Emergency Kit Checklist Part 3/3

E-Kit List of Medicines Part 3/3

• D50 Caloric Agent 50 mL polyampule # 1
• D5/0.3NaCl 500 mL # 1
• D5/0.3NaCl 1 L # 1
• D5IMB 500 mL # 1
• D5LR 500 mL # 1
• D5LR 1 L # 1
• D5NM 1 L # 1
• D5NSS 1 L # 1
• D5W 250 mL # 1
• D5W 500 mL # 1
• D5W 1 L # 1
• PlainLR 1 L # 1
• PNSS 1 L # 1
• Mannitol 20% 500 mL # 1

Emergency Kit Checklist Part 2/3

E-Kit List of Medicines Part 2/3

• Mefenamic Acid 500 mg tab # 5
• Meperidine 100 mg/mL ampule # 1
• Methylprednisolone 4 mg tablet # 5
• Metoclopramide 10 mg/mL ampule # 2
• Nicardipine 2 mg ampule # 1
• Nicardipine 10 mg ampule # 1
• Nitroglycerin patch # 1
• Norepinephrine 2 mg/2 mL ampule # 1
• ORS sachet # 1
• Paracetamol 300 mg/mL ampule # 2
• Phenobarbital 130 mg/mL ampule # 1
• Phenytoin 100 mg/2 mL ampule # 1
• Potassium Chloride 40 mEq ampule # 1
• Pyridoxine 1 g/mL ampule # 1
• Salbutamol 2 mg/mL nebule # 5
• Sodium Bicarbonate 50 mEq/50 mL ampule # 2
• Sodium Chloride 0.9% conc. 20 mL polyampule # 1
• Succinylcholine 200 mg ampule # 1
• Terbutaline 0.5 mg ampule # 1
• Tetanus Toxoid 0.5 mL ampule # 1
• Vitamin B Complex (B1B6B12) ampule # 1
• Tramadol 50 mg capsule # 5
• Verapamil 5 mg/2 mL ampule # 1
• Hydroxyethyl starch (130/0.4) 6%, NaCl 0.9% Solution # 1

Emergency Kit Checklist Part 1/3

E-Kit List of Medicines Part 1/3

• Activated Charcoal 25 g sachet # 1
• Activated Charcoal 50 g sachet # 1
• Amiodarone 150 mg ampule # 1
• Anti-Tetanus Serum 1 500 UI ampule # 1
• Aspirin 325 mg tablet # 3
• Atropine sulfate 1 mg/mL ampule # 10
• Calcium Gluconate 10 mg/mL ampule # 2
• Clonidine 75 mg tablet # 2
• Clonidine 150 mg tablet # 2
• Clonidine 150 mg ampule # 2
• Dexamethasone 80 mg/2 mL vial # 2
• Diazepam 10 mg/2 mL ampule # 2
• Digoxin 0.5 mg/mL ampule # 1
• Diphenhydramine 50 mg/mL ampule # 2
• Dobutamine 250 mg/5 mL Vial # 2
• Dopamine 200 mg/5 mL vial # 2
• Epinephrine 1 mg/mL ampule # 10
• Furosemide 20 mg/2 mL amp # 2
• Haloperidol 50 mg/mL ampule # 1
• Tranexamic Acid 500 mg ampule # 2
• Hydralazine ampule # 2
• Hydrocortisone 100 mg vial # 1
• Hydrocortisone 250 mg vial # 1
• Hydrocortisone 500 mg vial # 1
• Hyoscine-N-Butylbromide 20 mg/mL ampule # 2
• Ipratropium + Salbutamol nebule # 5
• Isosorbide Dinitrate 5 mg tablet # 2
• Isosorbide Dinitrate 10 mg/ 10 mL ampule # 1
• Lidocaine 2% polyampule # 2
• Magnesium Sulfate 1 g/mL ampule # 2

What is a Correct Prescription?

Parts of a Prescription

• Patient Information 

• Date

• Superscription (Rx symbol) - "Recipe" in Latin, meaning "to take".

• Inscription - It is considered as the body or the principal part of the prescription. It contains the full information and quantity of the the prescribed medication.

• Subscription - Considered as the dispensing direction for the pharmacist, it usually contains the number of units to be filled.

• Signa - Meaning "to mark", it contains instructions that are to be followed by the patient.

• Refill, Special Instruction, and/or Special Labeling 

• Prescriber's Information

How to Differentiate a Violative, Erroneous, or an Impossible Prescription and What Proper Actions are to be Taken

Violative Prescription

• The generic name is not written.
• Both the generic name and brand name are written but, only the brand name is legible. 
• Only the brand name is written and added with imposing instruction ("No other substitute") that can hinder, obstruct or prevent proper dispensing. 

What to do with a Violative Prescription?

Violative prescriptions shall not be filed. They are kept and reported by the pharmacist of drug outlet or any other interested party to the nearest DOH office for appropriate action. The pharmacist shall advise the prescriber of the problem and/or instruct the patient to get the proper prescription.

Erroneous Prescription

• The brand name precedes the generic name.
• The generic name is enclosed with a parenthesis instead of the brand name.
• The brand name is not in parenthesis.
• More than one drug is prescribed on one prescription.

What to do with an Erroneous Prescription

Erroneous prescriptions shall be filed. Such prescription shall also be kept and reported by the pharmacist of the drug outlet or any other interested party to the nearest DOH office for appropriate action. 

Impossible Prescription 

• Only the generic name is written but illegible.
• The generic name does not correspond with the brand name.
• Both the generic name and the brand name are illegible.
• The written drug product is not registered in FDA.

What to do with an Impossible Prescription

Impossible prescription shall not be filed. They shall be and reported by the pharmacist of drug outlet or any other interested party to the nearest DOH office for appropriate action. The pharmacist shall advise the prescriber of the problem and/or instruct the patient to get the proper prescription.

Stability of Antibiotics (upon reconstitution and dilution)

Antibiotics	Reconstitution		Dilution
	Diluent	Stability	Diluent	Stability
Ampicillin Na	SWFI	1 hour (RT)	PNSS	8 hours (CRT) 48 hours (REF)
			PlainLR	8 hours (CRT) 24 hours (REF)
			D5W	2 hours (CRT) 4 hours (REF)
Ampicillin-Sulbactam Na	SWFI	1 hour (RT)	PNSS	8 hours (CRT) 48 hours (REF)
			PlainLR	8 hours (CRT) 24 hours (REF)
			D5W	2 hours (CRT) 4 hours (REF)
Benzylpenicillin Na	SWFI, PNSS	3 days (REF)**	PNSS	3 days (REF)**
Cefazolin Na	SWFI	24 hours (CRT) 10 days (REF)	PNSS, D5W	24 hours (CRT) 10 days (REF)
Cefepime HCl	PNSS, D5W, D5NSS, D5LR	24 hours (CRT) 7 days (REF)	PNSS, D5W, D5NSS, D5LR	24 hours (CRT) 7 days (REF)
Cefotaxime Na	SWFI, PNSS, D5W	24 hours (CRT) 5 days (REF)	PNSS, D5W	24 hours (CRT) 5 days (REF)
Cefoxitin Na	SWFI, D5W, PNSS	6 hours (CRT) 7 days (REF)	D5W, D5NSS, PNSS	18 hours (CRT) 48 hours (REF)
Ceftazidime	SWFI	12 hours (CRT) 3 days (REF)	D5W, PNSS	12 hours (CRT) 3 days (REF)
Ceftriaxone Na	SWFI, PNSS, D5W, D5NSS	3 days (CRT) 10 days (REF)*	PNSS, D5W	3 days (CRT) 10 days (REF)*
Clindamycin PO4	PNSS, D5W	Administer as soon as possible, avoid refrigeration	PNSS, D5W	Administer as soon as possible, avoid refrigeration
Meropenem	SWFI	Immediate use is preferable 2 hours (CRT) 12 hours (REF)	PNSS	2 hours (CRT) 18 hours (REF)
Piperacillin-Tazobactam Na	SWFI, PNSS, D5W	24 hours (CRT) 48 hours (REF)	PNSS, D5W	24 hours (CRT) 48 hours (REF)

**Maintain refrigeration

*Selected preparations only, refer to the given drug literature if possible

Source: Gahart's Intravenous Medications

Prescription Limits of Dangerous Drugs

Prescription Limits

The prescription limits are based on Section 32, DDB Regulation No. 3 S. 2003.

Prescription limits are quantities that may be prescribed in a single applicable prescription by a licensed practitioner. They should not exceed the specified quantities as follows:

Health Information on the Web? Look for HONcodes!

With the easy access of the Internet today, there is an explosion of information to choose from. By typing anything to any search engines (just Google it), list of links are readily accessible for you to explore. It really is a like a digitized library, an intangible source of knowledge. Think of it as a repository of books but on-screen. I prefer mine hardbound or paperback.

In healthcare setting, sources of information comes in handy if it's readily available to you. If you think of hand-held books that are too bulky, who in their right mind would carry them while making their rounds? We pharmacists are not a walking library. Not every information thrown at us can be answered immediately. That is why we consult reliable sources of information. Carrying one drug handbook may be enough but two books may be a handful.

Smartphones and tablets can become our trusty allies when it comes to health information. With so much resources that we could use on the internet, how can we tell if it's reliable or not? Well, my friend, say hello to HONcode.

(https://www.hon.ch/images/honcode_big.jpg)

What is a HONcode?

The Health on the Net Foundation Code of Conduct (HONcode) insures the credibility of any given information published by a website. It intends to rate the quality of the information provided by a website. It defines a set of rules to hold website developers to basic ethical standards in the presentation of information and helps make sure that the readers always know the source and the purpose of the data they are reading(https://www.hon.ch/HONcode/). 

This logo is attached to any website with subscription. It can be found in the lowest section of the website. 

Just remember if you want to find a reliable website that possesses credible information, look for the HONcode.