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Spring 2016-17
1
College of Pharmacy and Nursing
School of Pharmacy
PHARMACY PRACTICE II LAB
PHCY 380L
Lab Manual
Spring 2016/17
Faculty: Ms Beena Jimmy
Lecturer, Pharmacy Practice
Name:
Student Id:
Spring 2016-17
2
Learning Objectives:
Develop the skills to review prescriptions to identify the
indications for the use of specified drugs, identify drug
interactions, need for dosage adjustment in patients
with renal and hepatic dysfunction
Develop the skills to review prescriptions to evaluate
the safety of drug use in pregnancy and lactation and
make appropriate recommendations using appropriate
information resources
Develop the skills to evaluate patient case notes to
identify the drug related problems including adverse
drug reactions, drug interactions and rationality of
drug use
Develop the skills to retrieve, evaluate and synthesis
information and formulate reply in response to a drug
information query using modified systematic approach
Skills such as searching reference texts, searching web-
based databases, and providing medicine counseling to
patients are also an integral part of this course. These
skills are at the core of modern pharmacy practice
Spring 2016-17
3
Lab Instructions:
Various patient oriented pharmacy services for the
given prescriptions will be discussed
Utilize appropriate references to provide patient
oriented pharmacy services for the respective cases
Evaluate the prescription and provide your
recommendation for each prescription
Communicate with the health care professional
regarding your recommendation with reference.
Food and drink are forbidden in the Laboratory.
Cell phones are forbidden and will be confiscated if
found.
Please take care of Reference Books that are used in the
Lab and do not write on it. If observed to be writing on
these books, it may have to be replaced by the student.
Spring 2016-17
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LAB EXERCISE -1
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Identifying the indication of the medicines and potential drug- drug interactions in
the given prescription
Review the given prescription and
a. Identify the indications of the prescribed medications
b. Evaluate the prescription for potential drug-drug interactions.
NIZWA Hospital
Nizwa
Name of the patient: Mr. Khamis Said Al Amri Hospital
No:11155672
Male,Omani,57year(s)
Department: Medicine Doctor: Dr: Abdul
Hakim
Physicians Name &
Reg.No: Dr. Abd Hak,
5789
Physicians Signature
& Stamp:
Dr. Abd Hak , 5789
Provisional Diagnosis: Heart Failure
Medicine Formulation Course
Lisinopril- 5 mg Tablets 5 mg/1 Tablet Oral OD for 14 days
Warfarin sodium- 3 mg Tablets 3 mg/1 Tablet Oral OD for 14 days
Aspirin- 75 mg Tablets 75 mg/1 Tablet Oral OD for 14 days
Date : 6 February 2017 Dispensed by: Ph Ahmed (1234)
Spring 2016-17
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Finding: ---------------------------------------------------------------------------------------------------------
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Summary/Recommendations:------------------------------------------------------------------------------
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References:------------------------------------------------------------------------------------------------------
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Spring 2016-17
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LAB EXERCISE -2
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Identify the problems in the prescription and Review the appropriateness of the
patient’s treatment
Review the appropriateness of patient’s treatment and identify any drug related problem
NIZWA Hospital
Nizwa
Name: Abdulaziz Said Al Hattali Hospital No:1115522 Male,Omani,42year(s)
Department: Medicine Doctor: Dr: Hamed Physicians Name &
Reg.No: Dr. Hamed,
6061
Physicians Signature
& Stamp:
Dr. Hamed , 6061
Provisional Diagnosis: Diabetes Mellitus with Allergic Rhinitis
Medicine Formulation Course
Montelukast- 4 mg Tablets 4 mg/1 Tablet Oral BD for 30 days
Cetirizine- 5 mg Tablets 10 mg/1 Tablet Oral OD for 30 days
Glibenclamide- 5 mg Tablets 5 mg/1 Tablet Oral OD for 30 days
Date : __ February 2017 Dispensed by: Ph ___________ (1234)
Spring 2016-17
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Finding: ---------------------------------------------------------------------------------------------------------
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Summary/Recommendations:------------------------------------------------------------------------------
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References:------------------------------------------------------------------------------------------------------
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Spring 2016-17
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Spring 2016-17
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LAB EXERCISE- 3
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Evaluate the prescription for safety of drug use during pregnancy
Dear Clinical/Ward Pharmacist/Pharmacist,
Please evaluate the safety of the medications in this patient considering her pregnancy status
NIZWA Hospital
Nizwa
Name: Huda Nasser Al Senaidi Hospital No:1115511 Female,Omani,24year(s)
Department: Medicine Doctor: Dr: Hilal Physicians Name &
Reg.No: Dr. Hilal,
6062
Physicians Signature &
Stamp:
Dr. Hilal , 6062
Provisional Diagnosis: Diabetes Mellitus with Hypothyroidsm
Additional Information: 34 Weeks of Gestation
Medicine Formulation Course
Glimepride- 4 mg Tablets 4 mg/1 Tablet Oral OD for 14 days
Levothyroxine- 50 mcg Tablets 50 mcg/1 Tablet Oral OD for 14 days
Date : __ February 2017 Dispensed by: Ph ___________ (1234)
Please document your recommendations on the patient’s case note.
Spring 2016-17
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Finding: ---------------------------------------------------------------------------------------------------------
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Summary/Recommendations: ------------------------------------------------------------------------------
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References:------------------------------------------------------------------------------------------------------
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Spring 2016-17
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LAB EXERCISE- 4
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Evaluate the prescription for safety of drug use during Lactation
Review the prescription considering the patients lactating status
NIZWA Hospital
Nizwa
Name: Shamna Ahmed Al Hajri Hospital No:141584
Age: 24 yrs Weight in Kg: 60 Sex: Female
Rx
Tetracycline 250 mg Tablet PO Q6H x 5 days
Ibuprofen 400 mg tablet 1-1-1 x 5 days
Additional information: Breast feeding; 4 months old infant
Diagnosis: Respiratory tract infection
Physicians Name & Reg.No: Dr.Ahmed, 254
Physicians Signature & Stamp:
Dr.Ah, 254
Date :__ March 2017 Dispensed by: Ph._______
Spring 2016-17
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Finding: ---------------------------------------------------------------------------------------------------------
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References:------------------------------------------------------------------------------------------------------
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Summary/Recommendations:------------------------------------------------------------------------------
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Spring 2016-17
13
LAB EXERCISE- 5
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Evaluating safety of drugs in patients with hepatic dysfunction
Evaluate the safety of the drugs considering the patients hepatic function
NIZWA Hospital
Nizwa
Name of the patient: Mr. Yakoob Salim Al Salmi Hospital No:56354
Age: 45yrs Weight in Kg:74 Sex: Male
Rx
1. Tab. Digoxin 125mcg PO 1-0-0
2. Tab. Pantoprazole 40 mg PO 1-0-1
3. Tab. Furosemide 20 mg PO 1-0-1
4. Tab. Metoprolol 100mg PO 1-0-1
Liver function tests: Altered liver function tests. Moderate hepatic failure
Diagnosis: Heart failure with hypertension
Physicians Name & Reg.No: Dr.Galila, 25472
Physicians Signature & Stamp:
Dr.Galila, 25472
Date :___March 2017 Dispensed by: Ph ________
Spring 2016-17
14
LAB EXERCISE - 6
PRESCRIPTION/MEDICATION ORDER REVIEW
Task: Evaluating safety of drugs in patients with renal dysfunction
Evaluate the safety of the drugs considering the patients renal function
Calculate the creatinine clearance and identify any need for dosage adjustment for the prescribed
drugs, considering the patients renal status
NIZWA Hospital
Nizwa
Name: Amani Salam Al Khalsi Hospital No:456891
Age: 38yrs Weight in Kg: 85 Sex: Male
Rx
Tab. Metformin 500 mg PO 1-0-1
Tab. Prazosin 500 mcg PO 1-1-1 x 3 weeks
Renal function tests: Scr:260 micromoles/L
Diagnosis: Diabetes with hypertension
Physicians Name & Reg.No:
Dr. Jamal, 24631
Physicians Signature & Stamp:
Dr.Jamal, 24631
Date ___ March 2017 Dispensed by: Ph. ________
Spring 2016-17
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Finding: ---------------------------------------------------------------------------------------------------------
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References:------------------------------------------------------------------------------------------------------
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Summary/Recommendations:------------------------------------------------------------------------------
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Spring 2016-17
16
LAB EXERCISE – 7
Drug Information
Answer the drug information from the health care professional
Dr. Abdul Satar, Professor, Department of Internal Medicine, Samail Hospital would like to have
the following information from the Drug Information Centre.
A 45 year old male patient, weighing 50 kgs is admitted to the hospital for treatment of
oropharyngeal candidiasis. Clinician plans to start Ketoconazole. The patient is alcoholic since
20 years. Based on the liver function tests, he is having moderate hepatic impairment. Clinician
would like to know the dose of Ketoconazole to be given in this patient. Further, he would like to
know whether the dose of Ketoconazole needs to be adjusted based on the liver function tests.
He would like to have the information within 1 hour.
Spring 2016-17
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Spring 2016-17
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Spring 2016-17
20
LAB EXERCISE – 8
SCENARIO
You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in
Nizwa.
A patient approaches your Pharmacy counter to fill his prescription.
Provide appropriate patient medication counseling.
NIZWA HEALTH CLINIC
FIRQ, Nizwa Name of the Patient: Ms. Amal Mustafa Al Salhi Hospital No: 1234567
Age: 45 years Weight in Kg: 70 Sex: Female
Rx
Glibenclamide 5 mg Tablet OD for 30 days
Metformin 500 mg Tablet BD for 30 days
Follow up after 30 days and FBS Test
Physicians Name & Reg. No:
Dr. Kamaluddin, 1054
Physician’s Signature & Stamp:
Dr. Kamaluddin, 1054
Date: __ April 2017
Dispensed By: Ph.X
Spring 2016-17
21
LAB EXERCISE – 9
SCENARIO
You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in
Nizwa.
A patient approaches your Pharmacy counter to fill his prescription.
Provide appropriate patient medication counseling.
NIZWA HEALTH CLINIC
FIRQ, Nizwa Name of the Patient: Ms. Amal Hospital No: 1234567
Age: 45 yrs Weight in Kg: 70 Sex: Female
Rx
Tab. Enalapril 5 mg 1-0-0 x 2 weeks
Tab. Atenolol 50mg 1-0-0 x 2 weeks
Follow up after 2 weeks
Physicians Name & Reg. No:
Dr. Kamaluddin, 1054
Physician’s Signature & Stamp:
Dr. Kamaluddin, 1054
Date: __ April 2017 Dispensed By: Ph.X
Spring 2016-17
22
Drug interactions are important to check for because they can:
Affect how your medication works by changing levels of the drug in your blood
Put you at risk for side effects and toxicity
Worsen a medical condition you may already have.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.