Medication Dispensing and Prescriptions

Dispensing

• Preparing and providing medicines, particularly when prescribed
• Supplying medication to a patient as per a practitioner's prescription
• Must be done, or directly overseen, by a pharmacist

What is a Prescription?

• An order from a medical doctor, dentist, or vet
• Used for supplying medicine, dressing, or appliances
• Intended for a patient or an animal's owner

Prescription - General Info

• Usually written and must be readable
• Should be written in indelible ink
• Can be typewritten or computer-printed
• Sometimes given verbally over the phone

Prescription Writing

• Should be written or printed clearly

Prescription Form Information

• Requires patient name and address
• Includes medication name and strength (e.g., Amoxicillin 250mg Tabs)
• Details dosage instructions (e.g., TT tablets p.o. T.I.D x 7 days)
• Should be determined as legal
• Must confirm if the prescription is for an adult, child, elderly person, or animal
• Name of the prepared medication should be stated
• Instructions for the patient should be included
• The dispensed quantity should be specified

Procedures When Presented with a Prescription

• Find out about the medication or medical appliance
• Determine what the medication is
• Determine how it works and how it is used
• Determine how the medication is prepared
• Ascertain what advice the patient needs

Procedures - Carrying Out

• Make or assemble the medication
• Pack in an appropriate container
• Label the container
• Endorse the prescription
• Make appropriate records
• Hand over to the patient with advice
• Correctly dispose of the prescription

Features of a Prescription

• Patient's name, address, and age, especially for those under 12
• Names and amounts of medications
• Patient's instructions
• Prescriber's profession, address, and signature
• Date prescription was written or signed

Required Patient Info

• Patient's name, address, and age if under 12
• Patient's title (e.g., Mr, Prof, Mrs) with their last name
• Initial(s) and/or a full first name
• Clear, unambiguous address

Patient's Name, Address and Age - Specifics

• Include age for children under 12 to help check the dose
• Weight may be needed for dose calculation (mg/kg body weight)

Handling Unclear Prescriptions

• Do not dispense until all necessary information is obtained
• If for an animal, know the type and weight to check the drug and dose

Names and Quantities of Medicaments - Details

• Note the preparation name
• Note the quantity to be dispensed
• Prescribers should write the medication names in full
• The quantity and dosage form should be included

Abbreviations and Instructions

• Common abbreviations are used
• $R_x$ (recipe) means "to take" in Latin and gives instructions from the prescriber

Handling Information - General

• Care must be taken when reading details, whether handwritten or computer-generated

Product and Drug Name Awareness

• Many names can be confused if the checking process is not careful,

Examples of Confusable Drug Names

• Aldactide vs Aldactone
• Promazine vs Promethazine
• Betaloc vs Berotec
• Betnesol vs Betnelan
• Carbamazepino vs Carbimazole
• Cardene vs Codeine
• Dacnil vs Danol
• Ergotamine vs Ergometrine
• Fucidin vs Fulcin
• Mobendazole vs Metronidazole

Instructions For The Patient

• State the quantity or amount to be used
• Include frequency and timing of administration/application
• Specify the route or method of administration
• Include special instructions such as dilution directions

Prescriber Information

• Note the profession, address, and signature
• Prescription should state if the prescriber is a doctor, dentist, or vet

Prescription Date Info

• Note the date it was written or signed
• Prescribers are legally required to date prescriptions
• A prescription will have a time limit

Proper Name Labeling

• NP (nomen proprium) means "the proper name" in Latin
• Dispensed medicines should be labeled fully with the product name
• Prescriber can ask to hide the identity of the medicine on the prescription

Repeat Prescriptions

• Has instructions allowing it to be dispensed more than once

Dispensing Procedures

• Read the prescription fully to ensure it is complete and valid
• Ascertain if the dosage and directions are appropriate
• Dispense the medicine
• Counsel the patient
• Make appropriate records

Reading Prescriptions Carefully

• Ensure all needed information is present
• Be aware that some prescriptions are hard to read due to poor handwriting
• Contact the prescriber if there is any doubt

Dosage and Directions

• Query unusually high or low doses with the prescriber
• Check for pharmaceutical or therapeutic incompatibilities
• Check for interactions if the patient is on multiple medicines

Dispensing a Medicine

• Check any calculations
• Verify storage requirements
• Collect the container
• Write the label
• Prepare or select the medicine
• Pack the medicine into the container
• Fix the label
• Check the final preparation

Counseling The Patient

• Hand the completed medicine to the patient
• Check the patient's name and address against the prescription
• Reinforce label information and give any extra verbal advice

Appropriate Records

• Anyone who gives Class A or B drugs must keep a "Dangerous Drug Record" book on the premises
• Before giving Class A drugs, it must be recorded in the 'Dangerous Drugs Record'

Pharmacy Act 1994 Act 489

• Says the prescriber must state their profession on a prescription
• The prescriber is responsible for correct medication doses