Lesson 1 - Retail Practice Settings Assignments Answer Key

Assignment 1 - Case Study Review the Case Study on page 373 of the Pharmacy Technician Practice and Procedures textbook. Then answer the following questions.

1. Why is multitasking important? Answer: A pharmacy technician may be required to do many things simultaneously at a pharmacy and therefore must prioritize his or her duties. Various duties include: answer phone inquiries, input information into the computer, count medicine, etc.

2. Why is it important to know your computer system? Answer: Pharmacy Technicians use the computer regularly while working in the Pharmacy for inputting patient information and looking up drug information as well as billing third parties. It can also be used for inventory control and ordering for the pharmacy. Knowing the system enables the processes to run more smoothly with less chance of error.

3. What are some examples of customer service being observed in this retail pharmacy by Tina?

Answer: Tina shows the customer where she can wait while her prescription is being filled. Tina then informs the customer where she can find certain items in the store that she is looking for. Finally Tina assists the customer in finding out why her medication claim was denied by her insurance company and gives her information on the cost of the medication and the time frame in which the pharmacy can have it in so the customer can come back in and pick it up once she was able to deal with her insurance problem. So in this instance Tina offered very good customer service to this customer as she spent a lot of time in order to be sure the customer was satisfied and able to get her medication.

Assignment 2 - At Your Service Review the At Your Service scenario on page 374 of the Pharmacy Technician Practice and Procedures textbook. Then answer the following question.

1. What is the role of the pharmacy technician in a retail pharmacy? Answer: To assist the pharmacist in the processing of a customer’s prescriptions.

2. What are some of the duties the pharmacy technician may be responsible for performing while working in a retail pharmacy? Answer: Assisting customers dropping off for picking up prescriptions, filling prescriptions, ordering medications, checking in orders from vendors.

3. Why is teamwork important in a retail pharmacy? Answer: Teamwork allows the pharmacy to operate more efficiently.

Assignment 3 - Critical Thinking

1. A patient presents a new prescription for prime effect 20 mg, which is an OTC medication. The patient wants to have the prescription submitted to a third-party provider. How would you handle the situation? Answer: Explain to the customer that the insurance companies do not cover OTC medications. Maybe offer to call the prescriber and see if they could provide another medication that might be covered by the insurance company or explain to the customer that the OTC medications are cheaper than prescribed medicines.

2. A patient wishes to refill a prescription; however, it is rejected by the third-party provider with an explanation of “refill too soon.” The patient informs you that the physician has changed the directions on the prescription. How would you handle the situation? Answer: Let the customer know you would be happy to look into the situation for them and show them where they could wait. Then call the physician to confirm the change. Then call the insurance company to explain the changes.

3. You are processing a new prescription for a patient and during the DUE phase, you receive a warning on the computer screen. What will you do and why? Answer: Inform the Pharmacist of the situation so that they can counsel the patient further and resolve any possible issues.

4. A patient calls in a prescription to be refilled for hydrochlorothiazide 50 mg (a diuretic) on Saturday afternoon. There are no refills remaining on the prescription and you fax a refill request to the patient’s physician. The patient comes into the pharmacy to pick up the prescription, but the physician has not approved a refill yet. You notice on the patient’s prescription profile that the patient has been receiving this medication for the past five years. What will you do? Answer: Consult with the Pharmacist and have them authorize the refill before proceeding, or at least enough for a couple of days until the authorization from the physician’s office came through. Also explain to the customer that because they did not have any refills left on the medication that the pharmacy had to get authorization from their doctor’s office before they could refill it and being that it was Saturday it could be that their doctors office was closed.

5. A patient is picking up a prescription for Coumadin (a blood thinner) and also picks up a bottle of Bayer aspirin. As a pharmacy technician, you know that a patient should never take aspirin while being prescribed Coumadin. What should you do? Answer: Inform the Pharmacist and have he/she counsel the patient about the dangers of taking these two medications together.

Assignment 4 - HIPAA Scenario John, the pharmacy technician, used the pharmacy’s computer system to access his wife Melissa’s prescription information. During a conversation with his wife, John let it slip that he knew about a medication she was taking, and Melissa realized that he had accessed her medical information at work. She immediately called John’s supervisor and asked if he had unlimited access to her medical records. The supervisor stated that while John, as an employee, had access to patient healthcare data, he was only allowed to access a patient’s data during the course of his duties as a pharmacy technician, as in filling or refilling a patient’s prescription. He said that John should have accessed her medication profile only if he was filling or refilling a prescription for her, and assured Melissa that John would be disciplined.

Discussion Questions

1. Should John be able to access his spouse’s medical data without her consent? Answers: John should not have been accessing his spouse’s medical data this is a breach of trust and goes against the rules of Pharmacy.

2. Did John’s access of Melissa’s data appear to be in conjunction with providing healthcare? Answer: John was not accessing this information as part of his duties in the filling or refilling of a prescription so he had not right being in this file.

3. What actions, if any, should be taken against John? Answer: The Pharmacist should remind him of his duties and the boundaries that he crossed by looking up his spouse’s information. Depending on past performance would determine if more action should follow i.e a suspension without pay etc. If this was his first incident than the reprimand by the Pharmacist would probably suffice in this instance.

Assignment 5 - Internet Activities Answers: Answers will vary.

1. Go to www.nacds.com and explore the website. What types of resources are available in the pharmacy section of the site? What types of opportunities are posted for pharmacy technicians?

2. Go to www.MedicineShoppe.com or http://www.futureofpharmacy.com/operation_support.htm and find out what one must do to obtain a franchise with the Medicine Shoppe.

Assignment 6 - Apply Your Knowledge

1. A prescription is rejected by a third-party payer with the following explanation: “NDC Not Covered.” How would you resolve this problem? Possible answer: Call the insurance company to find out why it was not covered and to see if there is a possible substitute that would be. If there is, call the prescriber to have them change it.

2. A physician writes a prescription for a 90-day supply of home maintenance medication. The patient’s prescription plan allows for a 30 day supply of medication. How would you explain to the patient why he or she only received a 30-day supply and what are the options to fill a prescription? Possible answer: Explain to the customer that their insurance company would only cover a 30-day supply and suggest that they could come back in 30 days to get a refill for another 30 days until the 90 day supply is used up and that way it would be covered. Or the customer could pay for the additional 60 days and then submit for a reimbursement themselves.

3. A patient has been receiving the following prescription:

Dr. John Williams 1100 Wilson Blvd. Arlington, VA 22209 Ed Tarboosch hydrochlorothiazide 50 mg #30 i po q am Refill prn Dr. John Williams

The prescription was written and filled initially on December 2, 2010. The patient attempts to refill the prescription on January 3, 2012, and the computer informs you that the prescription does not have any refills remaining and the prescription has expired. The patient tells you that his physician told him that he will need to take the medication the rest of his life. How would you handle the situation? Possible answer: Call the physician’s office and get them to fax a new prescription with refills so that the prescription could be filled.

4. You are processing a prescription and receive a warning message during the Drug Utilization Evaluation step. What do you do? Possible answer: Inform the Pharmacist and have them counsel the customer in regards to any possible problems concerning the medication that they are taking.

5. If you were filling a new prescription, would you fill it at a chain pharmacy, independent pharmacy, mass merchandiser, or grocery store? Why? Possible answer: Perhaps, fill it at an independent pharmacy as independent pharmacies are generally smaller and therefore more apt to have more one on one time with the customer and also know their history and make it a more personal experience. Whereas the other pharmacies deal in a higher customer base and may not know or remember you. Also they deal in a much higher volume of filling prescriptions making it easier for mistakes to be made.

6. Many retail pharmacies have drive-in windows to drop-off and pickup prescriptions. What advantages and disadvantages do you find for drive-in windows?

Possible answer: It is a less personal way of dealing with the customer. If problems arise and the customer has to wait it holds up others that may be waiting in the line behind them. Also when it comes to counseling a patient about a particular use of a medicine if others are in car there may be information that you do not want shared. The advantages are it may be quicker and a little more convenient for the customer if they are in a hurry.

7. What can a pharmacy technician do to help eliminate rejections of prescriptions by third-party insurance providers? Possible answer: They can make sure that all the information is correct before entering it into the system. They can check dates for refills to make sure the medication is not being ordered too soon. They can also check the insurance website to see what medications may be covered ahead of time and to see if there is a suitable generic brand that might be if the brand name is not.

8. Explain the importance of collecting accurate patient information to be included in the patient’s profile. Possible answer: It is important to have accurate patient information in their profile to help expedite third-party claims. Also it allows the system to pick up on any possible drug interactions or allergies to certain drugs.

9. What are the advantages and disadvantages of requiring prescription insurance cards to follow a standardized format? Possible answer: The advantages to such a format would allow easier input by the Pharmacy into their computer systems. It would make the cards easier for the Pharmacy workers to read and understand and thus preventing possible errors when inputting the information into their computers. And I would think the only disadvantage would be to the insurance companies themselves as they would have to change over their systems to reflect such a change.

10. Should pharmacy technicians be able to counsel patients? Why or why not? Possible answer: It is in the best interest for a Pharmacy Technician to counsel patients they just do not have the education and training required to do so and the liability would be too great for them if wrong information is given to a patient. It is best that the Pharmacist do all the counselling as he/she is ultimately the one in charge of overseeing all aspects of the Pharmacy and to make sure everything runs effectively and efficiently.

Assignment 7 - Practice Your Knowledge Visit a local retail pharmacy, and complete the following table.

Answers: Answers may be found in the PDR for Nonprescription Drugs and at several reputable online sources.

Drug Classification

OTC Product

Active Ingredients

Dosage Form

Drug Interactions Warnings

Analgesic Accupril Quinapril Hydrochloride

Tablets Dual blockade of the RAS is associated with

Less effect on BP and more reports of angioedema in

increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure); closely monitor BP, renal function, and electrolytes with concomitant agents that also affect the RAS.

blacks than nonblacks. Angioedema of the face, extremities, lips, tongue, glottis, and larynx reported; d/c and administer appropriate therapy if laryngeal stridor or angioedema of the face, tongue, or glottis occurs. Intestinal angioedema reported; monitor for abdominal pain. Patients with history of angioedema unrelated to ACE inhibitor therapy may be at increased risk of angioedema during therapy.

Antidiarrheal Agent

Imodium A-D

loperamide hydrochloride

Solution, Tablet, Chewable-Tab

Avoid in patients with bloody/black stool or have a history of rash or other allergic reaction associated with previous use. Caution in patients with fever, mucus in the stool, history of liver disease, or taking antibiotics. May impair mental/physical abilities. D/C if symptoms get worse, diarrhea lasts for >2 days, or abdominal swelling/bulging occurs.

Antifungal Agent

Diflucan fluconazole Injection, Suspension, Tablet

Avoid use with erythromycin or voriconazole. Risk of increased plasma

Associated with rare cases of serious hepatic toxicity; monitor for more severe hepatic injury

concentration of other compounds metabolized by CYP2C9 and CYP3A4. Oral hypoglycemics may precipitate clinically significant hypoglycemia; monitor and adjust dose of sulfonylurea. May increase PT with coumarin-type anticoagulants; monitor and adjust dose of warfarin if necessary.

if abnormal LFTs develop. D/C if signs and symptoms of liver disease develop. Rare anaphylaxis and exfoliative skin disorders reported; monitor for rash and d/c if lesions progress. Rare cases of QT prolongation and torsades de pointes reported; caution with potentially proarrhythmic conditions. Caution in elderly or with renal/hepatic dysfunction. May impair mental/physical abilities. (Sus) Contains sucrose; avoid with hereditary fructose, glucose/galactose malabsorption, and sucrase-isomaltase deficiency. (Tab) Consider risk vs. benefits of single dose PO tab vs. intravaginal agent therapy for the treatment of vaginal yeast infections.

Carminative Gas-X simethicone Chew Tablet, Thin Strip, Soft-Gel Cap.

None None

Contact Lens Agent

Visine for contacts

borate/glycerin/hypromellose/isotonic solution

Solution None Eye problems including corneal ulcers can occur; remove contacts if eye discomfort, excessive tearing,

vision changes or eye redness occur. Do not touch container tip to any surface to avoid contamination.

Cough Suppressant

Delsym Dextromethor-phan polistirex

Suspension

Avoid with MAOIs, or for 2 weeks after d/c MAOI drug.

Do not exceed recommended dosing. Caution in patients with chronic cough that lasts as occurs with smoking, asthma or emphysema, and cough that occurs with too much phlegm (mucus). D/C if cough lasts >7 days, comes back, or occurs with fever, rash, or headache that lasts; these could be signs of a serious condition. Contains sodium 7mg/5mL.

Dietary Supplement

Immunizen colostrum/dietary supplement/yeast

Capsules None Immunizen® is well tolerated. Some gastrointestinal discomfort may be experienced as with any dietary supplement.

Expectorant Mucinex guaifenesin Solution, extended-release Tab

None Caution with cough accompanied by too much phlegm, and persistent or chronic cough that occurs with smoking, asthma, chronic bronchitis, or emphysema. D/C if cough lasts >7 days, comes back, or occurs with fever, rash, or persistent headache. (Sol) D/C if hypersensitive to

any of the ingredients. Contains 8.4mg/5mL phenylalanine; caution with phenylketonurics.

First Aid Agent Neosporin Ointment

bacitracin/neomycin/polymyxin b sulfate

Ointment None For external use only. Avoid eyes. Do not use over large areas of the body. D/C if condition persists, worsens, or if a rash or other allergic reaction develops, or if treatment needed for >1 week.

Laxative Miralax Polyethylene Glycol 3350

Solution, powder

None Do not use with kidney disease unless directed. Caution with N/V, abdominal pain, sudden change in bowel habits that lasts >2 weeks, and irritable bowel syndrome (IBS). Loose, watery, more frequent stools may occur. D/C if rectal bleeding or diarrhea develops; if nausea, bloating, cramping, or abdominal pain worsens; or if patient needs to use a laxative for >1 week.

Local Anesthetic

Cetacaine Topical Anesthetic

Tetracaine HCl, Benzocaine, Butamben

Gel, Liquid, Spray

None Anaphylaxis and localized allergic reactions may occur; d/c if manifestations of allergy develop. To minimize serious allergic reaction, do not apply for prolonged periods except under continual

supervision; dehydration of the epithelium or an escharotic effect may result. Methemoglobinemia reported (rare). If patient becomes cyanotic, treat appropriately to counteract. Observe routine precaution for use during pregnancy.

Non-Steroidal anti-inflammatory agent

Celebrex Celecoxib Capsules Avoid with non-ASA NSAIDs. Caution with CYP2C9 inhibitors. Potential interaction with CYP2D6 substrates. Warfarin or similar agents may increase risk of bleeding complications; monitor anticoagulant activity. May increase lithium levels; monitor closely. ASA may increase rate of GI ulceration or other complications. May diminish the antihypertensive effect of ACE inhibitors and ARBs. Fluconazole may increase levels. May reduce the natriuretic effect of loop diuretics (eg, furosemide) and thiazides. Oral corticosteroids, anticoagulants,

Use lowest effective dose for the shortest duration possible. Not recommended with severe hepatic impairment. May lead to onset of new HTN or worsening of preexisting HTN; caution with HTN, and monitor BP closely. Fluid retention and edema reported; caution with fluid retention or heart failure (HF). Caution with history of ulcer disease, GI bleeding, and other risk factors for GI bleeding (eg, prolonged NSAID therapy, older age, poor general health status); monitor for GI ulceration/bleeding. May cause elevations of LFTs or severe hepatic reactions (eg, jaundice, fatal fulminant hepatitis, liver necrosis, hepatic failure); d/c if liver disease

smoking, or alcohol may increase risk of GI bleeding. Risk of renal toxicity with diuretics, ACE inhibitors, and ARBs. Aluminum- and magnesium-containing antacids may reduce plasma concentrations.

develops or systemic manifestations occur, or if abnormal LFTs persist/worsen. Renal injury reported with long-term use; increased risk with renal/hepatic impairment, HF, and in elderly. Not recommended with advanced renal disease; if therapy must be initiated, closely monitor renal function. D/C if abnormal renal tests persist/worsen. Anaphylactoid/anaphylactic reactions and angioedema reported. Caution with asthma and avoid with ASA-sensitive asthma and the ASA triad.

Nutritional Supplement

Concept OB

Pantothenic Acid, Vitamin B12, ProAscorb C, Zinc, Vitamin C, Vitamin B6, Riboflavin, Thiamine, Polysaccharide Iron Complex, Niacin, Copper, Magnesium, Folic Acid, Ferrous Fumarate, Biotin

Capsules Calcium may inhibit iron absorption; prescribe calcium salts separately for women at high nutritional risk.

Folic acid alone is improper therapy in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient. Folic acid in doses >0.1-0.4mg/day may obscure pernicious anemia; hematological remission may occur while neurological manifestations remain progressive.

Stool Softener Colace Docusate Sodium

Capsules, Syrup

Avoid concurrent use of mineral oil.

Avoid use for >1 week. Caution with stomach pain, N/V, and sudden change in bowel habits that

lasts over 2 weeks. D/C use if rectal bleeding occurs or fail to have bowel movement after therapy; these could be signs of a serious condition.

Topical Analgesic

Caladryl Pramoxine HCl, Calamine

Lotion None For external use only. Avoid contact with eyes. D/C if condition worsens or does not improve within 7 days, or if symptoms persist for >7 days or reoccurs within few days.

Topical Antibiotic

Polysporin Polymyxin B, Bacitracin

Ointment None For external use only. Do not use in the eyes, over large areas of the body, or if allergic to any of the ingredients. Caution with deep or puncture wounds, animal bites, or serious burns. D/C if use for >1 week is needed, condition persists or gets worse, or rash or other allergic reaction develops.

Vitamin Mephyton Phytonadione Tablets May cause temporary resistance to prothrombin-depressing anticoagulants, especially with large doses; use larger anticoagulant doses upon reinstitution.

Immediate coagulant effect should not be expected after administration. Does not counteract anticoagulant effects of heparin. Not a clotting agent. Patients on anticoagulant therapy and who are being treated for excessive anticoagulant-induced

Assignment 8 - Pharm Facts—Research Use Drug Facts and Comparisons or the PDR to complete the following table.

Answers: Brand Name

Generic Name

Indications 5 Side Effects Controlled Substance

Y or N

Advair Discus

Salmeterol,

Fluticasone

Propionate

Treatment of asthma in patients

≥4 yrs. (250/50) Maintenance

treatment of airflow obstruction

in patients with chronic

obstructive pulmonary disease

(COPD), including chronic

bronchitis and/or emphysema,

and to reduce exacerbations of

COPD in patients with history of

exacerbations.

Chills, Cough,

Fast Heartbeat,

Fever, Headache

N

Ambien Zolpidem

Tartrate

Short-term treatment of insomnia

characterized by difficulties with

sleep initiation.

Chest pain,

confusion, fever,

irritability, lack of

appetite

Y

Amoxil Amoxicillin Treatment of infections of the

ear, nose, throat, genitourinary

tract (GU), skin and skin

structure (SSSI), lower

respiratory tract (LRTI), and

acute, uncomplicated gonorrhea

Stomach Cramps,

Bloating, Bleeding

Gums, Dark Urine,

Dizziness

N

hypoprothombinemia are at risk for clotting hazards that existed prior to starting anticoagulant therapy. Avoid repeated large doses in liver disease if initial response is unsatisfactory. Failed response may indicate congenital coagulation defect or condition being treated is unresponsive.

(anogenital and urethral

infections) due to susceptible (β-

lactamase negative) strains of

microorganisms. Combination

therapy for Helicobacter

pylorieradication to reduce the

risk of duodenal ulcer

recurrence.

Coumadin Warfarin

Sodium

Prophylaxis and treatment of

venous thrombosis and its

extension, pulmonary embolism

(PE), and thromboembolic

complications associated with

atrial fibrillation (A-fib) and/or

cardiac valve replacement. To

reduce risk of death, recurrent

myocardial infarction (MI), and

thromboembolic events, such as

stroke or systemic embolization

after MI.

Fever, Itching,

Chills, Diarrhea,

Dizziness

Y

Fosamax Alendronate

Sodium

Treatment of osteoporosis in

postmenopausal women.

Treatment to increase bone

mass in men with osteoporosis.

(Tab) Prevention of osteoporosis

in postmenopausal women.

Treatment of glucocorticoid-

induced osteoporosis in men

and women receiving

glucocorticoids in a daily dosage

equivalent to 7.5mg or greater of

prednisone and who have low

bone mineral density (BMD).

Treatment of Paget's disease of

bone in men and women.

Stomach Pain,

Trouble

Swallowing,

Heartburn, Muscle

Pain, Skin Rash.

N

Lasix Furosemide Treatment of edema associated

with congestive heart failure,

liver cirrhosis, and renal disease,

including nephrotic syndrome in

adults and pediatric patients.

(PO) Treatment of HTN alone or

in combination with other

antihypertensive agents in

adults. (Inj) Adjunctive therapy

for acute pulmonary edema.

Chest Pain, Fever,

Chills, Headache,

Sore Throat

N

Lexapro Escitalopram

Oxalate

Acute and maintenance

treatment of MDD in adults and

adolescents 12-17 yrs. Acute

treatment of generalized anxiety

disorder (GAD) in adults.

Constipation,

Diarrhea, Dry

Mouth, Heartburn,

Trouble Sleeping

N

Lipitor Atorvastatin

Calcium

To reduce the risk of myocardial

infarction (MI), stroke,

revascularization procedures,

and angina in adults without

clinically evident coronary heart

disease (CHD) but with multiple

risk factors for CHD. To reduce

the risk of MI and stroke in

patients with type 2 diabetes,

and without clinically evident

CHD, but with multiple risk

factors for CHD. To reduce the

risk of nonfatal MI, fatal and

nonfatal stroke, revascularization

procedures, hospitalization for

congestive heart failure, and

angina in patients with clinically

evident CHD. Adjunct to diet for

treatment of primary

hypercholesterolemia

(heterozygous familial and

nonfamilial) and mixed

dyslipidemia (Types IIa and IIb).

Adjunct to diet for treatment of

patients with elevated serum TG

levels (Type IV). Treatment of

primary dysbetalipoproteinemia

(Type III) inadequately

responding to diet. Adjunct to

other lipid-lowering treatments or

if treatments are unavailable, for

treatment of homozygous

familial hypercholesterolemia

(HoFH). Adjunct to diet for

treatment of boys and

postmenarchal girls, 10-17 yrs of

age, with heterozygous familial

hypercholesterolemia.

Headache, Back

Pain, Hoarseness,

Painful Urination,

Stuffy or Runny

Nose

Y

Nexium Esomeprazol

e Magnesium

Short-term treatment (4-8

weeks) and maintenance (up to

6 months) in the healing and

symptomatic resolution of

erosive esophagitis. Short-term

Bad aftertaste,

Drowsiness, Acne,

Back Pain,

Change in Taste

N

treatment (up to 6 weeks) of

erosive esophagitis due to acid-

mediated gastroesophageal

reflux disease (GERD) in infants

1 month to <1 yr of age. Short-

term treatment (4-8 weeks) of

heartburn and other symptoms

associated with GERD in adults

and children ≥1 yr of age.

Reduction in occurrence of

gastric ulcers associated with

continuous NSAID therapy in

patients at risk for developing

gastric ulcers. Long-term

treatment of pathological

hypersecretory conditions (eg,

Zollinger-Ellison syndrome). In

combination with amoxicillin and

clarithromycin for the treatment

of Helicobacter pylori infection

and duodenal ulcer disease

(active or history of within the

past 5 yrs) for H.

pylori eradication to reduce the

risk of duodenal ulcer

recurrence.

Norvasc Amlodipine

Besylate

Treatment of HTN or coronary

artery disease (CAD), including

chronic stable or vasospastic

(Prinzmetal's/variant) angina,

alone or in combination with

other antihypertensives or

antianginals, respectively. To

reduce risks of hospitalization

due to angina and to reduce the

risk of coronary revascularization

procedure in patients with

recently documented CAD by

angiography and without heart

failure or ejection fraction <40%.

Swelling of the

Ankles, Dizziness,

Shortness of

Breath, Tightness

in Chest,

Wheezing

N

Prevacid Lansoprazole Short-term treatment of active

duodenal ulcer (DU), active

benign gastric ulcer (GU), and

erosive esophagitis (EE). Maint

of healing of DU and EE.

Treatment and risk reduction of

NSAID-associated GU.

Treatment of heartburn and

other symptoms associated with

gastroesophageal reflux disease

Diarrhea, Skin

Rash, Stomach

Pain, Joint Pain,

Nausea

N

(GERD). Long-term treatment of

pathological hypersecretory

conditions (eg, Zollinger-Ellison

syndrome). Combination therapy

with amoxicillin +/- clarithromycin

for Helicobacter

pylori eradication to reduce the

risk of DU recurrence.

Protonix Pantoprazole

Sodium

(Tab/Sus) Short-term treatment

(up to 8 weeks) in the healing

and symptomatic relief of erosive

esophagitis (EE) associated with

gastroesophageal reflux disease

(GERD) in adults and pediatric

patients ≥5 yrs of age.

Maintenance of healing of EE

and reduction in relapse rates of

daytime and nighttime heartburn

symptoms in adults with GERD.

Long-term treatment of

pathological hypersecretory

conditions, including Zollinger-

Ellison syndrome. (IV) Short-

term treatment (7-10 days) of

adults with GERD and a history

of EE. Treatment of pathological

hypersecretory conditions,

including Zollinger-Ellison

syndrome, in adults.

Dry Mouth,

Blurred Vision,

Nausea,

Sweating,

Vomiting

N

Singulair Montelukast

Sodium

Prophylaxis and chronic

treatment of asthma in adults

and pediatric patients ≥12

months of age. Relief of

symptoms of seasonal allergic

rhinitis in patients ≥2 yrs of age

and perennial allergic rhinitis in

patients ≥6 months of age.

Prevention of exercise-induced

bronchoconstriction (EIB) in

patients ≥6 yrs of age.

Abdominal Pain,

Bloody Nose,

Headache, Joint

Pain, Sweating

N

Synthroid Levothyroxine

Sodium

Replacement or supplemental

therapy in congenital or acquired

hypothyroidism of any etiology,

except transient hypothyroidism

during the recovery phase of

subacute thyroiditis. Treatment

or prevention of various types of

euthyroid goiters, including

thyroid nodules, subacute or

Chest Pain,

Extreme Fatique,

Fainting, Fever,

Hives or Welts

N

chronic lymphocytic thyroiditis,

multinodular goiter and as an

adjunct to surgery and

radioiodine therapy for

thyrotropin-dependent well-

differentiated thyroid cancer.

Toprol-XL Metoprolol

Succinate

Treatment of HTN alone or in

combination with other

antihypertensives. Long-term

treatment of angina pectoris.

Treatment of stable symptomatic

(NYHA Class II or III) heart

failure (HF) of ischemic,

hypertensive, or

cardiomyopathic origin.

Blurred Vision,

Chest Pain,

Confusion,

Shortness of

Breath, Sweating

N

Vicodin Hydrocodone

Bitartrate,

Acetaminoph

en

Relief of moderate to moderately

severe pain.

Chills, Fever, Dark

Urine, Hives,

Headache

Y

Zestril Lisinopril Treatment of HTN alone or with

other antihypertensive agents.

Adjunctive therapy in

management of heart failure

(HF) if inadequately responding

to diuretics and digitalis.

Treatment of hemodynamically

stable patients within 24 hrs of

acute myocardial infarction

(AMI), to improve survival.

Blurred Vision,

Cloudy Urine,

Confusion,

Sweating,

Dizziness

N

Zithromax Azithromycin Treatment of the following

infections caused by susceptible

strains of microorganisms: (Tab

[250mg, 500mg]/Sus

[100mg/5mL, 200mg/5mL])

Acute bacterial exacerbations of

chronic obstructive pulmonary

disease (COPD), acute bacterial

sinusitis (ABS), community-

acquired pneumonia (CAP),

pharyngitis/tonsillitis,

uncomplicated skin and skin

structure infections (SSSIs),

urethritis, cervicitis, genital ulcer

disease (men), and acute otitis

media. (Inj) CAP and pelvic

inflammatory disease (PID).

(Tab [600mg]/Sus [Single-Dose

Pkt]) Treatment of

Diarrhea, Loose

Stools, Dry Skin,

Fever, Swelling

N

disseminated Mycobacterium

avium complex (MAC) disease in

combination with ethambutol in

persons with advanced HIV

infection. Prevention of

disseminated MAC disease,

alone or in combination with

rifabutin, in persons with

advanced HIV infection.

Treatment of nongonococcal

urethritis and cervicitis.

Zoloft Sertraline HCl Treatment of MDD, social

anxiety disorder (SAD), panic

disorder with/without

agoraphobia, premenstrual

dysphoric disorder (PMDD), and

posttraumatic stress disorder

(PTSD) in adults. Treatment of

OCD in patients ≥6 yrs.

Decreased Sexual

Desire, Diarrhea,

Fever, Dry Mouth,

Lack of Energy

N

Zyrtec Cetirizine HCl Temporarily relieves symptoms

due to hay fever or other upper

respiratory allergies (runny nose,

sneezing, itchy/watery eyes,

itching of the nose or throat).

Fatigue, Dry

Mouth, Insomnia,

Headache,

Abdominal Pain

N

Assignment 9 - Calculation Corner A patient receives the following prescription: cephalexin 500 mg #40 i cap po qid

How many days will the prescription last? Answer: Days Supply = Quantity Dispensed Quantity taken each day Days Supply = 40 capsules 4 capsules taken each day = 10 days supply