Quality Use of Medicines (QUM) + Workshops

• Principles of Quality Use of Medicines (QUM)


  • Selecting management options wisely
  • Choosing suitable medicines if a medicine is considered necessary
  • Using medicines safely and effectively
• 5 rights of medicine administration

  • Right patient
  • Right drug
  • Right dose
  • Right route
  • Right time
• Consumer Medicine Information (CMI)


  A leaflet that provides essential information about a prescription or over-the-counter medicine, including how to use it, side effects, and storage instructions
• Purpose of CMI


  To help patients understand how to take their medicines safely and effectively
• Modifying dosage forms


  1. Adjusting for patient-specific needs, such as difficulty swallowing, pediatric or geriatric requirements

  2. Examples: Crushing tablets, mixing with food or liquid, using liquid formulations, or converting to transdermal patches
• Interpretation of don't rush to crush monographs

  Guidelines on whether a medication can be crushed or altered, ensuring safe and effective administration for patients who cannot swallow tablets
• Content of don't rush to crush monographs

  Information on the stability, absorption, and potential impact on efficacy and safety when modifying dosage forms
• Medications that you cannot crush and why

  • Enteric-coated medications: These medications have a coating that is designed to remain intact in the stomach and dissolve in the small intestine. Crushing them can lead to irritation of the stomach lining or reduce the effectiveness of the medication.
  • Extended-release medications: These medications are formulated to release the active ingredient slowly over an extended period. Crushing them can cause the entire dose to be released at once, which can be dangerous or lead to ineffective treatment.
  • Sublingual or buccal tablets: These medications are designed to be placed under the tongue or between the cheek and gum for absorption. Crushing them can interfere with their intended absorption route.
• Brand Name


  The commercial name given by the manufacturer (e.g., Tylenol)
• Generic Name


  The standard name of the drug (e.g., acetaminophen)
• Importance of identifying brand and generic names
• Pre/suffix of common drug classes

  • ACE Inhibitors: "-pril" (e.g., enalapril)
  • Beta Blockers: "-olol" (e.g., propranolol)
  • Calcium Channel Blockers: "-dipine" (e.g., amlodipine)
  • Antibiotics: Penicillins: "-cillin" (e.g., amoxicillin), Cephalosporins: "cef-" or "ceph-" (e.g., ceftriaxone)
  • Statins: "-statin" (e.g., atorvastatin)
  • Benzodiazepines: "-pam" or "-lam" (e.g., diazepam, alprazolam)
• Systemic Administration


  Drug enters the bloodstream and affects the whole body (e.g., oral, intravenous)
• Topical Administration


  Drug is applied to a specific area and primarily affects that area (e.g., creams, ointments)
• Main routes of administration and classification as either systemic or topical

  • Systemic Routes: Oral, Intravenous (IV), Intramuscular (IM), Subcutaneous (SC), Sublingual, Rectal, Cutaneous, Buccal, Transdermal
  • Topical Routes: Dermal, Ocular, Aural, Nasal, Inhalation, Vaginal
• Scheduling of medicines


  • Schedule 2 – Pharmacy medicine
  • Schedule 3 – Pharmacist only medicine
  • Schedule 4 – prescription only medication
  • Schedule 4D – prescription only medicine – appendix D (usually additional storage)
  • Schedule 8 – Controlled drugs (can be abused, risky drugs, highly addictive, can be used to make illicit drugs)
• Storage of medicines


  • Conditions: Follow specific storage conditions as indicated (e.g., room temperature, refrigeration)
  • Security: Ensure secure storage to prevent unauthorized access, especially for controlled substances
  • Expiry: Check and dispose of expired medications properly
• Who can prescribe, dispense, administer medicines


  • Prescribe: Doctors, nurse practitioners, dentists, and other authorized healthcare professionals
  • Dispense: Pharmacists and pharmacy technicians under supervision
  • Administer: Nurses, doctors, and other trained healthcare professionals depending on the medication and setting