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