Acetaminophen?
Tylenol - caution liver, gd6 deficiency
Blood-fever
500mg
Pain
Peds 15mg/kg q6hr
Adult 1g q6hr
OTC URTI & Pain & Headache
500mg 1or2 q4-6hrs max8/24hr
Antacid(gaviscon)
Caution peptic ulcers, Mg/Na restricted diet, renal disease, taking within 2hrs of another med
OTC GERD
2-4 tabs QID after meals and bedtime
Max 11tabs/24hrs
Bisacodyl(dolcolax)
May cause GI cramps/diarrhea/electrolyte imbalance
OTC Constipation
10mg 1-2 tabs at bedtime
Supply max 2 days worth
Desloratadine
Caution renal/liver, family hx seizures
OTC URTI
5mg once daily
Diclonfenac 2.23% (Voltaren xst)
Caution sensitivity nsaids and asa(cyclooxygenase 1&2)
OTC Pain
q12hr prn
Dimenhydrinate(gravol)
Caution glaucoma, chronic ling disease, prostatic hypertrophy, avoid other sedatives
Max 400mg in 24hrs
Cardiac -nausea
25-50 mg po/im
Eye - open globe
50mg q4hr
Nausea/Vomiting
25 mg q4-6hrs
Peds under 15kg: 12.5mg
OTC Motion Sickness
Rule out red flags,
50mg po/im q4hrs supply2-5days
Famotidine(pepcid)
Rule out red flags
Prolonged use may cause v12 deficiency, reduces gastric pH affecting absorption of other meds, works on histamine receptors of gastric cells
OTC Gerd
20mg 1tab BID
Supply 2-5days
Fluconazole(diflucan)
Vaginal Candidiasis
Rule out red flags
150mg stat
Supply 1 dose
Gastrolyte
OTC Diarrhea -pt dehydrated
Rule out red flags
1pack in 200ml water stat and after every loose stool
Hydrocortisone 1%
Caution sensitivity quinolines or iodine, viral conditions like heroes, pox, or ulcers
OTC Atopic Dermatitis/Dry Skin
BID for 7 days (give a tube)
Ibuprofen(advil/motrin)
Nsaid dont give with other nsaids, don’t give in hemorrhage(meloxicam okay for hem), cation liver/kidney/hyperkalemia, pregnancy
Pain
Peds: 10mg/kg po q8hr
Adult: 800mg q8hr
OTC URTI & Pain & Headache & Dysmenorrhea
Rule out red flags
400mg 1tab po 6-8hrs (max 3tabs/24hrs) supply 2-5days
Loperamide
Caution red flags
OTC Diarrhea
2mg 2 tabs stat then after very bm(max 8tabs/24hrs)
Supply 2 days
PEG(restoralax)
Caution red flags, affects other med absorption
OTC Constipation
1 dose(17g) dissolved
Once daily for 3-5days
Pseudoephedrine(sudafed)
Caution high bp, cardiac, glaucoma, diabetes, prostate, MAO inhibitor(old antidepressant) use in 2 week, other cold meds may contain this med, will keep awake take long before bed
OTC URTI
60mg 1 tab po q6-8hr(max4/24hrs)
“N” in Controlled Drugs and Substances Act, and Narcotic Control Regulations
Narcotics
“C” in CFHS catalogue. Part G of Food and Drug Regulations
Controlled Drugs
“T” in CFHS guide. Schedule 1 of B&TSR and Narcotic Controlled Substances
Targeted Substances ex. Benzos
Verbal Prescription Narcotic definition?
A narcotic plus 2 additional medicinal ingredients made for therapeutic use. Not intended for parenteral use. Does not include diacetylmorphine(heroin), hydrocodone, methadone, oxycodone, pentazocine
Who is responsible for narcotics and controlled drugs?
Pharmacist
If none, Senior Medical Officer or Commanding Officer
Follow QR&O 36.11 if loss/stolen
Which prescriptions can be refilled?
Controlled substances
Narcotics can not be refilled.
Dangerous abbreviations:
ug mistaken as mg
Abbreviations for drug names
QD and QOD (everyday and every other day) mistaken for eachother
OS OD OU (eyes) mistaken for eachother
D/S discharge mistaken as discontinue
First check?
Second check?
Third check?
1: written rx matches stock bottle
2: prepared med in vial matches stock bottle
3: final visual check and right pt(6 rights)
What are the 6 rights?
Person
Med
Dose
Time
Route
Documentation
Verbal order how to?
Confirm info with doc. “Z” extra space
Write “VO” on script and sign
When complete cross out(means its been filled) and annotate on back with din, quantity, dispensed on, by(pers dispensing),
Doc to sign in 24hrs ideally
