Deciding whether to dispense a medication and determining the best medication based on the doctor's diagnosis.
Omission of unimportant ingredients, dispensing ingredients separately, and adding an inert ingredient to correct the difficulty.
Liver impairment decreases the metabolism of many drugs, prolonging their effect.
They occur due to chemical interactions among ingredients, altering the original composition.
Reactions that occur slowly without immediate visible changes and may or may not result in loss of therapeutic activity.
Gastric bleeding/irritation.
The conversion of an optically active form to an optically inactive form without changing chemical constitution.
The formation of an insoluble substance, such as when tannin drugs are added with iron salts.
Unsightly or unpalatable mixtures, potential danger, or non-uniform dosage.
The ability of a substance to exist in several different crystalline forms.
Use of the product, safety and suitability, calculation of formula, method of preparation, choice of container, and labeling considerations.
By conducting research within the pharmacy practice, especially in community pharmacy.
Immiscibility or insolubility, and using the wrong solvent.
Providing drug information.
Substituting alcohol or glycerin for water or vice versa.
Alkaloidal salts are water-soluble, while free alkaloids are soluble in organic solvents.
Insolubility.
Acting as managers in some drugstores.
The lowering of the melting point when two ingredients are mixed, causing them to liquefy.
Potentiation of effect when two drugs with the same active ingredient or with the same action (synergistic action) are taken at the same time.
Reduction of efficacy when two drugs with opposing actions are taken together.
Carbamazepine, cigarette smoking, chronic alcoholism.
By adding potassium iodide.
Failure of therapy and adverse effects due to the formation of toxic products.
Implementing positive changes within the pharmacy practice.
Absorption penetrates the other substance, while adsorption adheres to the surface of the other substance.
Title, quantitative particulars, product-specific cautions, directions to patient, recommended cautions, discard date, and sample label.
A substance that increases the activity of an enzyme, leading to faster metabolism of drugs.
Prazosin + Beta-blocker.
Certain antibiotics like Chloramphenicol, some NSAIDs like Phenylbutazone, and antimalarial and antituberculosis drugs in people with G6PD enzyme deficiency such as Chloroquine, Isoniazid, and Primaquine.
Certain antipsychotic drugs like Clozapine, chemotherapy drugs like Cyclophosphamide, Mercaptopurine, Methotrexate, Vinblastine, and some drugs used to treat thyroid disorders like Propylthiouracil.
Write 'half-strength'.
Sulfonamide.
Using two or more drugs or ingredients, or dosage errors with a single drug.
In physical precipitation, the substance doesn't change, while in chemical precipitation, the precipitate is a byproduct of a chemical reaction.
To stay updated on current journals, pharmaceutical magazines, brochures, and FDA updates on drugs.
Worsening of a disease because of a drug, alteration of the effect of a drug because of a disease, or manifestation of side effects due to interaction between the drug and a disease other than the one for which the drug is being taken.
The amount of body water decreases while the amount of fat tissue increases, and the amount of acetylcholine decreases, resulting in decreased tolerance to drugs with anticholinergic effects.
To retain water and maintain consistency.
Write 'unit'.
They may intensify or reduce the efficacy of a drug or cause serious side effects.
Serious explosions may result from certain combinations.
It increases the risk of liver damage, drowsiness, sedation, or nausea.
Some analgesics like Acetaminophen in excessive doses.
It may explode.
Antibiotics can disrupt the GI flora, leading to increased levels of drugs like Digoxin or altered effects of drugs like Warfarin and Oral Contraceptive Pills (OCP).
The direct, responsible provision of medication-related care to achieve outcomes that improve a patient's quality of life.
Prescribing alkaloid salt to be dissolved in liquid petrolatum instead of free alkaloid.
A substance that decreases the activity of an enzyme, leading to slower metabolism of drugs.
Antidepressant + Azithromycin.
Write '3 times weekly' or '2 times weekly'.
Some drugs are protein-bound before becoming free drugs. If another drug occupies the binding site, it increases the concentration of the free drug in the body.
Cheese, tyramine, yogurt, sour cream, cured meat, liver, caviar, dried fish, avocado, banana, and red wine.
It causes symptoms similar to those experienced with disulfiram, such as flushing, tachycardia, and nausea.
They occur when two or more drugs, IV fluids, or both are administered together to produce a response differing in nature or intensity from the intended one.
Increased sensitivity of target organs in the body to drugs.
Reported information on a possible causal relationship between an adverse event and a drug, where the relationship is unknown or incompletely documented previously.
Teaching patients, doctors, and other professionals.
Interpretation of Latin abbreviations where necessary and recommended cautions.
To make smaller quantities first before mixing to ensure proper formulation.
Cimetidine, ciprofloxacin, chloramphenicol.
The effect of a drug is cancelled by the presence of another drug.
Write 'daily' and 'every other day'.
Delayed/reduced absorption, enzyme inhibition or induction, reduced plasma concentration, and increased or decreased action of the medication.
Write 'mcg'.
It can cause enzyme induction or inhibition, altering the biotransformation of some drugs.
Increase in GI motility leads to faster transit time from the stomach to intestine, affecting the therapeutic effect based on the site of absorption.
5,000 mg or 5 g.
One drug can enhance or inhibit the metabolism of another. CYP450 inducers metabolize drugs faster, decreasing therapeutic effects, while CYP450 inhibitors cause drugs to stay longer in the body, increasing therapeutic effects and potential toxicity.
Diagnostic errors, prescribing errors, insufficient study of the patient, contraindicated drugs, excessive single dose, excessive daily dose, additive and synergistic combination, antagonistic combination, Rx writing errors, nomenclature error, dosage form error, drug administration and patient care, placebo and psychosomatic factors, unpalatability, and combination of factors.
Fatty foods increase the bioavailability of these drugs.
Reduced or delayed therapeutic effectiveness, loss of activity, and delay in the release or absorption of the drug.
To prevent pooling or forming a layer on top of the IV fluid, which decreases the chance of incompatibility and prevents precipitate formation.
During compounding, dispensing, or administration of pharmaceuticals.
Physical, Chemical, Therapeutic, and Combination of types.
A second drug may increase or decrease the rate during ADME (Absorption, Distribution, Metabolism, Excretion) of the first drug.
Older people have more dramatic effects to drugs due to altered drug response.
Clavulanic acid inhibits the excretion of amoxicillin, allowing it to stay longer in the body.
Reactions unrelated to the goal of therapy.
Alopecia.
Complex formation (chelates) which are not absorbable by the body.
Light catalyzing the degradation of a certain product, such as Vitamin B2 or Nifedipine.
Vancomycin.
According to the age or weight, a fraction of the adult dose is given.
Vaginal adenocarcinoma.
The physician, but the pharmacist may inform the physician to eliminate errors in prescription writing/interpretation, overdose, contraindicated drugs, and synergistic/antagonistic effects.
Age, gender, comorbidities, polypharmacy/concurrent medications, duration of therapy, narrow therapeutic index, and ethnicity/genetics.
Talking to patients, doctors, and other professionals.
The first doses may lead to underdose and the last doses may lead to overdose.
By protecting the interests of the pharmacy business.
Solubility, vehicle/diluent, preservative, and flavoring when appropriate.
It can alter the final product's stability and efficacy.
The effect of one drug is added to the effect of another drug (combined effect).
Not following doctor's instructions or not taking the prescribed drug can be risky and life-threatening.
Write 'international unit'.
Natural substances that include certain herbs and products like cholesterol-lowering margarines and psyllium-fortified products.
Oxidizing agents such as potassium chlorate, chromic acid, potassium permanganate, silver oxide, hydrogen peroxide, nitric acid, or sodium peroxide.
The formation of bubbles, often due to mixing acid and carbonate or bicarbonate.
They are advised to take the medication with milk, crackers, or a full stomach.
Decomposition of chloral hydrate by alkali into chloroform.
Long-term effects usually related to the dose and duration of treatment.
Mix each drug thoroughly after adding it to the preparation, administer solutions promptly, keep the number of drugs mixed together to a minimum, and consult compatibility references for unfamiliar drugs or IV fluids.
Tolerance develops through time, requiring an increase in dose as a person no longer responds to a drug the way they did at first.
Weak bottles with thin spots or flaws may break inwardly due to the development of a slight vacuum, often from the removal of oxygen by oxidation of syrup.
pH and temperature. Drugs are only soluble or stable at certain pH levels, and increased storage temperature speeds up drug degradation.
It occurs when the effects of one drug are altered by the prior or concurrent administration of another drug.
Any undesirable experience associated with the use of a medical product in a patient, such as loss of balance after taking a medicine.
Emulsifying or suspending agents and a 'shake well before use' label.
Kidneys are less able to excrete drugs into the urine, resulting in the prolonged stay of the drugs in the body and thus prolonging their effect.
The effect of one drug combined with the effect of another drug results in a pharmacologic effect which is more than what was expected.
Effervescence, precipitation, color changes, and explosion.
There is a drug with effect (1) and a drug with no effect (0). The drug with no effect enhances the effect of the drug with pharmacologic activity.
Write 'morphine sulfate' or 'magnesium sulfate' or MgSO4.
Decreased libido.
Affects immunological responses and are totally abnormal effects unrelated to the drug's known pharmacological actions.
Write 'discharge'.
Write 'mL' for milliliters.
Fiber in oatmeal interferes with the absorption of digoxin.
If it provides greater efficacy, greater margin of safety, and more satisfactory onset or duration of effect.
Many substances hydrolyze in water, and the change may be hastened by heat, catalysts, esters, amides, certain metals (Zn, Fe), and glycosides.
Tachyphylaxis is a rapid diminution in responsiveness following the administration of a drug, characterized by a fast onset tolerance and a rapid decrease of response regardless of dose increase. Common drugs causing tachyphylaxis are those that act on the nervous system.
Physical and chemical drug properties, altering the quantity of drug available for systemic absorption, and influencing release rates.
Actions related to the pharmacological activity of the drug, such as dose-related responses arising from an extension of the therapeutic effect.
It inhibits aldehyde dehydrogenase, increasing serum acetaldehyde concentration, causing flushing, tachycardia, hyperventilation, and hypotension, which discourages alcohol consumption.
Propranolol + Albuterol.
Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg).
Exposure to air, temperature, light, excessive storage, overdilution, incorrect pH adjustment, and presence of catalysts.
The drug depends on the presence of electrolytes. For example, Digoxin + Non-potassium sparing diuretics can lead to digoxin toxicity.
Drugs are only soluble, stable, or absorbed at a certain pH. Change in environmental pH alters a drug's stability, absorption, or solubility.
Some anti-TB drugs like Isoniazid, iron supplements in excessive doses, NSAIDs like Ibuprofen, Ketoprofen, Naproxen, aminoglycoside antibiotics like Gentamicin, Kanamycin, and some chemotherapy drugs like Cisplatin.
Acute hepatic necrosis.
Dependence occurs when a patient experiences withdrawal effects without the drug or substance, requiring a steady concentration to avoid withdrawal syndrome. Common drugs that result in dependence are opioids and caffeine.
Sedatives + stimulants, demulcents + irritants, laxative + astringents, strychnine + barbital derivatives.
Pharmaceutical properties, pharmacokinetic properties, and pharmacodynamic effects.
A response to a drug that is noxious and unintended, occurring at doses normally used in humans for prophylaxis, diagnosis, or therapy of disease.
An expected and known effect of a drug that is not the intended therapeutic outcome, which is common, reproducible, predictable, and dose-dependent.
The science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problem.
Vitamin C, being acidic, increases the excretion of methamphetamine, a weak base.
Using auxiliary labels like 'Store in a Refrigerator' or 'Shake Well'.
Amoxicillin (antibiotic) + Clavulanic acid (inhibits excretion of amoxicillin) = Co-amoxiclav (amoxicillin stays longer in the body).
It produces effervescence or explosion.
Heating above 100°C or combining with nitrates, chromates, or permanganates.
Sedatives, including many antihistamines like Diphenhydramine, and antidepressants like Amitriptyline and Imipramine.
To avoid altering or disrupting the GI flora and to ensure better absorption.
Optic neuropathy.
Occurs after some time and includes carcinogenesis and adverse effects associated with reproduction.
Adverse effects that occur upon withdrawal of a drug.
The way a drug is handled by the body during ADME, such as ototoxicity with aminoglycosides in patients with renal failure.
Incompatibility increases with the length of time that drugs are in contact with each other.
It occurs when a dietary item influences the activity of a drug, such as cheese affecting monoamine oxidase inhibitors.
They can form a chelate with the drug, rendering both the drug and the heavy metal non-usable by the body.
Liberation or absorption of considerable amounts of heat.
Because there is no visible evidence of the reaction, making it hard to detect.
Delirium tremens (disorientation and visual hallucinations).
Presence of renal, hepatic, cardiac disease, age, previous ADR or drug allergy, sex/gender, genetic influence, diet, smoking, alcohol, and environmental exposures.
The more diluted the drugs are in a solution, the less ion interaction occurs, reducing incompatibility.
Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer.
A slow acetylator experiences toxicity from drugs like isoniazid, while a fast acetylator may not respond to the same drugs.
It occurs when compounds form a mass of cement-like hardness, often due to polymerization or conversion to new crystal forms.
Improved therapy, greater margin of safety, more appropriate onset or duration of action, lowered toxicity, and enhanced potency with diminished side effects.
It is when solutions form a gel when combined with certain substances.
Iatrogenic Cushing syndrome.
Phocomelia.
Lack of efficacy of drug products, often due to resistance, patient tolerance, poor compliance, or substandard medicine.
Peptic ulcers or bleeding from the stomach caused by oral corticosteroids, NSAIDs, and anticoagulants.
An injury resulting from the use of a drug, including harm caused by the drug (adverse drug reactions and overdoses) and harm from the use of the drug (including dose reductions and discontinuations of drug therapy).
Minor, Moderate, Severe, and Lethal.
Consult the physician, use pharmaceutical knowledge, add or remove ingredients, change the vehicle or dosage form, and read the literature.
It decreases the anticoagulant effect of warfarin.
KI + Hg2Cl2 (calomel) in the presence of moisture produces Hg+2 (toxic mercurous chloride).
Anaphylactic (IgE), Cytotoxic (IgM, IgG), Immune Complex (IgG), and Delayed (T-cell mediated).
