PRESCRIPTION PAPER

NEKEMTE HEALTH CENTER

Name of patient –TT Age-30 Sex-F wt-49 card no;000152
Region- Z Town-X woreda Y kebele 04 house no: 056 phone no: 011
Outpatient --x Inpatient -------Section/ward----------
D IAGNOSIS: Typhoid+ DM+ Amebiasis
Drug name strength dosage form, dose ,frequency, price /dispenser use only
duration, quantity ,how to use and other information

Rx-ciprofloxacin 500mg tablet po bid for 07 dys 28 birr

- ORS #1Sachet free

-Insulin injection 10ml 20/30Iu SC for 01 months 120 birr

-Metronidazole 250mg capsule 2 capsules po tid 84 birr

07 days
Total=234 birr
Prescribers Dispensers
Full name------------------------ -----------------------------------
Qualification------------------- -----------------------------------
Signature------------------------ -----------------------------------
Date------------------------------- -------------------------------------

Task 1 Apply good dispensing practice

 receive prescription
 With smile and attractive face.
 Name by his /her name and greet your patient
2. Interpretation and evaluation of a prescription
 Evaluate Legality –
 It has Header of the Health Institution
 Not legal - b/c it has no Prescriber information details
 Validity of the prescription- written on correct prescription
The prescription is not valid – because has no date
- has no stamp of health institution
- has no serial number and area code
 Legibility (must be clear-never do guess work) – there is no legibility problem
 Evaluate for completeness:-
Prescription detail
A prescription is complete when all parts on it are filled
This prescription has full part of prescription except serial no, Area code and date.
 Patient detail – name of patient is abbreviated.
other patient detail such as age ,sex ,wt. card number are fully described
 Medicine detail
-Name of medicine, dose, frequency and duration of treatment is mentioned.
 Prescriber detail is not described
 Check for drug interaction-no interaction but drug- alcohol interaction with
metronidazole
  Double medication- all are indicated for dx
 Check past medical history and current status(ciprofloxacin is contraindicated for
pregnancy) and history of alcohol consumption for metronidazole
 Checking for correctness of prescription
Check for Correctness of a prescription refers to appropriateness of the medicine for individual
patient in terms of indication, dose, duration, effectiveness and safety of the medicines in
reference to the current national treatment guideline or any available, reliable and acceptable
source or evidence. DIAGNOSIS: Typhoid+ DM+ Amebiasis
Task 2.calculate the quantity to be dispensed based on information provided
Calculation of Quantity:
 Total Quantity = Dose x Frequency x Duration of treatment (unit price for
500mg caps=2birr)
 Ciprofloxacin 500mg po BID for 7 days
= 500mg tab(1) x 2 x 7 =14 tabs
=14x2 =28 birr
 Metronidazole 500mg tab po Bid for 7 days(unit price for 250mg caps=2birr)
 Total Quantity = Dose x Frequency x Duration of treatment
= 250mg x 2x 3 x 7 = 42caps
= 42x2 =84 birr
Insulin injection 10ml, 20/30IU SC for 01 months
Daily dose____ 20IU + 30IU=50IU(0.5ml)
1vial =1000IU
1ml=100IU
Total quantity =Daily dose x duration of treatment
-------------------------------------------
1000 IU( IN 1VIAL)
=50IU X30 (Dys)
--------------------
1000IU
=1500IU
-------------- =1.5 vials Approx. 2 vials
1000IU/VIAL
Price = total quantity x unit price
= 2x60 birr
= 120 birr
-ORS- FREE
 Announcement of prices to the patients

Prices should not be announced to patients before prescriptions are evaluated for legality, legibility,
completeness and correctness

Announce price to the patient and confirm payment and if the patient

= 240 birr total price

Drugs Pharmacological category Side effect Contraindi
Indication MOA cation
Ciprofloxaci Typhoid fever Nausea,musle Pregnancy
n Antibacterial Inhibit DNA pain, and
Flouroquinolones synthesis lactation

Metronidazo Antiprotozoal Amebiasis Block nuclic Metallic

le /antibacterial/anti amoebic acid synthesis taste,dizzness,h Pregnancy
(Nitro imidazole) ead ache (1st
trimester)
ORS Fluid and electrolyte diahhrea(used Replaces fuid Hypersensitivit Suspected
replacement therapy for electrolyte and electrolyte y acute
replacement) losses abdomen ,
hypersensi
tivity to
one of the
componen
ts
Insulin Ant diabetic Diabetic Activates hypoglycemia Hypersens
mellitus glycogen itivity to
synthesis one
of the
componen
ts

Step 2.selection and manipulation

Select those medicine, check expired date, count and pack in appropriate container

Step 4.Labelling and packaging of the medicine in an appropriate container

Label and pack in appropriate container

Step 5. The provision of information and instructions to a patient

Give adequate instruction on

how much, when and how to take medicine

Not to share medicine with other else

To complete course of treatment and advice minor side effects

step 6. Recording the transaction and Prescription filing

Register on daily drug registration book and file prescription

ASIST EXTEMPORANEOUS PREPARATIONS

What Is Compounding?

 The preparation, mixing, assembling, altering, packaging, and labeling of a drug, drug-delivery device,
or device in accordance with a licensed practitioner’s prescription, medication order, or initiative based
on the practitioner/patient/pharmacist/compounder relationship in the course of professional practice.

Main reasons for compounding include:-

 Unavailable dosages, strengths and routes of commercial products

 Dilution of adult doses of medications to Pediatric/Geriatric strengths if a patient needs a
reduced strength of medication or a special dosage that is currently unavailable
commercially
 For children who have difficulty taking prescriptions that have an unpleasant taste
 Conversion of solid dosage forms to solutions or suspensions if a child or adult has trouble
swallowing pills
 Combination of topical dermatological products not available by the manufacturer
 Changing inactive ingredients of commercial products which may cause allergic reactions in
individuals

Preparing certain pharmaceuticals from raw materials (topical preparations, antiseptics, disinfectants,etc.)

Distinguishing Compounding from Manufacturing

 Compounding is the act of preparing, mixing, assembling, packaging, and/or labeling a

drug or device as the result of a practitioner’s prescription drug order or initiative based on
the practitioner–patient–pharmacy professional relationship in the course of professional
practice, or for the purpose of, or incident to, research ,teaching, or chemical analysis and
not for sale or dispensing.
 Manufacturing is the production, preparation, propagation, conversion, and processing of a
drug or device, either directly or indirectly, through extraction from substances of natural
origin or independently through means of chemical or biological synthesis; the term includes
any packaging or repackaging of the substance(s) or labeling or relabeling of its container
and the promotion and marketing of such drugs or devices.

Manufacturing also includes the preparation and promotion of commercially available products from bulk
compounds for resale by pharmacies, practitioners, or other persons.

PROJECT- 1.9-PREPARATION OF IODINE TINCTURE (B.P, 1988)

 Tinctures are alcoholic or hydro-alcoholic solutions of medicinally active ingredients

obtained from vegetable materials or from chemical substances.
 Tinctures can prepare by following process:
 Maceration
 Percolation
 Simple solution
Prepare and dispense 50 ml of iodine tincture based on the following master formula.

Master formula Factor working/derived formula

 Iodine ----------------------------25g x 0.50 = 1.25g

 Potassium iodide --------------25g x 0.05 = 1.25g
 Purified Water -----------------25ml x 0.05 = 1.25ml
 Ethanol 90% q.s to-----------1000ml x 0.05 = 50ml
 Prepare 90% ethanol from a given 98% stock solution.
Factor =send/total=50ml/1000ml=0.05
To prepare ethanol 90 % for this preparation
We must use the following formula C1V1=C1V2
Given
C1=98%(stock solution )
C2 = 90%
V1=?
V2=50ml
C1v1=C2V2
V1=C2V2/C1
V1=90%×50ml/98%
V1=45.91ml
Tare the bottle to 50ml by using water and prepare label of 90%

Measure 45.91 ml of ethanol 98% and add to tarred bottle

Then add purified water up to 250ml then label as 90% ethanol

Equipment /Tools

 Beam/digital balance
 Spoon spatula
 Watch glass
 Amber colored medicinal bottle
 Glass mortar and pestle/Erlenmeyer flask/ conical graduates
 Measuring cylinder
 Pipettes/droppers
 White paper

PROCEDURE:

1) Wear gown
2) Wash your hands
3) Wear all PPE
4) Clean lab bench
5) Collect necessary equipment’s
6) Develop your working formula
 7) Tare the bottle to the desired volume by using purified water
8) Adjust beam balance /digital beam balance and Weigh potassium iodide on paper and
iodine on watch glass.
9) Measure purified water and ethanol 90%
10) Dissolve potassium iodide and purified water in mortar and pestle then add iodine and
mix together by using strrir
10) Transfer to the final tarred bottle and make final volume needed
11) Shake well and then store in a closed wall container
12) Label it properly
13) Store the preparation at appropriate place
14) Clean the working equipment and environment
15) Complete the Recordings and documentation

ROLE OF INGREDIENTS

 Iodine------------------------------anti-septic and disinfectant/Active ingredient

 Potassium iodide---------------to enhance solubility of iodine
 Purified water------------------as drug carrier/solvent
 90% Ethanol---------------------as an anti-septic/solvent/co-solvent

Sample Label for iodine tincture

 Iodine Tincture-- 50 mL
 Ingredients: Iodine---------------------1.25g
 Potassium Iodide----------------------1.25g
 Ethanol 90% to-------------------------50ml
 Preparation Date----------------------17/11/2016
 BUD-------------------------------------1/11/2016
 Batch no---------------------------------mkxx1-
 USE- ANTISEPTIC
 Direction for use-apply affected area by using cotton ball
 Storage Condition—store in tightly closed container to protect from heat and light
 Precaution-For Externally use only
Keep out of the reach of children
 Place of preparation:SABANSI HEALTH SCIENCE COLLEGE
 Documentation and recording
Master formula

 Iodine ----------------------------25g
 Potassium iodide --------------25g
 Purified Water -----------------25ml
 Ethanol 90% q.s/ to-----------1000ml

 IODINE-
 Expiry date--------------------
Batch no-----------------------
 POTASIUM IODIDE
Expiry da--------------------
Batch no----------------------
 ETHANOL
Expiry date--------------------
Batch no-----------------------
Derived formula

 Iodine--------------------1.25g
 Potassium Iodide--------1.25g
 Purified water-----------1.25ml
 Ethanol 90% to-----------50ml
 Preparation Date------------17/11/2016
 BUD--------------------------1/11/2016
 Batch no--------------------mkxx1-
 USE- ANTISEPTIC
 Direction for use-apply affected area by using cotton ball
 Storage Condition—store in tightly closed container to protect from heat and light
 Precaution-For Externally use only
 Quantity-------------50ml of iodine tincture
 Preparation time-----------------
 Prepared by---------------------
 Sign--------------------------------
 Approved by ----------------------

Preparation place Sabansi Health Science College

Project -2 prepare zinc oxide ointment 30g based on the following master formula

Characteristics of ointments include:

 Viscous but Spreadable

 Greasy
 Occlusive
 Non-gritty
 Staining

There are two distinct purposes for an ointment base:

 As a vehicle from which drugs may be absorbed by the skin

 As a protective or emollient for the skin.

Preparation method for ointment

 A) Incorporation

B) Fusion

A. Incorporation (Trituration/ Levigation)

The components (active drug and base) are mixed using a mortar and pestle (trituration), or a
spatula and ointment slab (levigation) until a uniform preparation is attained.

B. Fusion method

Fusion method is used when the melting the starting material is needed for appropriate mixing
the components.

Project -2 prepare zinc oxide ointment 30g based on the following master formula

Master formula factor working formula

Zinc oxide------------200g-------x 0.03--------- 6g

White ointment-------650g-------x0.03----------19.5g

Mineral oil-------------150ml-----x0.03----------4.5ml

Ingredient needed
Zinc oxide
White ointment
Mineral oil
Equipment needed
 Beam/digital balance
 Flexible spatula
 Spoon spatula
 Ointment slab/tile
 watch glass
 Weighing paper
 Dropper
 180μm sieves
 Ointment Jars
 Label –white paper
 Cylinder

ROLE OF INGRIDIENTS
Zinc oxide----------------API/Antifungal
White ointment ---------ointment base
Mineral oil---------------used as emollients
Sample Label for zinc oxide ointment

 Zinc oxide ointment 30g

 Ingredients: zinc oxide--------------6g
 White ointment----------------------19.5g
 Mineral oil --------------------------4.5ml
 Preparation Date--------------------17/11/2016
 BUD----------------------------------17/12/2016
 Batch no------------------------------mkxx4
 USE- Antifungal
 Direction for use-apply on affected area
 Storage Condition—store in cool place
 Precaution-For Externally use only
Keep out of the reach of children
 Place of preparation:SABANSI HEALTH SCIENCE COLLEGE

PROCEDURE

1. Wear gown

2. Wash your hands

3. Wear PPE (glove, mask, eyeglass …)

4. Clean lab bench and equipment needed

5. Collect necessary equipment’s

6. Develop your working formula and prepare label

7. Sift the medicaments through separate 180μm sieves

8. Adjust beam balance and Weigh zinc oxide powder on paper after sifting then Place on one
side of the tile

9. Weigh white ointment on watch glass then place on other side of tile

10. Measure 4.5 ml of mineral oil .

11. Take a portion of white ointment base (about two to three times the weight of the power)
and levigate it with Zinc oxide powder mixture until there is no sign of any gritty particles (This
can be checked for by spreading a thin layer on the tile).and add mineral oil then levigate
together.

12) Gradually incorporate the remaining base in portions geometrically and continue levigation
until uniformly mixed
13) Finally, collect the ointment together to the center of the tile using the spatula and pack into
an ointment jar then label it.

14. Store in appropriate place

15) Clean the working equipment and the surroundings

16). Complete the Recordings and documentation