Document Category: Dispensing exercise
| Categories | Summary | Tags | Exercise Attributes | Author | Link | hf:doc_categories | hf:doc_tags | hf:doc_author |
|---|---|---|---|---|---|---|---|---|
| Dispensing exercise | IS is a 55 year old male with chronic lower back pain who comes to your pharmacy with a prescription for Percocet. His past medical history is significant for depression and anxiety. He has no known drug allergies. DRPs: 1) Safety > Adverse Drug Reaction > Dose too high Patient potentaill exceeds daily limit of 4 grams of Tylenol (acetaminophen). Counsel the patient to stop taking the OTC Tylenol because he will exceed the maximum daily dose of Tylenol if he continues to take it the way he was prior. Recommend the patient to only take the Percocet if he has pain continuously. 2) Adherence > Adherence Patient is not adherent to his medications/refilling his medications on time. Suggest alternatives including a weekly pill holder and use his cell phone alarm to remind him when to take his medications daily. 3) Indication > Unnecessary Drug Therapy > No indication at this time Suggest the patient talk to his MD about discontinuing his Aspirin regimen. There is no indication for him to be on Aspirin. | Dose too high, OXYCODONE / ACETAMINOPHEN 5/325 MG Tab | Community, 1 item on Rx, Do not dispense, Patient questions, Attachments | University of Kentucky | dispensing-exercise | dose-too-high oxycodone-acetaminophen-5-325-mg-tab | university-of-kentucky | |
| Dispensing exercise | RC is a 57 year old male who comes to your pharmacy with a new prescription for Viagra. In addition to his newly diagnosed ED, RC has a past medical history of chlamydia, stable angina, alcoholism, and chronic back pain. OUTCOME: drug-drug interaction. | Acetaminophen / Oxycodone 325 mg-5 mg Tab, Atenolol 50 mg Tab, DORYX 100mg Cap, drug-drug interaction, Lisinopril 10 mg Tab, NITROLINGUAL PUMPSPRAY, Sildenafil 50 mg Tab | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | acetaminophen-oxycodone-325-mg-5-mg-tab atenolol-50-mg-tab doryx-100mg-cap drug-drug-interaction lisinopril-10-mg-tab nitrolingual-pumpspray sildenafil-50-mg-tab | university-of-kentucky | |
| Dispensing exercise | MM, a 37 year old male, brings a new prescription for Lyrica to your pharmacy. He has a past medical history significant only for type 2 diabetes and occasional heart-burn (less than 3 times per month). He has no known drug allergies. Earlier today, MM saw his PCP and was diagnosed with fibromyalgia. The patient tells you he has not received any immunizations since the start of collegewhen he was 18 years old. OUTCOME: too high a starting dose for Lyrica. | fibromyalgia, Pregabalin 225 mg Cap | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | fibromyalgia pregabalin-225-mg-cap | university-of-kentucky | |
| Dispensing exercise | KD is a 24 year old female that comes to your pharmacy regularly. One day while you are working, KD rushes to your counter to pick up a prescription for Ortho Tri‐Cyclen Lo. KD is crying excessively at the counter, stating that her medications are ruining her life. She complains of increased confusion and has gained thirty pounds in the last two months (current BMI 41). KD has no additional complaints and states that her knee pain is well controlled on her current regimen. DRPs: 1) Safety > Adverse Drug Reaction > Drug-Drug Interaction NSAIDs used in combination with Lithium increase the serum concentration of lithium resulting in toxicity. Could alternatively alternatively suggest APAP. Therapeutic levels for Lithium are 0.6-1.2mEq/L and this patient’s levels are well over normal range. Since you haven’t had this in IDD yet, here is a reference: 1.5-2mEq/L – GI complaints/tremor 2-2.5mEq/L – confusion/somnolence >2.5mEq/L – seizures/death Monitoring Parameters: Serum lithium every 4-5 days during initial therapy; draw lithium serum concentrations 8-12 hours post-dose; renal, thyroid, and cardiovascular function; fluid status; serum electrolytes; CBC with differential, urinalysis; monitor for signs of toxicity; beta-hCG pregnancy test for all females not known to be sterile. Reference Range: … | estradiol, Ethinyl estradiol / Norgestimate 25 mcg-25 mcg Tab, NSAID | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | estradiol ethinyl-estradiol-norgestimate-25-mcg-25-mcg-tab nsaid | university-of-kentucky | |
| Dispensing exercise | Your long‐time patient, CA, is referred to your services for medication therapy management (MTM). CA is a 79 year old female with a past medical history of osteoporosis, GERD, occasional constipation and anxiety. She has no significant social or family history and no known drug allergies. Because the patient is elderly, there is a higher risk of adverse effects with diazepam than with other benzodiazepines that have shorter half lives. The patient should be counseled on these risks and to avoid operating machinery or doing anything that requires full attention until she knows how the medication affects her. | benzodiazepine, Diazepam, elderly | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | benzodiazepine diazepam elderly | university-of-kentucky | |
| Dispensing exercise | EJ is a 55 year old male who comes to your pharmacy with a new prescription for Carvedilol 25mg BID. He has a past medical history significant for hypertension, GERD, and hyperlipidemia. He has no known drug allergies. Of note, the patient has been complaining of a persistent dry cough for the past few months that will not go away. FEEDBACK 1) Dose too high: Wrong dose: Patient has a prescription for Carvedilol 25mg BID which is the therapeutic dose of Carvedilol, but too high to initiate on. The patient must be started on 6.25mg BID for 1-2 weeks, then increase to 12.5mg BID for 1-2 weeks, then increase to 25mg BID as tolerated by the patient. 2) Inappropriate adherence: Does not understand directions: Patient’s last refill of HCTZ is late. this means he has been missing doses of his medication. Counsel patient on proper techniques to make sure he takes his medicine on time (pill boxes, reminders, etc.) 3) Adverse drug reaction: Undesirable effect: Patient’s lisinopril is causing ACE-inhibitor induced cough. Suggest switching to an ARB with appropriate dose. 4) Needs additional therapy: prophylactic therapy: flu shot and Tdap for vaccines. this patient is also a candidate for Aspirin … | Carvedilol 25 mg Tab, GERD, Hyperlipidemia, lisinopril | Community, 1 item on Rx, Do not dispense, Patient questions, Attachments | University of Kentucky | dispensing-exercise | carvedilol-25-mg-tab gerd hyperlipidemia lisinopril | university-of-kentucky | |
| Dispensing exercise | RA is a 30 year old female that you recognize from your pharmacy. You see her lingering in the vitamin section today while waiting for a prescription refill, so you ask if there is something you can help her find. She says that lately she has felt cold, fatigued, and “run down” emotionally. DRPs: 1) Effectiveness > Dosage too low > Drug Interaction Interaction with calcium and levothyroxine. Assessment: patient is experiencing symptoms of hypothyrodism because of reduced bioavailability of levothyroxine. Resolution: Space out calcium and levothyroxine by 4 hours. Reassess TSH levels in 6-8 weeks to determine if you need to change the dose of levothyroxine. 2) Indication > Needs Additional Drug Therapy subtherapeutic dosing/condition Assessment: patients A1c is not at goal (<7% or 6.5% per ADA/AACE). Recommendation: Patient should be initiated on a second medication such as a sulfonylurea, thiazolidinedione, or another alternative therapy. Recommend follow-up with doctor to assess. 3) Indication > Needs Additional Drug Therapy > Preventative Therapy Assess immunization needs. | Calcium 500mg Tab, Ergocalciferol 50000 IU Liq cap, hypothyrodism, levothyroxine | Community, 2 items on Rx, Dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | calcium-500mg-tab ergocalciferol-50000-iu-liq-cap hypothyrodism levothyroxine | university-of-kentucky | |
| Dispensing exercise | VA is a 24 year old female with newly diagnosed depression, who comes to your pharmacy with a new prescription for Bupropion SR 150mg at bedtime from Dr. Anthony Fleming. DRPs: 1) Safety > Adverse Drug Reaction > Unsafe drug for patient The use of bupropion is contraindicated in patients with a history of bulimia. This medication cannot be dispensed to this patient, therefore the doctor must be called to make him aware of this. Another antidepressant may be suggested such as fluoxetine, which will not interact with her current medications and is not contraindicated in patients with a history of bulimia. 2) Effectiveness > Dosage too low > Dose too low This patient has inadequate blood pressure control. Her most recent blood pressure was 140/88, which is not within the goal of <140/90. Therefore, the hydrochlorothiazide could be titrated up to 25 mg PO daily. 3) Effectiveness > Dosage too low > Dosage too low This patient has trouble sleeping even though she is taking diphenhydramine 25 mg at bedtime. The dose of diphenhydramine for patients with insomnia is up to 50 mg PO at bedtime. Consider 50 mg of diphenhydramine PO at bedtime. 4) Indication > Needs Additional … | Adverse Drug Reaction, Bupropion SR, depression, Insomnia | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions, Attachments | University of Kentucky | dispensing-exercise | adverse-drug-reaction bupropion-sr depression insomnia | university-of-kentucky | |
| Dispensing exercise | This exercise aims to evaluate the students ability to identify contraindications for and appraise the appropriateness of commonly encountered medications when treating diabetes. AA is a 74-year old, non-smoking, white man comes to the pharmacy to pick up his prescriptions. His past medical history includes: DM2, HTN, dyslipidemia, and peptic ulcer disease. His physical exam was unremarkable. He shows you his vitals and fasting lab results obtained this month (03/01/17). You can view AA’s labs in the [Additional Documents] window. He said that he wants to take only oral medications at this time, not injections. He reports that he measures BP and HR at home and, for the past 3 months, they have run 142-156/72-78 mmHg and 52-62 bpm, respectively. He regularly eats 3 meals per day and reports 100% adherence to his medications and lifestyle changes. He has no complaints and denies any hypoglycemic episodes, weakness, fatigue, dizziness, lightheadedness, abdominal pain, or muscle pain. He uses only your pharmacy. To receive full credit, the student must complete two tasks: 1) Evaluate the medications AA is currently taking by viewing his patient profile in the computer. If you determine any of the medications to be inappropriate, identify them in the … | Diltiazem Cd 240mg, Glyburide 5 mg Tab, Niacin - Extended Release 500 mg | Community, 3 items on Rx, Do not dispense, Fact finding, Attachments | University of Kentucky | dispensing-exercise | diltiazem-cd-240mg glyburide-5-mg-tab niacin-extended-release-500-mg | university-of-kentucky | |
| Dispensing exercise | Mr. Peppers, a patient well-known to your pharmacy, comes to the counter with a new prescription. This patient has 12 dispensing records (Cymbalta 60mg cap and Effexor XR 150mg cap). The prescriber needs to be contacted based on the drug-drug interaction. | Desvenlafaxine 50mg, Quetiapine 50 mg | Community, 2 items on Rx, Fact finding, Patient questions | University of Kentucky | dispensing-exercise | desvenlafaxine-50mg quetiapine-50-mg | university-of-kentucky | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) identify patient allergy to prescribed drug, (3) contact prescriber for appropriate alternative antibiotic. When consulted about the allergy the prescriber responds “Oh, I didn’t know that. Thanks for contacting me and letting me know about this. Change to Zpak, you know the directions, right?”. | Allergy, Azithromycin 250 mg, Zpak | Community, 1 item on Rx, Dispense, Fact finding | University of Kentucky | dispensing-exercise | allergy azithromycin-250-mg zpak | university-of-kentucky | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) identify and fix a dosing error that would otherwise result in a toxic overdose. AJ approaches your pharmacy counter to get a prescription filled. He is traveling to Honduras in 5 days for one month and his doctor wrote a script for malaria prophylaxis. Student is required to contact prescriber regarding the dose (should be once per week instead of once per day). | Chloroquine 500 mg, dosing error | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Kentucky | dispensing-exercise | chloroquine-500-mg dosing-error | university-of-kentucky | |
| Dispensing exercise | Patient comes to the pharmacy counter requesting to have their prescription filled. They are about to leave the country and desire their sleeping pills before they depart. Date is missing from prescription. Student should contact the physician and request clarification/date authorization. | error on Rx, Zolpidem | Community, 1 item on Rx, Do not dispense, Fact finding | University of Kentucky | dispensing-exercise | error-on-rx zolpidem | university-of-kentucky | |
| Dispensing exercise | Mr. James Rawson comes to your pharmacy with a new prescription for azithromycin. You can dispense medication after discussing the dosing error with physician. Inform Mr. Rawson about the dose change. | azithromycin, dosing error | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Michigan | dispensing-exercise | azithromycin dosing-error | university-of-michigan | |
| Dispensing exercise | Mrs. Jenny Johns is a 46 years old female with history of atrial fibrillation who comes to your pharmacy to fill warfarin. Patient asks”Can I take over the counter herbal product St. John’s wort because Dr. Oz says it is good for depression?” There is a drug interaction between these two products. Taking St. John’s Wort with warfarin can result in warfarin not working as well which places the patient at risk for clots. | St. John's Wort, warfarin | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Michigan | dispensing-exercise | st-johns-wort warfarin | university-of-michigan | |
| Dispensing exercise | Mr. Peter Dawsin comes from his PCP office with a prescription for Bactrim DS Q12H for 3 days for urinary tract infection. Mr. Dawsin has documented allergy to co-trimoxazole. It is not safe to dispense this medication. In addition, patient is taking warfarin for atrial fibrillation that can interact with Bactrim. | Bactrim, Sulfamethoxazole / trimethoprim | Community, 1 item on Rx, Do not dispense, Fact finding | University of Michigan | dispensing-exercise | bactrim sulfamethoxazole-trimethoprim | university-of-michigan | |
| Dispensing exercise | Problem in the case – pregnant while taking ACE-inhibitor. The questions that must be asked include: allergies, other medications, and pregnancy status (25 year old female). | lisinopril, pregnancy | Community, 1 item on Rx, Do not dispense, Fact finding | University of Michigan | dispensing-exercise | lisinopril pregnancy | university-of-michigan | |
| Dispensing exercise | Mrs. Mia Gleadow is a 50 y.o. patient with type II diabetes who comes to you pharmacy to refill her Lantus. Patient states: “I had low sugar about 2-3 times the past week. I ran out of Lantus syringe and borrowed some regular syringes from her neighbor a week ago. The low blood sugars happened after I used the new syringes.” and “Should I ask my doctor to write a prescription for insulin syringes?” | Lantus, syringe | Community, 1 item on Rx, Dispense, Patient questions | University of Michigan | dispensing-exercise | lantus syringe | university-of-michigan | |
| Dispensing exercise | Mr. Dafydd Davies is a regular customer at your pharmacy. Today he comes in to refill his blood pressure medication Diovan HCT. When you review his medication profile, you identify that there may be an opportunity to improve medication adherence. Adherence is an issue because the patient does not like metformin because it caused bad diarrhea and he had to go to the bathroom 3-4 times a day. He knows it is important to control his blood sugar. Can you recommend another medication that causes less diarrhea? | Adherence, Diarrhoea, Metformin | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Michigan | dispensing-exercise | adherence diarrhoea metformin | university-of-michigan | |
| Dispensing exercise | Simple dispensing exercise with two items on the script: Lisinopril 40 mg Tab and Citalopram 10 mg Tab. Patient is also taking another blood pressure medication, hydrochlorothiazide. | Citalopram 10mg Tab, Hydrochlorothiazide 25mg Tab, lisinopril | Community, 2 items on Rx, Dispense, Fact finding, Patient questions | University of Michigan | dispensing-exercise | citalopram-10mg-tab hydrochlorothiazide-25mg-tab lisinopril | university-of-michigan | |
| Dispensing exercise | A simple dispensing exercise with no issues. Montelukast 10 mg Tab prescribed for asthma attack, shortage of breath & wheezing. | asthma, Montelukast 10 mg Tab | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Michigan | dispensing-exercise | asthma montelukast-10-mg-tab | university-of-michigan | |
| Dispensing exercise | This exercise has an error on the RX and requires the student to work with the physician to get the correct medication. | Clindamycin hydrochloride, dental, prescriber fact finding | Community, 1 item on Rx, Dispense, Fact finding | University of Connecticut | dispensing-exercise | clindamycin-hydrochloride dental prescriber-fact-finding | university-of-connecticut | |
| Dispensing exercise | This question assesses the student’s ability to do the following: (1) accurately dispense a medication from an oral prescription. Mr. Randy Roldolph wishes to pick up his medication that his physician called into your pharmacy. This exercise uses a voicemail file, so a device that can playback the audio is required. | triamcinolone 0.1% Oint, voicemail | Community, Fact finding | University of Connecticut | dispensing-exercise | triamcinolone-0-1-oint voicemail | university-of-connecticut | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) provide patient counseling. To receive full credit for this exercise, at a minimum students must include the following in your counseling: Include the following: (1) directions for use and storage and the importance of compliance with directions; and (2) precautions and relevant warnings, including common severe side or adverse effects or interactions that may be encountered. Should you deem it warranted in the exercise of your professional judgment, you may include additional information. HOW TO USE: This product should only be applied to healthy, normal skin. Do not apply to skin that is broken or irritated. Dosage is based on your medical condition and response to therapy. Remove the protective liner and apply the patch to the skin area that is most painful. Apply the prescribed number of patches, usually only once a day for up to 12 hours or as directed by your doctor. Do not apply more than 3 patches once a day or leave any patch on for longer than 12 hours in any 24-hour period. If a smaller patch is needed, it may be cut with scissors before the liner is … | Lidocaine Patch, Transdermal | Community, 1 item on Rx, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | lidocaine-patch transdermal | university-of-connecticut | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) provide patient counseling To receive full credit for this exercise, at a minimum students must include the following in their counseling: (1) directions for use and missed dose, storage and the importance of compliance with directions; and (2) precautions and relevant warnings, including common severe side or adverse effects or interactions that may be encountered. | Ethinyl estradiol/norethindrone, Women's health | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | ethinyl-estradiol-norethindrone womens-health | university-of-connecticut | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) provide patient counseling. To receive full credit for this exercise, at a minimum students must include the following in their counseling: Include the following: (1) directions for use and storage and the importance of compliance with directions; and (2) precautions and relevant warnings, including common severe side or adverse effects or interactions that may be encountered. | Rosuvastatin | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | rosuvastatin | university-of-connecticut | |
| Dispensing exercise | This exercise walks students through helping a patient who has a new prescription for her blood pressure, and also has an allergy. This patient is allergic to lisinopril, and Zestorectis is a combination product that contains lisinopril and HCTZ. | lisinopril, Zestorectis | Community, 1 item on Rx, Do not dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | lisinopril zestorectis | university-of-connecticut | |
| Dispensing exercise | This question assesses the student’s ability to do the following: (1) dispense the correct medicine to the patient, (2) provide patient counselling. Mr Dawson presents this script to you at the pharmacy to be filled. His daughter is with him, and he seems to be a little hard of hearing. Demonstrate how to instill eye drops. These eye drops can cause some side effects: Your irises may change color. Your eyelid skin may darken. Your eyelashes may get longer, thicker or change color. Your eyes may get red or inflamed, or you may get teary eyes. If this happens, call your ophthalmologist. If you miss a dose, just continue treatment the next evening. Keep this medication in your refrigerator until it is opened, then store at room temperature away from heat and light. | Latanoprost | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | latanoprost | university-of-connecticut | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) validate a prescription for a controlled substance. Advise the patient to read the FDA-approved patient labeling (Medication Guide). Instruct patients how to properly take MS Contin, including the following: Swallowing MS Contin tablets whole Not crushing, chewing, or dissolving the tablets Using MS Contin exactly as prescribed to reduce the risk of life-threatening adverse reactions (e.g., respiratory depression) Not discontinuing MS Contin without first discussing the need for a tapering regimen with the prescriber MS Contin may cause orthostatic hypotension and syncope. Advise patients of the potential for severe constipation | controlled substance, MS Contin | Community, 1 item on Rx, Dispense, Fact finding | University of Connecticut | dispensing-exercise | controlled-substance ms-contin | university-of-connecticut | |
| Dispensing exercise | This exercise assesses the student’s ability to do the following: (1) dispense appropriate medication, (2) provide patient counseling. To receive full credit for this exercise, at a minimum the student must include the following in their counseling: (1) directions for use and storage and the importance of compliance with directions; and (2) precautions and relevant warnings, including common severe side or adverse effects or interactions that may be encountered. To gain the most benefit, take every night at dinner and do not miss doses. Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. Store at room temperature. Store in a dry place. Do not store in a bathroom. Swallow whole. Do not chew, break, or crush. Take as you have been told, even if you feel well. Low blood sugar may occur. Signs may be dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating. Keep glucose tablets or liquid glucose on hand for low blood sugar. It is common … | Diabetes, Metformin Extended Release 500 MG Tab | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | diabetes metformin-extended-release-500-mg-tab | university-of-connecticut | |
| Dispensing exercise | This question assesses the student’s ability to do the following: (1) calculate the appropriate dose of antibiotic for the patient, (2) dispense the correct medicine to the patient, (3) choose the appropriate ancillary labels for the medicine to be dispensed (4) answer patient queries regarding dosing of pediatric tylenol. | calculations, Cefaclor 125mg/5mL, pediatrics | Community, 1 item on Rx, Dispense, Fact finding, Patient questions | University of Connecticut | dispensing-exercise | calculations cefaclor-125mg-5ml pediatrics | university-of-connecticut | |
| Dispensing exercise | C-IV medication prescription presented to the pharmacy; practice filing and labeling controlled substance Tramadol is a C-IV medication that should not be filled if 6 months has passed since the day it was written. | back pain, Rx expired, Tramadol 50 mg Tab | Community, 1 item on Rx, Do not dispense, Fact finding | University of Connecticut | dispensing-exercise | back-pain rx-expired tramadol-50-mg-tab | university-of-connecticut | |
| Dispensing exercise | Insomnia and nausea 3 This exercise involves dispensing a prescription, whilst taking into consideration a patient request. There is an additional request for an Emergency supply of Temazepam to manage jet lag. This exercise will allow for a wider discussion about the criteria that surrounds Emergency supply and what options are available to the pharmacist There are added challenges when counselling someone who is picking up a prescription on behalf of a patient. In this scenario it would seem the patient’s son may be distracted by his own concerns about receiving an emergency supply for Temaze. This challenge should not discourage you from asking whether the patient has any concerning symptoms or requires any information about their current medication. It is always approrpriate to double check if a patient is having any issues using eye drops, as it can be challenging for the elderly (e.g. due to dexterity issue and arthritis) | Ezetimibe 10mg Tab, Insomnia, Latanoprost 50mcg/mL 2.5mL Eye dr, Nausea, Pravastatin 40mg Tab | Community, 3 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | ezetimibe-10mg-tab insomnia latanoprost-50mcg-ml-2-5ml-eye-dr nausea pravastatin-40mg-tab | monash-university | |
| Dispensing exercise | Insomnia and nausea 2 This exercise involves dispensing a prescription whilst considering patient preferences. There is no errors or issues with this prescriptions and it should be dispensed. As the patient has been taking their current medication for some time, it is important to tailor the counselling to the patient’s current circumstances. Certain trigger factors can affect the stability of a patient suffering from Bipolar disorder. These include a lack of sleep (which can also be a sign a manic episode), sensory overload (dealines), stress (e.g. work related), illicit drugs or alcohol (3-4 glasses of wine after dinner). Given that some of these factors relate to the patients current circumstance, it would appropriate to highlight these to the patient so they can reflect on their current daily activities. It would also be important to promote good sleep hygiene. This might inlcude: limiting caffiene late in the day limiting screen time late in the day | Insomnia, Lithium Carbonate 450mg SR Tab, Nausea, Sodium Valproate 200mg EC Tab | Community, 2 items on Rx, Recommend medications | Monash University | dispensing-exercise | insomnia lithium-carbonate-450mg-sr-tab nausea sodium-valproate-200mg-ec-tab | monash-university | |
| Dispensing exercise | Insomnia and nausea This exercise involves dispensing a prescription, whilst taking into consideration patient concerns. There are no errors with this prescription, however the exercise may open a wider discussion about the side effects of a medication and how they are managed. Even though the patient has presented a prescription for Eliquis and Isoptin, the counselling provided may focus on the patient’s nausea. It is important to emphasise the importance of taking Flagyl with food, as it may help to settle the patient’s nausea. Further, also reiterate the need to abstain from drinking alcohol as the patient may have a severe reaction if alcohol is consumed with taking Flagyl. | Apixaban 5mg Tab, Insomnia, Nausea, Verapamil 180mg SR Tab | Community, 2 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | apixaban-5mg-tab insomnia nausea verapamil-180mg-sr-tab | monash-university | |
| Dispensing exercise | Women’s health 3 This exercise involves dispensing a prescription according to the patient preferences. This is no errors with this prescription and it should be dispensed. Even though the patient has taken the medication previously, it is still appropriate to ensure that the medication is well tolerated and achieving the desired outcome. | Atorvastatin 40mg Tab, Hydrochlorothiazide 25mg Tab, Irbesartan 150mg Tab, Women's health | Community, 3 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | atorvastatin-40mg-tab hydrochlorothiazide-25mg-tab irbesartan-150mg-tab womens-health | monash-university | |
| Dispensing exercise | Women’s health 2 This exercise involves dispensing a prescription according to the patient preferences. This is no errors with this prescription and it should be dispensed. When taking a COC it is important to always reiterate the following: If any of the following symptoms occur while on the pill, stop taking it and seek urgent medical advice: severe and sudden pain in the chest, severe headache, sudden blurred vision or loss of sight, unexplained tenderness or pain and swelling in one leg. The above information is important to pass on to the patient given that they smoke cigarettes “every now and then”. Effectiveness may be reduced by: some medicines; check with your doctor or pharmacist before starting or stopping any medicines, including herbal (particularly St John’s wort) and over-the-counter products vomiting or diarrhoea (which also may be caused by some medications) or forgetting to take an active pill | Citalopram 10mg Tab, Drospirenone/Ethinyloestradiol 3mg/20mcg, Women's health | Community, 2 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | citalopram-10mg-tab drospirenone-ethinyloestradiol-3mg-20mcg womens-health | monash-university | |
| Dispensing exercise | Women’s health 1 This exercise involves dispensing a prescription whilst considering patient preferences and previous tolerance of medication. There is no errors or issues with this prescriptions and it should be dispensed. It may be appropriate to create a note that Janumet is a new medication for the patient When a patient starts a new mediction it important to cover the following details: Purpose of medication Directions for use (dose, freq, route) Duration of use Any expected S/E Lifestyle advice Follow up advice More specific counseling for Janumet might involve: Take with or after food to reduce stomach upset. Tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss. Drinking alcohol can affect control of your diabetes. It can also increase the risk of serious side effects. Limit your alcohol intake, avoid binge drinking and have something to eat when you drink alcohol. Specific counseling for this patient may involve: A discussion around diabetes control and management. For some patients vaginal thrush may be result of poor diabetes management. As a once off, thrush may not be a concerning condition. Although, with appropriate counseling, if symptoms reoccur the patient would … | Nausea, New medication, Sitagliptin/Metformin 50mg/500mg Tab, Women's health | Community, 1 item on Rx | Monash University | dispensing-exercise | nausea new-medication sitagliptin-metformin-50mg-500mg-tab womens-health | monash-university | |
| Dispensing exercise | Eye conditions 3 This exercise involves dispensing a prescription whilst considering patient preferences. There are no errors or issues with this prescriptions and it should be dispensed. Eventhough the medication has been taken previously, some topics could be important to discuss with the patient includes: Checking the patient’s compliance with Progout. As a preventative medication, it must be taken everyday even when no gout attack is occuring; Ensure that the patient continues to take Progout even while he is having an attack (as he is taking the medication); reiterating the directions of lengout (as there is are many details to remember) | Allopurinol 300mg Tab, Colchicine 500mcg Tab, Eye condition, Gout | Community, Recommend medications, Fact finding | Monash University | dispensing-exercise | allopurinol-300mg-tab colchicine-500mcg-tab eye-condition gout | monash-university | |
| Dispensing exercise | Eye conditions 2 This exercise involves dispensing a prescription whilst considering patient preferences. There is no errors or issues with this prescriptions and it should be dispensed. There is a minor issue from this prescription in that the patient’s OTC request may be as a side effect of the Estraderm (i.e. dry eyes), but could simply be from the menopause alone. Even though the patient has taken the medication before, she is experiencing symptoms that may warrant further investigation and counseling. Estradot (estradiol) can cause side effects of concern (dry eye being one of them!). Hence further counseling should involve expressing to the patient to monitor the timing of her symptoms, the development of any new symptoms, and the effectiveness of her medication. | Estradiol 25mcg/24hrs 8 Patch, Eye condition, Quinapril 5mg Tab | Community, 2 items on Rx, Fact finding | Monash University | dispensing-exercise | estradiol-25mcg-24hrs-8-patch eye-condition quinapril-5mg-tab | monash-university | |
| Dispensing exercise | Eye conditions 1 This exercise involves dispensing a prescription whilst considering patient preferences. There is no errors or issues with this prescriptions and it should be dispensed. Given that the medication is being picked up by the patient’s wife and has been taken before, counseling on the medication may not seem required. However the student pharmacist should still open the dialogue for any questions regarding the medication. Further suggesting her mother can call the pharmacy if she has any queries. | Eye condition, Paracetamol 665mg SR Tab, Sertraline 50mg Tab | Community, 2 items on Rx, Fact finding | Monash University | dispensing-exercise | eye-condition paracetamol-665mg-sr-tab sertraline-50mg-tab | monash-university | |
| Dispensing exercise | Skin infections 3 A prescription is presented to be be dispensed. According to the patient history a dispensing error occurred on a previously for the same item. The prescription. The student should not dispense the prescription before speaking to the Doctor. Counselling would involve indicating to the patient that an error has previously occured. You would ask if they either currently or previously expierenced any unusual side effects or symptoms. Further ways to manage the dialogue would involve following a guide (e.g. PDL) to managing a dispensing error: Ensure the complaint is handled by a pharmacist Check alleged error and replace offending item An apology couched in the correct way will NOT constitute an admission of liability (e.g. “I am sorry this has happened to you”) Determine if the wrong medication has been used or any harm suffered? Has any expense been incurred? DO NOT OFFER COMPENSATION. DO NOT MENTION INSURANCE. Show empathy to the patient. At all times remain calm, sympathetic and co-operative. Telephone insurance to report the problem or gain advice. Record the details in the patient’s dispensing history If a complaint is initiated by correspondence, it is most important to not reply without contacting your insurance first … | Microgynon, Skin infection | Community, 1 item on Rx, Do not dispense, Fact finding | Monash University | dispensing-exercise | microgynon skin-infection | monash-university | |
| Dispensing exercise | Skin infections 2 This exercise involves dispensing a prescription according to the patient preferences. This is no errors with this prescription and it should be dispensed. This patient has 5 dispensing records for Motilium, Keflex and Amoxil Appropriate counselling would involve explaining the: Purpose of medication, Directions for use (dose, freq, route), Duration of use, Amount to apply, Any expected S/E, Lifestyle advice, Follow up advice. | Mometasone 0.1% 45g Cr, Mometasone 0.1% 45g Oint, Skin infection | Community, 2 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | mometasone-0-1-45g-cr mometasone-0-1-45g-oint skin-infection | monash-university | |
| Dispensing exercise | Skin infections 1 This exercise involves dispensing a prescription whilst considering patient preferences. There are no errors or issues with this prescriptions and it should be dispensed. This patient has 9 dispensing records. Given that the medication is being picked up by the patient’s daughter and has been taken before, counseling on the medication may not seem required. However the student pharmacist should still open the dialogue for any questions regarding the medication. Further suggesting her mother can call the pharmacy if she has any queries. | Amlodipine, Atorvastatin, Olmesartan, Skin infection | Community, 3 items on Rx, Recommend medications, Fact finding | Monash University | dispensing-exercise | amlodipine atorvastatin olmesartan skin-infection | monash-university | |
| Dispensing exercise | B12 injections Patient requests vitamin B12 injections as per her GPs instructions for vitamin B12 deficiency | B12 injection, Hydroxocobalamin 1mg/mL | Community, 1 item on Rx, Fact finding, Attachments | Monash University | dispensing-exercise | b12-injection hydroxocobalamin-1mg-ml | monash-university | |
| Dispensing exercise | Nocturnal hypoglycaemia. Rx has two items – Metformin XR 1g Tab and Insulin glargine 100 IU/ml Inj. Can dispense metformin but consider changing the Lantus. Consider changing the Lantus Solostar to Toujeo. Toujeo is a concentrated version of insulin glargine (Lantus). The concentration of Toujeo is three times that of Lantus. | hypoglycaemia, Insulin glargine, Metformin | Community, 2 items on Rx, Do not dispense, Fact finding | Monash University | dispensing-exercise | hypoglycaemia insulin-glargine metformin | monash-university | |
| Dispensing exercise | Diabetes – Continuous dosing. Rx for Insulin Detemir 100u/mL, 3mL Inj and Insulin Aspart 100units/mL, 3ml Inj. This patient has 12 dispensing records, showing use of (LEVEMIR PENFILL) and (NOVORAPID FLEXPEN) over time. Outcome is that pharmacist can dispense as pt still requires meds but can consider recommending pt to see his doctor/diabetes educator about switching from multiple daily injections to insulin pump therapy. | Diabetes, Insulin Aspart, Insulin Detemir | Community, 2 items on Rx, Do not dispense, Fact finding, Patient questions | Monash University | dispensing-exercise | diabetes insulin-aspart insulin-detemir | monash-university | |
| Dispensing exercise | Mrs Dawson has been prescribed Mogadon to help her sleep. Community. Outcome: Dispense. 3 items on Rx | benzodiazepine, coumadin, digoxin, lanoxin, mogadon, nitrazepam, warfarin | Monash University | dispensing-exercise | benzodiazepine coumadin digoxin lanoxin mogadon nitrazepam warfarin | monash-university |
Recent Comments