Name: RAFAEL, DUNE VIENIS KAREN N. Pharmacy 4A Group No.

: _____________________ 2009

Year & Section: BSDate Started: November 09, Date Submitted: ______________

Exercise No. 3 THE MEDICATION SHEET AND CARDS I. Objectives: a. To create a medication sheet and card, b. To fill the medication sheet and card correctly, and c. To understand the importance of medication sheet and card. II. Data Output: The output of this exercise is printed in separate paper after the conclusion. III. Answers to Questions: 1. Give the respective use of the following medication cards: Note: My answers are based on the Davao Regional Hospital 9DRH protocols. a. Whole yellow card – bid/q 12 hr medications b. Yellow card w/ one slit – for IV medications c. Whole pink card – for tid medications d. Pink card w/ one slit – for oral medications e. Pink card w/ two slits – for IVTT medications f. Whole green card – for q 4 hr medications g. Whole orange card – for qid medications h. Whole blue card – for q 6 hr medications 2. How are discontinued drugs labeled in medication sheets? Discontinued drugs are labeled by putting a “D/C” mark using red ink pen and putting a long horizontal line on the entire column. The date, time, signature and name of the pharmacist who discontinued the medication should be written. 3. For drugs or medications that are changed, what are the necessary corrections to be done? At the end of the column, a “changed” mark is written and the entire column is crossed out by a long horizontal line using a red ink pen. The date, time, signature and name of the pharmacist on duty should be written. 4. What are the necessary comments on medications that are hold? Comments such as “on hold” or “hold” are necessary on medications that are hold. 5. For medications that have been completed, what are the necessary comments/remarks? The entire column should be crossed out using a red ink pen and “completed” should be written on its end (to the right). The date, time and signature of the pharmacist should be written legibly. 6. If medications have precautions, how is this entry made? Precautions should be written under the “comment section” of the sheet if provided.

7. The medication card facilitates drug medication and therefore should include what information? Medication card should include the hospital information, name of patient, age, sex, address, date, attending physician’s name, ward name/location/number, bed number, name and amount of drug ordered including its dosage, frequency, route of administration, the name and signature of the pharmacist who prepared the medication/s and the medicating nurse.. I. Conclusion: Medication sheet and card are important instruments in order to keep the pharmacist, physician and nurses in track with the medications of the patient. These instruments are vital in order to properly document the events of medication and serves as a guide in order to track medication errors. Filling up medication sheets and cards should follow the hospital’s protocols.

ST. LUKE’S HOSPITAL Father Selga Street, Davao City PATIENT DRUG PROFILE Patient Name: Thomas Anzalone Central Avenue Age: 31 Height: 5’11” Sex: Male Attending Physician: Kris Jezreel N. Noveno, MD No.: 0057 Diagnosis: Acute Schizophrenic episode Date Admitted: August 14, 2009 18, 2009 Route of Administratio n Intramuscula r Oral Address: 2098 West Weight: 185 lbs Ward: 65-R Bed Date Discharged: August

Drug Description Haloperidol Risperidone

Dosage 5-10 mg 2 mg

Frequenc y/Time q 4 hours b.i.d.

Date Ordered August 14, 2009 August 17, 2009

Diet Regular diet

IV Fluids

Discontinu ed Medication
8/17: D/C Haloperidol

PRN / STAT Medications

Drug History

Allergies

8/14: Haloperidol 5 mg IM STAT. 8/14: Haloperidol 5-10 mg IM PRN agitation.

• •

Smoker 2 ppd for 10 years Outpatient medications include fluphenazine.

Penicillin Adverse Reactions 8/14: Dry mouth, constipation, tardive dyskinesia Diagnostic Impressions Acute schizophrenic episode 8/14: BP: 130/74; HCT: 39% BUN: 11; Hgb: 12.5 g/dL; Cr: 1.0 8/14: Na: 140; K: 4; Cl: 95; CO: 25

ST. LUKE’S HOSPITAL Father Selga Street, Davao City

MEDICATION SHEET
Patient Name: Thomas Anzalone Central Avenue Age: 31 Height: 5’11” Sex: Male Attending Physician: Kris Jezreel N. Noveno, MD No.: 0057 Date Admitted: August 14, 2009 18, 2009 Diagnosis: Acute Schizophrenic episode
DOSAGE, ROUTE OF ADMIN. & FREQUENCY

Address: 2098 West Weight: 185 lbs Ward: 65-R Bed Date Discharged: August

CLASSIFICATIO N

NAME OF DRUG

TIME/DAT E ORDERED

8/14

8/15

8/16

8/17

8/1 8

I.

Parente ral

Haloperid ol

5-10 mg; 8/14/09 IM; q 4 hrs

610-2

II. Oral

Risperido ne None Haloperid ol Haloperid ol

2 mg; bid

8/17/09

-

6102-610-2 -

6102-610-2 -

6102-610-2 6-6

6102D/C 6– D/C D/c

III. Treatme nt IV. STAT/PR N

None

None

10:3 0 am -

-

-

-

5 mg; IM; 8/14/09 STAT 5-10 mg; 8/14/09 IM; PRN agitation

-

-

-

D/C

St. Luke’s Hospital
Father Selga Street, Davao City Name: Thomas Anzalone Name: Thomas Anzalone Age & & Sex: 31, Male Age Sex: 31, Male Date: ______________ 0057 MD. Date: 17-Aug-2009 Ward: 65-R Ward: 65-R Bed No.: 0057 Bed No.: A.P.: Noveno, A.P.: Noveno, MD.

Risperidone Haloperidol
7.5 mg mg PRN agitation 2 IM IM b.i.d. Prepared By: Prepared By: Dune Rafael, RPh Sheila N.N. Noveno, RN Dune Rafael, RPh Sheila Noveno, RN Pharmacist on Duty Medicating Nurse Pharmacist on Duty Medicating Nurse

St. Luke’s Hospital
Father Selga Street, Davao City Name: Thomas Anzalone Age & Sex: 31, Male 0057 Date: 14-Aug-2009 Ward: 65-R Bed No.: A.P.: Noveno, MD.

Haloperidol
7.5 mg IM q 4 hrs. 5 mg STAT Prepared By: Dune Rafael, RPh Sheila N. Noveno, RN Pharmacist on Duty Medicating Nurse