Prescription Handling and Care required in Dispensing Prescription
HANDLING OF PRESCRIPTION
The following procedures should be adopted by the pharmacist while handling the prescription for compounding and dispensing:
I. Receiving
II. Reading and checking
III. Collecting and weighing the materials
IV. Compounding, packaging and labelling
I. Receiving
The prescription should be received by the pharmacist. While receiving a prescription, a pharmacist should not change his/her facial expression.
It gives an impression that he/she is confused or surprised after seeing the prescription.
II. Reading and checking
After receiving the prescription it should be screened behind the counter.
Prescription authenticity should be checked.
The signature of the prescriber and the date of prescription should be checked.
The pharmacist should read all the lines and words of the prescription.
He/she must not guess any word.
If there is any doubt, the pharmacist should consult with the other pharmacist or the prescriber over the telephone.
(III). Collecting and weighing the material
Before compounding a prescription all the materials should be collected from the shelves or drawers.
All the materials are kept on the left-hand side of the balance. After measuring each material should be kept on the right-hand side of the balance.
After compounding of the prescription materials is replaced back to the shelves/drawers. While compounding every container of material should be checked thrice in the following manner:
(i) When collected from the shelves/drawers.
(ii) When the materials are measured.
(iii) When the containers are replaced back to the shelves/drawers.
IV. Compounding, packaging and labelling
Only one prescription should be compounded at a time.
Compounding should be done on a clean table.
All equipment required should be cleaned and dried. The preparation should be prepared according to the direction of the prescriber or as per methods given in pharmacopoeia or formulary.
The compounded preparations should be filled in suitable containers.
Label the container.
Care required in Dispensing
- The prescription must be carried with the pharmacist while taking the medicine out of the shelves.
2.The dispensing balance should always be checked before weighing any ingredient.
3.All the chemicals should be replaced back into their original positions on the shelf.
4.Care should be taken to keep the balance clean after each measurement.
5.Liquid preparations for external use the label must display FOR EXTERNAL USE ONLY in red ink
6.Before handing over the medicine to the patient, again the preparation should be checked.
- Abbreviation
In most of the prescriptions abbreviated terms are used by the prescriber that leads to major errors during interpretation by the pharmacists. E.g. „SSKI‟ is the abbreviated term of „Saturated Solution of Potassium Iodide‟.
It is preferable to avoid these types of misleading abbreviations. - Name of the drugs
Names of some drugs (especially the brand names) either look or sound alike. So any error in the name of a drug will lead to major danger to the patient. e.g. Althrocin – Eltroxin, Acidin
– Apidin , Digoxin- Digitoxin etc. - Strength of the preparation
Drugs are available in the market in various strengths. So a drug must not be dispensed if the strength is not written in the prescription. E.g. Paracetamol tablet 500mg should not be dispensed when no strength is mentioned in the prescription. - Communication failure
Failures during the process of patient management – Includes illegible handwriting, incomplete prescribing order. Common errors include: „g‟ mistaken for „mg‟ - Dosage form of the drug prescribed
Many drugs are available in more than one dosage form. E.g. liquid, tablets, injections or suppositories. The dosage form intended for the patient must be mentioned in the prescription to reduce ambiguity.
- Dose
If unusually high or low dose is mentioned in the prescription then it must be consulted with the prescriber. Some time a sustained release (SR) dosage form is prescribed thrice or more times daily. Actually SR dosage forms should be given once or twice a day. - Instructions to the patient
Some times the instruction for a certain preparation is either omitted of mentioned partially. The route of administration should be mentioned clearly. - Incompatibilities
It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in the prescription. If more than two medicines are prescribed then it is the duty of the pharmacist to see whether their interactions will produce any harm to the patient or not. Certain drugs have interactions with food. E..g, Tetracycline should not be taken with milk or antacid.
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