who guide to good prescribing annex 3

7/23/2019 WHO Guide to Good Prescribing ANNEX 3

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http://apps.who.int/medicinedocs/en/d/Jwhozip23e/7.3.html

Guide to Good Prescribing - A Practical Manual

(1994; 115 pages)

a!le o" #ontents

$c%nowledgments

&h' 'o need this !oo%

a*t 1: +,e*,iew

a*t 2: -electing 'o* (e*sonal) d*gs

a*t 3: *eating 'o* patients

a*t 4: eeping ptodate

$nne0es

$nne0 1: ssentials o" pha*macolog' in dail' p*actice

$nne0 2: ssential *e"e*ences

Annex 3: How to explain the use of some dosage forms

##- 1. 'e d*ops

##- 2. 'e ointment

##- 3. a* d*ops

##- 4. asal d*ops

##- 5. asal sp*a'

##- 6. *ansde*mal patch

##- 7. $e*osol

##- . nhale* with capsles

##- 9. -pposito*'

##- 18. aginal ta!let with applicato*

##- 11. aginal ta!let withot applicato*

##- 12. $ppl'ing ,aginal c*eams ointments and gels

Annex 4. he use of in!ections

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ene*al p*actical aspects o" in


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Annex 3: How to explain the use of some

dosage forms

n"o*mation in simple langage on how to administe* e'e d*ops to a child o* how to se anae*osol inhale* is not alwa's easil' a,aila!le. his anne0 contains step !' step gidance on how

to administe* di""e*ent dosage "o*ms. his in"o*mation is inclded !ecase as a docto* 'o a*eltimatel' *esponsi!le "o* 'o* patient?s t*eatment e,en i" that t*eatment is actall' administe*ed

!' a colleage sch as a n*se o* !' patients themsel,es. @o will o"ten need to e0plain to

patients how to administe* a t*eatment co**ectl'. @o ma' also need to teach othe* healthwo*%e*s.

he inst*ctions ha,e !een p*esented in sch a wa' that the' can !e sed as a sel"standing

in"o*mation sheet "o* patients. " 'o ha,e access to a photocop' machine 'o might conside*

ma%ing copies o" them as the' a*e. @o might also wish to adapt them to 'o* own sitation o*

t*anslate them into a national langage.

"H#"$%&' (. #)e drops

1. &ash 'o* hands.

2. =o not toch the d*oppe* opening.

3. oo% pwa*d.

4. ll the lowe* e'elid down to ma%e a Agtte*?.

5. >*ing the d*oppe* as close to the Bgtte*C as possi!le withot toching it o* the e'e.

6. $ppl' the p*esc*i!ed amont o" d*ops in the Agtte*?.

7. #lose the e'e "o* a!ot two mintes. =o not sht the e'e too tight.

. 0cess "lid can !e *emo,ed with a tisse.

9. " mo*e than one %ind o" e'ed*op is sed wait at least "i,e mintes !e"o*e appl'ing the ne0t

d*ops.

18. 'ed*ops ma' case a !*ning "eeling !t this shold not last "o* mo*e than a "ew mintes." it does last longe* conslt a docto* o* pha*macist.


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'teps 4 and *

+hen gi,ing e)e-drops to children:

1. et the child lie !ac% with head st*aight.

2. he childCs e'es shold !e closed.3. =*ip the amont o" d*ops p*esc*i!ed into the co*ne* o" the e'e.

4. eep the head st*aight.

5. Demo,e e0cess "lid.

"H#"$%&' . #)e ointment

1. &ash 'o* hands.2. =o not toch an'thing with the tip o" the t!e.

3. ilt the head !ac%wa*ds a little.

4. a%e the t!e in one hand and pll down the lowe* e'elid with the othe* hand to ma%e aAgtte*?.

5. >*ing the tip o" the t!e as close to the Agtte*? as possi!le.

6. $ppl' the amont o" ointment p*esc*i!ed.

7. #lose the e'e "o* two mintes.

. Demo,e e0cess ointment with a tisse.9. #lean the tip o" the t!e with anothe* tisse.


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'teps 4 and *

"H#"$%&' 3. #ar drops

1. &a*m the ea*d*ops !' %eeping them in the hand o* the a*mpit "o* se,e*al mintes. =o not se

hot wate* tap no tempe*at*e cont*olE

2. ilt head sidewa's o* lie on one side with the ea* pwa*d.

3. entl' pll the lo!e to e0pose the ea* canal.

4. $ppl' the amont o" d*ops p*esc*i!ed.

5. &ait "i,e mintes !e"o*e t*ning to the othe* ea*.

6. Fse cotton wool to close the ea* canal a"te* appl'ing the d*ops +@ i" the man"act*e*

e0plicitl' *ecommends this.

7. a*d*ops shold not !*n o* sting longe* than a "ew mintes.


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'tep (

'teps and 3


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'tep

"H#"$%&' 4. /asal drops

1. >low the nose.

2. -it down and tilt head !ac%wa*d st*ongl' o* lie down with a pillow nde* the sholde*s; %eep

head st*aight.

3. nse*t the d*oppe* one centimete* into the nost*il.

4. $ppl' the amont o" d*ops p*esc*i!ed.

5. mmediatel' a"te*wa*d tilt head "o*wa*d st*ongl' (head !etween %nees).

6. -it p a"te* a "ew seconds the d*ops will then d*ip into the pha*'n0.

7. Depeat the p*oced*e "o* the othe* nost*il i" necessa*'.

. Dinse the d*oppe* with !oiled wate*.


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'teps and 3

'tep *

"H#"$%&' *. /asal spra)

1. >low the nose.2. -it with the head slightl' tilted "o*wa*d.

3. -ha%e the sp*a'.

4. nse*t the tip in one nost*il.5. #lose the othe* nost*il and moth.

6. -p*a' !' sGeezing the ,ial ("las% containe*) and sni"" slowl'.

7. Demo,e the tip "*om the nose and !end the head "o*wa*d st*ongl' (head !etween the %nees).. -it p a"te* a "ew seconds; the sp*a' will d*ip down the pha*'n0.


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9. >*eathe th*ogh the moth.

18. Depeat the p*oced*e "o* the othe* nost*il i" necessa*'.

11. Dinse the tip with !oiled wate*.

'teps 4 and *


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'tep 0

"H#"$%&' . ransdermal patch

1. Ho* patch site see inst*ctions inclded with the d*g o* chec% with 'o* pha*macist.

2. =o not appl' o,e* !*ised o* damaged s%in.

3. =o not wea* o,e* s%in "olds o* nde* tight clothing and change spots *egla*l'.4. $ppl' with clean d*' hands.

6. #lean and d*' the a*ea o" application completel'.

7. Demo,e patch "*om pac%age do not toch Ad*g? side.

. lace on s%in and p*ess "i*ml'. D! the edges to seal.9. Demo,e and *eplace acco*ding to inst*ctions.


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'tep 0

'tep 1

"H#"$%&' 0. Aerosol

1. #ogh p as mch sptm as possi!le.2. -ha%e the ae*osol !e"o*e se.

3. old the ae*osol as indicated in the man"act*e*Cs inst*ctions (this is sall' pside down).


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4. lace the lips tightl' a*ond the mothpiece.

5. ilt the head !ac%wa*d slightl'.

6. >*eathe ot slowl' empt'ing the lngs o" as mch ai* as possi!le.. >*eathe in deepl' and acti,ate the ae*osol %eeping the tonge down.

9. old the !*eath "o* ten to "i"teen seconds.

18. >*eathe ot th*ogh the nose.11. Dinse the moth with wa*m wate*.

'teps 4 and *

'tep 1


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"H#"$%&' 1. &nhaler with capsules

1. #ogh p as mch sptm as possi!le.

2. lace the capsle(s) in the inhale* acco*ding to man"act*e*Cs inst*ctions.3. >*eathe ot slowl' and empt' lngs o" as mch ai* as possi!le.4. lace lips tightl' a*ond the mothpiece.

5. ilt head !ac%wa*d slightl'.

6. a%e a deep !*eath th*ogh the inhale*.

7. old the !*eath "o* ten to "i"teen seconds.. >*eathe ot th*ogh the nose.

9. Dinse the moth with wa*m wate*.

'teps 4


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'tep *

"H#"$%&' 2. 'uppositor)

1. &ash 'o* hands.

2. Demo,e the co,e*ing (nless too so"t).

3. " the spposito*' is too so"t let it ha*den "i*st !' cooling it ("*idge o* hold nde* cold *nning

wate* still pac%edE) then *emo,e co,e*ing.

4. Demo,e possi!le sha*p *ims !' wa*ming in the hand.

5. Ioisten the spposito*' with cold wate*.

6. ie on 'o* side and pll p 'o* %nees.

7. entl' inse*t the spposito*' *onded end "i*st into the !ac% passage.

. Demain l'ing down "o* se,e*al mintes.

9. &ash 'o* hands.


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18. *' not to ha,e a !owel mo,ement d*ing the "i*st ho*.

'tep

"H#"$%&' (. aginal tablet with applicator

1. &ash 'o* hands.

2 Demo,e the w*appe* "*om the ta!let.

3. lace the ta!let into the open end o" the applicato*.

4. ie on 'o* !ac% d*aw 'o* %nees p a little and sp*ead them apa*t.

5. entl' inse*t the applicato* with the ta!let in "*ont into the ,agina as "a* as possi!le do +se "o*ceE

6. =ep*ess the plnge* so that the ta!let is *eleased.

7. &ithd*aw the applicato*.

. =isca*d the applicato* (i" disposa!le).

9. #lean !oth pa*ts o" the applicato* tho*oghl' with soap and !oiled l%ewa*m wate* (i" not

disposa!le).

18. &ash 'o* hands.


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'teps 4 and *

'tep


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"H#"$%&' ((. aginal tablet without applicator

1. &ash 'o* hands.

2. Demo,e the w*appe* "*om the ta!let.3. =ip the ta!let in l%ewa*m wate*


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9. old the c'linde* and with the othe* hand psh the plnge* down ths inse*ting the d*g into

the ,agina.

18. &ithd*aw the applicato* "*om the ,agina.11. =isca*d the applicato* i" disposa!le o* clean tho*oghl' (!oiled wate*) i" not.

12. &ash 'o* hands.

'teps 4 and *

'teps 0 and 1


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he*e a*e two main *easons to p*esc*i!e an in


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3. 'terilit)

=*ing the whole p*epa*ation p*oced*e mate*ial shold !e %ept ste*ile.

&ash 'o* hands !e"o*e sta*ting to p*epa*e the in


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7. $spi*ate the "lid "*om the ampole.

. Demo,e an' ai* "*om the s'*inge.

9. #lean p; dispose o" wo*%ing needle sa"el'; wash 'o* hands.

'tep 4

'tep *


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'tep

"H#"$%&' . Aspirating from a ,ial

Materials needed

ial with *eGi*ed d*g o* soltion s'*inge o" the app*op*iate size needle o" *ight size (im sc o*i,) on s'*inge disin"ectant gaze.

echni9ue

1. &ash 'o* hands.

2. =isin"ect the top o" the ,ial.

3. Fse a s'*inge with a ,olme o" twice the *eGi*ed amont o" d*g o* soltion and add the

needle.

4. -c% p as mch ai* as the amont o" soltion needed to aspi*ate.

5. nse*t needle into (top o") ,ial and t*n psidedown.

6. mp ai* into ,ial (c*eating p*ess*e).

7. $spi*ate the *eGi*ed amont o" soltion and 8.1 ml e0t*a. Ia%e s*e the tip o" the needle is

!elow the "lid s*"ace.

. ll the needle ot o" the ,ial.


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9. Demo,e possi!le ai* "*om the s'*inge.

18. #lean p; dispose o" waste sa"el'; wash 'o* hands.

'tep 4


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'tep


25/34

'tep 0

"H#"$%&' 3. 6issol,ing dr) medicine

Materials needed

ial with d*' medicine to !e dissol,ed s'*inge with the *ight amont o" sol,ent needle o" *ight

size (i, sc o* i,) on s'*inge disin"ectant in


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'tep 4


27/34

'tep *


28/34

'tep 1

"H#"$%&' 4. 'ubcutaneous in!ection

Materials needed

-'*inge with the d*g to !e administe*ed (withot ai*) needle (ass 25 sho*t and thin; on

s'*inge) liGid disin"ectant cotton wool adhesi,e tape.

echni9ue

1. &ash hands.

2. Deass*e the patient and e0plain the p*oced*e.

3. Fnco,e* the a*ea to !e in


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6. nse*t needle in the !ase o" the s%in"old at an angle o" 28 to 38 deg*ees.

7. Delease s%in.

. $spi*ate !*ie"l'; i" !lood appea*s: withd*aw needle *eplace it with a new one i" possi!le and

sta*t again "*om point 4.

9. n


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'tep

"H#"$%&' *. &ntramuscular in!ection

Materials needed

-'*inge with the d*g to !e administe*ed (withot ai*) needle (ass 22 long and medimthic%ness; on s'*inge) liGid disin"ectant cotton wool adhesi,e tape.

echni9ue

1. &ash hands.


3. Fnco,e* the a*ea to !e in


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12. #lean p; dispose o" waste sa"el'; wash 'o* hands.

'tep 4

'tep *


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'tep

"H#"$%&' . &ntra,enous in!ection

Materials needed

-'*inge with the d*g to !e administe*ed (withot ai*) needle (ass 28 long and medim

thic%ness; on s'*inge) liGid disin"ectant cotton wool adhesi,e tape to*niGet.

echni9ue

1. &ash 'o* hands.


3. Fnco,e* a*m completel'.

4. a,e the patient *ela0 and sppo*t his a*m !elow the ,ein to !e sed.

5. $ppl' to*niGet and loo% "o* a sita!le ,ein.

6. &ait "o* the ,ein to swell.

7. =isin"ect s%in.


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. -ta!ilize the ,ein !' plling the s%in tat in the longitdinal di*ection o" the ,ein. =o this with

the hand 'o a*e not going to se "o* inse*ting the needle.

9. nse*t the needle at an angle o" a*ond 35 deg*ees.

18. nct*e the s%in and mo,e the needle slightl' into the ,ein (35 mm).

11. old the s'*inge and needle stead'.

12. $spi*ate. " !lood appea*s hold the s'*inge stead' 'o a*e in the ,ein. " it does not come t*'

again.

13. oosen to*niGet.

14. n


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'tep 2

'teps (( to (4

who guide to good prescribing annex 3

Documents