Medication management in the Kenntnisprüfung

What does the 6-R rule (6-R-Regel) of medication administration include?

• Right patient, right drug, right dose, right route (Applikationsform), right time, right documentation
• Right doctor, right ward, right drug, right dose, right day of the week, right signature of the pharmacist
• Right patient, right drug, right dose — the other three R apply to controlled drugs (Betäubungsmittel) and infusions
• Prescription, consultation, calm, order, purity and respect as six basic attitudes for every drug administration

Explanation: The 6 R are the safety check before every administration. Some hospitals add further R (e.g. right monitoring of effect, right expiry date). Being able to recite them fluently is a must in the exam.

You are asked to give a sustained-release tablet (Retardtablette) through the PEG tube. What do you do?

• Crush it finely, suspend it in water and flush with 20 ml of water before and after giving it
• Let it dissolve whole in warm water, since this does not change the sustained-release effect
• Do not crush it — consult the doctor/pharmacy about an alternative suitable for the tube
• Crush it and divide the dose into several doses over the day to stretch the effect

Explanation: Sustained-release and enteric-coated (magensaftresistente) forms must not be crushed — otherwise the whole dose is released at once (dangerous) or destroyed in the stomach. Always clarify a suitable dosage form.