PREPARED BY BEKUWET SOLOMON COC Assisment for level III

Project – One

Pharmacology

1/ Identifying the group of drugs.

Example:- Diclofenac-NSAIDS

Salbutamol _ Respiratory drugs

Methyl dopa- Anti hypertensive drugs

Metformin – Antidiabetics

Norfloxacillin- Antibiotics

2/ Discussing about Mechanism of Action ( MOA) of the drugs

Example – Ciprofloxacillin-Inhibit Nucleic Acid synthesis the bacteria by

Inhibiting the DNA Dyrase & topoisomerese enzymes.

- Salbutamol – Is B2-agomists
- Enalapril- Angiotesin converting Enzyme Inhibitors.
- Glibenclamide- stimulates Insulin release.
- Metronidazole – Inhibit DNA synthesis
- Mebendazole-Inhibit Glucose reuptake

3/ Identifying the strength of the drugs

Example – Amoxicillin 500mg –strength 500mg

- Abendazde 400mg –strength 400mg

- Dimenhydranate 10mg – strength 10mg

4/ Identifying the Brand and Generic name of the drugs

Example- Amoxicillin – Amoxi -denk

Generic Brand or trade name

- Metronidazole- meazel
Generic Brand or trade name

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 - Glibeniclamide – Daonil

Generic Brand or trade name

5/ side Effects of the drugs

Example – metronidazole – metallic taste

- Enalopril, captopril – dry cough

- Quinine- hypogly cemia
- Zidovvudine- Anemia

6/ Contraindications of drugs with disease, Age

Example – Tetracycline- pregnant and lactation mother, children <8yrs.

- Penicillin – hypersensitive to penicillin group .

- CAF – for pregnant, lactating mother, children <12 yrs, For aneamic patients.
- Catrimoxazole- for Renal failure patients

7/ Store the drug according to the legal & product Requirements

Example – Insulin- In the Refrigerator

- Librax- Is controlled drug stored in locked cabinet

- Morphine- “ “ “ “ “
- Codeine- “ “ “ “ “
- Pethidine- “ “ “ “ “
- Amoxicillin – on the shelf

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Arranging Drug Pharmacologically

1/ Antibiotics/ Antibacterial - Diphenhyramine ( Berantin)

- Amoxicillin - ceftroxione 3/ Antihelmentics

- Ampicillin – ceftazidine
- Albendazole ( zentel)
- Cloxacillin – cefalexin
- Mebendazole ( vermox)
- Procaine penicillin/ PPF
- Thiabendazole
- Crystalline penicillin
- Pipperazine ( worm expel)
- Benzanthine penicillin
- Niclosimide
- Doxycilline
- Pyrantel
- Gentamycin
- Praziquantel
- Streptomycin
4/ GIT Drugs
- Neomycin
- Hyoscine
- Kanamycin
- Atropine Injection
- Azitromycin
- Omeprozole
- Chlorphenicol
- Lansomeprezole
- Erythromycin
- Cimetidine
- Clarithromycin
- Ranitidine
- Ciproflacillin
- Famotidine, nizatidine
- Norfloxacillin
- Antacids
2/ Respiratory drugs - Metoclopromide ( plasil)
- Dimenhydranate
- Salbutamol
- Bisacodyl
- Hydrocortisone
- Castor oil
- Prendisolone
- Glycerin suppository
- Promethazine
- Lamotil(Diphenoxylate +Atropine)
- Celestamine ( Betamethesone +
- Antihemoroids
chlorpheniromine )
Sediproct
- Celestone
Pilocaine
- Almentamine
Annusol.
- Adrenaline
- Ephedrine 5/ Anti diabetics drugs
- Theophedrine
- Glibeclamide( Daonil)
- Dexromethorphen( Ephedex)
- Metformin

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 10/ Hormonal & Vitemines &
minerals

- Oral contraceptive pills ( ocp)

6/ CVS ( cardio vascular drugs) - Post pills
- Multi vitamins
- Nifedipine - Vitamin B-complex
- Fe So4
- Atenolol
- Propranol 11/Otics,Opthalmic&Nasol
Preparations
- Enalapril
- Captopril - TTC eye ointment
- CAF eye ointment
- Lisinopril
- Dexamethasone eye
- Methyl dopa (Aldomet) Drop (mexidex)
- Hydrochlorozthiazide (HCL) - Gentemycin eye drop
- Eye visol
- Frusemide ( lasix/
- Eye vision
- Sprinolactone ( Aldoctone/ - Timolol eye drop
- Digoxin
12/ CNS drugs
- Nitroglycerin
- Verapamil - Chlorpromazine (CPZ)
- Amitriptiyline
7/ Anti protozoa Drugs - Impramine
- Diazepam
- Metronidazole - Thiorodiazine
- Haloperidol
- Quhine
- Carbamazapine
- Chloro quinine - Fluoxitine
- Prima quinine - Paracetamol
- Fansider ( sulfadoximine 13/ In Locked cabinet
- Coolrtum ( Aethimesinin lumfent
- Phenobarbitone
8/ NSAIDS
- Phenytoin
- Ibuprofen
- Morphine
- Diclofenoc
- Indomethacin - Codeine
- Asprin - Pethidine

9/ Anti fungal drugs - Librax(chlorodiazepoxide+

clidium bromide)
- Fluconazole
- Ketoconazole - Silidinefil or cupid.
- Amphotericin B - Palathione & malathione
- Griseo fulvin
- Clatrimazole 14/ 2n Refrigerator

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 - Oxytoxin or pitocin - Syringe with needle
- Ergometrin - Canula
- Insulin - Catheter
- TAT - Glove
- Gauze
- Catton
- Bandage
- Plaster
- Water for Injection
15/ Medical supplies - fluids

Groups of drugs

Example –

1/ ACE inhibitors (Angiotensin Converting Enzyme inhibitors)

- Enalapril, captopril and lisinopril.

2/ Aminoglycosides

- Gentamycin
- Streptomycin
- Neomycin

3/ macrolides- clarithromycin & Erythromycin

4/ NSAIDS- Ibuprofen, Indomethacin, Diclofenac & ASA.

5/ penicillin- Amoxacilin, Ampicillin, PPF, Benzenthine , crystalline Penicillin,

6/ cephalosporins- ceftrioxane, cephalexin, ceftazidine.

7/ fluoro quinolone- ciprofloxacillin & Norfloxacillin.

8/ phenothiazine- chloropramazine & promethazine

9/ H2 – blockers – cimetidine, Ranitidine & famotidine.

10/ cardiac Glycisides- Digoxin & Digotoxin

11/ Steroids – Betamethasone, Dexamethasone, Prendisolone & Hydrocortisone.

12/ cholinergic- Antogonists- Hyoscine & Atropine.

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13/ H1 –blockers – Diphenhydramine, promethazine, citrizine, chlorpheramine.

Combinations drugs

Celestamine or Almentomine = Betamethasone + chlorpheniramine

Lamotil = Diphenoxylate + Atropine

Augmentin = Amoxicillin + Clavulin Acid ( clavulin potassium)

Librax = Chlorodiazepoxide + Clidium bromide

Cotrimexazole = Sulfamethoxazole + trimethoprim

Fansider = Sulfadoxin + pyrimethamine

Coartum = Arthimesinin + lumfenatrin

Project – Two

Dispensing of prescriptions

1/ check the legality, validity & completeness of the prescription

Legality- regarding to the health Institution

- Legality of the prescriber

- Stamp
- Prescription paper for narcotic drug- narcotic prescription
For psychotropic drug- psychotropic prescription
For other drugs- ordinary prescription
- In special prescription one prescription only for one drugs.

Validity- regarding to the prescribing date

- Checking the prescription elapsed 15 days.

Completeness – regarding to patient Information

- Regarding to prescription Information.

- Regarding to drug information

Example – patient information –patient name, Age, sex, Address

- Prescription information – prescriber name, Qualification, Registration

number, signature, date.
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 - Drug Information – Drugs name, strength, Dosage forms, frequency, duration
of therapy.

Example :- Enalapril 5mg tablet po daily for 10 days.

2/ Interpret Medication abbreviation

Example - gtt – drop

Pc – after meal

Qd – every day

Hs – at noct time or at bed time

Bid – two time day

3/ Depict the Indication and MOA of the drugs

Example – Rx- Cotrimoxazole 480mg tablet po Bid for 7 days.

- Indication – Cotrimoxazole antibiotics mainly used for pneumonia corni

pneumonia (PCP).
- MOA – Inhibit the folic acid synthesis of bacteria by the inhibiting the PABA.

4/ calculate the quantity of each drug.

Example :- Rx - Insulin 20/30 I.U Bid for 2 month

- Ketoconazole 200mg tablet po daily for days

Insulin – 20x30 =-50 I.u per days

50x 60 = 3000 I.u

1 vial = 100 I.u/1ml or 1000 I.u/10ml

1vial = 10ml

1vial = 1000 I.u

? x = 3000 I.u = 3 vials

Ketoconozole - 1x20 = 20 tablets

5/ determine price of each drugs

Example – Rx- Clarithromycin 500mg tablet po Bid for 7 days

price 1 tablet clarithromycin = 3 birr

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2x7 = 14 tablets

1 tablet = 3 birr 14 x 3 = 42 birr

14 tablet = ?

6/ Detect and respond to drug Interaction & contraindications

Example – Rx- Frusemide 40mg tablet po daily for 10 days

- Gentamycin injection Bid for 14 days

Gentamycin and Frusemide Interact each other

Drugs- drug Interaction- Gentamycin and frusemide interact each other both of them
have a side effects of ototoxicity. Potentiate ototoxicity side effects.

Ototoxicity.

Contraindication – Gentamycin – for Renal failure patients.

Rx – Tetracycillin 500mg capsule po daily for 7 days

- Antacids suspension 10ml Tid for 10 days

Drugs- drugs Interactions- TTC Indirect with antacid in the absorption

- Antacid decreased the absorption of TTC.

- Our advice should be to use time gap.

Drug – food Interaction

- TTC & Antacid Interact with foods b/c of this must be used before 1 or 2 hours
or after 1 or 2 hours meals (foods.

Contraindication – TTC – contraincated for pregnant women

Lactating mother

Children < 8 year

7/ provide product specific counseling

Example: - Rx citrizine 10 mg tablet po daily at noct time for 10 das.

- Doxycillin 100mg capsule po Bid for 10 days.

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Counseling – for citrizine to take at night or Bed time because of their sedation side
effects.

- Doxycillin – to used 12 hours gap. ( two times a days

To avoid misuse & premature discontinuation

Generally on prescription

Rx

- Insuin 20/30 I.u Bid for 20 months

- Omeprazole 20mg capsule Bid for 7 days
- Clarithromyicin 500mg tablet po Bid for 7 days
- Amoxicillin 1000mg (1g) capsule po Bid for 7 days.

1/ Insulin 20 x30 = 50 I.u

50 x 60= 3000 I.u

1 vial + 1000 I.u

? x 3000 I.u

1 x3000 I.u = 3 vials

1000 I.u

Omeprazole – 2 x7 = 14 capsule

Clarithramycin – 2 x 7 = 14 capsules

Amoxacillin = available a 500mg so need two capsule for one administration.

2x2x7 = 28 capsule

 The use of insulin is for Diabetic patients especially for types I DM. b/c type
one is Insulin dependent diabetes millitus.
 Insulin is secreted by pancreatic Beta cells.
 Stored in refrigerator. / cold storage /
 Have hypoglycemia side effects due to -over dose
-Exercise
-Using other oral hypoglycemic drugs.
- Alcohol.

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 - Also have liptrophy side effects – damaging lipid cell in the injection site. We
can avoid these side effects by administering different sites.
- In morning the dose is not high b/c there is no glucose more in our body.
- In evening the dose is higher (greater than the morning) b/c there is more
glucose in our body.
- Omeprazole, Amoxicillin, clarithromycin this all drugs are used for ttt of PUD
associated by Helico bacter pyroli.
- Also known as triple therapy.

2/ Rx – PPF 600,000 I.u daily for 7 days

- Ferrous sulfate tablet take as before

- Neomycin 500mg tablet Bid for 7 days
- Paracetamol 500mg prn = 10 tablet

1/ PPF = 600,000 I.u x7 = 4, 200,000 I.u water for

1 PPF vial = 4,000,000 I. u injection

? = x = 4,200,000 I.u 10m = 1 vial

1 x4 , 200,000 = 1.05  1vials 5ml= 2 vial

4,000,000

Ferrous sulfate – Is not dispensed b/c it says take as before.

Neomycin – 2 x7 = 14 days paracetamol = 10 tablet or 1 strip.

Comment

-PPF after reconstituted stored at refrigerator.

- PPF is penicillin group is antibiotics.

- PPF given by IM injection.

- Ferrous sulfate and Neomycin are Interact each other ferrous sulfate decrease
absorption of Neomycin.

- Ferrous sulfate – used for Iron deficiency.

- Neomycin – Antibiotics Is Amino glycosides group

- Inhibit the protein synthesis of the bacteria

- Amino glycosides are highly polar b/c of this the oral absorption is less.

- But Neomycin is available in tablet forms for local effects. Have bactericidal effects.

- group of Neomycin are like Gentamycin, streptomycin

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- paracetamol – Is non-opoid analgesics .

- have antipyretics & analgesics effects

Antipyretics- lowering body temperature.

Project – 3
Compounding project

Criteria-

1. Wear personal protective (Gowon, Masks, Glove, etc) & hand washing.

2. Clean work row material and Ingredients

3. Collect row material and equipments

4. Tare bottles

5. Correct calculation

6. Weighing technique use of paper or watch glass

7. Measuring technique

8. Mixing /levigation of technique

9. Packaging choice of container

10. Labeling

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11. Clean work area.

Example :- Magnesium sulfate mixture/oral suspension/

Ingredients Master formula Reduced formula

Magnesium sulfate ……………………. 400g …………. ………………….. 10g

Light magnesium carbonate ............ 50g ………………………………… 1.25g

Concentrated peppermint emulsion …. 25ml ……………………………… 0.6ml (12drop/

Double strength chloroform water ….. 300ml ……………………………. 7.5ml

Purified water to ……………………….. 1000ml … to …………………… 25ml.

Send 25 ml

Sig 10ml tid, shake the bottle before use

Compounding: - mix magnesium sulfate and light magnesium carbonate in mortar

and pestle and triturate the mixture with some water. Transfer the mixed mixture to a
measure and double strength chloroform water and add concentrated peppermint
emulsion. Finally adjust to the final volume with the water.

Action and use – laxative

Reducing the formula

- Magnesium sulfate = 400 g __ 1000ml 400 x 25

? x 25 1000 = 10g
- Light magnesium carbonate = 50 – 1000ml = 50 x 25= 1.25g
? x 25 1000
- Concentrated pipperment Emulsion = 25 – 100ml = 25 x 25 = 0.6ml
? x 25 1000 =
1ml = 20 drop 0.6ml x 20 = 12 drop
0.6ml x ? 1
Double strength chloroform water: 300ml – 1000ml = 300 x 25
? x 25 = 7.5ml

Uses of the Ingredients

Magnesium sulfate –Active Ingredients (for laxatives )

Light magnesium carbonate – Adjuvant for magnesium sulfate

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Conc. Peppermint emulsion – flavoring agent – Impart flavors

Double strength chloroform water – preservations

Water – vehicles.

Label for magnesium sulfate oral suspension

Magnesium sulfate

25ml

Use – laxative

Direction for use – orally shake well the bottle before use

manufacturing date – 10/11/04 .

Expiry date – 5/12/04

Storage conditions – store at cool place

precautions – keep reach out of children.

Each magnesium sulfate contains

Magnesium sulfate …………………….10g

Light mg carbonate …………… ………1.25g

Conc. Peppermint Emulsion …….. ……0.6ml

Double strength ch. Water………. ……7.5ml

Water …………….. to ………………. ……25ml.

Example 2- white field ointment

Ingredients Master formula Reduced formula

Benzene Acid …………………….. 6% ……………………………… 1.2g

Salicylic Acid ……………………….3% ……………………………….0.6g

White petroleum ………qs……………1000g ……………qs……… 20g (18.2g)

Send 20 g

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Compounding – weight the amount of Benzoic Acid, salicylic acid and white
petroleum and put on the ointment tile then triturate each other by taking small
amount & levigate two or three times until grity particle are not shown then transfer to
the ointment jars.

Action and uses – Anti fungal.

Calculations- B.A = 6g – 100g

? x 20g

6 x20 = 1.2g

100

S.A = 3g – 100g

? x 20g

3 x 20 = 0.6g

100

White petroleum 1.8 – 20 = 18.2

Label

White field ointment

20g

Use – Anti fungal

Direction for use – external use only applied on the affected area

Storage condition – at cool place

m. date – 20/11/04

E. date – 20/12/04

Precaution – keep reach out of children

- Protect from warm and cold area.

Each white field ointment contain
Benzoic acid ………….. 1.2g
Salicylic acid …………. 0.6g
White petroleum …qs….20g

Other Compounding project

- Lugol’s solutions

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- Iodine Tincture
- Iodine paint
- Ferrous sulfate syrup
- Simple syrup
- Sulfur ointments
- Calamine lotion

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