PHD 222 Faculty of Pharmacy

Hospital Pharmacy Universiti Teknologi MARA

Oncology prescription 5
Name : AMIRA KHALIDA BINTI MISNAN Group : P2PH1104A2
Student Mat. No. : 2018241346 Date : 11/7/2020
Name: Rx Perubatan 6A-Pin.3/96
Ahmad Wazir CPP B No. 538845
No.K/P:
680209-72-5683 T. Tamoxifen 20 mg OD
No. Daftar
T. Cyclophosphamide 100 mg OD 2/52
Doxorubicin 60 mg/m² IV q14 Days
Umur:
50 YEARS
T. anastrozole 1 mg od for 2 weeks
Tarikh:
16 /06/2020
Signed/stamped
Penyakit:
Dr. Lilie
Breast cancer HOSPITAL UITM PULAU PINANG

A. Prescription screening

Screen the prescriptions (or medication orders), evaluate whether there are any errors
found and propose its possible correction wherever possible.

No Prescription error Yes No Proposed correction or

comments
1 All required information on
prescription (e.g. name,
doctor’s signature, date,
expiry date )
2 Dosage regimen (drug name,
dose, frequency, duration)
 3 Drug-drug interaction

B. Calculate the quantity of each drug to be dispensed.

Drug Name Calculation Total

(with strength) Amount to
be
Dispensed
C. State the relevant information of the dispensed drugs.

Indications Recommended Main Side Effects/ Drug

Pharmacological Put * on those applicable Dose for Interactions/
Generic Name Advice/ Instructions for Patients
Classification to patient with this *Indication Contraindications/
prescription Quote the reference Precautions/
Tamoxifen Cancer Hormone *Breast cancer, Adult: 20 mg daily as a S/E: Stroke, pulmonary
Therapy Reduction of breast cancer single or in 2 divided embolism, uterine sarcoma, Endometrial changes: Patients should
incidence in women at doses. Max: 40 mg endometrial cancer. be informed of the risk of
high risk, Anovulatory daily. (MIMS) D/I: Increases dopaminergic effect endometrial cancer and told to report
infertility of bromocriptine. Increased risk of relevant symptoms promptly.
thromboembolic events w/
cytotoxic drugs. Increased risk of Thromboembolism: Patients should
bleeding w/ platelet aggregation be made aware of the symptoms of
inhibitors. May mutually reduce thromboembolism and advised to
effects w/ hormone preparations report sudden breathlessness and any
particularly oestrogens (e.g. OCs). pain in the calf of one leg.
Reduced plasma levels w/
CYP3A4 inducers (e.g rifampicin)
and CYP2D6 inhibitors. Increased
plasma levels w/ CYP3A4
inhibitors. Significant increase in
anticoagulant effect w/ coumarin-
type anticoagulants (e.g. warfarin).
C/I: History of DVT or pulmonary
embolism. Pregnancy and
lactation. Concomitant coumarin-
type anticoagulant therapy.
P: Patient w/ leucopenia and
thrombocytopenia,
hyperlipidaemias. CYP2D6 poor
and intermediate metaboliser.
D. State the relevant information of the dispensed drugs.

Indications Recommended Main Side Effects/ Drug

Pharmacological Put * on those applicable Dose for Interactions/
Generic Name Advice/ Instructions for Patients
Classification to patient with this *Indication Contraindications/
prescription Quote the reference Precautions/

Cyclophosphamide Cytotoxic * Malignancies, Adult: Low dose S/E: Alopecia, haemorrhagic Should be taken on an empty
Chemotherapy / Nephrotic syndrome regimen: 2-6 mg/kg cystitis, immunosuppression stomach. Preferably taken on an
Immunosuppressants weekly in divided empty stomach, but may be taken w/
dose. Alternatively, D/I: Increased risk of meals to minimise GI irritation.
100-300 mg daily in cardiotoxicity w/ doxorubicin or Ensure adequate fluid intake.
divided doses, or 50- other cardiotoxic drugs. May Swallow whole.
250 mg/m2 daily or increase incidence of mucositis w/
80-300 mg/m2 daily in protease inhibitors. May increase This drug may cause visual
divided doses. (MIMS) haematotoxicity and/or impairment and dizziness, if affected,
immunosuppression w/ ACE do not drive or operate machinery.
inhibitors, natalizumab, paclitaxel,
thiazide diuretics, zidovudine. May
increase pulmonary toxicity w/
amiodarone. May increase
nephrotoxicity w/ amphotericin B.
May result to acute water
intoxication w/ indometacin.

C/I: Patient w/ bone marrow

aplasia, urinary outflow
obstruction, UTI, acute infection,
drug- or radiation-induced
urothelial toxicity. Pregnancy.

P: Patient w/ DM, severe

immunosuppression, acute
porphyria, pre-existing CV disease
or those at risk for cardiotoxicity.
Renal and hepatic impairment.
Lactation.
E. State the relevant information of the dispensed drugs.
Indications
Pharmacological Put * on those applicable
Generic Name
Classification to patient with this
prescription
Doxorubicin Cytotoxic *Metastatic breast cancer,
Chemotherapy AIDS-related Kaposi's
sarcoma, Ovarian
carcinoma, Local
malignant neoplasms in the
bladder
Recommended Main Side Effects/ Drug
Dose for Interactions/
Advice/ Instructions for Patients
*Indication Contraindications/
Quote the reference Precautions/
S/E: Anemia, Bone marrow
Adult: 60-75 mg/m2 suppression, Cardiotoxicity.
BSA once every 3
weeks in combination D/I: Doxorubicin interacts with a
with number of other drugs e.g.
cyclophosphamide antibiotics (aminoglycosides),
given as an infusion steroids, aminophylline and
over 1 hour diluted in propranolol.
0.9% sodium chloride Potentially Fatal: Cholestasis
or 5% glucose. induced by mercaptopurine may
(MIMS) be potentiated by concurrent
administration of the drug.
Toxicity may be increased if
streptozocin is given concurrently.
C/I: Cardiac disease, neonates,
pregnancy and lactation, prior
irradiation to mediastinum. IM/SC
admin. Severe myelosuppression
due to previous treatment with
antitumor agents or radiotherapy.
P: Elderly, children, hepatic
impairment. Monitor blood counts
and ECG.
F. State the relevant information of the dispensed drugs.

Indications Recommended Main Side Effects/ Drug

Pharmacological Put * on those applicable Dose for Interactions/
Generic Name Advice/ Instructions for Patients
Classification to patient with this *Indication Contraindications/
prescription Quote the reference Precautions/

Anastrozole Cancer Hormone * Adjuvant therapy for Adult: As S/E: Gastrointestinal distress, This drug may cause asthenia and
Therapy postmenopausal women monotherapy in Joint disorders, Nausea somnolence, if affected, do not drive or
with hormone receptor hormone receptor- operate machinery.
positive early breast positive advanced D/I: Diminished therapeutic effect
cancer, cases or in patients with oestrogen derivatives.
Breast cancer in with disease Decreased serum concentration
postmenopausal women progression following with tamoxifen.
tamoxifen therapy: 1
mg once daily. C/I: As monotherapy in pre-
Treatment may be menopausal women with breast
continued up to 5 years cancer. Severe renal impairment
for adjuvant therapy or (CrCl <20 mL/min). Pregnancy
until tumor and lactation.
progression for
advanced breast P: Patient with hyperlipidaemia;
cancer. (MIMS) pre-existing osteopenia, ischaemic
cardiac disease. Moderate to
severe hepatic or mild to moderate
renal impairment.

.
C. Prepare the label and auxiliary label (if any) for each drug to be dispensed.

Label Auxiliary Label

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN
HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN
HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN

HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK

 Label Auxiliary Label

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN

HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN

HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK

NAMA R/N:

UBAT BIJI

BIJI SEKALI MAKAN

SEBELUM
KALI SEHARI SELEPAS MAKAN

HOSPITAL TARIKH:

NAMA UBAT

JAUHI DARI KANAK-KANAK