January 26, 2023

##### This video will help you calculate the number of tablets needed to be dispensed for prednisone taper prescriptions.

So this is another video concerning calculations that you can use with prescriptions in community pharmacy in this video looks at prednisone dosing with prednisone any patients that are going to be on high doses or on the medication for more than a few days should have their dose tapered and we taper the dose in order to prevent suppression of the hpa axis if we

Don’t do this and we keep people on high doses and then quickly take them off of the high dose then their hpa axis will not recover for a little while following a discontinuation of the dose and so tapering the dose um helps to prevent that hpa axis suppression but anyway this is a typical prescription that you might see in a community setting and sometimes may

Be a little bit overwhelming for the pharmacist or the technicians to calculate the total number of tablets that need to be dispensed in order to fulfill the medication or or excuse me in order to fulfill the prescription so this video will kind of walk you through a quick way to calculate the total number tablets needed so really there’s three parts um to each

Line in the prescription you’ll notice that we have the total number of tablets a frequency in this case the frequency is qd so it’s once a day and then instructions for how many days were to use that dose of the medication in this case it’s three days for each line and so what we want to do is we want to multiply the number of tablets by the frequency and then

Multiplied by the number of days so in this case we have four tablets so that’s four for tablets we’re going to multiply by 1 because it’s once a day sometimes one and then we’re going to go ahead and multiply by three for three days until we take 4 times 1 times 3 here we get 12 so for this first line we’re going to need 12 tablets and we do the same thing as we

Work our way down now what i’ve written here is more shorthand of the first line and this is the way that some providers will write their prescriptions they won’t write p oqd on every line so it’s implied that the qd applies to each line as we work our way down so we then take our three tablets multiplied by one for the qd then we’ll multiply by three for three

Days when we come up with nine tablets for the second line for a third line we’ll take two tablets times once a day times three days so we get six we take one tablet times once a day times three days and we get three we then add up all the tablets and we should come to 30 so we need 30 tablets of the ten milligram prednisone in order to fulfill this prescription

Now sometimes we won’t see number of tablets right now and instead what we’ll see is something that looks like this because we’ll see just the plain prednisone but then we’ll be given a strength for example you might see something like this you might see something like 40 milligrams qd by two days and then this dosing regimen will continue so let’s see something

Like this okay so if you see something that’s written like this there’s an extra step that’s needed because the pharmacists or the technician needs to decide what milligram strength tablet to use now we’re looking here and we see instructions 40 30 22 milligrams so it makes sense to use either a 20 milligram tablet or a 10 milligram tablet and depending on whether

The patient wants to split tablets or whether the pharmacist will go ahead and cut tablets for the patient might influence the decision whether to use 20 milligrams or 10 milligrams and also availability of your strength might dictate which strengths the pharmacist uses so if we go ahead and base this off a 20 milligram tablet the first arm step that we’re going

To do is we need to take the strength that’s desired in this case 40 milligrams and we need to divide it by the strength running use in this case 20 milligram tablets so 40 divided by 20 is 2 so i’m going to go ahead and put a 2 up here we then follow the same procedure that we did in the previous example so we multiplied by the frequency in this case once a day

Times 2 for the number of days at that frequency in that strength so we’ll take 2 times 1 times 2 and we get 4 so we need 4 cowlitz for the first line okay then we’ll go ahead and do the second line so we do the same thing we take our 30 milligrams divided by 20 so we get one and a half tablets and again this is where i said um if you use the 20 milligram tablet

Either patients are going to have to split the tablet themselves or the pharmacist will do it for them so 30 milligrams divided by 20 is one and a half so 1.5 x 1 x 2 okay times 1 4 once a day for two days and we get 3 okay so three tablets for the second line the third line 20 and divided by 20 so to get one tablet times 1/4 once a day for two days so we get 2

Tablets then down here we’ll take 10/20 we get 1/2 tablet once a day for 2 days so that’s one tablet okay 1/2 times 1 times 2 we add this together we get 10 tablets okay so if you use the 20 milligrams drink me 10 tablets now if you don’t feel like fooling around and exploding tablets or patient doesn’t want to split tablets instead what we can do is use 10 milligram

Tablets okay so we use the 10 milligram tablets it’s going to change this up here so if we use the 10 milligram tablets we do the same procedure we take our 40 and we divide by 10 so we get 4 tablets this time multiply by 1/4 once a day times 2 for 2 days so 4 times 1 times 2 and we get 8 tablets and we continue down the line so 30 divided by 10 is three tablets

Once a day for two days six for this line it’s four and for the bottom line and ones will be in two we add all this together we get 20 so we need 20 tablets if we go ahead and use the 10 milligram strength so again this is a relatively simple procedure but sometimes you know you can get some complex prescriptions it might be overwhelming to staff members but

Hopefully this is um just an easy way to go through the calculation again remember you multiply your number of tablets times times the frequency times the number of days in the second example if you’re given a strength take your strength and divide by the tablet that you want to use in this case we use 10 milligram tablets then you multiply by the frequency and

Then multiply by the number of days and if you have any questions on this or if you have topics for future videos don’t hesitate to email me i do read all the emails that are sent to me and if you need to email me i’ll leave you with my email address and you can go ahead and email me and and we will do videos on future topics have a good day

Transcribed from video
Community Pharmacy Prescriptions II: Prednisone Dosing By tyeUM13