Receiving and Filling Prescriptions Flashcards
- First step in the dispensing process
- The actual receipt of the prescription from the patient or a representative
RECEIVING
Check for legalities of prescription (validity and completeness)
mandated by law
may differ from one country to another
Legal Check
Check for clinical appropriateness of prescription (correctness and appropriateness)
Determined by individual patient characteristics
Clinical Check
Legal Check
- Date/Duration
- Drug Classification
- Prescription Limit
- Prescription Errors
- Parts of a Prescription
Date/Duration: 1 month
Ordinary Prescription:
Date/Duration: 7 days
Antibiotic prescription:
Date/Duration: 1 month (no refills)
Dangerous Drug prescription:
Period of validity may be longer in case of ___________ and ___________ for chronic conditions
maintenance drugs; prescription refills
- Drug Classification
• Over- the-counter Drugs
• Beyond- the-counter Drugs
• Prescription Drugs
• Regulated Drugs
-also known as nonprescription drugs may be sold to the public without a prescription and must bear a complete label as required by the FDA. They may be prescribed and dispensed with a prescription label only if this is pursuant to a valid prescription.
Over- the-counter Drugs
may be sold without a prescription but must either be sold by a pharmacist or at least not displayed to the public.
Beyond- the-counter Drugs
-also known as legend drugs, because their labels were formerly required to bear the legend, “Caution: Feder al law prohibits dispensing without prescription.” These drugs may now b e labeled “Rx only.”
Prescription Drugs
also known as controlled drug substances are drugs or their precursors that have a significant potential for abuse. They are divided into five schedules, depending on their medical use and potential for abuse.
Regulated Drugs
Regulated Drugs
Examples:
alprazolam,
fentanyl,
morphine,
phenobarbital,
oxycodone
Prescription Drugs
Examples:
antibiotics,
ibuprofen 800 mg,
mefenamic 500 mg
Beyond- the-counter Drugs
Examples: contraceptive pills
Over- the-counter Drugs
Examples:
cetirizine,
loperamide,
ibuprofen 400 mg,
mefenamic 250 mg,
Prescription Limit: Benzodiazepines
30 tabs/cap
10 amp x 1ml
3 amp x 2 ml
2 amp x 3 ml
2 amp x 5 ml
1 amp x 10 ml
Prescription Limit: Phenobarbital
2 weeks supply
2 bottles (100 tabs/bottle) for epilepsy
Prescription Limit: Pethidine
3 amp
Prescription Limit: Ephedrine
1 vial
Prescription Limit: Other DDs (ordinary)
1 vial
Prescription Limit: Morphine sulfate
3,000 mg (tab)
448 mg (amp/vial)
Prescription Limit: Fentanyl
30 patches 25/hr
15 patches 50/hr
10 amp x 1 ml
3 amp x 2 ml
50 amp (PCA machine)
Prescription Limit: Oxycodone HCl
1200 mg
Prescription Limit: Pethidine HCl
14 vials
Prescription Limit: Other DDs (cancer)
20 amps
40 tabs
40 caps
If BN precedes GN
GN is the only one in parenthesis
BN is not in parenthesis
Erroneous
If only BN is written
If BN is written but the GN not legible
Terms that hinder generic dispensing
Violative
GN is written but not legible or both are not legible
GN not equal with BN
Impossible
Action: Erroneous
Fill
Keep
Report
Action: Violative
Keep
Report
Action: Impossible
Keep
Report
Parts of a Prescription
▪ Prescriber’s Information
▪ Patient’s Information
▪ Date of Prescription
▪ Superscription (for Rx drugs)
▪ Inscription (must bear the name, dosage strength, dosage form and amount to be dispensed)
▪ Subscription (not always present)
▪ Signa
▪ Prescriber’s Signature and License numbers
Clinical Check
- Interactions
- Dose
- Evidence of Harm/Benefit
- Appropriate
- Legal and Complete
- Cost-effective
- Acceptable to patient
- Safe
- Effective/Evidence-based
Interactions
Drug-Drug
Drug-Food
Drug-Disease
Drug-Herb
Drug-Lab Test
-calculated based on age, weight and height, BMI and, co-morbidities/condition
Dose
-monitoring parameters to check for adverse effects and evidence of improvement
-benefits must outweigh the risk/harm
Evidence of Harm/Benefit
-checks for the specifics of the drug to know if it is the most appropriate considering all factors
Appropriate
Appropriate: 5 Rights
Right patient
Right drug
Right dose
Right route
Right time
compliance to laws, signed and dated, genuine
Legal and Complete
weigh the overall cost of treatment compared to the benefits the patient might get
Cost-effective
- check patient’s capability/preference in taking medications
- ease of administration (size/amount of drug), religion (Halal), price, generic/branded
Acceptable to patient
checks if treatment coincides with available clinical practice guidelines and protocols
Effective/Evidence-based
- Aka: assembly of the product
- May be carried out by humans (pharmacists, pharmacy technicians) or robots
- May involve extemporaneous (small-scale) compounding
FILLING
FEFO
First Expiry, First Out
SALAD
Sound-alike, Look-alike Drugs
Salad Example Read
vinBLAStine - vinCRIStine
CIMETidine – CETIrizine
PENTObarbital – PHENObarbital
NIFEdipine – NICARdipine
medroxyPROGESTerone – methylPREDNIsolone
hydrALAZINE – hydroxyzine
ePHEDrine – EPINEPHrine
ceFAZolin - cefoTEtan – cefOXitin – cefTAZidime – cefTRIAXone
