Pharmacy Practice

Prof. Yahya
Lecture 2
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• This alternating question and answer formats
keeps the patient actively involved in the
consultation process, which for the adult
learner is crucial to knowledge retention and
recall.
• Inappropriate responses should alert the
pharmacist to possible problems with
comprehension due to hearing , Vision , or
language problems.
• Content of patient counseling:
• Several guidelines have been published
regarding's the points to be covered while
counseling the patient's.
• The pharmacist should discuss at least the
following points while counseling the patient:
1. Name and description of medication.
2. Dosage form.
3. Route of administration.
4. Duration of therapy.
5. Special directions and precautions for
preparation.
6. Administration and use of prescribed drugs
by the patient.
7. Common side effects or interactions and
therapeutic contraindications that may be
encountered, including their avoidance and
the action required if they occur.
8. Techniques of self-monitoring of drug
therapy.
9. Proper Storage.
10.Prescription refill information.
11. Action to be taken in case of missed dose.
12.The medications expected onset of action
and what to do if the action does not occur.
13.Proper disposal of contaminated or
discontinued medications and used
administration devices.
14.Potential drug-drug (including non-
prescription) ,drug- food and drug-disease
interactions or contraindications.
• Then ask the patient if he or she has any
additional questions. close the consultation
with an offer to help when questions arise.
• The pharmacist responsibility :
• The pharmacist must play an active role in the
proper use of prescription medication by the
patient.
• The pharmacist is often the last member of the
health-care team to see the patient before he
takes the drug without direct medical
supervision.
• Therefore, it is the responsibility of the
pharmacist to ensure the safe and appropriate
use of the medication and to answer
questions of concern to the patient.
• The responsibility also encompasses non -
prescription (OTC) products.
• As the health-care provider, the pharmacist is
obligated morally and legally and is, perhaps ,
in the best position to provide patients with
adequate understandable information on the
drugs they take or use to maximize the
therapeutic outcome and prevent convievable
problems during therapy.
• To prevent these problems, the pharmacist
must first understand how a patient misuses
prescribe medications.
• Medication misuses:
• The misuses are as follows:
1. Overdosage:
a) Taking more than the prescribed dose at
any one Administration.
b) Taking more than the prescribed number of
doses in any one day.
c) Taking a dose, prescribed as needed, at a time
other than when needed.
d) taking the same medication from two or more
different containers simultaneously.
2. Under dosage:
a) Taking less than the prescribed dose at any
one administration.
b) Omitting one or more doses.
c) Discontinuing the drug before the prescribed
time.
d) Omitting the dose of medication prescribed
as needed when it is needed.
3) Taking the dose at different time if the time
has been specified in the directions.
4) Taking a dose in a form other than that
specified in the directions.
5) Using the wrong route of administration.
6) Taking medication that has been
discontinued.
7) Taking outdated medications.
8) Taking two or more medications which are
contraindicated therapeutically.
9) Failing to get the prescription filled.
10) Failing to understand how to properly use the
administration unit ( e.g. inhaler).
11) Failing to understand how to properly use or
administer the dosage form.

* The types of misuse committed most frequently

were overdosage and omission of doses.
• Who and when to counsel:
The amount and type of information provided
to the patient will vary based on the patient
needs and practice setting.
• Patients who should always be counseled:
• Confused patients and their caregiver.
• Patients who are sight or hearing impaired.
• Patients with poor literacy.
• Patients whose profile shows a change in
medication or dosing.
• New patients, or those receiving a medication
for the first time.
• Children and parents receiving medication.
• Patients receiving medication with special
storage requirements, complicated directions ,
significant side effects.
• Removing the drug from the package:
• Removing the drug from its package may
seem to be a simple procedure to the
pharmacist but not always to the patient.
• Removing the rapping from a suppository
before insertion is quite obvious to the
pharmacist, but not to some patients.
• Opening " safety containers" has presented
considerable problems to patients.
• Administering the drug :
• The pharmacist should ensure that the patient
understands the details of using the medicine.
• Tablets:
• The most common method to administer a tablet is to
place on the tongue and to swallow with water.
• Most patients understand this method of
administration. Some , however , need to be reminded
to take the tablet with a glass full of water.
• This is very important with those drugs that
are irritating to the stomach e.g. ferrous
sulphate , aspirin, tetracycline or potassium
chloride.
• The patient should be told not to chew
enteric -coated or sustained- release tablets.
• Place the medication well back on the tongue.
• Administration of sublingual and buccal
tablets:
1) Wash hands.
2) Place the medication:
under the tongue (sublingual) or between the
upper molar teeth and the cheek (buccal).

* Do not administer with water.

* Allow the drug to dissolve where placed.