Introduction to Dispensing Prescriptions (Pharm 161) PDF

Kwame Nkrumah University of Science & Technology, Kumasi, Ghana Pharm 161 Prescriptions M. El Boakye-Gyasi, PhD Department of Pharmaceutics FPPS, CHS, KNUST [email protected] Course Objectives and Learning Outcomes Definition of a prescription...

Kwame Nkrumah University of Science & Technology, Kumasi, Ghana Pharm 161 Prescriptions M. El Boakye-Gyasi, PhD Department of Pharmaceutics FPPS, CHS, KNUST [email protected] Course Objectives and Learning Outcomes Definition of a prescription Features and parts of a prescription Handling of a prescription At the end of this lesson, students should be able to read, interpret and identify valid prescriptions www.knust.edu.gh FPPS Pharmacy Practice LAB Students will be able to practice reading and handling of prescriptions and dispensing medicines at the FPPS Pharmacy Practice LAB’s “Pharmacy”. www.knust.edu.gh www.knust.edu.gh What is a Prescription? www.knust.edu.gh  What is a Prescription? An order from a medical doctor, dentist veterinary practitioner (or nurse practitioner in the United States of America, USA) for the supply of medicine, medical appliance or wound dressing to a patient (or to the owner of an animal). www.knust.edu.gh  Examples of medical appliances Hearing Aids Spectacles Neck Braces Teeth braces Spectacles Contact lenses and etc. www.knust.edu.gh  Prescription Usually given in a written form (must be legible) Written in indelible ink Type written or Computer printed Occasionally, it involves giving verbal instructions from the prescriber by telephone. Can you name other modes via which prescriptions may be given or received? Class Discussion www.knust.edu.gh  Prescription Writing Prescriptions should be written or printed legibly www.knust.edu.gh Prescription www.knust.edu.gh  FEATURES OF A PRESCRIPTION Patient’s name, address and age ESPECIALLY if under 12 years Names and quantities of medicaments to be supplied Instructions for the patient Prescriber’s profession, address and signature Date on which the prescription was written or signed www.knust.edu.gh  Patient’s name, address and age if under 12 years Title of the patient, eg. Mr, Prof, Mrs together with the surname Initials and/ or one full forename should be given Clear and unambiguous address www.knust.edu.gh  Patient’s name, address and age if under 12 years Age of a child under 12 years should also be included to help the pharmacist in checking the prescribed dose Weight of the patient or animal may also be required in order to calculate the appropriate dose (mg/kg body weight) www.knust.edu.gh  Patient’s name, address and age if under 12 years Any prescription where this is unclear should not be dispensed until the necessary information has been obtained. If the prescription is for an animal, information on the type and possibly the weight of the animal is needed, in order to check that the drug and dose are appropriate. www.knust.edu.gh Names and quantities of medicaments What is the name of the preparation? What quantity is to be dispensed? Prescribers are recommended to write the names of medicines in full The following should also be stated by the prescriber: The quantity to be supplied The dosage form to be supplied www.knust.edu.gh  Prescription Several abbreviations are used in prescription writing Rx is an abbreviation for the Latin word “recipe” which means “to take” This is instruction from the prescriber Whether a prescription is hand written or computer generated, care MUST be taken when reading details of the product to be dispensed www.knust.edu.gh  Prescription There are many products and drug names which can be confused if checking is not thorough and careful. www.knust.edu.gh Aldactide Aldactone Betaloc Berotec Betnesol Betnelan Carbamazepine Carbimazole Cardene Codeine Daonil Danol Ergotamine Ergometrine Fucidin Fulcin Mebendazole Metronidazole Promazine Promethazine www.knust.edu.gh  Instructions for the patient  Quantity to be taken or the amount to be used  Frequency and timing of administration or application  Route of administration or method of use  Special instructions such as dilution directions www.knust.edu.gh Prescriber’s profession, address and signature The prescription should state whether the prescriber is a doctor, dentist or veterinary practitioner www.knust.edu.gh  Date prescription was written or signed Legal requirement for prescribers to date prescriptions. Time limit after which the prescription ceases to be valid www.knust.edu.gh When presented with a prescription, the following method should be adopted: 1.Read the prescription Is the prescription legal? Who is it for? Adult, child, elderly, animal? What is the name of the preparation? What are the instructions for the patient? What quantity is to be dispensed? www.knust.edu.gh When presented with a prescription, the following method; should be adopted 2. Find out information about the medication/ medical appliance What is it? How does it act and how is it used? How is it prepared? What advice does the patient require? www.knust.edu.gh When presented with a prescription, the following method; should be adopted 3. Carry out procedures Make or assemble the preparation. Pack into appropriate container. Label the container. Endorse the prescription. Make appropriate records. Hand over to the patient with appropriate advice. Correctly dispose of the prescription. www.knust.edu.gh Proper name labeling requirement  NP is abbrev. for the Latin ‘nomen proprium’ which means ‘the proper name’  Dispensed medicines should be labeled fully with the name of the product  Should the prescriber wish to conceal from the patient the identity of the medicine he must indicate that on the prescription www.knust.edu.gh  Repeat prescription A prescription with instruction that it may be dispensed on more than one occasion www.knust.edu.gh  Procedures in dispensing  Read the prescription carefully and check that it is complete and valid  Check that the dosage and directions are appropriate  Dispense the medicine  Counsel the patient  Make the appropriate records www.knust.edu.gh  Read the prescription carefully  Ensure that all the necessary information is present  Some prescriptions are difficult to read because of illegible writing by prescriber  Prescriber should be contacted if there is any doubt as to his intention www.knust.edu.gh  Check that dosage and directions are appropriate  Unusually high or low doses should be queried with the prescriber  Check for pharmaceutical or therapeutic incompatibilities in a prescribed preparation  Check that different medicines for the same patient do not interact with each other www.knust.edu.gh  Dispense the medicine  Check any calculations  Check the storage requirements  Collect the container  Write the label  Prepare or select the medicine  Pack the medicine into the container  Fix the label  Check the finished preparation www.knust.edu.gh  Counsel the patient  Completed medicine is handed to patient  Good practice to check patient’s name and address against that on prescription before handing over medicine (Patient centered care)  Pharmacist should reinforce information given on label and give any necessary additional verbal advice or information www.knust.edu.gh  Make the appropriate records 34 (1) “A person who supplies Class A or B drugs shall keep on the premises from which he supplies these drugs a book of the prescribed description to be known as the “Dangerous Drug Record” (2)” Before any person supplies Class A drugs he shall record in the ‘Dangerous Drugs Record’ Pharmacy Act 1994 Act 489 www.knust.edu.gh  Health Institutions and Facilities Act, 2011. Act 829. Established the Health Facilities Regulatory Agency heFRA Read the sections that talk about Pharmacy Practice hefra.gov.gh www.knust.edu.gh  Dispensing Dispense: To distribute or provide a service or information to a number of people To prepare and give out medicines, dressings or medical appliances especially on prescription. www.knust.edu.gh  Dispensing Dispensing: the supply of a medicine, dressing or medical appliance to an individual patient in accordance with a prescription issued by a practitioner and should be undertaken by or under the direct supervision of a pharmacist. www.knust.edu.gh IS THIS A PRESCRITION? GIVE REASONS FOR YOUR ANSWER www.knust.edu.gh  Sample Questions: ANSWER CODE SUMMARY First statement Second statement A T T Second statement is a correct explanation of first statement B T T Second statement is NOT a correct explanation of first C T F D F T E F F The prescriber’s profession must be stated on a prescription BECAUSE the prescriber is responsible for administering accurate doses of medications. www.knust.edu.gh  Which of the following is appropriate for a valid prescription A. Paracetamol 250 mg to be inserted rectally B. Paracetamol twice daily C. Supp. Paracetamol 250 mg at night for 3 days D. Supp. Paracetamol 500 mg to be inserted rectally nocte X 3/7. E. Supp. Paracetamol when needed www.knust.edu.gh www.knust.edu.gh