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Pharmskills Online - Counseling Topic Verification - View Detail

ELECTRONIC PRESCRIPTION
Date: 02/11/2026 at 08:39 PM
Patient: Phoebe Khan
Address: 1761 S. Grant Street
Drug: Amoxicillin 400 mg/5 mL Oral Suspension
Dispense: 100 mL
SIG: 2 tsp po BID x5 days for AOM
Refills: none
DAW:
Prescriber: Harold L. Green
Address: 2-G Medical Arts Building
DEA#: AG1294230
Rx#
1336430
Written Date
02/11/2026

Name
Phoebe Khan
DOB
11/6/2021
Age
5
Address
1761 S. Grant Street
Phone
(785) 555-1096
Allergies

Prescriber
Harold L. Green
Practice
Pediatric Specialists
Address
2-G Medical Arts Building
Fax
(785) 555-7718
DEA
AG1294230
NPI
5946269224
Phone
(785) 555-5566

Dispensed
Amoxicillin 400 mg/5 mL Oral Suspension
NDC #
00093-4161-73
Mfg
Teva
Pres Qty
100 mL
Dis Qty
100 mL
Day Supply
5
Refills
0
DAW
0
Origin Code
3

Instructions
Take 2 teaspoonfuls (10 mL) by mouth in the morning and evening for 5 days for ear infection.

Dispensing Notes

 
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Document Patient Counseling Topics To Be Given Verbally
Used For: It is used to treat bacterial infections like otitis externa.
Need to Know: Do not give to your child longer than you have been told. A second infection may happen.
Need to Know: Severe heart rhythm changes like prolonged QT interval have happened with this drug. Sometimes, these can be life-threatening or deadly.
Side Effects: Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
Side Effects: Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
Best Taken: Give this drug at the start of a meal to help it work the best and lower the chance of upset stomach.
Best Taken: Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
Med Guide: I am also providing you with a required medication guide that can help patients avoid serious adverse events.