Medication order

Is the patient on all appropriate maintenance medications Are medications at the appropriate doses for weight and/or age If the patient is admitted, are maintenance medications ordered ... 

Each time a patient moves from one setting to another, clinicians should compare previous medication orders with new orders and plans for care and reconcile any differences. If this process does not occur in a standardised manner designed to ensure complete reconciliation, medication errors may lead to adverse events and harm (IHI MedReconcilliation 2008). Several national organisations round the world have now produced help to reduce errors with medication reconciliation. Some examples are given below. 

In Pharmaceutical and Clinical Calculations, second edition, Drs. Mansoor Khan and Indra Reddy have provided a contemporary resource that can help pharmacy students learn the basic principles of how to accurately interpret prescriptions and medication orders, measure, calculate and compound quality dosage forms. In the latter chapters, the student can learn multiple methods to accurately and safely dose patients. The computational methods to accomplish these ends are clearly presented, and the examples used to demonstrate the concepts are relevant to contemporary practice. Pharmacy students will... 

The interpretation of prescription medication orders is one of the most important requirements of professional pharmacy practice. According to the National Association of Boards of Pharmacy s (NABP s) Model State Pharmacy Act,... 

Pharmacists receive prescriptions by telephone, fax, as written prescriptions from individual prescribers, practicing in a group, or hospitals and other institutions. Telephone orders are reduced to a written prescription (hard copy) by pharmacists. Generally, prescriptions include printed forms called prescription blanks which include the name, address, and telephone number of the prescriber a provision to write the name, address, age or date of birth of the patient and the I symbol. Medication orders are prescription equivalents which are written by practitioners (prescribers) in a hospital or a similar institution. Components of medication orders with appropriate examples are presented in the subsequent section. 

While prescriptions are written in an outpatient setting, medication orders... 

Refer to the sample medication order (Figure 3.3) to answer questions 4 and 5. 

A medication order for theophylline oral suspension for a patient to be taken in doses of one teaspoonful three times a day for five days, and then one teaspoonful two times a day for two days. How many milliliters of the suspension should be dispensed to provide the quantity for the prescribed dosage regimen ... 

A physician ordered 1.5 mg of theophylline to be administered orally to a baby. How many milliliters of theophylline elixir containing 30 mg of theophylline per 10 mL should be used in dispensing the medication order ... 

A physician prescribes an ophthalmic suspension to contain 100 mg of cortisone acetate in 8 mL of normal saline solution (NSS). The pharmacist has a 2.5% suspension of cortisone acetate in NSS. How many milliliters of this and how many milliliters of NSS should be used in preparing the medication order ... 

A medication order in the hospital setting calls for isophane insulin suspension to be administered to a 152-lb patient on the basis of 1 unit per kg per 24 hours. How many units of isophane insulin suspension should be administered daily ... 

A pharmacist receives a medication order for 300,000 units of penicillin G potassium to be added to 500 mL of D5W. A vial of penicillin G potassium 1,000,000 U is on hand, and the directions on the 1,000,000 unit package state Add diluent 4.6 mL (for a) concentration of solution 200,000 units/ mL. How many milliliters of the reconstituted solution must be withdrawn and added to the D5W ... 

A medication order calls for 400 mg of Kefzol (cefazolin sodium) to be administered IM to a patient every 12 hours. Vials containing 250 mg, 500 mg, and 1 g of cefazolin sodium are available. According to the manufacturer s directions, dilutions may be made as follows ... 

A physician orders 1.75 g of an antibiotic to be placed in 1000 mL of normal saline solution (NSS). Using a reconstituted injection which contains 250 mg of the antibiotic per 1 mL, how many mL should be added to the NSS in filling the medication order ... 

A medication order for an intravenous infusion for a patient weighing 143 lbs calls for a 0.25 mEq of ammonium chloride per kilogram of body weight to be added to 500 mL of 5% dextrose injection. How many... 

A medication order for a TPN solution includes additives as indicated in the following formula ... 

Using the sources listed, calculate the amount of each component required in filling the medication order. 

How many mL of each additive should be used in filling the medication order ... 

Note It should be remembered that in many situations, the information given for dosage conversion from adult to children is not direct. The dose prescribed on a prescription or a medication order may be for an adult while the patient profile may reveal that the age of the patient is a few months or a few years and the patient is a child. 

A medication order for a nine-month-old child weighing 8 kg includes dopamine in a dose of 5 mcg/kg/min. The drug available is dopamine 400 mg/5 mL. The physician ordered 70 mg of dopamine in 200 mL of D5W to be administered at 6.75 mL per hour to this child who is in septic shock. Check for the accuracy of the dilution order. 

A medication order for a 55-lb child calls for Sandoglobulin 0.2 g/kg IV. The supply on hand contained 6 g of Sandoglobulin in 100 mL. How many milliliters of this solution should be given ... 

A medication order calls for prostigmin 0.25 mg IM. The only supply of prostigmin is 1 200 solution. How many milliliters of this solution would contain 0.25 mg ... 

A medication orders 5.5 mEq Ca++. What is the amount of calcium dihydrate (equivalent weight of CaCl2-2H20 = 73.5) needed ... 

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