© 2012 the mcgraw-hill companies, inc. all rights reserved. chapter 10 interpreting medication...
TRANSCRIPT
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 10 Interpreting Medication Labels and Package Inserts
PowerPoint® Presentation to accompany:
Math and Dosage Calculations for Healthcare Professionals
Fourth Edition
Booth, Whaley, Sienkiewicz, and Palmunen
10-2
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
10.1 Differentiate information on a medication label and within a package insert.
10.2 Distinguish information related to administration routes for medications.
Learning Outcomes
10-3
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Key Terms Bar code
Dosage strength
Generic name
ID – intradermal
IM - intramuscular
IV- Intravenous
10-4
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Key Terms (cont.)
Package insert
Reconstitute
Subcut – subcutaneous
Trade name
Transdermal
10-5
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Introduction The drug label and
package inserts contain information needed to perform dosage calculations.
Read the label carefully.
10-6
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Information on Medication Label and Package Insert
Drug name
Form of the drug
Dosage strength
Total amount in the container
Warnings
Route of administration
Storage requirements
Manufacturing information
10-7
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Drug Name
Generic Name
Official name
Used for national listings
United States Pharmacopeia (USP)
National Formulary (NF)
Levothyroxine Sodium (generic name)
Levothyroxine Sodium (generic name)
10-8
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Drug Name (cont.)
Trade Name Brand name
Used to market the drug
Property of drug company – Registered
mark ®
Synthroid
(trade name)
Synthroid
(trade name)
10-9
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Drug Name (cont.)
Rule 10-1Rule 10-1You must know both the generic and trade
names of drugs.
ExampleExample Vicodin® is a narcotic painkiller.
Generic name: hydrocodone bitartrate and acetaminophen
Other trade names: Anexsia®, Lortab®, Zydone®
10-10
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
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
10-11
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Dosage Strength
Dosage strength is the amount of drug present per dosage unit or form of the drug.
Labels include information about the amount of drug present.
10-12
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Dosage Strength (cont.)
Solid medications The dosage strength is the amount of drug
present per tablet, capsule, or other form.
Dosage strength2.5mg/1 tab
Dosage strength2.5mg/1 tab
10-13
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Dosage Strength (cont.)
Liquid medications The dosage strength is the amount of drug
present in a quantity of solution.
Medications are manufactured with dosage strengths that match commonly prescribed doses.
10-14
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Combination Drugs
If available, the trade name may be used to order combination drugs.
Generic names and dosage strengths of all components must appear on the label.
10-15
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Total Number or Volume in Container
Many meds are packaged in unit doses.
10-16
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Total Number or Volume in Container
Multiple-dose containers Prescription medications Non-prescription medications
10-17
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Total Number or Volume (cont.)
Rule 10-2 Rule 10-2
Do not confuse the total amount of drug in the container with the dosage strength.
10-18
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Total Number or Volume (cont.)
ExampleExample
This container holds 100 tablets, and each tablet has a dosage strength of 5 mg per tablet.
This container holds 100 tablets, and each tablet has a dosage strength of 5 mg per tablet.
10-19
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Route of Administration Directions may be on the label
Tablets, capsules, gelcaps, caplets Swallowable Sublingual Chewable
Liquid medications Oral Injectable
Inhalants Topical /
transdermal medications
10-20
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Error Alert!
Read the label carefully!
Do not administer drugs by any route other than as described in the drug label or on the order.
10-21
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Warnings
Warnings help to administer drugs safely.
There are many types of warnings. Dispensing recommendations
For specific groups, i.e. children, pregnant women
For controlled substances
About combining with other drugs or products
10-22
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Warnings (cont.)
10-23
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Warnings (cont.)
Disposal – follow facility guidelines
10-24
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Storage Information
Proper storage helps maintain the drug’s potency and effectiveness.
Storage information on the label may include directions about:
storage temperature;
exposure to light; length of time the drug will remain potent after the container
has been opened or reconstituted.
10-25
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Storage Information (cont.)
10-26
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Manufacturing Information
Labels Regulated by the U.S. Food and Drug
Administration (FDA)
Must include: Name of the manufacturer Expiration date (EXP) Lot number Bar codes
10-27
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Manufacturing Information (cont.)
10-28
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Manufacturing Information (cont.)
Rule 10-3Rule 10-3 Never use a drug after the expiration
date has passed.
Older drugs may become chemically unstable or altered.
Patients should be educated to check expiration dates.
10-29
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Information About Reconstituting Drugs
Powder forms must be reconstituted.
Other drugs require dilution.
10-30
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Information About Reconstituting Drugs (cont.)
Directions for reconstituting or diluting are on the label. These include:
type and amount of diluent;
solution strength once reconstituted;
time period for safe administration.
10-31
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Information About Reconstituting Drugs (cont.)
10-32
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Error Alert!
Consider the age and health needs of the patient when administering a drug.
10-33
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Package Inserts
Provide complete and authoritative information about a medication
Include a number of sections
Description -- chemical and physical
Clinical Pharmacology -- actions of the drug
Indications and Usage
10-34
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Package Inserts (cont.)
Contraindications
Warnings – serious side effects
Precautions
Adverse Reactions – anticipated side effects
10-35
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Package Inserts (cont.)
Overdosage
Dosage and Administration
Preparation for Administration
Manufacturer Supply
10-36
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
PracticeWhat is the generic name of the drug?
At 25°C (77°F) excursions permitted to 15-30°C (59-86°F)
50 mg/1 capsule
What is the dosage strength?
How should this drug be stored?
celecoxib
10-37
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Label Information Related to Medication Routes
Labels include unique information related to administration route.
Read labels carefully when: calculating doses; administering medications; dispensing medications.
10-38
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Medications
Oral medications come in solid or liquid forms.
Tablets Scored
Chewable
Enteric-coated
10-39
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Medications Capsules
A gelatin shell holds the drug. Some should be swallowed whole. Others may be opened and mixed with food.
Controlled-release medications Usually swallowed whole
10-40
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Drugs (cont.)
Rule 10-4 Rule 10-4
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)
10-41
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Medications (cont.)
Liquids
Oral solutions
Syrups
Elixirs
Oral suspensions
Liquids
Dosage strength corresponds to a specific volume of the solution –
500 mg / 10 mL
10-42
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Medications (cont.)
Rule 10-5Rule 10-5
When reconstituting a drug, you must write your initials and the time and date of reconstitution on the label.
shf 7/21/08 @ 1400
shf 7/21/08 @ 1400
10-43
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Oral Medications (cont.)
Measured by
Droppers
Calibrated spoons
Medicine cups
Oral syringes
10-44
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Patient Education Check for language barriers.
Make sure patient/caregiver can read and understand the label.
Check for drug allergies.
Review dose, frequency, and length of time drug is to be taken.
10-45
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Patient Education
Review special instructions.
Describe adverse effects.
Refer to label as needed.
10-46
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Practice
Skelaxin®
1 tablet tid
What is the trade name of the drug?
What is the usual dosage?
What is the dosage strength?
800 mg/1 tablet
10-47
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Packaged as Single-use ampules or vials Single-use prefilled syringes Multi-use vials
Small containers have small labels Limited space Some information printed on package insert
Parenteral Medications
10-48
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Parenteral Drugs (cont.)
Routes Intradermal (ID)
Intramuscular (IM)
Intravenous (IV)
Subcutaneous (Subcut)
Inhalant
Transdermal
10-49
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Parenteral Medications (cont.)
Dosage strength is the amount of drug per dosage unit.
10-50
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Insulin labels Origin of insulin Onset of action
Parenteral Medications (cont.)
10-51
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Practice
20 mg/2 mL
Furosemide
What is the dosage strength of the drug?
What is the drug’s name?
What is the route of administration?
IM or IV
10-52
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Medications Administered by Other Routes
Sublingual (under the tongue)
Buccal (between the tongue and cheek)
Rectal
Vaginal
Topical
Otic or Ophthalmic
Transdermal
Inhalant
10-53
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Drugs Administered by Other Routes (cont.)
Dosage strength varies with type of drug and how it is administered.
10-54
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
In Summary
In this chapter you learned to
differentiate information on a drug label and on a package insert.
10-55
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
In Summary (cont.)
distinguish administration routes for medications.
10-56
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Apply Your Knowledge
1. What is another name for the brand name?
2. What is the official name of a drug?
ANSWER: trade name
ANSWER: generic name
10-57
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Apply Your KnowledgeTrue 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 include transdermal and inhalant drugs.
T
F
F
This would allow the drug to be absorbed sooner than intended.
Some capsules should be swallowed whole.
10-58
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
Apply Your KnowledgeTrue 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.
T
F
It may not provide correct dosage strength or may have an effect different than intended.
10-59
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
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.
F
You must follow the directions for reconstituting a drug that are on the label or in the package insert.
T
10-60
© 2012 The McGraw-Hill Companies, Inc. All rights reserved.
End of Chapter 10
Read in order
to live.
-Henry Fielding