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Rational Drug Use Program (RDU) Methodology DOH-WHO Criteria

CLINICAL PHARMACOLOGY: Dr. Leonardo Torres May 22, 2014

1. Definitive Dx: Acute Migraine Headache


B. Yes, but not completed, any serious
2. Basic Problem: Unilateral Headache SE/ADR
No, treatment continued
3. Pathophysiology: CGRP and Substance-P Vasodilators Yes, reconsider dosage, change RDU

4. Management Goal / Type of Tx Applicable: Stop the attack by C. No, disease not cured. Verify all
the use of the rational drug vasoconstrictor and Px against Steps:
subsequent attack Dx correct?
Therapeutic objective correct?
5. Comparison of Rational / Effective Pharmacologic / P-Drug suitable to the patient?
Therapeutic Group: Drug prescribed correct?
Specific Example/s of Drug/s based on ESSA or SANE Criteria: Patient instruction correct?
Vasoconstrictor Effect/s monitored correctly?
Gabamimetic Other problems? Complications?
Beta-blocker
Ca-Channel-Blocker ADD: Keep an up-to-date Information on Drugs
Journals Local and International (PSECP)
E S S A Article, Author, Research Methodology
Sumatriptan +++ ++ +++ + = 3 References, Critique on Reliable Literature/s
Ergotamine ++ ++ + ++ = 7
Valproate Na + + + ++ = 5 Clinical Drug Trial/s done, Randomized Double-blind,
Propanolol + ++ + ++ = 6 Meta-analysis, Validity for Clinical Tx
Verapamil + ++ + ++ = 6
Statistical Analysis, Significance, Relevance, Control
6. Choose the Best / Appropriate / Rational Drug: Sumatriptan for Bias

7. Write a correct and complete Prescription Form: Essential References on Drugs:


(see next page) Pharmacology, Toxicology, Therapeutics
National Drug Formulary (DOH)
8. Expected Beneficial / Undesirable / Withdrawal Effects: Essential Drug Lists (WHO)
Symptom Disappaer, What happen, Side-effect / ADR, Treatment guidelines for different dses
if any
Melmon and Morelli Clinical Pharma. And
9. Complete Instructions to the patient / nurse: Thera.
Dosage Regimen, ROA, Duration, Any warning, What Averys Drug Therapy
to do / not to do, Contraindication (Vasoconstriction, Goodman-Gilmans Pharma. Basis of
Cardiovascular Disorder) Therapeutics Ed.
Katzung et. al. Basic Clinical Pharmacology
10. Follow-up / Monitor Patients Response: 12th Ed.
Next appointment, Information needed, understood, Tx Martindale Pharmacopoeia
effective?

A. Yes, disease cured, stop the treatment

1 ICB 2016
Rational Drug Use Program (RDU) Methodology DOH-WHO Criteria
CLINICAL PHARMACOLOGY: Dr. Leonardo Torres May 22, 2014

PRESCRIPTION PAD:

1. _______________________
_______________________
_______________________

2. ___________________ 3. ____________________
___________________

4. Rx

5. _________________________
6. M / D ____________________ #

7. LAB. / SIGNA.
___________________________________________
___________________________________________
___________________________________________

8. REFILL INFO.: ____________

9. ___________________________
___________________________

4. Doctors Heading and Information 1. Transcription (Signatura): Command Verb (Route of


Printed/Personalized Name of Physician, Admin.)
Specialization, Clinic Address, Clinic Number, Single Dose (Initial), Frequency, Relation to
Clinic Hours Food,
5. Name, Age, Address of Patient Duration, Purpose (Optional) [3 pts]
6. Date Instruction to Patient for the use of drug
Since the prescription is a Legal Document LAB: Label ; SIGNA: Signatura (Latin)
7. Superscription (Recipe) [1 pt] Explain Personally
Printed Rx First word should ALWAYS be a VERB
8. Inscription: Generic Drugs (Brand Name) e.g. Take, Drink, Inject, Insert, Apply
Strength: Amount / Stock Dose / Dose Do not use abbreviations
Form [5 pts] If possible, in their own dialect
e.g. Sumatriptan 5 mg TAB Take 5mg tab of Sumatriptan 2x a day for 2
9. Subscription: D-Dispense / M Mix / Prepare weeks (DOSAGE REGIMEN)
Total Amount / No. Purpose only placed if with INFECTION or
Instruction to the Pharmacist regarding drug CANCER
Prescription should be good for two weeks 2. Refill Information
only. Do not give prescriptions lasting for a Will the patient repeat the prescription?
month to monitor patients response NO REFILL: after 2 weeks, patient must come
e.g. 2 for 2 weeks # 28 back for follow-up ALWAYS
3. Original Signature of M.D.
License No. (PRC)
Narcotic License (If regulated drug)

2 ICB 2016
Rational Drug Use Program (RDU) Methodology DOH-WHO Criteria
CLINICAL PHARMACOLOGY: Dr. Leonardo Torres May 22, 2014

CLINICAL PHARMACOLOGY AND THERAPEUTICS


CLINICAL CASES FOR RDU
Dr. Leonardo Torres

PHARMACOKINETICS / PHARMACODYNAMICS / CLINICAL DRUG TRIAL DESIGN

Methamphetamine Overdose AMMONIUM CHLORIDE (NH4Cl) Forced Diuresis


Bronchial Asthma with Mild HPN VERAPAMIL 40-80 mg. tab
Atrial Fibrillation DIGOXIN 250 mcq. tab / day
Paracetamol Biotransformation GLUTATHIONE-CONJUGATION, Liver 300-500 mg.tab.
Clinical Drug Trial Design FDA-Approval Meta-analysis / Randomized Controlled T.

ANS DRUGS

Orthostatic Hypotension due to PROMETHAZINE, An A-Adrenergic Blocker


Baroreceptor Mechanism to Normal BP / MIBOBRINE 5-10 mg.tab.
Neurogenic Bladder (Bladder Atony) BETHANECOL 25-50 mg.tab / NEOSTIGMINE 15 mg.tab
Intestinal Atony (Paralytic Ileus) BETHANECOL 5 mg/ml SC / NEOSTIGMINE 2.5 mg/ml IM
Myasthenia Gravis NEOSTIGMINE 15 mg.tab / PYRIDOSTIGMINE 30-50 mg.tab. 5 mg/ml IM
Glaucoma PILOCARPINE Optha. 10% / 5mg.tab
Organo-PO4 Poisoning (Insecticide) ATROPINE 1 mg/ml INJ / PRALIDOXIME 50 mg/ml VIAL
Carbamate Poisoning ATROPINE 1 mg.ml AMP
Atropine Overdose NEOSTIGMINE / PHYSOSTIGMINE (see above)
Nicotine / Mushroom Poisoning ATROPINE (see above)
Sjogrens Syndrome CEVIMALINE 30 mg. CAP
Cigarette Smoking Cessation BUPROPION 25-75 mg. TAB
Alzheimers Dementia DONEPEZIL 5-10 mg. TAB / MEMANTINE 5-10 mg. TAB
UIS after Prostatectomy (BPH) OXYBUTYNIN 5-10 mg TAB / TOLTERODINE 2-5 mg. CAP
Hypermotility GIT Disorder HYOSCINE M-BROMIDE 10 mg TAB
COPD (Emphysema) IPRATROPIUM 20 mcg. / dose MDI / TIOTROPIUM 18 mcg/dose MDI
Opthalmologic Examination HOMATROPINE (prevent synechiae PO) 2-5% OPHTH

CARDIOVASCULAR DRUGS:

Atherosclerosis SIMVASTATIN 20-40 mg. TAB / AMLODIPINE 5-10 mg. TAB


Cardiogenic Shock DOBUTAMINE 12.5 50 mg/ml VIAL / AMP. IV
Hyperlipidemia (Dyslipidemia) SIMVASTATIN / FENOFIBRATE 100 mg TAB / 200 mg. TAB
NIACIN 50-100 mg. TAB
Hyperprolactinemia BROMOCRIPTINE 2.5 mg TAB / 5 mg CAP
ADHD (Pedia) METHYLPHENIDATE 5-20 mg. TAB / 40 mg CAP / MODAFINIL 100-200 mg
TAB
Anaphylactic Shock EPINEPHRINE 1 mg/ml IV
Stress Urinary Incontinence (Female) PSEUDOEPHEDRINE 60-120-240 mg TAB/CAP

3 ICB 2016