to start
and stop taking medication and the appropriate
administration route.
Prescription Components (cont’d.)
F: What is “F” and what does it stand for?
What directions are included here?
Prescription Components (cont’d.)
F: What is “F” and what does it stand for?
Subscription—directions to pharmacist for filling
prescription (number of doses, quantity to dispense, form
of drug).
Question
A patient calls you at the office to report that he is out of
refills for his medication. He asks you to call in the
prescription refills to his pharmacist. When you ask him
to make an appointment with the physician first, the
patient says he does not have time. How would you
handle this situation?
Answer
A refill prescription should be handled in the same
manner as a new prescription. Because the physician
is the only person who may approve a refill request,
you should consult with the physician first. Also check
the patient’s medical record for any allergies, adverse
reactions, or other prescription issues. If the physician
approves the request, tell the patient that you will call in
the prescription. Record the refill in the patient’s
medical record. If the physician denies the request, tell
the patient that he needs to make an appointment to
see the physician before the prescription can be
refilled.
Patient Compliance
 Why is it important to encourage patients to fill all
prescriptions at one pharmacy?
 How might financial issues be barriers to compliance?
 How might you assist patients with remembering to
take their medications?
Patient Compliance
In order to increase patient compliance:
 Provide written instructions.
 Ensure patient/caregiver thoroughly understands
medication directions.
 Encourage using one pharmacy to fill all prescriptions.
 Confirm that patients understand why they are taking a
medication.
 Take time to answer questions.
Review Exercises
Interpret this order:
Keflex 250 mg #20, Sig: cap I po qid with food
Review Exercises (cont’d.)
Keflex 250 mg #20, Sig: cap I po qid c food
Answer:
Keflex 250 mg. Dispense 20 capsules. Take 1 capsule by
mouth 4 times a day with food.
Review Exercises (cont’d.)
Interpret this order:
Brethine 5 mg #30, Sig: tab i po tid
Review Exercises (cont’d.)
Interpret this order:
Brethine 5 mg #30, Sig: tab i po tid
Answer:
Brethine 5 mg. Dispense 30 tablets. Take 1 tablet by
mouth 3 times a day.
Review Exercises (cont’d.)
Interpret this order:
Restoril 15 mg #30, Sig: cap I hs prn sleep
Review Exercises (cont’d.)
Interpret this order:
Restoril 15 mg #30, Sig: cap I hs prn sleep
Answer:
Restoril 15 mg. Dispense 30 tablets. Take 1 capsule at
bedtime as needed for sleep.
Review Exercises (cont’d.)
Interpret this order:
furosemide 20 mg tabs #90, Sig: 40 mg qam and 20 mg
@ 1 pm
Review Exercises (cont’d.)
Interpret this order:
furosemide 20 mg tabs #90, Sig: 40 mg qam and 20 mg
@ 1 pm
Answer:
furosemide 20 mg tablets. Dispense 90 tablets. Take 2
tablets every morning and 1 tablet at 1:00 pm
Documentation Exercises
Document the following using abbreviations:
Lopressor 50 milligrams, 1 tablet taken at breakfast and
again at bedtime
Documentation Exercises
Document the following using abbreviations:
Lopressor 50 milligrams, 1 tablet taken at breakfast and
again at bedtime
Answer:
Lopressor 50 mg tab i am and hs
Documentation Exercises
Document the following using abbreviations:
 indomethacin 25 milligrams, taken 3 times daily with
meals
Documentation Exercises
Document the following using abbreviations:
 indomethacin 25 milligrams, taken 3 times daily with
meals
Answer:
indomethacin 25 mg tid with meals
Documentation Exercises
Document the following using abbreviations:
Phone an order for Zithromax 250 mg (Z-Pak), 2 tablets to
be taken on the first day, followed by 1 tablet on days 2
to 5, 24 hours apart, on an empty stomach
Documentation Exercises
Document the following using abbreviations:
Phone an order for Zithromax 250 mg (Z-Pak), 2 tablets to
be taken on the first day, followed by 1 tablet on days 2
to 5, 24 hours apart, on an empty stomach
Answer:
Zithromax (Z-Pak) 250 mg; tab ii today then tab i on days
2 to 5, 24 hours apart on an empty stomach
Ch. 7
Measurement
System &
Their
Equivalents
Question
 The international Bureau of Weights and Measures
adopted the International System of Units in 1960 to
standardize the notation used in measurements. Why
is this standardization especially important in medical
applications?
Answer
When medicine is prescribed, it is important that the
physician’s instructions for dosage be followed
precisely. Without a standard notational system, there
can be room for confusion regarding dosage
administration.
Metric System
Weight Conversion Factors
 Given Smaller number to find Larger number =
division = moving decimal to the left
I.e.
635 mcg = ___________ mg (0.635 mg)
5.5 cm = ____________ m (0.055 m)
1427 mL = ___________ L (1.427 L)
Weight Conversion Factors
 Given Larger number to find Smaller number =
multiply = moving decimal to the right
I.e.
8g= ___________ mg (8000mg)
5m = __________ mm (5000mm)
1.6L= _________ mL (1600mL)
Weight Conversion Factors
______ mg = 8 g
8 x 1000 = 8000 mg
8000 mg = 8 g
______ mg = 635 mcg
635 ÷ 1000 = 0.635 mg
0.635 mg = 635 mcg
______ g = 4.5 kg
4.5 x 1000 = 4500
4500 g = 4.5 kg
Household Measurement System
 Also called United States Customary System of
Measurement
 uses common kitchen measuring devices
 not recommended for measurements in a medical
facility because of different sizes of measuring devices
 drop— gtt
 teaspoon— t, tsp = 5 mL
 tablespoon— T, tbs = 3 tsp
 cup—c = 8 ounces
Household Measurement System
15 gtt = 1t
1tbs = 3t
Review:
60gtt = _____t
2tbs = ______t
3 t = ______ gtt
45 gtt _____tbs