22-May-23

Professional Certificate in Caregiving

Module No:
M 16
Module Title
Pharmaceutical Science
Ruwan Raigamkoralage
[D.Pharm (Col). B.A.M.S (Col). MSc FST (SJP)]

Curriculum Outline –
Professional certificate in Care givers [Level -4]
Competency Profile: Competency area

Curriculum outline for Pharmaceutical Science

[09hours] Followed by Practical sessions

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Practical Training Programme

@ Retal Pharmacy Outlets
Name of the selected Location Pharmacist
• Practical sessions will be pharmacy Outlet
Flamingo Pharmacy Gothatuwa new town Mr. Gurusinghe
Flamingo Pharmacy Narahenpita Mr. Dushantha
scheduled at end of theory Lanka Pharmacy Kiribathgoda Mr. Abeysinghe

lecture series. [3hrs per day Aruna Pharmacy Matara Mr. Susantha
Matara Pharmacy Matara Mr. Krishanta
Hiruni Pharmacy Matara Mrs.Wathsala
& 2 days per week ] x 03
Suwaya Pharmacy Tangalle Mrs. Jayamali
weeks. Practical work sheet Aloka Pharmacy
Kodikara Pharmacy
Ambalathota
Middeniya
Mrs. Jayani
Mr. Sarath
My Care Pharmacy Beliatta Mrs. Suboda
will provide to record the Sethsuwa Pharmacy Angulukolapalassa Mr. Prasad
Sajeewa Pharmacy Walasmulla Mrs. Sajeewa
Jayarathna Pharmacy Embilipitiya Mr. Jayarathna
activities
Star Pharmacy Galle Mrs. Shasira
Medicare Pharmacy Galle Mrs. Pumi

Work Schedule for Retail Pharmacy

Practical sessions
1. Observe General management Process of Retail Pharmacy setup

2. Observe routine dispensing process of a prescription

including identification of genuine prescription

3. Identify main dosage form types available in pharmacy

Ex. Solid dosage forms – Tablets/ Capsules
Semi-Solid dosage forms – Cream, Ointments
Liquid dosage forms – Syrup, Suspensions etc

4. Identify special dosage form types such as

Calander pack, Modified released & enteric coated tablets…

5. Identify the medicine categories as per drug administration route.

EX. Oral route, Injectable route, Local route, Inhalation route, rectal route
drugs etc.

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Work Schedule for Retail

Pharmacy Practical sessions
6. Identify Over The Count [OTC] drugs available in a pharmacy.

7. Familiar with different packaging types of

medicines such as Blister pack, strip pack, Glass or plastic bottle

8. Identify the lifesaving drugs available in pharmacy.

9. Identify the important devices in patient care management.

Ex. Insulin pen/syringe, Inhalation devices, Blood Pressure apparatus, Blood glucose devices

10. Familiar with surgical devices used in outdoor patient management

such as Catheters, urine bags, syringes, diapers etc.

11. Observe the drug storage conditions in retail pharmacy setup

including Identification of refrigerated items

Curriculum Outline – for Pharmaceutical Science

Task No: 08 – Medication Administration

8.1 Introduction to Drug Administration Technics

8.2 Basic Facts Regard Drug Administration Route

8.3 Importance of Drug Administration Route

8.4 Importanat point of views for caree givers

regardning drug administration

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Drug administration
• Basic facts

Dispensing of drugs with correct advices is a duty of a pharmacist

Administration of medication is a basic activity in nursing practice

Administration to the right patient, by checking identification is

essential. [Because some patients answer to any name]

Drug administration
Introduction

Drugs can be administered by many different routes

 The choice of route depends on both convenience & necessity

 However drugs can be mainly administered through 02 routes.

1) Systemic Routes
Enteral – Oral, Sublingual, Rectal
Par-enteral – Intra–Muscular[IM]
Intra–Venous[IV]
Sub–Cutaneous[SC] [Main 3 Parenteral routes]

2) Local Routes

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Drug administration
2) Local Routes
• Topical application (Local applications to surface of skin, mucus membrane

• To skin. E.g. Cream, Ointment, Lotion.

To Mucus membrane. E.g. Mouth paint, Oral gels

To Eye, Ear, Nose. - E.g. Drops, Ointment.

Topical applications mainly for local action,

but also for systemic administration of some drugs.
E.g. Transdermal patches
Inhalations – Limited in to the lungs
Into Cavities – Ex. Arteries, Joints, peritoneal

Drug administration
Oral Route
• The most common & convenient route of
drug administration to produce systemic effect.
 But certain limitations such as;
a) unconscious patient
b) when the drug is inactivated by the gastric juice
c) Relatively slower on set of action
d) Irregular absorption-
e) When the drug is produce, excess gastric side effects

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Drug administration
• Sublingual Route

• The drug is design to keep under the tongue &

absorbed to systemic circulation.

• This way is suitable for;

A. When rapid relief is necessary.
B. When the drug is unstable to gastric PH
C. When the drug is rapidly metabolize d by the liver.[so to bypass the liver]
• Only few drugs can be given successfully by this route. E.g. G.T.N

Drug administration
• Rectal Route
• The drug is administered through the rectum &
used either as local effect OR systemic effect.
 This way is suitable for; a)Un-conscious patients.
b)Gastric irritable patients
Two main dosage forms for rectal administration; as Enema
[liquid rectal dosage form] & as suppositories [solid rectal dosage form].
Suppositories tend to soften at room Temperature.
So, need to be refrigerated.
Explain the procedure with providing privacy. Instruct to lie on left side.
Breath to relax sphincter.
Insert the suppository beyond the internal anal sphincter.

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Drug administration
• Intra venous Route
• Drug is directly injected in to the
veins.[Means directly to systemic
circulation.
• No steps of disintegration & dissolution
like in oral]
• The quickest method of drug
administration.
• [So prefer when emergency call for an
immediate response]

Drug administration
• Intra Muscular Route

Drug is injected in to the muscle

for slower action than I.V

Not possible for self administration.

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Drug administration
Subcutaneous Route

• Drug is injected under the skin for further slower action than I.M

• Used to administrate some drugs which Cannot be given orally.

E.g. Insulin(as maintain Rx).

• Suitable for self administration.

Drug administration

Intramuscular
Subcutaneous
Intravenous

Intracutaneous

Epidermis

Corium
(cutis/dermis

Subcutis & fatty tissue

Vein

Muscle

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Drug administration
• Time variability for start of action of different dosage forms

On set of action Dosage form

• Seconds I.V injection
• Minutes IM & SC inj. Bucal tabs, Aerosol
• Min. to Hour Short term depot injections,
Suspension, capsules & S.R tabs
• Several hours Enteric coated formulation
• Days Depot inj. Implants
• Varies Topical preparations

Drug administration

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Methods to minimizing Pain associated with insulin injections

• Select correct insulin needle size. Special needle for subcutaneous injection.
Very fine needle of 29 G.

• Needle gauges below 27 must not be used to inject subcutaneously.

since cause pain during injection.

• Preferable to use pen device, if patient can afford.

Since it has a very fine needle of 31G, experience minimal pain.

• Insulin vial stored in a refrigerator be taken out,

at least 15-30 mins before the injection time.
Since cold insulin causes more pain compared to insulin @ room temperature.

Methods to minimizing Pain associated with insulin injections

• Remove air bubbles tapping on the syringe while needle is still inside the
insulin.

• Daily application of surgical spirit may case roughening of skin & difficulty in
piercing. So it is not to be applied routinely to clean the skin.
The recommended method of cleaning the injection site
at home is with soap & water.

• Raise a skin fold up, especially important for pts who are thin.

• Insert the injection needle at 90 degree to the skin rather than at an angle

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Placebo effect

What is Placebo drug ? (Placebo means at Latin "I will please")

• That means any chemically inert substances, given to improve
some physical & psychological conditions of the patient.
Ex. Multi vitamin preparations sometimes used for this effect.
• Numerous studies on placebos, as they can relieve both mental &
physical symptoms. As all drugs may produce placebo effects that
complicating clinical drug responses in human either due to
pharmacological effect or placebo effect.
• Therefore sometimes drug regulatory authorizes request placebo
control data…..?

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What is
Placebo drug ?
• Placebo effect = Healing power of mind..?
Every patient has inner healing capacity means power of mind in healing.
Ex. Role of emotional peptides. [Over 300 already identified]
Ex – Endophines.

• Also defined as pharmaceutical preparation containing only non-active

ingredient. Ex. Starch.

• Placebo should have a same appearance as active drug. [color, size..etc]

Any questions?
Thank you and Good luck

22-May-23 MA Siriwardhene USJ Sri Lanka 24

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Curriculum Outline – for Pharmaceutical Science

Task No: 07 – Prescribing In Special Situations

7.1 Prescribing in elderly [Geriatric

Medicines]
7.2
Pharmaceutical Care in elderly patients
Point view by Care givers

Prescribing in Elderly [Geriatric Pharmacology]

• Adults >65 years old - Fastest growing population in world.
Growing faster than any other age group.
Sri Lanka has the fastest aging population in South East Asia.

• Multiple medications to control multiple health problems.

Some normal age related problems misdiagnosed as disease
& Prescribed Dx.? Ex. Age related muscle weakness > As neurological
problem, Loneliness > as depression., Ordinary forgetfulness > as dementia

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Factors which influence the prescribing in elderly

1. Patient Factors
• Multiple morbidity-
multiple diseases needing treatment with several
medicines at same times.
So greatly increase risk of D.I, ADRs

• Poor Compliance

• Errors in administration: Confusion from multiple Rx, Memory loss,

Poor Vision & hearing, Physical Disability

Factors which influence the prescribing in elderly

• Differences in pharmacokinetics- Their liver & kidney functions may be reduced.

So excretion of medicines may be impaired

• Ploy Pharmacy – Eg: In very old people, features of normal ageing: like mild joint
pains, gravitational ankle swelling, difficulty in maintaining balance, light headache &
slightly reduce appetite are some times mistaken as disease & treated with medicines
unnecessarily. [ ? Pharmacist be aware – OTC]

Case study – Most elderly have bi lateral ankle oedema due to gravitational
factor. So relieved by exercise & elevation of legs.

But unnecessarily diuretic is given…..? If Elderly male >> having BPH >>
Urinay retention >> ???

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We entered the world

@BIRTH with help of
medicines & Most of us
depart from it @DEATH
With assistance of
medicines

Warmest congratulations Flamingo Pharmacy Academy.. Wishing you even more success in the future.

Thank you

Presented By
Ruwan Raigamkoralage
D.Pharm (Col), MSc. FST (SJP)

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Thank you for your excellent attention

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