Exercise 1: ABBREVIATIONS

Interpretation of Prescriptions
& Medication Orders

● Prescription or Medication Order

- A lawful order of a prescriber for a drug,
device or procedure for a specific patient.
- It serves as a vehicle or medium of
communication between the prescriber and
the pharmacist regarding the needs of the
patient.

● Parts of a Prescription
- Prescriber’s Information
- Patient’s Information
- Date of issue
● NahCO3 - sodium bicarbonate
- Superscription
● U/A - urinalysis
- Inscription
● HTN - hypertension
- Subscription
● Q.s a.d - a sufficient quantity to make
- Transcription
- Refills authorized and special instructions, if
DRUGS THAT SHOULD NOT BE CHEWED,
any
CRUSHED or OPENED
- Prescriber’s signature and license number/s
Abbreviations:
● CR/Chrono = controlled release
● PRE-TASK
● CRT = controlled release
- INSCRIPTION: It is the most important part
● EC/EN = enteric coated
of the prescription containing the name,
● LA = long acting
strength and dosage form of the medication
● MR/Retard = modified release
● SA = sustained action
- PRESCRIBER'S INFORMATION: It
● SR/Dur/Dural = sustained release
provides assurance that the prescription is
● XL/XR = extended release
legal
- Aspilet EC
- SUBSCRIPTION: It includes the direction
- Adalat GITS
intended to the pharmacist on how to
- Diamicron MR
compound or dispense the prescription
- Feldene Flash
- Glubitor OD
- TRANSCRIPTION / SIGNA: A part that
- Glumet XR
provides the instructions for the guidance
- Kalium Durules
of the patient regarding the use or
- Lipway SR
administration of the medication
- Plendil ER
- Prevacid FDT - fast dissolving tablet
- DATE: A part that tells whether the
- Vastarel MR
prescription is valid for filling or refilling
- Versant XR
DRUGS THAT SHOULD BE GIVEN ON Exercise 2:
AN EMPTY AND FULL STOMACH Calculations on Special Clinical Cases
- Some drugs should be taken on a full
stomach, meaning with food, to minimize GI ● Dosage Regimen
discomfort while drugs should be taken on - schedule of doses of a medicine,including
an empty stomach, meaning without food, the time between doses (dose
for optimal absorption. frequency), the duration of treatment and
- An empty stomach means taking the the amount to be taken each time (dose
medication one hour before eating or two size).
hours after eating. - how a medicine is to be taken (route of
administration), and in what formulation
(dosage form).

a. Empirical Dosage Regimen

- designed by physicians based on empirical
data, personal experience and clinical
observations.
- This method however is not very accurate.

b. Individualization of Dosage Regimen

- most accurate approach and is based on
the pharmacokinetics of the drug in the
individual patient.
- Approach is suitable for hospitalized
patients but is quite expensive.

c. Dosage Regimen on Population

Averages
(1) Fixed Model – is based on population
average pharmacokinetic parameters are
used directly to calculate the dosage
regimen.
(2) Adaptive Model – is based on both
population average pharmacokinetic
parameters of the drug as well as patient
variables such as weight, age, sex, body
surface area and known patient
DRUGS THAT CAN BE SPLIT pathophysiology such as renal diseases.
● Tablet scoring or Tablet Splitting
- Is the practice of partitioning the tablets in
order to attain a desired efficacy dose.
● The primary reason is to adjust the dose:
dose tapering or dose titrating.
CALCULATIONS INVOLVING MEASURES OF ● Creatinine
POTENCY - breakdown product of muscle metabolism
● Potency of some antibiotics, endocrine and it is generally produced at a constant
products, vitamins, products derived rate and in quantities that depend on the
through biotechnology like vaccines are muscle mass of the patient.
based on their activity and are expressed - Females usually have a lower serum
in terms of units of activity, in creatinine than males due to less muscle
micrograms per milligram (mcg/mg) or in mass.
other standardized terms of - eliminated from the body
measurement. - Essentially through renal filtration, reduced
kidney performance results in a reduced
SPECIAL DOSING CONSIDERATIONS IN creatinine clearance rate
CANCER CHEMOTHERAPY:
● Chemotherapeutic agents may be ● Creatinine Clearance Rate
administered concomitantly or alternately - Represents the volume of blood plasma
on the same or different days during a that is cleared of creatinine by kidney
prescribed treatment cycle. filtration per minute.
- D = Day - Normal creatinine clearance rate is
- Dash (-) = To equivalent to 100 mL per minute.
- Comma (,) = And - The normal adult value of serum creatinine
is 0.6 to 1.3 mg/dL.
HEPARIN-DOSING CALCULATIONS
● Heparin
- a very useful but potentially dangerous
agent. It is administered only when
necessary and with extreme caution.
- Hemorrhage is a distinct risk with heparin
use, requiring patients to be closely
monitored.

DOSAGE CALCULATIONS BASED ON

● For those with kidney problems, the
CREATININE CLEARANCE
creatinine clearance can be adjusted based
- Drugs are eliminated from the body through
on the body surface area.
the liver and kidneys. Most drugs are
eliminated through the renal route but with
Adjusted CrCl = ( BSA/1.73m2 ) / CrCl
a loss of kidney function, the rate at which
the drug is cleared from the body is
dramatically affected.
IBW (MALE)
- As kidney function is lost, the quantity of
- IBW = 50 kg + 2.3 kg for each inch of
plasma filtered per minute decreases,
patient’s height over 5 fee
with an accompanying decrease in drug
- IBW = 110 lb + 5 lb for each inch of the
clearance.
patient’s height over 5 feet
IBW (FEMALE)
- IBW = 45.5 kg + 2.3 kg for each inch of
patient’s height over 5 feet
- IBW = 100 lb + 5 lb for each inch of the
patient’s height over 5 feet

For the Loading Dose

● LD= IBW in lb/kg X Drug dose per kg or lb

For the Maintenance Dose

● For normal patients:
MD = IBW (kg) X Dose/kg
● For the renally impaired patients:

MD = CrCl (patient) X Dose for normal patient

CrCl (normal)

Exercise 3:
Extemporaneous Compounding of a Non-Sterile
Preparations

● Extemporaneous Compounding
- Traditional compounding or
Extemporaneous compounding is the
preparation of a product specifically
prescribed for an individual patient.
- Examples:
Reconstituted suspensions
TPNs
Paper tabs