DISPENSING II: DIPENSING PROCESS AND  It must be clean because most medicinal

GUIDELINES IN COMMUNITY AND HOSPITAL products are for internal use, making it
SETTING important that they are hygienic and
uncontaminated.
CONTENT:  It must be organized so that dispensing
 INTRODUCTION can be performed accurately and efficiently.
 DISPENSING ENVIRONMENT
 DISPENSING PHARMACIST Staff Members
 DISPENSING PROCESS
 involved in dispensing must maintain good
personal hygiene and should wear
prescribed uniform or other clean and
INTRODUCTION appropriate clothing
Dispensing
Physical Surroundings
 sum of process performed by a pharmacist
from READING, VALIDATING, and  must be kept free of dust and dirt as
INTERPRETING PRESCRIPTIONS possible
 preparing, packaging, labeling, record  LOCATION OF THE DISPENSARY should
keeping, dose calculations. and be in a protected place and not open to
counseling in relation to sale or transfer of other areas where dust. dirt and pollution
pharmaceutical products, with or without a are commonly present while maintaining the
prescription or medication order to the accessibility to the patients.
patient or duly authorized representative.  Regular routine of cleaning shelves, daily
cleaning of floors and working surfaces, and
Good Dispensing Practice daily removal of segregated garbage and
 Ensures that the right medicines of wastes following safe disposal procedures.
desired quantity are delivered to the right  Regular schedule should be in place for
patient with: checking, cleaning and defrosting the
refrigerator
o right dose  Spills should be wiped immediately
o strength especially if it is sticky, sweet. Or attractive
o frequency to insects and flies
o dosage form  Food and drink must be kept out of the
o quantity dispensing area, the refrigerator is strictly
 together with clear instructions, both for medicines and other similar cold-chain
written and verbal, and with appropriate products
packaging suitable for maintaining the  REGULAR MONITORING of
quality and efficacy of the medicine REFRIGERATOR TEMPERATURE should
be an established procedure, together with
DISPENSING ENVIRONMENT detailed actions to be taken to promptly
It includes: repair the refrigerator if temperatures fall
o STAFF outside the acceptable limits (2-8C)
o PHYSICAL SURROUNDINGS Dispensing Equipment
o SHELVING and STORAGE AREAS
o SURFACES used during work  used for measuring liquids, weighing solids
o EQUIPMENT counting tablets or capsules
o PHYSICAL MATERIALS  clean is both between uses and at the end
of the day to avoid contamination
 DISPENSING ENVIRONMENT must be
organized to create a safe and efficient
working area
  Space should be sufficient to allow the specific therapies such as antiretroviral
movement of staff members during the therapy for HIV/AIDS patients, which are
dispensing process rapidly increasing in number in resource-
limited settings.
Stock containers and prepacked medicines
DISPENSING PROCESS
 must be stored in an organized way on  The development and use of written
shelves, preferably according standard operating procedures (SOP) for
pharmacotherapeutic category, dosage the dispensing process will improve the
forms and in alphabetical order. consistency and quality of work, hence used
 All stock containers in use must be clearly as training and references.
and accurately able to ensure safe selection
of the correct preparation and to minimize SIX MAJOR AREAS OF ACTIVITY
the risk of error (WHO Pharmaceutical Procedure Framework)
 A system stock rotation should determine
1. Receive and validate the prescription;
which items are to be used first, on either a
2. Understand and interpret the prescription;
FIRST-IN/FIRST-OUT (FIFO) or FIRST
3. Prepare and label the items for issue;
EXPIRY/FIRST-OUT(FEFO) basis
4. Make a final check;
 Recommended storage conditions in terms 5. Record the action taken; and
of temperature, light and moisture should be 6. Issue medicine to the patient with clear
followed as closely as possible c maintain instructions and advice
product quality
STEP 1
DISPENSING PHARMACIST RECEIVE AND VALIDATE PRESCRIPTION
 Laws mandate that the distribution of
medicines and important medical supplies  confirms the name of the patient before
to the general public be carried out by issuing the medicines.
professional or duly REGISTERED or  check also the legality of the prescription
LICENSED including the:
 In addition to READING, WRITING, - NAME OF PATIENT
COUNTING, and POURING, the dispenser - AGE
or dispensing team needs specific additional - SEX/GENDER
knowledge, skills, and attitudes to complete - DATE
the dispensing process. These includes: - SIGNATURE/STAMP/ADDRESS
 knowledge (common use, correct OF THE PRESCRIBER
dose, precautions, method or use,
common side effect, etc) STEP 2
 Good calculations and arithmetic UNDERSTAND INTERPRET THE
preparations. PRESCRIPTION
 Skills in assessing the quality of interpreting a prescription must be done by a staff
preparations who can do the following:
 Attributes or cleanliness, accuracy.
and honesty: and  Read prescription
 attitudes and skills required to  Correctly interpret any abbreviations used
communicate effectively by the prescriber
 Dispensing personnel must receive an  Confirm that the doses prescribed are in the
appropriate level of training. Dispensing normal range for the patient
pharmacy assistants should work under the  Correctly perform any calculations of dose
guidance and supervision of a trained and issue the quantity needed for the
pharmacy staff. regimen Identify any common drug -drug
 Dispenser training in medication counseling interaction
and adherence is especially important to the
Verbal orders
success of certain programs providing
  medication should be given only in Measure or count the quantity from stock
exceptional and emergency situations. containers
 the order should be repeated back to the
 liquid must be measure in a clean vessel
prescriber to ensure accuracy; and
and should be poured from the stock bottle
 written confirmation should be supplied
with the label kept upward to avoid damage
within an agreed-upon period which may be
to the label from any spilled or dripping
specified on protocols set by the
liquid.
establishment or institution.
 count tablets and capsules.
STEP 3  hands must not be in direct contact with the
PREPARE AND LABEL THE ITEMS FOR ISSUE medicine.

 Self-checking and counter-checking must STEP 4

be including to ensure accuracy MAKE A FINAL CHECK
 Labeling is a form of self-check after
 dispensed preparation should be checked
validating the necessary information to
against the prescription and against the
avoid repeated work
stock containers used.
3 Activities during preparation and labeling:
Final check:
1. Select stock container or prepack
o reading and interpreting the prescription
2. Measure or count the quantity from
before looking at the dispensed medicines:
stock containers
o checking the appropriateness of doses
3. Pack and label medicine
prescribed; checking for drug interactions;
Select stock container or prepack o checking for the identity of the medicine
dispensed;
 read the label and cross-match the product o checking the labels; and countersigning the
name and strength against the prescription prescription
 not expired, or do FIFO/ FEFO method in o Let other pharmacists recheck your work if
dispensing medicine possible.
 check the label at least twice
STEP 5
Measure or count the quantity from stock RECORD THE ACTION TAKEN
containers
 Documentation and proper record-keeping
 Counting should be done using one of the is an essential part of dispensing as is
following: facilitating good management and
o Clean piece of paper and clean knife monitoring of the services being provided
o spatula Clean tablet-counting
device STEP 6
do the stock container in use ISSUE MEDICINE TO THE PATIENT WITH
o Any other clean or dust-free surface CLEAR INSTRUCTIONS AND ADVICE

Pack and label medicine  The medicine must be given to the named
patient, or the patients representative, with
 Tablets or capsules should be packed into a clear instructions and any appropriate
clean, dry container such as a bottle, plastic advice about the medicine.
envelope, cardboard box, or paper envelope  advice should concentrate on:
 Moisture-resistant containers should also be o when to take medicine
considered if the products are most o how to take the medicine?
vulnerable to moisture o How to store the medicine?
o the instruction on how to use the
device (MDI, dropper)
S3 Activities during preparation and labeling: o Lifestyle changes
o Dosage, interactions. side effect,
contraindication. etc
o other inquiries and concerns of the
patient