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Tommy is a 30 year old teacher who is complaining about frequent episodes of bloating and abdominal discomfort. He has a past medical history of gastro esophageal reflex disease (GERD). Ours mission is to:

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Jamie is a 20 year old student who has recently been experiencing heart burn and indigestion. jamie does not want to go to her general practitioner and would like to buy medication over the counter. She hates tablets and prefers the medication in liquid form.
Our mission is to:

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Group 6

Jenny is planning to visit her best friend in Penang and has booked a coach to get there. The last time she took a bus she experienced motion sickness with nausea and vomiting that ruined her trip.  YOUR MISSION is to:

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  Help Jenny find a suitable over the counter medication. 

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  Help Jenny find a suitable over the counter medication. 

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Dimenhydrinate (Dramamine)
Diphenhydramine (Benadryl)

Promethazine (Phenergan)

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2.       Explain the mode of action (how the chosen drug works) and side effects (if any).

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2.       Explain the mode of action (how the chosen drug works) and side effects (if any).

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MOA : Blocks histamine-1 receptors to suppress nausea and vomiting.

Adverse effects includes dry mouth, dysuria and drowsiness.

Dimenhydrinate: tachycardia, dizziness, drowsiness, nervousness, restlessness, lassitude, excitement, hypersensitivity.

Benadryl:Disturbed coordination, double vision and tremors.

Phenergan:Anxiety, tinnitus and swelling of the hands or feet.

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3.	Share an example of a potential medication error that can occur when administering this medication to a patient under your care.

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3.	Share an example of a potential medication error that can occur when administering this medication to a patient under your care.

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Benadryl is not advisable to be taken by nursing mothers especially if they are actively nursing their newborn infants. This is due to the medication being secreted from the mother’s mammary glands into their breast milk thus in the period of breastfeeding, the infant will have the risk of developing seizures.

The wrong dosage could be a potential medication error. For adults, the dose is two tablets. For children between the ages of 7-12, the dose is half a tablet. For children above the age of 12, the dose is one tablet. Ensuring that the correct medication dosage is administered while tallying against the patient’s case notes and their age is vital. Hence, this will prevent the onset of a potential drug error possibly a drug overdose for the patient.

For phenergan, taking the medication at the wrong timing could be a potential medication risk. For motion sickness, the first dose of promethazine should be taken 30 to 60 minutes before beginning travel. One should ensure that the medication is taken at the right time, and not once the patient starts to experience motion sickness, to allow the medication to be the most effective.

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Andy is a 45 yrs old banker. He started to have watery stools after a BBQ 3hrs. Earlier, he is wondering what over the counter drug could help him with his symptoms.

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Adsorbs toxic substances, thus inhibiting GI absorption and preventing systemic toxicity

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1. Vomit, constipation, black stool (if charcoal is taken)

For ultracatbon common side effects:
Diarrhea, constipation, or vomiting
Black stool
Serious side effects:
—Blockage in the stomach or intestines
—Hard dry lumps of stool that get stuck in the gut (fecal impaction)
—Breathing in fluid, mucus, or foreign materials into the lungs, known as aspiration
-dehydration if taken when low level of fluid in body
-haemorrhaging if taken when has bleeding in the GI tract

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Examples of potential medication error occurs during administering

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Examples of potential medication error occurs during administering

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Cannot be taken with other medication, as charcoal will absorb other medication if taken at the same time. Must space charcoal and other medications 2 hours apart, to prevent the absorption.

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Potential medication error when administering

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Potential medication error when administering

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1. Not shaking the suspension before pouring out the prescribed volume of antacid to serve the patient.

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Antacid Tablet ( dual antacids )
Contains simethicone ( anti- flatulent), aluminium hydroxide, magnesium trisilicate

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Antacids neutralizes gastric acid and simethicone decreases the volume of gas associated with bloating and discomfort.
Side Effects
Aluminium based: constipation, nausea, stomach cramps
Severe adverse effects: faecal impaction, hypophosphatemia
Magnesium based: diarrhoea, nausea, vomiting, abdominal cramping
Severe adverse effects: hypermagnesemia

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Wrong time of administration
Administration of antacids needs to be separated by at least 2 hours from other drugs like tetracycline, fluoroquinolone antibiotics and levethyroxine. Reason being antacids interfere with absorption of many drugs that are given orally.

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Side effects:

The medication may cause:
-nausea
-constipation
-diarrhea
-headache

Rare but very serious side effects:
-black/tarry stool
-slow/shallow breathing
-slow/irregular heartbeat
-abdominal pain
-pain with urination

Seek immediate medical attention if any allergic reaction such as:
-rash
-itching/swelling(especially face,tongue,throat )
-dizziness
-trouble breathing

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Gaviscon double action liquid brings relief from the pain and discomfort of heartburn and acid indigestion. It gets to work in two different ways:
1. neutralising excess stomach acid to relieve pain and discomfort.
2. forming a protective barrier over the stomach contents to soothe the burning pain in the chest

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Wrong product - Products with similar names may contain different ingredients meant for different purposes. For example gaviscon dual action and gaviscon extra strength liquid antacid. Gaviscon dual action is to improve indigestion relief as well as soothing heartburn relief whereas the extra strength one is for fast acting heartburn relief and help keeps acid down for hours

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Grace is a 26-years-old flight attendant who is experiencing constipation for the pass 4 days due to her hectic flight schedule. She hates vegetables and fruits and does not drink much water because she is worried about water retention.

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Lactus ( Lactulose )

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Lactulose is used as a laxative to treat constipation. It reaches the colon where bacteria digest it and thereby alter the composition of the stool. In the colon, lactulose is broken down by bacteria into products that help to draw water into the colon, which softens the stool.

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2. Make sure that the patient is not on sodium restricted diet as antacids contain sodium and patient might have a spike increase in sodium level in the body

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diarrhoea, nausea, vomiting, bloating, gas, stomach pain/discomfort

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Wrong dose - patient consumed too much or too little of lactulose than required may cause the patient to experience more severe side effects or the medication to be ineffective.
Wrong time - giving the medication at night affects patient sleep routine.

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Can you give an example of your chosen medication error? Any example of product with similar name? (Wendy)

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Can you give an example of your chosen medication error? Any example of product with similar name? (Wendy)

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You chose tablet form of Gaviscon, why would you need to shake the bottle? ;-(

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You chose tablet form of Gaviscon, why would you need to shake the bottle? ;-(

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Your chosen potential medication error should be related to the form of the drug you are giving.
And where is your MOA? (Wendy)

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Good! Wrong dose is a common medication error with liquid form!

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Good! Wrong dose is a common medication error with liquid form!

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(Wendy)

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Re: the answer about charcoal "inactivated" because it has very fine particle size? Can you rephrase that answer? Coz i don't get what you are trying to say and what is the relevant pharmacological importance of it being "activated"?

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Re: the answer about charcoal "inactivated" because it has very fine particle size? Can you rephrase that answer? Coz i don't get what you are trying to say and what is the relevant pharmacological importance of it being "activated"?

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Antacids neutralize gastric acid

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Gaviscon is an antacid that reduces gastric acid by binding with phosphate in the intestine, and then is excreted as aluminum carbonate in feces. Thats why it should be taken orally.

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It helps to soothe the oesophagus and blocks acid reflux, removing the symptoms of heart burn and indigestion.

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How to prevent heart burn and indigestion? (extra info)

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How to prevent heart burn and indigestion? (extra info)

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- avoiding late-night eating.
- drink fluids after meals, rather than during.
chew food completely and eat slowly.
- drink milk or water to ease the acid in the stomach.
- limiting acidic foods, such as grapefruit, oranges, tomatoes or vinegar.
- eat smaller portions.
- eat your last meal 2-3 hours before bedtime.
- wear loose-fitting clothing to avoid pressure to the abdomen.

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POSSIBLE Side effect:
Calcium based:
Common: constipation, flatulence
• Serious adverse effects: faecal impaction, metabolic alkalosis, hypercalcaemia, renal calculi

Sodium based :
Common: flatulence, abdominal distension
Serious adverse effects:
metabolic alkalosis, fluid retention, oedema, hypernatremia