College of Pharmacy and Nursing School of Pharmacy PHARMACY PRACTICE I LAB PHCY 280L Lab Manual Fall 2017/18 Faculty: Ms Beena Jimmy Lecturer, Pharmacy Practice Name: Student Id: 1
Learning Objectives Develop the communication skills (role play) using WWHAM to interact with simulated patients to assist in diagnosis, triaging, decide on referral, selection of management options and counseling regarding pharmacological and non-pharmacological management options Develop the communication skills for history taking, triaging, decide on referral and selection of appropriate drug for management of minor diseases of dermatology system- acne, dandruff Develop the communication skills for history taking, triaging, decide on referral or selection of appropriate drug for management of minor diseases of gastrointestinal system- mouth ulcer, constipation, diarrhea, dyspepsia Develop the communication skills for history taking, triaging, decide on referral or selection of appropriate drug for management of minor diseases of EENT- conjunctivitis, ear disorders, cough 2
Develop skills to demonstrate various steps for using specialized dosage forms like eye drops, eye ointment, ear drops, nasal drops, nasal spray, and suppository. Role play to highlight what the pharmacist can AND can t do. 3
Instructions Prepare a list of questions to respond to patient s symptoms before coming to the lab for respective cases. Use WWHAM format to collect details about the patient and disease. Based on the information obtained from the patient and your clinical judgement, recommend the best possible OTC medicine. Mention the name, dosage form, dose, major side effects and directions for use of the medicine that is dispensed to the patient. Please follow the OTC drug list while choosing a drug for the patient. 4
Case 1 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of white heads/pimples. 5
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (at least 2) 6
Case 2 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of itching on head. Prepare the questions that you would like to ask the patient before interacting with the patient -------- 7
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (at least 2) 8
Case 3 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of pain in the mouth. 9
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (at least 2) 10
Case 4 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of difficulty in passing stools. 11
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (at least 2) 12
Case 5 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of loose stools and pain in stomach. 13
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (at least 2) 14
Case 6 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of heart burn, fullness and gas in stomach. -------- 15
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (atleast 2) 16
Case 7 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of cough. 17
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (atleast 2) 18
Case 8 You are the Pharmacist/Assistant Pharmacist in a Community Pharmacy located in Nizwa. A patient comes to your pharmacy with complains of itching in the ear. -------- -------- -------- -------- -------- -------- -------- -------- 19
List of OTC drugs available for this condition: Name of drug Dosage form Major side effects (atleast 2) 20
Instructions for how to use various dosage forms Page No. 1. How to Use Eye Drops 3 2. How to Use Eye Ointments and Gels 6 3. How to Use Ear Drops 8 4. How to Use Nose Drops 11 5. How to Use Nasal Sprays 13 6. How to Use Rectal Suppositories 15 21
How to Use Eye Drops (Using a mirror or having someone else give you the eye drops may make this procedure easier.) 1Wash your hands thoroughly with soap and water. 2 Check the dropper tip to make sure that it is not chipped or cracked. 3 Avoid touching the dropper tip against your eye or anything else - eyedrops and droppers must be kept clean. 4 While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket. 5 Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it. 22
6 Brace the remaining fingers of that hand against your face. 7 While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid. 8 Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids. 9 Place a finger on the tear duct and apply gentle pressure. 10 Wipe any excess liquid from your face with a tissue. 11 If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop. 12 Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip. 23
13 Wash your hands to remove any medication. 24
How to Use Eye Ointments and Gels (Using a mirror or having someone else give you the eyedrops may make this procedure easier.) 1Wash your hands thoroughly with soap and water. 2 Avoid touching the tip of the tube against your eye or anything else - the medication and its container must be kept clean. 3 Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it. 4 Brace the remaining fingers of that hand against your face. 5 Tilt your head forward slightly. 6 While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket. 7 Squeeze ribbon of ointment or gel into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid. 25
8 Blink your eye gently; then close your eye for 1 to 2 minutes. 9With a tissue, wipe any excess ointment or gel from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean. 10 Replace and tighten the cap right away. 26
How to Use Ear Drops 1Wash your hands thoroughly with soap and water. 2Gently clean your ear with a damp facecloth and then dry your ear. 3 Warm the drops to near body temperature by holding the container in the palm of your hand for a few minutes. 4 If the drops are a cloudy suspension, shake the bottle well for 10 seconds. 5 Check the dropper tip to make sure that it is not chipped or cracked. 6 Draw the medication into the dropper, or hold the dropper-top bottle with the dropper tip down. 7Tilt the affected ear up or lie on your side. Pull the ear backward and upward (or if giving to a child younger than 3 years of age, pull backward and downward) to open the ear canal. 27
8 Place the correct number of drops in your ear. Gently press on the small skin flap over the ear to help the drops to run into the ear canal 9 Keep your ear tilted up for a few minutes or insert a soft cotton plug in your ear, whichever method has been recommended by your pharmacist or doctor. 10 Replace and tighten the cap or dropper right away. 28
11 Wash your hands to remove any medication. 29
How to Use Nose Drops 1Blow your nose gently. 2 Wash your hands thoroughly with soap and water. 3 If your nose drops are a suspension, shake the bottle before using the drops. 4 Avoid touching the dropper tip against your clean nose. If the dropper touches the nose, then rinse in hot water and wipe with a towel. 5 Tilt your head as far back as possible, or lie down on your back on a flat surface (such as a bed) and hang your head over the edge. 30
6 Place the correct number of drops into your nose. Keep your head tilted back for a few minutes to allow the drops to drain into the back of the nose. 7 Bend your head forward toward your knees and gently move it left and right. 8 Repeat this procedure for the other nostril if advised to do so by your doctor or pharmacist. 9 Clean the dropper tip with warm water. Cap the bottle right away. 10 Wash your hands to remove any medication. 31
How to Use Nasal Sprays 1Wash your hands thoroughly with soap and water. 2 Blow your nose gently before using the spray. 3Gently insert the bottle tip into one nostril. Press on the other side of your nose with one finger to close off the other nostril. 32
4Keep your head upright. 5 Breathe in quickly while squeezing the bottle. 6 Repeat in other nostril. 7 Wash your hands thoroughly with soap and water. YOUR NASAL SPRAY SHOULD BE CLEANED AT LEAST ONCE A WEEK, OR MORE OFTEN IF IT GETS BLOCKED 33
How to Use Rectal Suppositories 1Wash your hands thoroughly with soap and water. 2 If the suppository is soft, hold it under cool water or place it in a refrigerator for a few minutes to harden it before removing the wrapper. 3Remove the wrapper, if present. 4 If you were told to use half of the suppository, cut it lengthwise with a clean, single-edge razor blade. 5 Put on a finger cot or disposable glove, if desired (available at a pharmacy). 34
6 Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water. 7 Lie on your side with your lower leg straightened out and your upper leg bent forward toward your stomach. 8 Lift upper buttock to expose the rectal area. 35
9 Insert the suppository, pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1/2 to 1 inch in infants and 1 inch in adults. (If not inserted past this sphincter, the suppository may pop out.) 10 Hold buttocks together for a few seconds. 11 Remain lying down for about 5 minutes to avoid having the suppository come out. 12 Discard used materials and wash your hands thoroughly. 36
Name: College of Pharmacy and Nursing School of Pharmacy Objective Structured Clinical Examination (OSCE) Non- clinical station Id No: You must use a Blue or Black colored pen only. The use of Pencil or any other colored pen will earn you a ZERO. You have 10 minutes time to complete this station Good Luck! You receive the following Prescription for:- UNIVERSITY OF NIZWA HOSPITAL Birkat Al-Mouz, Nizwa Name of the Patient: ABC Hospital No: 584761 Age: 30 years Weight in Kg: 64 Sex: Female Rx XYL Eye ointment- both eyes b.i.d for 5 days Physicians Name & M.O.H. Reg.No: Dr. EFG( Regn.No: 5525 ) Date:1-01-2016 Physician s Signature: EFG Dispensed By: Ph (P.T.O) 37
As a Pharmacist what are the directions you would give to this patient for proper use of her medication. Write down the directions in proper order (sequence) as points. ------------------------------------------------------------------------------------------------------ 38
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