Skip to main content

Author name: contact@devinevisiontech.com

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04212 Medical Stores Keeping

Issuing Medicines and Medical Supplies from a Store – PST04212 Medical Stores Keeping

/

NTA Level 4 • Semester 2 • PST04212 Issuing Medicines and Medical Supplies from a Store Medical Stores Keeping • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 4: Issuing Medicines and Medical Supplies from a Store Total Session Time: 120minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Issuing of Medicines and Medical Supplies From a Store • Identify the Documents Used for Issuing Medicines and Medical Supplies From a Store. • Explain the Procedure for Issuing of Medicines and Medical Supplies • Filling Documents Used in Issuing Medicines and Medical Supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Worksheet 4.1 Issue voucher • Worksheet 4.2 Issue voucher SESSION OVERVIEW Activity/ Step Time Content Method 1 5 minutes Presentation Introduction, Learning Task Presentation Definition of Issuing Medicines and Medical 2 10 minutes Brainstorming Supplies From a Store Documents Used for Issuing Medicines and 3 15 minutes presentation Medical Supplies From a Store. Procedure for Issuing of Medicines and Medical 4 30 minutes presentation Supplies Presentation Filling Documents Used in Issuing Medicines and 5 50 minutes Small group Medical Supplies discussion 6 5 minutes Presentation Key Points 7 5 minutes Presentation Evaluation 28 SESSION CONTENTS STEP1: Introduction, Learning tasks (5minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Issuing Medicines and Medical Supplies From a Store (10minutes) Activity: Brainstorming (5 minutes) ASK students to pair up and buzz on the following question for 5 minutes • What is issuing medicine from a store? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Issuing of medicines from a store o Issuing of medicine from a store is the process of distributing a specific amount of an item from store to different department of the health facility. • STEP 3: Documents Used for Issuing Medicines From a Store(30 minutes) • Document that is common used in health facility for issuing medicines from a store is issue voucher. • Issue voucher is a document used when you issue items to another health unit or to department in your unit. It records : o The date of issue o The item requested and quantity o The items issued and quantity o The department receiving o Signature of the receiver and issuing officer • STEP 4: Procedure for Issuing of Medicines and Medical Supplies (30 minutes) • Medicines and related supplies should be issued within or moved out of the facility by following agreed procedure o Requisition officer has to identify requirement of needed supplies o Requisition has to be clearly written on the standard requisition form o On reaching the store, the requisition has to be examined by a store keeper and any necessary change made and initialed. o Store keeper should issue the supplies accordingly. o The assembled order has to be checked by the storekeeper. 29 o All records should be documented on bin card and ledger book with all necessary details completed on the same date. o Types, name and quantity of the required items, signature of the receiving and issuing officer and the date should appear on the issue voucher. o Store keeper has to ensure proper handling of the supplies to requisition officer. STEP 5: Filling Documents Used in Issuing Medicines and Medical Supplies (50 minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • How to fill issue voucher used in issuing medicines and medical supplies? ALLOW students to discuss for 30 minutes ALLOW few groups to present and the rest to add points not mentioned REFER students to work sheet 1 and 2 for further reading. CLARIFY and SUMMARIZE by using the contents below • Filling documents used in issuing medicines and medical supplies require a trained personnel • The following below documents shall be filled as follows o Requisition officer  Write the full name, designation and official signature of the person requesting supplies. o Serial number (S/N)  Write the numbers of items requested in sequence order. o Description of item  Write generic name of the product, strength and dosage form e.g. Paracetamol tablet 500mg o Unit  Write unit of measure of item ( pack size ) o Quantity required  Write the quantity of the items required o Quantity issued  Write the quantity of item to be supplied out of store o Remarks  Write important information about movement of item, batch numbers, expiration dates, borrowed from or returned to other health facility. o Date  Write the date when the supplies were issued. o Issuing voucher  Write designation and signature of the issuing officer. NOTE. The line shall be drawn below the last item to be issued to avoid tempering. 30 STEP 6: Key Points (5minutes) • Issuing of medicine from a store is the process of distributing a specific amount of an item from store to different department of the health facility. • Document which is common used in health facility for issuing medicines from a store is issue voucher. • One of the Procedures for issuing of medicines and medical supplies include identifying the correct quantity required to be supplied. • Documents used in issuing medicines and medical supplies shall be properly filled with generic name, quantity of the required items, signature of the receiving and issuing officer and the date on the issue voucher. STEP 7: Evaluation (5 minutes) • What is issuing of medicines and medical supplies from a store? • What

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04212 Medical Stores Keeping

Introduction to Housekeeping of Medicines and Medical Supplies Store – PST04212 Medical Stores Keeping

/

NTA Level 4 • Semester 2 • PST04212 Introduction to Housekeeping of Medicines and Medical Supplies Store Medical Stores Keeping • Source Session/Topic 3 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 3: Introduction to Housekeeping of Medicines and Medical Supplies Store. Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Housekeeping of Medicines and Medical Supplies Store • Describe Housekeeping Tasks for Store • Explain the Importance of Housekeeping in the Store • Explain the consequences of Poor Housing Keeping Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 10 minutes Definition of Housekeeping of Medicines Presentation 2 and Medical Supplies Store Brainstorming 45 minutes Description of Housekeeping Tasks in Presentation 3 Small group discussion Medicine and Medical Supplies Store 25 minutes Presentation Importance of Housekeeping in Medicines 4 Buzzing and Medical Supplies Store 25 minutes Presentation Consequences of Poor Housing Keeping in 5 Buzzing Medicines and Medical Supplies store 6 05 minutes Presentation Key Points 7 05 minutes Presentation Evaluation 22 SESSION CONTENTS STEP1: Introduction, Learning tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Housekeeping of Medicines and Medical Supplies Store (10 minutes) Activity: Brainstorming (5 minutes) ASK students to brainstorm on the following question: • What is housekeeping of Medicines and Medical Supplies store? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board ` CLARIFY and SUMMARIZE by using the content below • Housekeeping o This is the tasks in a store which include the following activities cleaning, pest control, a regular inspection system, disposal of stock, precaution against fire, and strict security measures. STEP 3: Description of Housekeeping Tasks in Medicines and Medical Supplies Store (45 minutes) Activity: Small Group Discussion ( 20 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are housekeeping tasks in Medicines and Medical Supplies store? ALLOW students to discuss for 20 minutes ALLOW few groups to present and the rest to add points not mentioned CLARIFY and SUMMARIZE by using the contents below 23 • Cleaning and pest control o The store should be kept tidy and should be cleaned two or three times a week. o Pest control can be difficult task, but to avoid possible contamination and physical damage to stock. o It‘s necessary to keep insect, mice and other pests out of the storage area. If needed, pest control measure such as poison should be implemented with proper precaution. • Inspection o Senior staff should inspect the store regularly. The chief storekeeper must make sure that store room employees check the shelves and pallets daily and for deterioration due to climatic condition. Store keepers should open suspect containers and reports problems to managers. • Disposal of expired or damaged stock o Damaged or expired stock should be placed in a designated salvage area to wait authority for disposal. A written record of all stock consigned to this area should be maintained. It‘s recommended that each item be valued at its acquisition cost. The responsible authority should be informed in writing that stock is to be written off. Disposal may be delayed if a committee decision is required, and substantial storage space and May needed for junk stock. Once destruction is authorized, the inventory control clerk must adjust the stock records. All drugs and other potentially toxic products should be disposed of in accordance with local regulation in a manner that does not pose not pose a risk to public health. • Fire precaution o Flammable trash, such as cartons and boxes, must not be allowed to accumulate in the store. Smoking must be strictly forbidden, with ―No smoking‖ signs posted throughout the store. Senior staff must obey the rule as strictly as junior staff, and penalties should be imposed on these who ignore the rules. A smoking area outside the warehouse should be designated. Management must ensure that fire-detection and fire-fighting equipment is regularly inspected and that staff receive adequate training in fire -fighting technique and emergency action. There should be regular fire drills to reinforce the training. • Security o Ideally, the chief storekeeper‘s office should have windows that overlook the loading bay, the compound entrance, and the store itself. A storekeeper who sits behind a closed door with curtains drawn cannot observe what is happening on the site. No vehicles should be allowed into the store compound unless they are authorized by the chief storekeeper or senior staff member. A list of authorized vehicles should be prepared for the compound gate-keeper. 24 STEP 4: Importance of Housekeeping in the Store (25 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 5 minutes • What are the importances of housekeeping in Medicines and Medical Supplies store? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • The following are the importance of housekeeping in the store o Promotes quality safety productivity o Decreases fire hazards o Makes the store looks neat and orderly and eases flow of drug and supplies o Improves morale among workers o Better control of drugs and supplies, including inventory maintenance o Better hygienic conditions leading to improved health o More effective use of space o Reduces drug and supplies damage o Reduces tripping and slipping accidents in clutter-free and spill-free work areas o Minimize workers exposures to hazardous

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04212 Medical Stores Keeping

Record Keeping on Medicines and Medical – PST04212 Medical Stores Keeping

/

NTA Level 4 • Semester 2 • PST04212 Record Keeping on Medicines and Medical Medical Stores Keeping • Source Session/Topic 2 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 2: Record Keeping on Medicines and Medical Supplies in a Store Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Keep records of medicines and medical supplies o Define Medicines and Medical Supplies Records o List Records of Medicines and Medical Supplies o Explain the Importance of Records of Medicines and Medical Supplies o Demonstrate Ability to Record and Keep Medicines and Medical Supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Ledger, Bin Card, Issue voucher, Receipt voucher, and Requisition forms • Handout 2.1: Records of medicines and medical supplies • Figure 2.1: Samples of medicines and medical supplies records SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation Definition of Medicines and Medical Supplies 2 10 minutes Buzzing Records Presentation 3 15 minutes Records of Medicines and Medical Supplies Brainstorming Importance of Medicines and Medical Supplies 4 20 minutes Presentation Records Presentation Recording and Keeping Medicines and Medical 5 60 minutes Small Group Supplies discussion 6 05 minutes Presentation Key Points 7 05 minutes Presentation Evaluation 11 SESSION CONTENTS STEP1: Introduction, Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Medicines and Medical Supplies Records (10 minutes) Activity: Buzzing (5 minutes) Ask students to pair up and buzz on the following question for 2 minutes: • What is medicines and medical supplies records? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below Medicine and medical supplies records • Is the records which contain important information concerning: o What items are available o How much is available of each item o How much is used on a regular basis o When and how much of an item should be reordered • They are used to record information about medicines and medical supplies in storage. • They must contain the quantity of medicines and medical supplies on hand; the quantity of losses; and the quantity of adjustments, by individual product. • The medicines and medical supplies records are completed by anyone who receives or issues stock from storage, and by anyone who takes a physical count of medicines and medical supplies in stock, service delivery point (SDP) staff. 12 STEP 3: Records of Medicines and Medical Supplies (15 minutes) Activity: Brainstorming (5 minutes) ASK students to brainstorm on the following question: • What are the records for medicines and medical supplies? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board ` CLARIFY and SUMMARIZE by using the content below • Records for medicines and Medical supplies o Store Ledger o Bin Cards o Issue voucher o Receipt voucher o Requisition form • Stores ledger o Stores ledger is a stock keeping record forms bound like a book that containing the information about the products regarding quantities in the store. o It also records dates and quantities from who received into the store as well as quantities to whom issued from the store. o It is a legal document used by auditors, stock-verifiers to assess validity of stocks. o The Government policy in most countries requires the use of stores ledgers for accountability , because commodities are considered assets of the government or organizations and should be accounted for carefully • Bin Card o It is an individual stock keeping record that holds information about all the lots of a single product. o One Bin Card is for each product • Issue vouchers o Issue vouchers are used where the issuing facility determines the quantity to be sent and issues the supplies to the receiving facility. • Receipt voucher o A Receipt Voucher lists the items and quantity issued from supplier and received by a facility. o It also includes a separate column for the quantities received in case any items are lots or damaged en route o The issuing facility completes the date and quantities issued, signs the voucher • Requisition forms/ vouchers o A requisition voucher is completed by facility staff by listing the items and quantities requested by a facility. o It also includes a column for the quantity actually issued. REFER students to Handout 2.1: Records of Medicines and Medical supplies for further reading. 13 STEP 4: Importance of Medicine and Medical Supplies Records (20 minutes) • Importance of Medicine and medical supplies records are: o They reflect/show quantities of the items at the store ( stock in hand ) o They protect the store keeper from rumours of misuses or fraud of the medicines and medical supplies in the store. o They provide information on the consumption rate, for deciding what to order and the quantity to order. o They are used for accountability of medicines and medical supplies regarding quantities received, issued and to whom they were issued. o They indicate the value of assets of an institution o They are used as legal requirement for accountability during auditing, stock verification. o They are also required by professional bodies like pharmacy council, for accountability of sources and movement of medicines and medical supplies ( legal sources and uses) STEP 5: Recording and Keeping Medicines and Medical supplies (60 minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What is the most important reasons for having stock keeping records? ALLOW students to

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04212 Medical Stores Keeping

Arrangement of Medicines and Medical Supplies – PST04212 Medical Stores Keeping

/

NTA Level 4 • Semester 2 • PST04212 Arrangement of Medicines and Medical Supplies Medical Stores Keeping • Source Session/Topic 1 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 1: Arrangement of Medicines and Medical Supplies in a Store Total Session Time: 120 minutes + 2 hours visit to a pharmacy store Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Medical Store • Describe Common Systems for Arranging Medicines and Medical Supplies in the Store • Describe Common Equipment Used for Medicines and Medical Supplies Storage • Describe Arrangement of Medicines and Medical Supplies in the Store Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Handout 1.1 Arrangement and Organization of a Store • Worksheet 1.1 Pictures of Store Equipments • Field Trip Guide 1.1 A guide for a Visit to Hospital Pharmacy Store SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation 2 10 minutes Definition of a Medical Store Brainstorming 20 minutes Presentation Common Systems for Arranging Medicines and 3 Buzzing Medical Supplies 30 minutes Presentation 4 Small Group Common Equipment Used in a Store Discussion 30 minutes Presentation Arrangement of Medicines and Medical 5 Small Group Supplies in the Store Discussion 6 05 minutes Presentation Key Points 7 10 minutes Presentation Evaluation 10 minutes Presentation 8 Pharmacy Store Visiting Visit to a store 1 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Definition of a Medical Store (10 minutes) Activity: Brainstorming (5 minutes) ASK students to pair up and buzz on the following question for 5 minutes • What is a Medical Store? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • A medical store is a room where medicines are kept under lock and key for the security and safety of medicines and medical supplies. • It is an area set aside into which all the items and materials required for production, sale/distribution are received, where they are housed for safekeeping, and from which they will be issued as required. • Also refers to a service department headed by a store-keeper who is responsible for a proper storage, protection and issuing of all kinds of material. • The organization of the store depend up on the size, layout of the factory, nature of the material stored, frequency of purchases and issue of material • The functions of a storekeeper o To organize medicines and medical supplies in a store and maintaining storage condition o To keep and maintain proper records of medicines and medical supplies o To select and determine items and quantities to be ordered as per requirements o To receive items in a store, arranging them properly and issue them as required o Checking expiry and proper disposal of unwanted items. 2 STEP 3: Common System for Arranging Medicines and Medical Supplies (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 10 minutes • What are the common systems used in arranging medicines and medical supplies? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their responses on the flip chart/board CLARIFY and SUMMARIZE by using the content below • The Common Systems for Arranging Medicines and Medical Supplies includes: o Alphabetical by generic name: the medicines are arranged in the shelves according to their alphabetical names, e.g. medicines starting with A- Albendazole, Amoxicillin, Aminophylline, Ampicillin, with B- Bisacodyl, Bisoprol. o Pharmacological/therapeutic: this is a classification or grouping of medicines with similar pharmacological effects, for examples all Analgesics are grouped together, or Anti-bacterial grouped together o Dosage form: this is a system of classifying medicines based on dosage forms used in stores, for example Tablets and capsules are stored together, a separated area or location is reserved for say oral liquids, Injections, creams and Ointments etc. o Frequency of use: frequently used products that move quickly or often through the store should be placed in the front of the room or closest to the staging area. This system should be used in combination with another system o Commodity coding: this system is based on a unique article code combined with a unique location code. For example therapeutic class/clinical indication in certain location name; MSD Item is an example; 01300 7544 i.e.01300 item Code, and 7544 location code. STEP 4:Common Equipment Used in Store (30 minutes) Activity: Small Group Discussion ( 15 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are the common equipment used to store medicines and medical supplies in a store? REFER students to Worksheet 1.1: Pictures of Store Equipments ALLOW students to discuss for 15 minutes ALLOW groups to present their opinions CLARIFY and SUMMARIZE by using the contents below • Medicines/products are stored so that they are easily accessible and protected against damage 3 • The four basic equipment used for storage are Shelves, Floor pallets, Block stacked pallets, and pallet racks. o Shelves  Storage on shelves does not require mechanical handling equipment and is a suitable choice when the volume and weight of individual items are too small to justify pallets, the internal height of a building is not large enough for multitier pallet racking and shelving can be used on its own or in combination with floor pallets or two-tier racking.  Manual goods handling is locally more reliable or economical than mechanical handling.  If shelving is used

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Vaccines for Immunization ………………………………….297 – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Vaccines for Immunization ………………………………….297 Basic Pharmacology • Source Session/Topic 46 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 46: Description of Vaccines for Immunization ………………………………….297 PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide iii Background There is currently an ever increasing demand for pharmaceutical personnel in Tanzania. This is due to expanding investment in public and private pharmaceutical sector. Shortage of trained pharmaceutical human resource contributes to poor quality of pharmaceutical services and low access to medicines in the country (GIZ, 2012). Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with Development Partners (DPs) in Germany and Pharmaceutical Training Institutions (PTIs) worked together to address the shortage of human resource for pharmacy by designing a project named “Supporting Training Institutions for Improved Pharmaceutical Services in Tanzania‖ in order to improve quality and capacity of PTIs in training, particularly of lower cadre pharmaceutical personnel. The Pharmacy Council formed a Steering committee that conducted a stakeholders workshop from 18th – 22ndAugust 2014 in Morogoro to initiate the implementation of the project. Key activities in the implementation of this project included carrying out situational analysis, curriculum review and harmonization, development of training manual/facilitators guide, development of assessment plan, training of trainers and supportive supervision. After the curricula were reviwed and harmonized, the process of developing standardised training materials was started in August 2015 through Writer‘s Workshop approach. The approach included two workshops (of two weeks each) for developing draft documents and a one-week workshop for reviewing, editing and formatting the sessions of the modules. The goals of writers workshops were to build capacity of tutors in the development of training materials and to develop high-quality, standardized teaching materials. The training package for pharmacy cadres includes a facilitator guide, assessment plan and practicum. There are 12 modules for NTA level 4 making 12 facilitator guides and one practicum guide. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide iv Acknowledgment The development of standardized training materials of a competence-based curriculum for pharmaceutical sciences has been accomplished through involvement of different stakeholders. Special thanks go to the Pharmacy Council for spearheading the harmonization of training materials in the pharmacy after noticing that training institutions in Tanzania were using different curricula and train their students differently. I would also like to extend my gratitude to St. Luke Foundation (SLF)/Kilimanjaro School of Pharmacy –Moshi for their tireless efforts to mobilize funds from development partners. Special thanks to John Snow Inc (JSI), Deutsche GesellschaftFür Internationale Zusammenarbeit (GIZ), Merck Kgaa, BoehringerIngelheimGmbhand Bayer Pharma Ag and action medeor.V for the financial and technical support. Particular thanks are due to those who led this important process to its completion, Mrs Stella M. Mpanda Director, Childbirth Survival Intenational, and Members from the secretariat of National Council for Technical Education (NACTE) for facilitating the process. Finally, I very much appreciate the contributions of the tutors and content experts representing PTIs, hospitals, and other health training institutions. Their participation in meetings and workshops, and their input in the development of this training manual/facilitators guide have been invaluable. These participants are listed with our gratitude below: Mr.Wilson Mlaki DSt. Luke Foundation/Kilimanjaro School of Pharmacy Mr.Samwel M. Zakayo- Pharmacy Council Ms. Ester A. Tuarira MUHAS Ms. Tumaini H. Lyombe MUHAS PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide v Ms. Dilisi J. Makawia KSP Ms. Julieth Koimerek KSP Rev. Baraka A.M. Kabudi MEMS Mr. Kelvin E. Mtanililwa Royal Pharmaceutical Training Institute Ms. Rose Bulilo CEDHA Ms. Diana H. Gamuya CEDHA Dr.Melkiory Masatu CEDHA Mr. Habel A. Habel City College of Health and Allied Sciences Ms. Zaina Msami Meru District Council Director of Human Resources Development Ministry of Health, Community Development, Gender, Elderly and Children PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide vi Introduction Module Overview This module content is a guide for tutors of Pharmaceutical schools for training of students. The session contents are based on sub-enabling outcomes and their related tasks of the curriculum for Basic Technician Course in Pharmaceutical Sciences. The module sub- enabling outcomes and their related tasks are as indicated in the in the Basic Technician Certificate in Pharmaceutical Sciences (NTA Level 4) Curriculum Target Audience This module is intended for use primarily by tutors of pharmaceutical schools. The module‘s sessions give guidance on the time, activities and provide information on how to teach the session. The sessions include different activities which focus on increasing students‘ knowledge, skills and attitudes. Organization of the Module The module consists of forty six (46) sessions; each session is divided into several parts as indicated below: • Session Title: The name of the session • Total Session Time: The estimated time for teaching the session, indicated in minutes • Pre-requisites: A module or session which needs to be covered before teaching the session. • Learning Tasks: Statements which indicate what the student is expected to learn by the end of the session • Resources Needed: All resources needed for the session are listed including handouts and worksheets • Session Overview: The session overview box lists the steps, time for each step, the activity or method used in each step and the step title • Session Content: All the session contents are divided into steps. Each step has a heading and an estimated time to teach that step as shown in the overview box. Also, this section includes instructions for the tutor and activities with their instructions to be done during teaching of the contents • Key Points: Key messages for concluding the session contents at the end of a session This step summarizes the main points and ideas from the session, based on the learning tasks of the sssion • Evaluation: The last section of the session consists of short questions based on the learning tasks to check the understanding of students. •

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Sera and Immunoglobulin – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Sera and Immunoglobulin Basic Pharmacology • Source Session/Topic 45 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 45: Description of Sera and Immunoglobulin Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of Sera and Immunoglobulin • List Contraindication of Sera and Immunoglobulin • Describe dose, dosage and course of Sera and Immunoglobulin • List side effects and adverse effects of Sera and Immunoglobulin • Describe interaction and precaution of Sera and Immunoglobulin Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector • Handout 32.1: Management of rabies for exposed individuals SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 20 minutes Indications of Sera and Immunoglobulin Buzzing Presentation/ 3 10 minutes Contraindication of Sera and Immunoglobulin brainstorming Dose, Dosage and Course of Sera and 4 40 minutes Presentation Immunoglobulin Presentation/ Side Effects and Adverse Effects of Sera and 5 20 minutes brainstorming Immunoglobulin Interaction and Precaution of Sera and 6 05minutes Presentation Immunoglobulin 7 10 minutes Presentation Key Points 8 10 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 288 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Sera and Immunoglobulin (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following questions for 2 minutes • What are Sera and Immunoglobulins? • What are the indication of sera and immunoglobulins? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below Definition • Antisera o Refers to purified and concentrated preparations of serum of horses actively immunized against a specific antigen o Example are Tetanus antitoxin (ATS), Gas gangrene antitoxin (AGS), Diphtheria antitoxin (ADS), Antirabies serum (ARS) and Antisnake venom polyvalent • Immunoglobulins (lGs) o Refers to a separated human gamma globulins which carry the antibodies o They are more efficacious than the corresponding antisera o Example are normal human gamma globulin, Anti-D immunoglobulin, Tetanus immunoglobulin, Rabies immuneglobulin and Hepatitis-B immunoglobulin Indications • Gamma – Globulins Injection o Indications for its use are viral hepatitis A and B (prophylaxis), measles, mumps, poliomyelitis and chickenpox (prophylaxis and modification of course of illness), and has some beneficial action in burns  It is especially valuable in agammaglobulinemia, premature infants and in patients of leukemia or those undergoing immunosuppression PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 289 • Anti-D(Rho) Immunoglobulin Injection o Prevention of Rho(D) sensitisation to rhesus negative woman • Anti-rabies Immunoglobulin Injection o Post-exposure prophylaxis against rabies infection • Activated Prothrombin o Treatment of bleeding episodes • Factor VII o Treatment of bleeding episodes • Snake venom polyvalent Antiserum injection o Snake bite/Poisoning • Tetanus Immunoglobulin o Post-exposure prophylaxis and treatment of tetanus infection  Indicated for prophylaxis in non-immunized persons receiving a contaminated wound who are at high risk of developing tetanus STEP 3: Contraindications of Sera and Immunoglobulin (10 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the contraindications of sera and immunoglobulin? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • The immunoglobulins o Patients with a history of allergic reactions after administration of human immunoglobulin preparations o Individuals with isolated immunoglobulin A (IgA) deficiency (individuals could have an anaphylactic reaction to subsequent administration of blood products that contain IgA) • The antisera o Patients with hypersensitivity to horse serum or any other component of the serum PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 290 STEP 4: Dose, Dosage and Course of Sera and Immunoglobulin (40 minutes) • Gamma – Globulins Injection o Available as Gamma – Globulins Injection I.V 500mg, 2.5g and 5g o Hereditary haemolytic anaemia  Immunoglobulin IgG 400mg/kg (IV) daily for 5 days o Idiopathic thrombocytopenic Purpura (ITP) for the emergence of acute bleeding caused by severe thrombocytopenia  IV immunoglobulin may be given as a single dose infusion of 0.4-1.0g/kg followed immediately platelets transfusion Splenectomy • Anti-D(Rho) Immunoglobulin Injection o Available as Anti-D(Rho) Immunoglobulin Injection 0.25 mg/ml in set of 5ml o Dose by deep intramuscular injection, to rhesus-negative woman for prevention of Rho(D) sensitisation;  Following birth of rhesus-positive infant: 500 units immediately or within 72 hours  For transplacental bleed of over 4mL fetal red cells: Extra 100–125units per mL fetal red cells  Following any potentially sensitising episode (e.g. stillbirth, abortion, amniocentesis) up to 20 weeks‘ gestation . 250 units per episode (after 20 weeks, 500units) immediately or within 72 hours  Antenatal prophylaxis 500 units given at weeks 28 and 34 of pregnancy; if infant rhesus-positive, a further dose is still needed immediately or within 72 hours of delivery  Following Rho(D) incompatible blood transfusion 100–125 units per mL transfused rhesus-positive red cells • Anti-rabies Immunoglobulin Injection o Available as Anti-rabies Immunoglobulin Injection 1000 IU/5ml ampoule o Passive immunization of rabies  Anti-rabies human immunoglobulin 20 IU/kg half the dose given parenterally and the other half injected into and around the wound o Active immunization of rabies  Rabies immunoglobulin with the first dose (day 0) Tetanus toxoid vaccine Refer students to Handout 31.1: Management of rabies for exposed individuals for further reading • Activated Prothrombin o Treatment of bleeding episodes o Activated Prothrombin Complex Concentrate (APCC) 50-100IU/kg every12-24hrs • Factor VII PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Vitamins and Minerals – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Vitamins and Minerals Basic Pharmacology • Source Session/Topic 44 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 44: Description of Vitamins and Minerals Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of vitamins and minerals • List Contraindications of vitamins and minerals • Describe dose, dosage and course of vitamins and minerals • List side effects and adverse effects of vitamins and minerals • Describe interactions and precautions of vitamins and minerals Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation/ 2 20 minutes Indications of Vitamins and Minerals Buzzing Presentation/ 3 20 minutes Contraindications of Vitamins and Minerals brainstorming Dose, Dosage and Course of Vitamins and 4 30 minutes Presentation Minerals Presentation/ Side Effects and Adverse Effects of Vitamins 5 20 minutes brainstorming and Minerals Interactions and Precautions of Vitamins and 6 15 minutes Presentation Minerals 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 282 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Vitamins and Minerals (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are the vitamins and minerals listed in national essential medicine list • What are the indications of Vitamins and Minerals? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Vitamins are organic compounds and a vital nutrients that organisms require in limited amounts • Vitamins and minerals listed in national essential medicine list include: vitamin A, vitamin B complex, vitamin C, vitamin D, vitamin E, vitamin K, calcium and selenium • Indications of Vitamins and Minerals: o Vitamin A, is used for prevention and treatment of ocular defects known as xerophthalmia it is also used as a supplement where diet is known to be inadequate. o Vitamin B complex, is composed of nicotinamide, thiamine and riboflavin. It is used in management of vitamin B complex deficiencies, isoniazid induced neuropathy and penicillin induced neuropathy o Vitamin C is used in prevention and treatment of scurvy o Vitamin D, the term Vitamin D is used for a range of compounds which possess the property of preventing or treating rickets o Vitamin E is indicated for some neuromuscular abnormalities o Vitamin K is used for prevention and treatment of vitamin K deficiency bleeding o Calcium gluconate used in the management of hyperphosphataemia o Selenium is used in management of selenium deficiency PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 283 STEP 3: Contraindications of Vitamins and Minerals (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the Contraindications of Vitamins and Minerals? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Contraindication of vitamin and mineral o Vitamin A, is not contra indicated to any specific group of individual o Vitamin B complex, is not contra indicated to any specific group of individual but should be given with caution because it may cause anaphylactic shock when given by injection o Vitamin C is not contra indicated to any specific group of individual o Vitamin D is contraindicated to people with hypercalcaemia, metastatic calcification o Vitamin E is not contra indicated to any specific group of individual neonate weighing less than 1.5 kg o Vitamin K neonates, infants and women in their late pregnancy. o Calcium is contraindicated to people with all conditions associated with hypercalcaemia and hypercalciuria o Selenium is not contra indicated to any specific group of individual STEP 4: Dose, Dosage and Course of Vitamins and Minerals (30minutes) • Vitamin A, in prevention of vitamin deficiency, child 1 month–5 years, 5 drops daily (5 drops contain vitamin A approx. 700 units, vitamin D approx. 300 units, ascorbic acid approx. 20 mg) until the condition subside • Vitamin B complex, is usually formulated as a tablet contains combination of nicotinamide 15 mg, riboflavin 1 mg, thiamine hydrochloride 1 mg. The dose is usually 1–2 tablets daily • Vitamin C is given prophylactically at the dose 25–75 mg daily; therapeutic, not less than 250 mg daily in divided doses • Vitamin D, is given as oral supplement of only 10 micrograms (400 units) of Ergocalciferol, calciferol, vitamin D2 or colecalciferol daily • Vitamin E it is given as a supplement at the dose of 3 to 5mg daily until the condition subsides • Vitamin K 10–40 mg daily, adjusted as necessary; child 1–12 years, 5–10 mg daily, adjusted as necessary, 12–18 years, 10–20 mg daily, adjusted as necessary PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 284 • Calcium is presented as given orange flavored tablet of calcium carbonate at the dose of 2.5 g daily until the condition is corrected • Selenium is given by mouth or by intramuscular injection or by intravenous injection, 100–500 micrograms daily until the condition is corrected STEP 5: Side Effects and Adverse Effects of Vitamins and Minerals (20 Minute) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the side effects and adverse effects of Vitamins and Minerals ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Oxytocics, Tocolytics and Related Medicines – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Oxytocics, Tocolytics and Related Medicines Basic Pharmacology • Source Session/Topic 43 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 43: Description of Oxytocics, Tocolytics and Related Medicines Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List indications of essential oxytocics, tocolytics and related preparations • List contraindication of essential oxytocics, tocolytics and related preparations • Describe dose, dosage and course of essential oxytocics, tocolytics and related preparations • List common side effects and adverse effects of essential oxytocics, tocolytics and related preparations • Describe interactions and precautions of essential oxytocics, tocolytics and related preparations Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and projector SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning tasks Presentation/ Clinical Indications of Oxytocics, Tocolytics 2 20 minutes Buzzing and Related Preparation Presentation/ Contraindications of Oxytocics, Tocolytics 3 20 minutes brainstorming and Related Preparation Dose, Dosage and Course of Oxytocics, 4 30 minutes Presentation Tocolytics and Related Preparation Presentation/ Common Side Effects and Adverse Effects of 5 20 minutes brainstorming Oxytocics, Tocolytics and Related Preparation Interaction and Precaution of Oxytocics, 6 15 minutes Presentation Tocolytics and Related Preparation 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 274 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Clinical Indications of Essential Oxytocics, Tocolytics and Related Preparations (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are the clinical indications of essential oxytocics, tocolytics and related preparations? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • According to Tanzania Standard treatment guideline, essential oxytocics, tocolytics and related preparations include salbutamol, ergometrine, oxytocin, misoprostol and magnesium sulphate Salbutamol • Salbutamol is used for myometrial relaxation • It is used in selected cases in attempt to inhibit premature labor once it has begun. Ergometrine • Its main action is the production of intense contractions • It is used in the active management of the third stage of labor, and to prevent or treat postpartum or postabortal haemorrhage caused by uterine atony • Ergometrine maleate or methylergometrine maleate have been used in a provocation test for the diagnosis of Prinzmetal's angina Oxytocin • Synthetic oxytocin is the most widely used drug for stimulating uterine contractions following the rapture of membranes during labor • It is also used to augment abnormal labor that is protracted or displays arrest disorder. • Oxytocics used in the immediate postpartum period, including the control of uterine hemorrhage after vaginal or cesarean delivery (Postpartum Haemorrhage – PPH) PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 275 Misoprostol • It is commonly used for labor induction • It causes uterine contractions and the ripening (effacement or thinning) of the cervix • It is also used to prevent and treat stomach ulcers, and treat postpartum bleeding due to insufficient contraction of the uterus Magnesium Sulphate • Used as a tocolytics to stop preterm labor and for severe pre-eclampsia STEP 3: Contraindication of Essential Oxytocics, Tocolytics and Related Preparation (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the contraindications of essential oxytocics, tocolytics and related preparation? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below Salbutamol • Salbutamol is contraindicated in the suppression of labor in women with heart disease, eclampsia or severe pre- eclampsia, antepartum haemorrhage or placenta previa • It should be used with caution in women with diabetes, hypertension or hyperthyroidism Oxytocin • Oxytocin is contraindicated in women, for whom vaginal delivery is contraindicated because of conditions such as unfavorable foetal position (e.g. transverse lie) or placenta previa – a condition in which the placenta grows over the cervix, blocking the baby‘s exit Ergometrine • Ergometrine maleate is contra-indicated for the induction of labor or for use during the first stage of labor • Ergometrine maleate has been associated with acute attacks of porphyria and is considered unsafe in porphyric patients Misoprostol • Misoprostol is contraindicated in Pregnancy when used to reduce risk of NSAID-induced ulcers and to individuals with hypersensitivity to misoprostol, prostaglandins, or prostaglandin analogues PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 276 Magnesium sulphate • Magnesium sulphate is contraindicated in the patients with the following conditions:- o Hypersensitivity, myocardial damage, diabetic coma, heart block, hypermagnesemia, hypercalcemia • Administration during 2 hours preceding delivery for mothers with toxemia of pregnancy STEP 4: Dose, Dosage and Course of Essentail Oxytocics, Tocolytics and Related Preparation (30 minutes) Salbutamol • 10 micrograms per minute of Salbutamol is given and gradually increasing to 45 micrograms per minute until contraction has ceased and then reduce gradually • Alternatively, give by IM injection 100 -250 micrograms and repeat according to the patient response and subsequently, give orally 4mg every 6 to 8 hours as maintenance dose • Salbutamol is administered by IV infusion using dextrose 5% until 12 to 48 hour after contractions have ceased, followed by oral maintenance therapy Oxytocin • For induction of labor use: Oxytocin IV the dose will depend on parity o Primigravida:  Oxytocin IV 5 IU in 500mls of fluid titrate at 15, 30, 60 drops per minute until desired uterine contractions are attained o Multiparous:  Oxytocin IV Starts

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Eye, Ear and Nose Preparations – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Eye, Ear and Nose Preparations Basic Pharmacology • Source Session/Topic 42 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 42: Description of Eye, Ear and Nose Preparations Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List preparations of the eye, ear and nose and their indications • List Contraindication of eye, ear and nose preparations • Describe dose, dosage and course of eye, ear and nose preparations • List side effects and adverse effects of eye, ear and nose preparations • Describe interactions and precautions of eye, ear and nose preparations Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Overhead projector (OHP) and Computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Objectives Presentation A List of the Eye, Ear And Nose Preparations 2 40 minutes small Group and their indications Discussion Dose, Dosage and Course of the Eye, Ear and 3 20 minutes Presentation Nose Preparations Presentation Side Effects and Adverse Effects of the Eye, 4 20 minutes Buzzing Ear and Nose Preparations Presentation Contraindications of the Eye, Ear and Nose 5 10 minutes Brainstorming Preparations Presentation Interactions and Precautions of 6 15 minutes Brainstorming the Eye, Ear and Nose Preparations 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 267 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Objectives (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: List of the Eye, Ear and Nose Preparations and their indications (40 minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are the eye,ear and nose preparations that are used in clinical settings? • What are the indications of the eye, ear and nose preparations? ALLOW students to discuss for 15 minutes ALLOW few groups to present and the rest to add points not mentioned CLARIFY and SUMMARIZE by using the contents below List of preparations • Nasal preparations o Beclomethasone spray o Ephedrine nasal drops • Ear preparations o Chroramphenicol ear drops o Neomycin + Dexamethasone ear drops o Ciprofloxacin ear drops o Aluminium diacetate ear drops • Eye preparations o Anti-effective agents  Acyclovir ointment  Chloramphenicol drops  Chloramphenicol ointment  Gentamycin drops  Povidone iodine  Oxytetracycline ointment  Ciprofloxacin  Dexamethasone + Chloramphenicol PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 268  Dexamethasone + Gentamycin  Natamycin  Econazole o Steroidal anti-inflammatory agents  Dexamethasone  Prednisolone  Methylprednisolone  Triamcinolone cream and injection o Ant infective and ant inflammatory agents  Cyclopentolate  Atropine  Timolol  Hydroxypropylmethylcellulose  Iodoxamine tromethazine  Sodium cromogylate  Pilocarpine  Zinc sulphate  Latanoprost  Acetazolamide Indications • The eye preparations can be indicated in either of the following: o Bacteria, fungal and viral infections o Inflammations like conjunctivitis o Mydriasis and cycloplegia o Anaesthesia induction o Glaucoma o Lubrication o Diagnosis • The ear preparations are usually indicated in microbial infections, inflammations like otitis media and lubrication in removal of ear wax • The nose preparations are indicated in microbial infections of the nose, diagnosis of nose disorders, inflammations of the nose and shrinking of the nasal polyps by corticosteroids STEP 3: Dose, Dosage and Course of Eye, Ear and Nose Preparations (20 minutes) • The dose of respective antimicrobial agent should be given to an individual depending on the diagnosis, weight and vital body organs functions • The dosage of respective antimicrobial agent depends on the severity of diagnosis, half life of an agent and vital organ functions • One to two drops of eye formulations are given 2-4 times a day depending on their half lives PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 269 • 2-3 drops of ear formulations is given 3-4 times a day and reducing the frequency as the day dose • The course of antibacterial treatment can be up to 14 days, antifungal up to three months and antiviral up to six weeks • Lubricants can be used until there is a promising outcome • The duration of treatment with steroidal ant inflammatory agents should be short especially in corticosteroids because are immunosuppressants STEP 4: Side effects of Eye, Ear and Nose Preparations (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question • What are the side effects of the eye, ear and nose preparations listed above? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Aplastic anaemia and transient stinging caused by preparations containing chloramphenicol • Local burning and itching; lid margin crusting; hyperaemia; taste disturbances; corneal staining, keratitis, lid oedema, lacrimation, photophobia, corneal infiltrates; nausea and visual disturbances reported in preparations containing ciprofloxacin and other quinolones • Local irritation and inflammation, superficial and punctate keratopathy in products containing acyclovir • Aggravation of red eye, steroid cataract and glaucoma and thinning of cornea and sclera for eye corticosteroids • Local sensitivity reactions may occur in ear preparations • Dryness, irritation of nose and throat, and epistaxis in nose corticoid preparations. PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 270 STEP 5: Contraindications of Eye, Ear and Nose Preparations (10 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the contraindications of the eye, ear and nose preparations? ALLOW few students to respond WRITE their responses

Pharmaceutical Sciences Notes, PST Level 4 Semester 2, PST NTA Level 4, PST04211 Basic Pharmacology

Description of Muscle Relaxants and Cholinesterase Inhibitors – PST04211 Basic Pharmacology

/

NTA Level 4 • Semester 2 • PST04211 Description of Muscle Relaxants and Cholinesterase Inhibitors Basic Pharmacology • Source Session/Topic 41 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 41: Description of Muscle Relaxants and Cholinesterase Inhibitors Total Session Time: 120 minutes Prerequisite module • None Learning Tasks By the end of this session students are expected to be able to: • List indications of muscle relaxants and cholinesterase inhibitors • List Contraindication of muscle relaxants and cholinesterase inhibitors • Describe dose, dosage and course of muscle relaxants and cholinesterase inhibitors • List side effects and adverse effects of muscle relaxants and cholinesterase inhibitors • Describe interaction and precaution of muscle relaxants and cholinesterase inhibitors Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and overhead projector SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning tasks Presentation/ Listing Indications of Muscle Relaxants and 2 20 minutes Buzzing Cholinesterase Inhibitors Presentation/ Listing Contraindication of Muscle Relaxants 3 20 minutes brainstorming and Cholinesterase Inhibitors Description of Dose, Dosage and Course of 4 30 minutes Presentation Muscle Relaxants and Cholinesterase Inhibitors Listing Side Effects and Adverse Effects of Presentation/ 5 20 minutes Muscle Relaxants and Cholinesterase brainstorming Inhibitors Description of Interaction and Precaution of 6 15 minutes Presentation Muscle Relaxants and Cholinesterase Inhibitors 7 05 minutes Presentation Key Points 8 05 minutes Presentation Evaluation PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 260 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning tasks (5 minutes) READ or ASK students to read the learning objectives and clarify ASK students if they have any questions before continuing. STEP 2: Indications of Muscle Relaxants and Cholinesterase Inhibitors (20 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What are muscle relaxants and cholinesterase inhibitors? • What are the indications of muscle relaxants and cholinesterase inhibitors? ALLOW few pairs to respond and let other pairs add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Muscle relaxants are also known as neuromuscular blocking drugs. They include: Gallamine, Suxamethonium Chloride, Vecuronium Bromide, and Pancuronium Bromide. Anti-cholinesterase includes Edrophonium and Neostigmine • They are used in anaesthesia o They enable light anaesthesia to be used with adequate relaxation of the muscle o Gallamine is used to produce relaxation of skeletal muscle during surgery o Suxamethonium Chloride is used for short to intermediate duration neuromuscular blockade for surgery or during intensive care o Vecuronium Bromide is used for intermediate duration neuromuscular blockade for surgery or during intensive care o Pancuronium Bromide is used for long duration neuromuscular blockade for surgery or during intensive care • Anticholinesterases reverse the effects of the non-depolarising (competitive) neuromuscular blocking drugs such as pancuronium but they prolong the action of depolarizing neuromuscular blocking drugs o Edrophonium has a transient action and may be used in the diagnosis of suspected dual block due to suxamethonium o Neostigmine has a longer duration of action than edrophonium and is used specifically for reversal of nondepolarising (competitive) blockade PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 261 STEP 3: Contraindication of Muscle Relaxants and Cholinesterase Inhibitors (20 Minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the Contraindication of muscle relaxants and cholinesterase inhibitors? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Most muscle relaxants are not contraindicated to any specific individuals except Suxamethonium and galamine chloride which is contraindicated to those with: o Family history of malignant o Hyperthermia o Hyperkalaemia o Major trauma o Severe burns o Neurological disease involving acute wasting of major muscle o Prolonged immobilisation o Hyperkalaemia o Low plasma-cholinesterase activity (including severe liver disease) • Cholineaterase inhibitors are contraindicated in o Intestinal obstruction o Urinary obstruction STEP 4: Dose, Dosage and Course of Muscle Relaxants and Cholinesterase Inhibitors (30 minutes) • Dose dosage and course of muscle relaxants o Atracurium Besilate:  Surgery or intubation, adult and child over 1 month, by intravenous injection, initially 300–600 micrograms/kg, then 100–200 micrograms/kg as required  Intensive care, ADULT and CHILD over 1 month, by intravenous injection, initially 300–600 micrograms/kg then by intravenous infusion 4.5–29.5 micrograms/kg/minute PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide 262 o Suxamethonium Chloride  By intravenous injection, initially 1 mg/kg; maintenance, usually 0.5–1 mg/kg at 5–10 minute intervals; max. 500 mg/hour; CHILD under 1 year, 2 mg/kg; CHILD over 1 year, 1 mg/kg  By intravenous infusion of a solution containing 1–2 mg/mL (0.10.2%), 2.5–4 mg/minute; max. 500 mg/hour; CHILD reduce infusion rate according to body- weight  By intramuscular injection, CHILD under 1 year, up to 4–5 mg/kg; CHILD over 1 year, up to 4 mg/kg; max o Gallanium  Adults: 1-1.5 mg/kg i.v. initially, then 0.5-1 mg/kg as required at about 40-minute intervals  Children: 1.5 mg/kg initially, then 0.5 mg/kg as required  Infants of less than 1 month: 250-750 micrograms/kg initially, then 100-500 micrograms/kg o Mivacurium  Intravenous injection, 70–250 micrograms/kg; maintenance 100 micrograms/kg every 15 minutes  CHILD 2–6 months initially 150 micrograms/kg, 7 months–12 years initially 200 micrograms/kg o Vecuronium Bromide  By intravenous injection, intubation, adult and child, initially 80–100 micrograms/kg; maintenance 20–30 micrograms/kg adjusted according to response; neonate  By intravenous infusion, 0.8–1.4 micrograms/kg/minute (after initial intravenous injection of 40–100 micrograms/kg) o Pancuronium Bromide  Intubation, by intravenous injection, initially 50–100 micrograms/kg then 10–20 micrograms/kg as required: Intensive care, by intravenous injection, 60 micrograms/kg every 60–90 minutes • Dose dosage and course of cholinesterase inhibitors o Edrophonium Is given by intravenous injection over several minutes, 500–700 micrograms/kg (after or with atropine) o Neostigmine Is given

banner
Scroll to Top
Adsterra publisher referral