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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5854_Библиотеки_им_академика_М_И_Перельмана
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3. Add the Ora-Blend SF (sugar-free) suspension slowly while mixing in
the mortar until a smooth, uniform suspension results.
4. Pour into amber glass bottle for labeling and dispensing.
a. What would be the sensitivity requirement for a balance to be able
to weigh the amount of carvedilol in the formula with an
allowable error of 5%?
b. If 12.5-mg carvedilol tablets are used as the source of the drug,
describe the compounding procedure to use.
CALCQUIZ
3.A. A pharmacist receives a prescription for ear drops, calling for 0.05
mL of glacial acetic acid, 2 mL of glycerin, and 8 mL of purified water.
Using a 10-mL graduated cylinder with a minimum accurate volume of
2 mL, explain how the required quantity of glacial acetic acid could be
obtained.
3.B. A pharmacist quizzes a pharmacy intern on the aliquot method in
the preparation of 12 capsules each to contain 80 mg of morphine
sulfate and 3.2 mg of naltrexone hydrochloride. Lactose is to be used as
a diluent, a prescription balance with a sensitivity of 6 mg is proposed,
and a 4% error is acceptable. Provide the relevant calculations.
3.C. The aliquot method was used to obtain 8 mg of a drug with a
prescription balance having a sensitivity of 6 mg. A weighing error of
5% was accepted. If 140 mg of the drug was weighed, added to 2.1 g of
lactose, and 120 mg of the mixture used to provide the required
quantity of drug, were the calculations correct or incorrect?
3.D. In preparing a zinc oxide ointment, 28.35 g of zinc oxide was used
rather than the correct quantity, 31.1 g. What percentage error was
incurred?
ANSWERS TO “CASE IN POINT” AND
PRACTICE PROBLEMS
Case in Point 3.1
Preliminary Step. The smallest quantity that should be weighed on the
balance:
STEP 1. Choosing 6 as the multiplier, the amount of estrone to weigh
would be:
25 mg estrone × 6 = 150 mg estrone to weigh
STEP 2. The weight of the aliquot can be set as 150 mg
STEP 3. The weight of lactose can be determined as follows:
150 mg aliquot × 6 = 900 mg dilution
900 mg dilution – 150 mg estrone = 750 mg lactose
STEP 4. The directions for weighing utilizing the amounts calculated
previously are shown here:
1. Weigh 150 mg of estrone.
2. Weigh 750 mg of lactose.
3. Combine estrone and lactose. Mix thoroughly.
4. Weigh 150-mg aliquot from mixture to obtain 25 mg estrone.
Proof:
Case in Point 3.2
The smallest quantity that should be weighed on the balance:
Quantity of mixture required to prepare 25 capsules each containing
the minimum weighable quantity of 120 mg:
120 mg/capsule × 25 capsules = 3000 mg
Quantity of lactose required equals the quantity of mixture required
less the weight of the crushed tablets:
3000 mg − 280 mg = 2720 mg or 2.72 g of lactose required
Quantity of mixture to fill each capsule:
3000 mg ÷ 25 capsules = 120 mg/capsule
Proof of 4 mg of drug per capsule:
Amount of drug in mixture:
25 mg/tablet × 4 tablets = 100 mg
Amount of drug per capsule:
100 mg ÷ 25 capsules = 4 mg/capsule
or,
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Practice Problems
Aliquot Parts by Weighing
Aliquot Parts by Measuring Volume
9.
10.
11.
12.
13.
14.
16.
1.
2.
3.
4.
Percentage of Error
8%
6.32%
1.4%
7.5%
6.67%
313.5 – 346.5 mg
a. a.5 mg
b. Eight 12.5-mg carvedilol tablets may be pulverized in a mortar
with the purified water and a portion of Ora-Blend SF suspension, as
needed, until smooth. The remaining portion of the suspension
vehicle may then be added and blended until a uniform product
results.
References
US Pharmacopeial Convention, Inc. General Chapter <1176> Prescription Balances and
Volumetric Apparatus Used in Compounding. United States Pharmacopeia 42 National
Formulary 37 [book online]. Rockville, MD: US Pharmacopeial Convention, Inc.; 2019.
Young L, Allen LV Jr, eds. The Art, Science, and Technology of Pharmaceutical
Compounding. 2nd Ed. Washington, DC: American Pharmaceutical Association; 2002.
Hormone replacement therapy. Secundum Artem 8(1):4. Available at:
http://www.paddocklabs.com. Accessed June 6, 2012.
Pharmaceutical Service Division, Ministry of Health Malaysia. Extemporaneous
Formulation. Selangor, Malaysia. Available at:
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
http://www.pharmacy.gov.my/v2/en/documents/extemporaneous-formulation-moh-
2015.html. Accessed January 18, 2021.
4
Interpretation of Prescriptions and
Medication Orders
OBJECTIVES
Upon successful completion of this chapter, the student will be able to:
Demonstrate an understanding of the format and components of
traditional prescriptions and electronic prescriptions.
Demonstrate an understanding of the format and components of a
typical institutional medication order.
Interpret common abbreviations and symbols used on prescriptions
and medication orders and apply them correctly in pharmaceutical
calculations.
Apply calculations to indicate medication adherence.
Introduction
By definition, a prescription is an order for medication issued by a
physician, dentist, or other properly licensed medical practitioner. A
prescription designates a specific medication and dosage to be prepared
and dispensed by a pharmacist and administered to a patient.
A prescription may be written on preprinted prescription forms
(traditional prescriptions) or transmitted to a pharmacy by computer
(electronic prescription, or e-script), telephone, or facsimile (fax). As
shown in Figure 4.1, a typical preprinted prescription form contains the
traditional symbol (meaning “recipe,” “take thou,” or “you take”),
name, address, telephone number, and other pertinent information
regarding the prescriber. Blank areas are used by the prescriber to provide
patient information, the medication desired, and directions for use. A
prescription written by a veterinarian generally includes the animal species
and/or the pet’s name and the name of the owner.
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Figure 4.1. Components of a typical prescription. Parts labeled
are as follows:
1. Prescriber information and signature.
2. Patient information.
3. Date prescription was written.
4. symbol (the Superscription), meaning “take thou,” “you take,” or
“recipe.”
5. Medication prescribed (the Inscription).
6. Dispensing instructions to the pharmacist (the Subscription).
7. Directions to the patient (the Signa).
8. Special instructions.
In hospitals and other institutions, the forms are somewhat different and
are referred to as medication orders. A medication order may be written
(paper) or transmitted electronically. A typical paper medication order
sheet is shown in Figure 4.2.
Figure 4.2. Typical hospital medication order sheet.
A prescription or medication order for an infant, a child, or an elderly
person may include the age, weight, and/or body surface area (BSA) of the
patient. This information is applicable in dose calculation (as discussed in
Chapter 8). An example of a prescription for a pediatric patient is shown in
Figure 4.3.
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Figure 4.3. Example of a prescription for a pediatric patient.
A prescription may call for a prefabricated dosage form (e.g., tablet) or it
may call for multiple components and require compounding by a
pharmacist.a A medication may be prescribed by its brand name or by the
nonproprietary (generic) name.b In some cases, the product selection may
be affected by pharmacy regulations and/or by provider–payer options.
a
The extemporaneous compounding of prescriptions is an activity for which pharmacists are
uniquely qualified by virtue of their education, training, and experience. “Traditional”
pharmacy compounding involves the mixing, packaging, labeling, and dispensing of a
medication upon receipt of a prescription or medication order for a specific patient. Extended
compounding activities involve the outsourcing of compounded medications to other health
care providers. Pharmaceutical manufacturing is the large-scale production of product for the
marketplace. A distinction between these different activities is provided by legislation,
guidelines, and regulations of state boards of pharmacy and the federal Food and Drug
Administration.13,
14
b
A brief overview of the designation of nonproprietary and brand names may be found in
Authors’ Extra Point A at the end of this chapter.
Prescriptions requiring compounding include the name and quantities
of each ingredient, the form into which they are to be prepared (e.g., syrup,
capsules), and directions for patient use. Definitions and descriptions of
dosage forms and drug delivery systems are presented in Appendix B.
Examples are shown for prescriptions calling for trade name products
(Figs. 4.1 and 4.3), a generic drug (Fig. 4.4A), and compounding (Fig.
4.5). Figure 4.4B shows the label of a product that may be used by the
pharmacist in filling the medication order as prescribed in Figure 4.4A.
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