Slide 1

Slide 2

+ Pharmacy Technician Math Module

Slide 3

+ Calculate the Dosage Hi, my name is Ashia; I am a pharmacy technician. Ashia is a pharmacy technician at a local hospital. She works part time to support her family and provide health insurance coverage for her family. She prefers to work evenings when her husband can assist her by watching their two children.

Slide 4

+ Focus The focus of this math strand is for you to be able to figure out the amount of medication, in the proper form, to fill a prescription ordered by a doctor. In this math strand, you will be learning and reviewing the following math skills: 1) Applying medical abbreviations to math solutions 2) Using a formula to calculate dosage 3) Adding 4) Multiplying 5) Dividing 6) Sorting necessary and unnecessary information to solve a word problem 7) Noting key math words or phrases to solve math problems such as simplify an expression and per as in 5 milligrams per milliliter 8) Reading drug labels 9) Applying the standard formulas used in health care

Slide 5

+ Calculating Dosage On the evening shift,Ashiasupports the nursing staff at the hospital by calculating medical dosages and providing the medicine in measured doses to the nursing staff. To do this, Ashia relies on some basic knowledge about medications.

Slide 6

+ Calculating Dosage The dose is located directly after the name of the medication. This is the individual dose that the doctor is ordering. The total medication order covers a certain period of time such as: take for 7 days, take for 10 days, or take daily. Look at the doctors prescriptions and consider the following questions: Phone 360-293-9999DEA# 23476512 Angela Truong, MD Pediatrician Pt. name Thi Tran Age 12 Date May 1, 2008 Address: 234 7th Avenue, Anacortes, WA 98221 R X Ceclor 10 mL bid X 10 d Refill _ 0 _ _ X _Generic and/orequivalent allowed Physicians Signature Angela Truong Anacortes Pediatric Medical Office 23453 Mall Blvd. Anacortes, WA 98221

Slide 7

+ Questions 1) What is the drug name on the prescription? Click Here 2) What is the individual drug dosage? Click Here 3) How many times a day is this medication to be given? Click Here Ceclor 10 milliliters twice a day For 10 days

Slide 8

+ Listen Listen and read along as Aisha defines medical order and prescription. Did you know that a medical order or medication order is a drug order written in a hospital, nursing home, or recovery center for a patient? A prescription is a drug order that is written in an office or clinic or for a client or patient being discharged. Licensed medical personnel like physicians, nurse practitioners, and other certified practitioners are allowed under state law to write medical orders and prescriptions.

Slide 9

+ Task One: Reading the Doctors Prescription A doctor writes a prescription or drug orders for patients. Again, a prescription is a written medication order for a patient leaving a medical facility. A medical order is used in a hospital or care facility. For example, a patient in the hospital may have a change in medication or need to have an increase or decrease in the amount of medication. Both of these medical prescriptions follow a similar format and include the essential information that the pharmacy technician or other licensed health care workers will use to fill the order. Please note that the paper forms of prescriptions and medical orders do not all look the same; however, the information is the same. This information may be in a different location on the form.

Slide 10

+ Stop! Safety Alert: A pharmacy technician may fill the drug order and work under the supervision of the pharmacist. The pharmacist will check and verify the accuracy of each filled prescription before handing it to the patient or client.

Slide 11

+ Format Look at the general format of a prescription. Do you ever look carefully at your prescription before you hand it to the pharmacist or pharmacy technician to fill? You should so that you know what medicine you are getting and the amount. You can also ask the pharmacist questions about what the doctor has prescribed. The job of a pharmacy technician requires careful reading. You need to read the prescription carefully to understand the medication ordered and then compare this drug order to the supply available on the pharmacy shelves. _Phone_#_________ -DEA# 123456878 Thelma Cook, MD 2332 Medical Way Renton, WA 98056 Pt. Name: ______________________ Age:__________ Address:______________________________________ R X: ___________________________________________________________________ Refill: _____________ __________Generic and/or equivalent allowed ___________________________________Date______ Physicians Signature

Slide 12

+ Format As a pharmacy technician, you need to read the prescription carefully; otherwise, you may not select the correct medicine to fill the bottle. This is especially true because many medications have similar names and often times a particular medication comes in several forms. The form of medication must match the route, or way, that the medication will be taken. For example, an elixir is a liquid and easily swallowed by a young child. An older adult may take the medication in tablet or capsule form. As a patient, you should check the number and type of medicine you get from the pharmacy to make sure that it matches what the doctor ordered.

Slide 13

+ Think About It! What information is included on the prescription? Why do you think that this information is important to the pharmacist? Advance to the next screen for the answers.

Slide 14

+ Answers The prescription contains: a)The patients or clients full name b)The date c)The drug name d)The doctors order for dosage amount (how much medication) e)The administration route (by mouth, IV, injection) f)The frequency with which the patient is to take the medication g)The duration, the number of days that the patient is to take the medication h)The quantity or amount that the pharmacist is to dispense. i)A check off or box allowing a substitute j)The physicians signature k)The physicians DEA number (United States Drug Enforcement Agency registration number) if the medication is a controlled substance such as morphine or codeine

Slide 15

+ Answers The medical community requires that all prescriptions contain certain information. This is to avoid making medical errors. Again, the information is not required to be in the same format or placed in the same area on the prescription form. Thus, there is no single form for medical orders and prescriptions.

Slide 16

+ Contents of a Prescription Here are the eleven items of a prescription: a)The patients or clients full name b)The date c)The drug name d)The doctors order for dosage amount (how much medication) e)The administration route (by mouth, IV, injection) f)The frequency with which the patient is to take the medication g)The duration, the number of days that the patient is to take the medication h)The quantity or amount that the pharmacist is to dispense. i)A check off or box allowing a substitute j)The physicians signature k)The physicians DEA number (United States Drug Enforcement Agency registration number) if the medication is a controlled substance such as morphine or codeine

Slide 17

+ Example Can you locate all eleven parts of the prescription? Phone 425-235-9999 DEA# 123456878 Thelma Cook, MD Pt. name Bruce Brown Age 50 Date April 29, 2008 Address: 12347 NE 2nd Street, Seattle, WA 98432 R X Darvon 1 g tab. p.o.q4 h.for 3 days Refill _ 0 _ ___Generic and/or equivalent allowed Physicians Signature ________________ Thelma Cook Sweet Meadow Medical Office 546 North Street Seattle, WA 98045

Slide 18

+ Practice Print, and fill in the chart with the information from the prescription: The patients or clients full name The date The drug name in manufacturer or generic format The doctors order for dosage amount (how much medication) The administration route (by mouth, IV, injection) The frequency with which the patient is to take the medication The duration, the number of days that the patient is to take the medication The total quantity or amount that the pharmacist is to dispense A check off or box allowing a generic substitute The physicians signature The physicians DEA number

Slide 19

+ Answers The patients or clients full nameBruce Brown The dateApril 29, 2008 The drug name in manufacturer or generic formatDarvon The doctors order for dosage amount (how much medication)1 gram The administration route (by mouth, IV, injection)Orally, by mouth The frequency with which the patient is to take the medicationEvery 4 hours The duration, the number of days that the patient is to take the medication For 3 days The total quantity or amount that the pharmacist is to dispense 4 hrs x 6 times a day x 3 days =72 tablets A check off or box allowing a generic substituteNo The physicians signatureThelma Cook The physicians DEA number123456878

Slide 20

+ Practice Practice locating the eleven parts of the medical order or prescription. Complete your chart, and then compare it with the answers on the next screen. Phone 360-456-9999DEA# 44567823 Buck Sawyer, MD Pediatrician Pt. name Sammie Smith Age 12 Date May 1, 2008 Address: 546 4th Avenue, Everett, WA 99876 R X Loratidine 5 mg tabletsqd X 5 d Refill 1_ _ X _Generic and/or equivalent allowed Physicians Signature ________________ Buck Sawyer Everett Pediatric Medical Office 23453 Mall Blvd. Everett, WA 99876 Phone 360-456-9999DEA# 44567823 Buck Sawyer, MD Pediatrician Pt. name Sammie Smith Age 12 Date May 1, 2008 Address: 546 4th Avenue, Everett, WA 99876 R X Loratidine 5 mg tabletsqd X 5 d Refill 1_ _ X _Generic and/or equivalent allowed Physicians Signature ________________ Buck Sawyer Everett Pediatric Medical Office 23453 Mall Blvd. Everett, WA 99876

Slide 21

+ Answers The patients or clients full nameSammie Smith The dateMay 1, 2008 The drug name in manufacturer or generic formatLoratidine The doctors order for dosage amount (how much medication)5 mg The administration route (by mouth, IV, injection)oral by mouth The frequency with which the patient is to take the medicationqd-every day The duration, the number of days that the patient is to take the medication X 5 d, daily for 5 days The total quantity or amount that the pharmacist is to dispense 5 tablets A check off or box allowing a generic substituteYes, it is checked, so a generic may be used. The physicians signatureBuck Sawyer The physicians DEA number44567823

Slide 22

+ Practice Read the prescription and then complete the chart below, complete your chart, and then compare it with the answers on the next screen. Phone 206-777-9999DEA# 98072653 Yu Thi Nguyen, MD Gerontology Pt. name Ethyl Bonker Age 98 Date May 5, 2008 Address: 234 Madison Ave E., Seattle, 98021 R X acetaminophen 650 mg. tablets po. q 4h x 5 d Refill _ 2 _ _ _Generic and/or equivalent allowed Physicians Signature ________________ NguyenYuThi Capitol Hill Senior Medical Center, 3000 Broadway N., Seattle, WA 98045

Slide 23

+ Answers The patients or clients full nameEthyl Bonker The dateMay 5, 2008 The drug name in manufacturer or generic formatacetaminophen The doctors order for dosage amount (how much medication)650 mg. The administration route (by mouth, IV, injection)po., by mouth or orally The frequency with which the patient is to take the medicationq 4h, every 4 hours The duration, the number of days that the patient is to take the medication 5 days The total quantity or amount that the pharmacist is to dispense Every 4 hours x 6 times a day x 5 days= 120 tablets A check off or box allowing a generic substituteno The physicians signatureNguyenYuThi The physicians DEA number98072653

Slide 24

+ Practice Read the prescription and then complete the chart below, complete your chart, and then compare it with the answers on the next screen. Phone 206-333-8888DEA# 34455667 Pt. name Mohamed Soma Age 32 Address: 23234 Ballard Ave E., Seattle, 98567 R X Pencillin-G 2 million U IM qid X 7 d Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Aretha Arnold, MD Date May 2, 2008 Aretha Arnold, MD Infection Specialist North Central Medical Center, 23 Antioch Way N., Seattle, WA 98655

Slide 25

+ Answers The patients or clients full nameMohamed Soma The dateMay 2, 2008 The drug name in manufacturer or generic formatPencillin-G The doctors order for dosage amount (how much medication)2 million U- 2 million units The administration route (by mouth, IV, injection)IM intramuscular, injection The frequency with which the patient is to take the medicationqid The duration, the number of days that the patient is to take the medication 7 days The total quantity or amount that the pharmacist is to dispense 56 million units A check off or box allowing a generic substituteno The physicians signatureAretha Arnold The physicians DEA number34455667

Slide 26

+ Tablets Listen and read along as Aisha discusses scored tablets. Did you know that only tablets that are scored may be split in half? What is a scored tablet? A tablet that is scored has a cut where it may be divided. It is important to know that the only scored tablets are divided along the score line to ensure an even distribution of medication. Enteric-coated tablets, those tablets with a special coating over the medicine, are not divided because they are coated with a special substance that allows them to dissolve in the intestines instead of the stomach. Dividing a tablet also impacts its absorption. Capsules (two-part soft tablets) and suppositories (medicine capsules inserted into the rectum) are never divided because the medicine needs to remain coated when it enters the body and even distribution of medication may be a problem scored tablet

Slide 27

+ Practice 1. Scored tabletA. dry weight of a medication 2. CapsuleB. liquid or syrup 3. SuppositoryC. a tablet that is able to be divided. 4. ElixirD. a two-part tablet with soft outer shell 5. mgE. medication inserted rectally M atch the terms,Click Here to see the correct answers 1. C 2. D 3. E 4. B 5. A

Slide 28

+ Think About It! Why do some drugs come in different forms? How do you know what form it comes in? Advance to the next screen for the answers.

Slide 29

+ Answers Drugs come in different forms because there are many different kinds of patients. For example, babies do not swallow tablets so there are injections, liquids, and suppositories. Adults can swallow tablets and capsules. Also, different administration routes have different absorption rates, or the medicine form determines how quickly it will become effective. For example, a tablet takes longer to work in the body than an injection. An injection goes into blood stream quicker. A tablet must be absorbed through the stomach and that takes time. Read the prescription or medical order. Note that g or mg or mcg is a dry weight and so these are tablets, capsules or suppositories. Milliliters and units (a special unit of measure used in medicine) are volume or liquid measures, which could be elixirs or injections.

Slide 30

+ Task Two: Understanding the Parts of the Dosage Formula The dosage formula has four parts. We use this formula to translate a doctors order so that a pharmacy technician can calculate an individual dose for a patient. Doctors Order Supply on Hand x quantity = dosage to be administered

Slide 31

+ Think About It! Why would a formula assist a pharmacy technician to calculate a drug dosage? Click Here Do you think that a formula can help sort out the parts of a word problem? Click Here A formula is an agreed upon method of calculating dosages in the same way so that the dosages are equivalent (or equal). Yes, because the quantities represented in the formula go in the same place in the math equation. Pharmacy technicians learn how to read the prescriptions and substitute the information into the dosage formula.

Slide 32

+ Dosage Formula Lets look at the parts of the dosage formula.

Slide 33

+ Dosage Formula Lets look more closely at the parts of the dosage formula. InformationWhere is it located? What is the format for the information? Doctors OrderThis information is on the prescription or in the medical chart of the patient. The information will be in grams(g), grains(gr), teaspoon(t), milliliter(mL)or other medication format. Supply on handOn the pharmacy shelves, in a locked area for controlled medications, in the refrigerator of the pharmacy. The information will be on the drugs label. The information will be in grams(g), grains(gr), teaspoon(t), milliliter(mL)or other medication format. QuantityThis is the information from the drug label and the information from the prescription. The information will be in grams(g), grains(gr), teaspoon(t), milliliter(mL)or other medication format.

Slide 34

+ Dosage Formula Another part of the prescription to know about is the medical terms used to detail the doctors order. To calculate an individual drug dosage, we use a formula. Patients have individual dosages and daily doses. The formula is used to calculate an individual or one time dose. The daily dose has to do with the frequency of a dose. qd = every dayevery 8 hours bid = twice a dayat hs = hour of sleep tid= three times a dayprn = as needed qid = four times daily

Slide 35

+ Dosage Formula Note that time does not play a role in calculating the individual dose. The factors are the doctors order for an amount of drug, the form of the medication available in the pharmacy, and the form of the medication (tablet, capsule, mL).

Slide 36

+ Units of Measure Aisha is often asked to describe how much a gram, milligram, and a microgram weigh. She shows the clients this chart to show the relationship among these common metric units of measure. KilogramGramMilligram 2.2 pound pineapple a medium paperclip 60 grains of salt

Slide 37

+ Stop! In the metric system, the answers will be either whole numbers or decimals. No fractions are used in the metric system. For example: 2.75 grams or 1.2 milliliters or 0.5 micrograms. Also, any decimal number that is not greater than 1 has a 0 in front. So the correct form is 0.8 mL instead of.8 mL.

Slide 38

+ Units of Measure AbbreviationTermFormat/Explanation mgMilligramDry weight measure used in tablets mLMilliliterLiquid volume measure in liquids grGrainsDry weight of medication ggramDry weight measure used in tablets IMIntramuscular UUnitsA measure for penicillin and insulin qevery ddayConsidered to be 24 hours hhour poorallyBy mouth

Slide 39

+ Practice Practice matching the medication forms. Click Here 1. qidA. by mouth or orally 2. hsB. liquid or syrup 3. bidC. every day 4. gD. three times a day 5. mgE. medication inserted rectally 6. poF. milligram 7. qdG. four times a day 8. grH. at the hour of sleep; bedtime 9. UI. twice a day 10. tidJ. gram 11. Elix.K. grain 12. Supp.L. Unit 1. G 2. H 3. I 4. J 5. F 6. A 7. C 8. K 9. L 10. D 11. B 12. E

Slide 40

+ Practice Use the formula to practice substituting the information from the prescription into the formula. dd hh x q = individual drug dose Doctors Order Supply on Hand x quantity = dosage to be administered

Slide 41

+ Stop! Safety Alert: The quantity is important to know because it leads the pharmacy technician to the correct form or unit of measure for a specific drug. In other words, if the quantity (q) is a tablet, the individual dose will be in tablets. If the quantity is in milliliters, the pharmacy technician knows that the medication is in liquid form. Including the quantity in the formula, helps ensure proper form of the medication. Young children would take medication in a liquid form while adults may take a tablet or capsule.

Slide 42

+ Task Lets put Aishas task together and see the medication vial and the prescription and learn how they are the tools of the pharmacy technician. Rx: Doctor Sheila Smith orders 30 mg of Augmentin for his patient. Ashia, a pharmacy technician, looks at the drug label and discovers that the medicine is supplied in 60 milligrams per tablet. 60 mg R X 30 mg Augmentin Dr. Sheila Smith 4/6/08

Slide 43

+ Practice Practice setting up the problems. Do not work the problems yet. (d) 30 mg x (q) 1 tablet = drug dose (h) 60 mg 1) Order: 500 mg Supply on hand:250 mg per tablet x = drug dose Click Here 2) Order: 1000 mg Supply on hand:2000 mg per scored tablet x = drug dose Click Here (d) 500mg x (q)1 tablet = drug dose (h) 250mg (d) 1000mg x (q)1 tablet = drug dose (h) 2000mg

Slide 44

+ Practice 3) Order: 1 g Supply on hand:12. gr per capsule x = drug dose Click Here 4) Order: 50 mg Supply on hand:25mg per 5 mL x = drug dose Click Here 5) Order: 500 mg Supply on hand:125mg per caplet x = drug dose Click Here (d) 1gr x (q)1 capsule= drug dose (h) gr (d) 50mg x (q) 5mL= drug dose (h) 25mg (d) 500mg x (q) 1 caplet= drug dose (h) 125mg

Slide 45

+ Task Three: Calculating the Dosage Formula To calculate a doctors drug order (how much medication is needed for an individual dose), we use a formula. Review: Remember that the fraction bar means to divide. Doctors Order Supply on Hand x quantity = dosage to be administered

Slide 46

+ Methods There are two ways to look at calculating this formula. Method 1: Multiply d (doctors order) times q (format of the medicine on hand) then divide the result by h (supply on hand). The doctor orders 250 mg of a medication. Aisha has the medication in 125 mg per capsule in her pharmacys supplies. 250mg 125mg x 1 capsule = _________ a) 250 x 1 = 250 b)250 125 = 2 Thus, the answer is 2 capsules, but it is a bad habit to get into, if it wasnt a 1 in the quantity youd get an incorrect answer.

Slide 47

+ Methods Method 2: Divide d (the doctors order, the numerator, or top number) by h (the supply on hand, the denominator, or bottom number) then multiply by q (the format of the medicine on hand). The doctor orders 250 mg of a medication. Aisha has the medication in 125 mg per capsule in her pharmacys supplies. 250mg 125mg x 1 capsule = _________ a) 250125 = 2 b) 2 x 1 =2 Thus, the answer is 2 capsules.

Slide 48

+ Simplify One of the things to consider is the possibility of simplifying the expression before multiplying or dividing. For example, Aisha filled this prescription earlier in the day. The doctor order 100 milligrams of a medication. The drug was available in 25 milligrams per 5 milliliters. 100mg 25mg x 5 milliliters = _________ 100mg 100mg 25mg x 5 milliliters = 5 mg x 1milliliters = 100 5 = 20 Thus, the answer is 20. Notice since 5 divides evenly into 25, Aisha simplifies the expression before multiplying or dividing.

Slide 49

+ Practice Practice simplifying expressions to be ready to work with Aisha. 1) 25mg 100 mg x 20 milliliters = Click Here 2) 5mg 32mg x 8 milliliters = Click Here 3) 500mg 50 mg x 2 milliliters = Click Here 4) 75mg 5mg x 20 milliliters = Click Here 5) 25mg 100mg x 5 milliliters = Click Here 6) 5mg 100mg x 20 milliliters = Click Here 5 mL 1.25 mL 20 mL 300mL 1.25 mL 31 mL

Slide 50

+ Practice Aisha needs to fill the following drug orders for the evening shift nurses. Assist her in the set up and the solutions of each medical order. 1) Ampillicin 500 mg p.o. qid X 5 d. Dosage available: 250 mg capsules. Click Here ______________ x __________ = ____________ 2) Ordered Clondine 0.4 mg p.o. bid X 3 d. Dosage available: 0.1 mg tablets. Click Here ______________ x __________ = ____________ 2 capsules 4 tablets

Slide 51

+ Practice 3) Prescribed: Tigan 200 mg IM q 8 h x 4 d for nausea. On hand: Single use vials 100mg/1mL. Click Here ______________ x __________ = ____________ 4) Give: Digoxin elixir 150 mcg stat p.o. Dosage available: 50 mcg/mL. Click Here ______________ x __________ = ____________ 5) Ordered: Codeine sulfate 60 mg p.o. q 4 h until further notice. Dosage available: 30 mg tablets. Click Here ______________ x __________ = ____________ 2 milliliters or 2 mL 3 milliliters or 3 mL 2 tablets

Slide 52

+ Practice Put the pieces together to complete the following medication orders as Aisha would. Read the prescription, and look at the medication bottle. Then use the dosage formula (d/h x q) to calculate the drug order. 1. Phone 206-344-8888 DEA# 98098766 Bertha Bolls, MD Pt. name KumiKaur Age 30 Date May 1, 2008 Address: 2349 Busy Ave E., Seattle, 98567 R X Lasik40 mg p.o. q 12 h x 4 d Refill _ 0 _ _Generic and/or equivalent allowed Physicians Signature Bertha Bolls, MD South Central Medical Center, 34 Burlington Way N., Seattle, WA 98655 Phone 206-344-8888 DEA# 98098766 Bertha Bolls, MD Pt. name KumiKaur Age 30 Date May 1, 2008 Address: 2349 Busy Ave E., Seattle, 98567 R X Lasik40 mg p.o. q 12 h x 4 d Refill _ 0 _ _Generic and/or equivalent allowed Physicians Signature Bertha Bolls, MD South Central Medical Center, 34 Burlington Way N., Seattle, WA 98655

Slide 53

+ Practice Supply on Hand Set up your formula:x= The patient will receiveeach dose. Click Here Lasix 20 mg tablets 2 tablets

Slide 54

+ Practice Read the prescription, look at the vial, then calculate the drug order. Phone 206-355-9999DEA# 45632144 Richard Smalls, MD Pt. name Brenda Guiliani Age 44 Date May 1, 2008 Address: 65 Lake Drive E., Seattle, 98567 R X Ampicillin 250 mg p.o.qid x 10 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Richard Smalls, MD Mid Central Medical Center, 64 Booth Garnder Way N., Seattle, WA 98655 Phone 206-355-9999DEA# 45632144 Richard Smalls, MD Pt. name Brenda Guiliani Age 44 Date May 1, 2008 Address: 65 Lake Drive E., Seattle, 98567 R X Ampicillin 250 mg p.o.qid x 10 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Richard Smalls, MD Mid Central Medical Center, 64 Booth Garnder Way N., Seattle, WA 98655 Ampicillin 125 mg capsules

Slide 55

+ Answer Set up your formula:x= The patient will receiveeach dose. Click Here 2 capsules

Slide 56

+ Practice Read the prescription, look at the vial, then calculate the drug order. Phone 206-888-9999DEA# 546565651 Wing Hu Chi, MD Pt. name Elsa Bridges Age 23 Date May 7, 2008 Address: 45 Riveria Way, Seattle, 98567 R X Ampicillintrihydrate 250 mg p.o. qid x 10 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Wing Hu Chi, MD Lake View Medical Center, 54 Sealth Blvd. N., Seattle, WA 98655 Phone 206-888-9999DEA# 546565651 Wing Hu Chi, MD Pt. name Elsa Bridges Age 23 Date May 7, 2008 Address: 45 Riveria Way, Seattle, 98567 R X Ampicillintrihydrate 250 mg p.o. qid x 10 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Wing Hu Chi, MD Lake View Medical Center, 54 Sealth Blvd. N., Seattle, WA 98655 Ampicillintrihydrate 125 mg in 5 mL of syrup

Slide 57

+ Answer Set up your formula:x= The patient will receiveeach dose. Click Here 10 milliliters or 10 mL

Slide 58

+ Task Four: Calculate daily doses and beyond When Aisha is not filling individual medical orders, she often has a stack of other prescriptions to fill for her supervising pharmacist. She must prepare these for him to review for accuracy before they are bagged and binned for the customers to pick up at the pharmacy. To do this she must correctly interpret the prescriptions, duration, and/or the number of individual doses that the doctor has ordered. This relies on her skills in addition and multiplication as well as her ability to read the prescription.

Slide 59

+ Think About It! Why would a pharmacy technician need to be able to calculate a full prescription dosage? Click Here Do you think that multiplication is the most efficient means to solve this problem? Click Here To fill the complete prescriptions for clients. For example, clients do not go to the pharmacy on a daily basis. They go once to get the complete order filled. Yes, multiplication is usually faster than adding the number over and over.

Slide 60

+ Review Lets review an earlier prescription: Phone 206-333-8888DEA# 34455667 Pt. name Mohamed Soma Age 32 Address: 23234 Ballard Ave E., Seattle, 98567 R X Pencillin-G 2 million U IM qid X 7 d Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature Aretha Arnold, MD Date May 2, 2008 Aretha Arnold, MD Infection Specialist North Central Medical Center, 23 Antioch Way N., Seattle, WA 98655 The key to filling this prescription for the patient is to read the line: Penicillin-G 2 million U IM quid x 7 d.

Slide 61

+ Review Penicillin-G 2 million U IM quid x 7 d. This translates to 2 million units 4 times a day x 7 days. So to figure out the daily dosage: a) 2 million units x 4 = 8 million units b) To figure out 7 days dosage, multiply 8 million units x 7 days. For 7 days supply, the pharmacy must have on hand 56 million units of Penicillin-G.

Slide 62

+ Practice Help Aisha calculate the daily and the total prescription by days. Advance to the next screen for the answers. Doctors orderAvailable SupplyIndividual Dose Total dose to fill the complete prescription Give Ciprofloxin 750 mg1 tab po a day for 10 d 500 mg scored tablets Give MedXZ 300 mg bid x 14 d MedXZ 200 mg/5 ml Give Amoxicillin 500 mg capsule potid x 10 d 500 mg/1 capsule Order reads: Prednisone 40 mg po bid x 3d Prednisone 10 mg tab PenVK 250mg po qid x 10 d PenVK 250mg/1 tsp

Slide 63

+ Answers Doctors orderAvailable SupplyIndividual Dose Total dose to fill the complete prescription Give Ciprofloxin 750 mg1 tab po a day for 10 d 500 mg scored tablets 1 tablets 750mg 500mg x 1 tab 15 tablets 1 x 10 Give MedXZ 300 mg bid x 14 d MedXZ 200 mg/5 ml 7.5 milliliters 300mg 200mg x 1 tab 210 milliliters 7.5 x 2 x 14 Give Amoxicillin 500 mg capsule potid x 10 d 500 mg/1 capsule 1 capsule 500mg 500mg x 1 cap 30 capsules 1 x 3 x10 Order reads: Prednisone 40 mg po bid x 3d Prednisone 10 mg tab 4 tablets 40mg 10mg x 1 tab 24 tablets 4 x 2 x 3 PenVK 250mg poqid x 10 d PenVK 250mg/1 tsp 1 teaspoon 250mg 250mg x 1 tsp 40 teaspoons 1 x 4 x 10

Slide 64

+ Key Math Concepts 1) Using a formula to calculate dosage 2) Addition 3) Multiplication 4) Division 5) Apply the standard forms used in health care 6) Sorting needed information from extra information in a word problem

Slide 65

+ Math Vocabulary Calculate Simplify an expression Per Divide Formula Fraction Gram Milligram Multiply Milliliter

Slide 66

+ Quiz: Calculating Drug Dosage 1) The doctor has ordered Zyloprim 0.25 g twice a day. The pharmacy has on hand: Zyloprim 0.1 g scored tablets. The patient will receive the following individual dose:_________________________ Click Here 2) Order:75 milligrams of medication x Available:25 milligrams in 2 milliliters Give:Click Here 3) Give Dilaudid1.5 milligram IM from a vial that is labeled 0.6 milligrams per milliliter. Give Click Here 4) Order: Zocor 40 milligrams; On hand: Zocar 20 milligrams per tablet. Give Click Here 2 tablets 6 milliliters or 6 mL 2.5 milliliters or 2.5 mL 2 tablets

Slide 67

+ Quiz 5) Dr. Mix prescribes Procardia XL 60 milligrams once daily. The drug on hand is Procardia XL 30milligram tablets. The patient will receive _________________________ Click Here 6) The physician orders Plendil 7.5 mg once a day in the morning. The drug label reads: Plendil (felodipine) 2.5 mg tab. Give Click Here 7) The doctors order is for 20 milligrams of a medication. You have 10 milligrams per 5 milliliters. The dosage to be administered is Click Here 8) Order: 1.25 milligrams of a medication. On hand is 0.25 milligrams in 5 milliliters of the medication. Give Click Here 2 tablets 3 tablets 10 milliliters or 10 mL 25 milliliters or 25 mL

Slide 68

+ Quiz 9) The pharmacy has 15 milligram tablets on the shelf. Dr. Smith orders 30 milligrams of Phenobarbital. The patient will receive _________________________ Click Here 10) Read the prescription, look at the vial, and calculate the drug order. 2 tablets Phone 206-888-9999DEA# 54699999 Mori Chisata, MD Pt. name Tommy Smart Age 22 Date May 5, 2008 Address: 23 Roosevelt Way, Seattle, WA 98567 R X Neurontin 375 mg p.o. tid x 7 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature MoriChisata, MD Lake View Medical Center, 125 Bridge Blvd. S., Seattle, WA 98655 Phone 206-888-9999DEA# 54699999 Mori Chisata, MD Pt. name Tommy Smart Age 22 Date May 5, 2008 Address: 23 Roosevelt Way, Seattle, WA 98567 R X Neurontin 375 mg p.o. tid x 7 days Refill _ 0 _ _ _Generic and/or equivalent allowed Physicians Signature MoriChisata, MD Lake View Medical Center, 125 Bridge Blvd. S., Seattle, WA 98655

Slide 69

+ Quiz 10) cont. Set up your formula: ______________ x __________ = ____________ The individual dose. A seven-day supply will be. Click Here Supply on Hand 7.5 milliliters or 7.5 mL 157.5 milliliters or 157.5 mL

Slide 70

+ Congratulations! You have completed the Math Module.