Basic Pharmacology and Medication Assistance
This domain tests safe assistance with medicines: the rights of administration, reading a prescription, routes and storage, and what to do when something goes wrong.
Core rules
- The rights: right patient, right drug, right dose, right route, right time - plus correct documentation, right reason and the patient's right to refuse.
- Parts of a prescription: superscription, inscription (drug and strength), subscription (dispensing directions), signa (directions to the patient), prescriber's signature and date.
- Routes: oral, sublingual, buccal, topical, inhalation, rectal, intramuscular, intravenous, subcutaneous, intradermal.
- IM sites: ventrogluteal is preferred in adults; deltoid takes up to 1 mL; vastus lateralis is used in infants.
- Forms: tablet, capsule, syrup, suspension (shake before use), ointment, suppository, ampoule and vial.
- Storage: cool, dry, protected from light; vaccines at 2–8 °C and never frozen; check expiry dates; narcotics in a double-locked cupboard with a register.
- Side effect = predictable, dose-related effect; adverse drug reaction = harmful, unintended response; allergy = immune-mediated - stop the drug and report.
- Assist only under a valid prescription. Never give an unknown medicine, never crush enteric-coated or sustained-release tablets without instruction, and watch for look-alike, sound-alike names.
Worked example
A prescription reads paracetamol 15 mg/kg for a child weighing 12 kg, and the syrup contains 120 mg in 5 mL. Reasoning: dose = 15 × 12 = 180 mg; volume = (180 / 120) × 5 = 7.5 mL. Recheck the patient's identity, the strength on the bottle and the time of the last dose before pouring.
Traps that cost marks
Giving a medicine because it was left on a shared tray; confusing milligrams with millilitres; mixing up BD and TDS; giving aspirin to a febrile child; crushing a sustained-release tablet; failing to record a refused dose.