PRESCRIPTION ERRORS IN COMMUNITY PHARMACIES Common Prescription errors

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PRESCRIPTION ERRORS IN COMMUNITY PHARMACIES

PRESCRIPTION ERRORS IN COMMUNITY PHARMACIES

Common Prescription errors -examples v. Errors in Prescription writing Should be written legibly with

Common Prescription errors -examples v. Errors in Prescription writing Should be written legibly with ink and easy read it ü Avoid spelling mistakes eg: - Neurobion, Neurontin v. Errors in Dose/Strength eg: - Warfarin 10 mg instead of 1 mg Digoxin(Lanoxin) 25 mg instead of 250 microgram/0. 25 mg ü to

Common Prescription errors -examples v. Looks like similar drug names / pronounce like same

Common Prescription errors -examples v. Looks like similar drug names / pronounce like same eg: Lamisil & Lamictal Lanoxin & Livosyn K-Dur & Cardura Aldomet & Aldactone Ponstan& Bonisan……etc Similarity in brands with same generic name Tenormin-Atormin Motilium-Motilone Nerurobion-Neurorubine forte Rantag-Rantac-Zantac

Common Prescription errors -examples v. Error in administration /route error eg: - Isordil 5

Common Prescription errors -examples v. Error in administration /route error eg: - Isordil 5 mg p. o, sos, instead of S/L v. Wrong dosage form error eg: - Syp. Augmentin 625 mg/ml Tab. Augmentin 625 mg Syp. Ciprobay 250 mg Tab. Ciprobay v. Errors in dose frequency eg: - Tab. Ciprofloxacin 500 mg 3 times daily

Common Prescription errors – Abbreviations

Common Prescription errors – Abbreviations

Common Prescription errors: –Drug-Drug Interactions v. When the interaction causes an increase in the

Common Prescription errors: –Drug-Drug Interactions v. When the interaction causes an increase in the effects of one or both of the drugs the Interaction is called a synergistic effect v. Two drugs when their interaction causes a decrease in the effects of one or both of the drugs are antagonistic effects v. Cytochrome P 450 enzyme inducers and inhibitors (metabolic interactions) v. Food –Drug Interactions

Common Prescription errors: –Drug-Drug Interactions v. Synergistic interactions eg: - Isosorbide Dinintrate (Isordil) Sildenafil

Common Prescription errors: –Drug-Drug Interactions v. Synergistic interactions eg: - Isosorbide Dinintrate (Isordil) Sildenafil Citrate (Viagra) Effects: - causes extreme hypotension eg: Aspirin + Brufen Effects: NSAI effects will increase, Induce Gastric bleeding Additive Synergistic interactions Eg: - Paracetamol + Codiene

Common Prescription errors: –Drug-Drug Interactions v. Antagonistic effcts eg: - Inderal+Ventolin Brufen+ Asthalin v.

Common Prescription errors: –Drug-Drug Interactions v. Antagonistic effcts eg: - Inderal+Ventolin Brufen+ Asthalin v. Food –Drug interaction Alcohol+ Most of the drugs Milk+Iron Supplements Grape Juice+CCB, Ciclosporine, Carmabazepines, Alprozolam… etc Tyramine containing foods+MAO inhibitors Vit. C+ Iron supplements Green leaf Vegetables, Avocado, Garlic, Ginseng + Anticoagulants increases the effect

Cytochrome P 450 enzyme inducers and inhibitors (metabolic interactions) v. Hepatic Enzyme Inhibitors Drugs

Cytochrome P 450 enzyme inducers and inhibitors (metabolic interactions) v. Hepatic Enzyme Inhibitors Drugs are: - Sodium Valporate INH Cimetidine Ketconazole Fluconazole Chloramphenicol Erythromycin Sulfonamides Ciprofloxacin Omeperazole Metronidazole Alcohol binge drinking…etc

Cytochrome P 450 enzyme inducers and inhibitors (metabolic interactions) v. Hepatic enzyme Inducers Griseofulvin

Cytochrome P 450 enzyme inducers and inhibitors (metabolic interactions) v. Hepatic enzyme Inducers Griseofulvin Phenytoin Rifampicin Carbamazepines Sulfonylureas Phenobarbitione Alcoholb Chronic use…. . etc

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