Dispensing Pharmaceuticals

By. Badri shekh

Chapter 1. Dispensing Administration Tasks
Introduction
Definition
• Dispensing refers to the process of preparing and
supplying medicines to a named person together
with clear instructions, advice and counseling on the
use of medicines.
Arranging medications in dispensary
• Dispensing units must have a known system for
organizing medicines.
• Medicines should be arranged on shelves made of
steel, treated wood, strong and robust.
 Cont..
• Health institutions and retail outlets can use one or a
combination of the following:
1. Pharmacotherapeutics category
2. Alphabetical order by generic name
3. Dosage forms of final preparation
 Pharmaco-therapeutic category
• This method is based on the pharmacological or
therapeutics use of drugs.
• Pharmacological classification is an effective way of
organizing medicines in dispensaries.
• Pharmacologic class knowledge is critical step in
effective dispensing in this system.
 Alphabetical order
• Alphabetical order by generic name is attractive in
dispensaries that keep a small items.
• Each change in the level-of-use list requires
reorganization of the dispensary
• May not result in optimal use of available space.
 Dosage form of final preparation
• Arranging drugs as per the dosage form they are
available
• Commonly used in smaller dispensaries.
• Easy to recognize when receiving goods
• Allows optimal use of space.
 Cont..
• Usually used in conjunction with the therapeutic
arrangement.
– Solid dosage forms (tablets, capsules, powers) are placed
together
– Liquid dosage forms ( elixirs, syrups, suspensions,...) are
placed together
– Semi solid dosage forms ( ointments, creams, pastes) are
placed together
 Cont..
• In arranging medicines, the following points should be
considered:
– Each dosage form of medicine is arranged in separate and
distinct areas
– Sufficient empty space should demarcate one medicine or
dosage form from another
– Put medicine in well ventilated, dry and place protected from
direct sun light and heat
– Store liquids in a pallet on the floor or on the lowest shelf
– Do not store anything directly on the floor and store cold-
chain items in refrigerator.
Parts and types of prescription paper
• Prescription’ means any order for medicines written
by a duly licensed medical practitioner issued to a
patient in order to collect medicine from dispensing
unit.
 Cont..
Based on the type of preparation prescribed,
prescription is classified into two types.
1. Prescription for pre-compounded medication; it is
a type of prescription for already prepared drug by
pharmaceutical companies.
2. Prescription for extemporaneous preparation; in
this prescription the pharmacists prepare the
medication according to the drugs and dosages
directed by the physician.
 Cont..
Based on the nature of the drugs prescribed,
prescription is also classified into two types.
1. Ordinary prescription: this type of prescription used
for all drugs except narcotic and psychotropic
substances, can be prescribed by nurses, physicians,
health officers, dentists, psychiatrics and useful for OTC
and prescription only medicines prescribing.
2. Special prescription: it is used for narcotic and
psychotropic drugs and prescribed by specialized
professionals. The drugs prescribed on this prescription
need special counseling and drugs cannot be OTC in
any level of knowledge.
 parts of prescription
1. Serial number
• FMHACA recommended that prescription paper shall
have a serial number with area code as shown on the
top of the prescription paper above.
• 14H000000 is a serial number given to Private,
Governmental and Non-Governmental health
institutions
• where 14H is code for these health institutions and
• 000000 is a consecutive serial numbers of prescriptions
for a given health institution.
 Cont..
2. Name and address of the health institution
• The name of the health institution
• The address of the health institution
– Telephone number , Region, Kebele, Woreda, House
number, P.O.Box
 Cont..
3. Patient information
• Full name of the patient
• Age and sex of the patient
• Card number
• Address of the patient
– Telephone number, Region, Town, Kebele, Woreda, House
number.
 Cont..
• Type of patient: Outpatient or Inpatient
– The name, address, age and sex of the patient help in
identifying the prescription
– The prescribed medication is only for the patient whose
name is on the prescription.
• Weight, age and sex of the patient are important in
verifying the correct patient and/or dosing of the
medication.
 Cont..
4. Type of diagnosis
• Diagnosis is the identification of the nature and cause of
a disease.
• The type of diagnosis can be written on a prescription
paper either on words or codes referred to as diagnostic
codes.
• In healthcare, diagnostic codes are used to group and
identify diseases, disorders, symptoms, human response
patterns, and medical signs, and are used to measure
morbidity and mortality.
 ICD
• Under this system, every health condition can be
assigned to a unique category and given code, up to
six characters long.
• Most ICD-9 codes are comprised of three characters
to the left of a decimal point, and one or two digits
to the right of the decimal point.
– 250.0 means diabetes with no complications
– 530.81 means gastro reflux disease (GERD)
– 079.99 means a virus disease.
 Cont..
5. Superscription
• The 'Rx' symbol is called the superscription is used as
an abbreviation of the Latin word recipe, which
means, “Take thou” or “you take”.
 Cont..
6. Inscription
• The inscription comprises an important part of
prescription containing
– Name(s) and strength of drug(s)
– Instruction regarding dosage form like tablet, capsule,
suspension, mixture, etc.
 Cont..
7. Subscription
• Gives specific directions for the pharmacist on how to
compound the medication.
• Most of direction is usually expressed in contracted
Latin or in the form of abbreviation.
• Consists of directions given to the pharmacist with
respect to the dosage form and the number of dosage
units/quantity to be supplied.
• Instructions for preparation are also given such as 'make
a mixture', 'mix and make 10 tablets', or 'dispense 10
capsules.
 Cont..
8. Transcription or Signature
• In this portion, the physician indicates to the patient:
– How he/she should take the prescribed medicine/s.
– Directions are usually written using abbreviated forms of
Latin.
– Instructions are preceded by abbreviation 'Sig.' from the
Latin, meaning ‘mark’ indicates how, how much, when,
and how long the drug is to be taken.
– e.g., 1 cap tid po means take one capsule thrice a day
orally.
 Cont..
• In the best interest of the patient, it is advisable that no
abbreviations be used.
• The prescriber should preferably write the dosage
schedule in simple, unambiguous terms that the patient
or his representative/caretaker can read and
understand.
• If the physician does not write the instructions in
layman's terms, it is the responsibility of the pharmacist
to explain the dosage to the client/patient in simple
terms.
 Cont..
9. Refill information
• In certain cases, a single course of therapy may not be
sufficient for effective treatment of the patient. Under
such circumstances, the physician may decide to repeat
the course of therapy, and indicate the same on the
prescription. This information is called refill information.
• The refill information should indicate the number of
times the prescription should be refilled and the
intervals after which it should be refilled.
 Cont..
• Example: –
• Benzodiazepines are ideally prescribed for short-
term therapy for a maximum of two or three weeks.
• A physician may therefore write a prescription for
say, 10 days, with no refilling instructions.
• The pharmacist must ensure that such a prescription
is not refilled, unless specified by the doctor, as it
can lead to the patient getting habituated to the use
of medicines prescribed.
 Cont..
10.Prescriber/dispenser information
• Full Name of professional
• Qualification
• Registration number
• Signature; signature of the prescriber/dispenser in
his own handwriting.
 Cont..
11.Prescription Date
• Should be written on the top of the prescription
paper and/or below the signature of the prescriber.
The date also essential to mark the legality of the
prescription.
 OTC and prescription only drugs
1. Prescription only drugs: means drugs which are
dispensed with prescription only.
2. OTC drugs : means drugs which are dispensed with
out prescription.