Is memorizing dosage strengths, forms and dosing range important ?

[aldolase]

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Hey everyone,

This semester, we are responsible for knowing everything on the drug cards. The questions will be case based. What would be a good strategy to learn dosage forms, dosage strengths ? I work at CVS and know most of the fast movers but what about the rest ? There are too many strengths. Also, is it necessary when working out there to know that info by memory ?

I also find dosing range, drug interactions difficult to memorize. Different disorders have diff. dosing ranges. How important would it be know the dosing ranges for the top 200 drugs ?
Currently trying to make flash cards. Would it be helpful to cross reference the drug cards with Diprio to filter the information ?

Mechanism of action is the easiest since that's conceptual and many times I can remember the side effects linked to MOA.

 

[confettiflyer]

Good way to waste time if your school has nothing better to teach.

 

[BeLikeBueller]

Hey everyone,

This semester, we are responsible for knowing everything on the drug cards. The questions will be case based. What would be a good strategy to learn dosage forms, dosage strengths ? I work at CVS and know most of the fast movers but what about the rest ? There are too many strengths. Also, is it necessary when working out there to know that info by memory ?

I also find dosing range, drug interactions difficult to memorize. Different disorders have diff. dosing ranges. How important would it be know the dosing ranges for the top 200 drugs ?
Currently trying to make flash cards. Would it be helpful to cross reference the drug cards with Diprio to filter the information ?

Mechanism of action is the easiest since that's conceptual and many times I can remember the side effects linked to MOA.

Your best bet right now is to ask someone who is a year ahead of you what they were tested on.

From a practical standpoint, I would study common side effects (especially class side effects), MOA, and things that have major drug interactions first, then I would go to the more trivial if I had time. I can't imagine they would ask you questions about dosing ranges. With regards to drug interactions, there are some drugs that you just need to watch out for in general - rifampin, warfarin, phenytoin, carbamazepine, and digoxin to name a few - obviously there are more. Your key word for these kinds of drugs is going to be "major" CYP 450 interaction - particularly of the 3A4, 2D6, and 2C9/2C19 variety - those seem to be the bigger ones. If your drug cards are unclear, I would cross-reference with lexicomp or micromedex. Both of these have good "patient education" sections that are going to highlight some of your more common/relevant side effects. In addition, their interaction sections are going to give you the big picture CYP-type interactions.

P.S. - sorry you got stuck with a professor that doesn't teach. It happens from time to time...

 

[zelman]

If you know commercially available strengths, you can approximate appropriate doses for adults. There will be exceptions, but that's the rule of thumb I used in school. It's rare that you see 16 caps per day a la early HIV meds. People take 1-2 of the highest or second highest strength of most drugs in most cases.

 

[aldolase]

Your best bet right now is to ask someone who is a year ahead of you what they were tested on.

From a practical standpoint, I would study common side effects (especially class side effects), MOA, and things that have major drug interactions first, then I would go to the more trivial if I had time. I can't imagine they would ask you questions about dosing ranges. With regards to drug interactions, there are some drugs that you just need to watch out for in general - rifampin, warfarin, phenytoin, carbamazepine, and digoxin to name a few - obviously there are more. Your key word for these kinds of drugs is going to be "major" CYP 450 interaction - particularly of the 3A4, 2D6, and 2C9/2C19 variety - those seem to be the bigger ones. If your drug cards are unclear, I would cross-reference with lexicomp or micromedex. Both of these have good "patient education" sections that are going to highlight some of your more common/relevant side effects. In addition, their interaction sections are going to give you the big picture CYP-type interactions.

P.S. - sorry you got stuck with a professor that doesn't teach. It happens from time to time...

Thank you for the helpful info. I am looking to retain high yield information that is really important to know by memory as a pharmacist vs info that can be easily looked up without looking like someone who doesn't know anything. Info that knowing would be a huge time saver.

 

[BeLikeBueller]

Thank you for the helpful info. I am looking to retain high yield information that is really important to know by memory as a pharmacist vs info that can be easily looked up without looking like someone who doesn't know anything. Info that knowing would be a huge time saver.

No problem. Most of what you would ever get asked in retail is going to be side effect related. A second to that would be what is this drug for/what does it do? Also, probably 99% of all retail pharmacies have computer systems that automatically check and list drug-drug interactions, so your job becomes more about figuring out whether or not something is serious enough to warrant a change in therapy rather than figuring out which drugs interact.

In a clinical-type setting, you're likely to see some other questions too regarding adverse events (i.e. could any of this pt's medications cause this problem that we're seeing) and drug interactions, but from talking to some folks that work in a clinical setting, a lot of that type of information is gained on rotation, during residency, and through real-world experience.

 

[swatchgirl]

What would be a good strategy to learn dosage forms, dosage strengths ? I work at CVS and know most of the fast movers but what about the rest ? There are too many strengths. Also, is it necessary when working out there to know that info by memory ?

I also find dosing range, drug interactions difficult to memorize. Different disorders have diff. dosing ranges. How important would it be know the dosing ranges for the top 200 drugs ?

I had been wondering about the very same things as you. I imagine if you don't know all the dosage range and dosages, you won't be able to recognize an erroneous prescription when you see it?

A doctor writes a script for a dangerously high dosage, and you didn't identify it before dispensing, because you were clueless what the correct dosage was? I don't believe the computers in a retail pharmacy have a built-in function that would screen the dosages for you. They will screen for potential drug-drug interactions, but not proper dosages and dosage ranges.

It doesn't seem to make sense to me when I hear people say a working pharmacist isn't expected to know all the dosages and common dosage ranges for everything they dispense. That just sounds like a lawsuit waiting to happen. Could someone please clarify this confusion?

 

[swatchgirl]

Good way to waste time if your school has nothing better to teach.

One would think so, but I was thinking along the line that if you don't memorize all the dosage range and dosages for every drug under the sun, then you won't be able to recognize an erroneous prescription when you see it?

A doctor writes a script for a dangerously high dosage, and you didn't identify it before dispensing, because you were clueless what the correct dosage was? I don't believe the computers in a retail pharmacy have a built-in function that would screen the dosages for you. They will screen for potential drug-drug interactions, but not proper dosages and dosage ranges.

It doesn't seem to make sense to me when I hear people say a working pharmacist, aka. a "drug expert", isn't expected to know all the dosages and common dosage ranges for everything they dispense. That just sounds like a lawsuit waiting to happen. Could someone please clarify this confusion?

 

[gwarm01]

It's not realistic to know every dose of every drug for every indication, but if you know what strengths are commercially available you have a good starting point to learn appropriate dosing.

 

[monkieez]

One would think so, but I was thinking along the line that if you don't memorize all the dosage range and dosages for every drug under the sun, then you won't be able to recognize an erroneous prescription when you see it?

A doctor writes a script for a dangerously high dosage, and you didn't identify it before dispensing, because you were clueless what the correct dosage was? I don't believe the computers in a retail pharmacy have a built-in function that would screen the dosages for you. They will screen for potential drug-drug interactions, but not proper dosages and dosage ranges.

It doesn't seem to make sense to me when I hear people say a working pharmacist, aka. a "drug expert", isn't expected to know all the dosages and common dosage ranges for everything they dispense. That just sounds like a lawsuit waiting to happen. Could someone please clarify this confusion?

In retail, the computer system will not allow a technician to pull and dispense a strength of drug that doesn't exist because they must assign a commercially available product to the script and thus at this stage would let you know if there is an issue. There is some degree of pharmacy common sense. There isn't going to be a tablet size that is more than the maximum dosage. Therefore, if a script that had instructions to take multiple pills of the tablet at the same time should trigger a red flag in your mind and would make you want to look up what the maximum dosage is, which is very easy to look up.

 

[Chriskahn]

I just use the micromedex app on my phone. I pull it out during my rotations and nobody really seems to care. Actually my preceptor encouraged it. You can look up doses for specific indications pretty quick.