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    Chapter06 Chapter06 Presentation Transcript

    • MATH AND DOSAGE CALCULATIONS FOR HEALTH CARE THIRD EDITION BOOTH & WHALEY McGraw-Hill 6- Chapter 6: Drug Labels and Package Inserts Edited by B. Holmes MSN/Ed, RN
    • LEARNING OUTCOMES
      • 6.1 Identify on a drug label the drug name, form, dosage strength, route, warnings, and manufacturing and storage information.
      • 6.2 Locate directions on drug labels and package inserts for reconstituting and diluting medications.
      6-
    • LEARNING OUTCOMES
      • 6.3 Recognize different types of tablets and capsules.
      • 6.4 Distinguish administration routes for medications.
      • 6.5 Locate additional information in a package insert.
      6-
    • INTRODUCTION
      • The drug label and package inserts contain information needed to perform dosage calculations.
      • Read the label carefully.
      6-
    • LOCATING INFORMATION
      • Drug name
      • Form of the drug
      • Dosage strength
      • Total amount in the container
      • Warnings
      • Route of administration
      • Storage requirements
      • Manufacturing information
      6-
    • DRUG NAME
      • Generic Name
        • Official name
        • Must appear on label
        • National listings
          • United States Pharmacopeia (USP)
          • National Formulary (NF)
      6- Levothyroxine Sodium (generic name)
    • DRUG NAME (CONT.)
      • Trade Name
        • Brand name
        • Used to market the drug
        • Property of drug company
          • Registered mark ® - name registered with the U.S. Patent and Trademark Office
        • Drug may be manufactured by more than one company.
      6- Synthroid (trade name)
    • DRUG NAME (CONT.)
      • Rule 6-1
      • You must know both the generic and trade names of drugs.
      6- Example Vicodin ® is a narcotic painkiller Generic name : hydrocodone bitartrate and acetaminophen Other trade names : Anexsia ® , Lortab ® , Zydone ®
    • FORM OF THE DRUGS
      • Solid oral medications
        • Tablets, capsules, gelcaps, caplets
      • Liquids
        • Oral, injections, inhalants, drops, sprays, mists
      • Other
        • Ointments, creams, lotions, patches, suppositories, shampoos
      6-
    • DOSAGE STRENGTH
      • Labels include information about the amount of drug present.
      • The amount of drug present per dosage unit combined with information about the form identifies the drug’s dosage strength.
      6-
    • DOSAGE STRENGTH (CONT.)
      • Solid medications
        • Dosage strength is the amount of drug present per tablet, capsule, or other form.
      6- Dosage strength 10 mg/1 tab
    • DOSAGE STRENGTH (CONT.)
      • Liquid medications
        • Dosage strength is the amount of drug present in a quantity of solution.
        • Amount of solution varies per dosage unit.
        • Pharmaceutical companies manufacture meds with dosage strengths that match commonly prescribed doses.
          • Reduces the risk of error when calculating dosages.
      6-
    • COMBINATION DRUGS
      • Generic names and dosage strengths of all components must appear on the label.
      • If available, the trade name may be used to order combination drugs.
      6-
    • TOTAL NUMBER OR VOLUME IN CONTAINER
      • Many meds are packaged in unit doses
        • One tablet / section of package
        • Vial with 2 mL of solution for injection
      • Multiple-dose containers
        • Prescription medications
        • Non-prescription medications
      6-
    • TOTAL NUMBER OR VOLUME IN CONTAINER (CONT.)
      • Rule 6-2
      • Do not confuse the total amount of drug in the container with the dosage strength.
      6- The container may hold 100 tablets and each tablet has a dosage strength of 2.5 mg per tablet.
    • ROUTE OF ADMINISTRATION
      • Directions for route of administration may be on the label.
        • Tablets, capsules, gelcaps, caplets
          • Swallow
          • Sublingual
          • Chewable
        • Liquid medications
          • Oral
          • Injections
        • Inhalants
        • Topical / transdermal
      6-
    • ERROR ALERT!
      • Give the right medication by the right route.
        • Do not administer drugs by any route other than described in the drug label or on the order.
      6-
    • WARNINGS
      • Help to administer drugs safely
      • Types of warnings
        • For specific groups, i.e. children, elderly
        • For controlled substances
        • About combining with other drugs or products
      • Proper disposal following facility guidelines
      6-
    • STORAGE INFORMATION
      • Maintain the drug’s potency and effectiveness
      • Information on label
        • Storage temperature
        • Exposure to light
        • Length of time drug will remain potent after container has been opened
      • Improper storage can trigger a chemical reaction and make the drug unusable
      6-
    • MANUFACTURING INFORMATION
      • Labels
        • Regulated by the U.S. Food and Drug Administration (FDA)
        • Must include:
          • Name of the manufacturer
          • Expiration date
          • Lot number
            • When and where a drug was produced
            • Trace problems
      6-
    • MANUFACTURING INFORMATION (CONT.)
      • Rule 6 - 3
      • Never use a drug after the expiration date has passed.
        • Older drugs may become chemically unstable or altered.
          • Incorrect dose
          • Effect different than intended one
        • Educate patients to check expiration dates.
      6-
    • INFORMATION ABOUT RECONSTITUTING DRUGS
      • Powder forms must be reconstituted and other drugs require dilution prior to use.
      • Directions for reconstituting or diluting are on the label.
        • Type and amount of diluent
        • Solution strength once reconstituted
        • Time period for safe administration
      6-
    • ERROR ALERT!
      • Consider the age and health needs of the patient when administering a drug.
        • If another form of a drug is better suited to a patient’s needs, consult the physician or pharmacist about changing the order.
      6-
    • PACKAGE INSERTS
      • Complete and authoritative information about a medication
      • Sections
        • Description – chemical and physical
        • Clinical Pharmacology – actions of the drug
        • Indications and Usage
      6-
    • PACKAGE INSERTS (CONT.)
        • Contraindications
        • Warnings – serious side effects
        • Precautions
        • Adverse Reactions – anticipated side effects
      6-
    • PACKAGE INSERTS (CONT.)
        • Overdosage – effects and instruction for treatment
        • Dosage and Administration
        • Preparation for Administration
        • Manufacturer Supply – dosage strength and form availability
      6-
    • PRACTICE 6- What is the generic name of the drug? Answer At 25 ° C (77 °F) excursions permitted to 1 5-30°C (59-86°F) Answer 50 mg capsules What is the dosage strength? How should this drug be stored? Answer celecoxib
    • ORAL DRUGS
      • Solid or liquid forms
      • Tablets
        • Scored – can be broken into equal portions
        • Chewable – should be chewed to be effective
        • Enteric-coated – must be swallowed whole
        • Capsules
          • Some should be swallowed whole
          • Others may be opened and mixed with food
        • Controlled-release – usually swallowed whole
      6-
    • ORAL DRUGS (CONT.)
      • Rule 6 - 4
      • Tablets may be broken to give a partial dose only when the tablets are scored.
        • Never crush or break
          • Enteric-coated medications
          • Controlled-release medications (CR)
          • Extended-release medications (ER or XL)
          • Sustained-release medications (SR)
      6-
    • ORAL DRUGS (CONT.)
      • Liquids
        • Oral solutions
        • Syrups
        • Elixirs
        • Oral suspensions
        • Simple liquids
        • Dosage strength corresponds to a specific volume of the solution –
        • 500 mg / 10 mL
      6-
    • ORAL DRUGS (CONT.)
      • Rule 6 - 5
      • When reconstituting a drug, you must write your initials and the time and date of reconstitution on the label.
      6- shf 7/21/08 @ 1400
    • PRACTICE 6- Answer Zetia ® Answer 1 tablet daily What is the trade name of the drug? What is the usual dosage? What is the dosage strength? 10 mg/tablets
    • PARENTERAL DRUGS
      • Packaged as
        • Single-use ampules or vials
        • Single-use prefilled syringes
        • Multi-use vials
      • Small containers have small labels
        • Difficult to read
        • Review package insert
      6-
    • PARENTERAL DRUGS (CONT.)
      • Routes
        • Intradermally ( ID )
        • Intramuscularly ( IM )
        • Intravenously ( IV )
        • Subcutaneously ( Sub-q )
        • Inhalants
        • Transdermal Delivery
      6-
    • PARENTERAL DRUGS (CONT.)
      • Dosage strength is the amount of drug per dosage unit
        • Examples
          • mg / tablet
          • mg / mL
          • mEq / mL
        • units / mL
        • gm / mL
        • gm / tablet
      6-
    • PRACTICE 6- Answer 20 mg/2 mL Answer Furosemide What is the dosage strength of the drug? What is the drug’s name? What is the route of administration? Answer IM or IV
    • DRUGS ADMINISTERED BY OTHER ROUTES
      • Sublingual (under the tongue)
      • Buccal (between the tongue and cheek)
      • Rectal
      • Vaginal
      • Topical
      • Eye or Ear drops
      • Transdermal
      • Inhalants
      6-
    • DRUGS ADMINISTERED BY OTHER ROUTES (CONT.)
      • Dosage strength varies with type of drug and how it is administered
        • Examples
          • Transdermal – 0.2 mg/hr (the amount absorbed over time through the skin)
          • Inhalent – 84 mcg / metered spray
      6-
    • APPLY YOUR KNOWLEDGE
      • 1. What is another name for the brand name?
      • 2. What is the official name of a drug?
      6-
        • Answer trade name
        • Answer generic name
    • APPLY YOUR KNOWLEDGE
      • True or False
      • Enteric-coated tablets can be crushed and mixed with food.
      • All capsules may be opened and mixed with food.
      • Parenteral forms of drugs includes transdermal and inhalants.
      6- T F F This would allow the drug to be absorbed sooner than intended. Some capsules should be swallowed whole.
    • APPLY YOUR KNOWLEDGE
      • True or False (cont.)
      • The warnings section of a package insert lists the more serious, possibly fatal, side effects of a drug.
      • You may administer a drug after the expiration date has expired if you do not have any new ones.
      6- T F It may not provide correct dosage strength or have an effect different than intended.
    • APPLY YOUR KNOWLEDGE
      • True or False (cont.)
      • You can use as much solution as you need to reconstitute a powdered medication.
      • The amount of drug in a container is not the same as the dosage strength.
      6- F You must follow the directions for reconstituting a drug that are on the label or in the package insert. T
    • END OF CHAPTER 6 6- Read in order to live. -Henry Fielding