Practicum 2

Lesson 1: DISPENSING PRESCRIPTION Types of Medication based on

PRESCRIPTION REQUIREMENT:
Dispensing: comparison of the 3 drugs in terms of
prescription required:
Dispensing refers to the pharmacist's
function of taking an order or OTC DRUG:
prescription, preparing the drug/s
according to the instructions of a ❖ Prescription required: None
physician or dentist, and delivering it to ❖ Number of Copies: None
the patient or client with proper ❖ Ways of Identifying: No Rx sign
instructions. ❖ Recording Required: No
❖ Filing of Prescription: No
Prescription:
Rx DRUG:
An order for medication written by a
licensed physician, dentist, or other ❖ Prescription required: Ordinary
licensed medical practitioner and given prescription
to the patient for presentation to the ❖ Number of Copies: One
pharmacist. It contains specific ❖ Ways of Identifying: With Rx sign
medication and dosage to be and additional label requiring
administered to a particular patient at a prescription
specified time. ❖ Recording Required: Prescription
book
The prescription serves as a vehicle for ❖ Filing of Prescription: 2 years
communication from the prescriber to
the pharmacist about the needs of the Dangerous Drug:
patient.A formula written on a piece of
paper called a prescription blank. ❖ Prescription required: Yellow
prescription
❖ Number of Copies: RPh, MD, &
George Urdang: patient
- The first person to study the ❖ Ways of Identifying: With Rx sign
prescription of today. and additional label requiring
- The term "prescription" originated from prescription and List A
the two Latin words "prae," meaning ❖ Recording Required: Dangerous
before, and "scribe," meaning I write. drug book
❖ Filing of Prescription: 1 year
Additional Note: List A Drugs:

● For poison drugs, the prescription Prohibited Drugs Include:

should be kept for 5 years and - Opium and its active components and
recorded in the poison book. derivatives, Coca leaf and its derivatives,
Hallucinogenic drugs.Other preparations
containing physiological effects of a
Nonprescription drugs: narcotic drug.

Pharmaceutical products or drug Regulated Drugs:

preparations that can be dispensed - Sedative-hypnotics, Drugs which
without the written order of a licensed contain a salt derivative of a salt of an
physician, dentist, or veterinarian, for the isomer of amphetamine.
prevention or symptomatic relief of
minor or self-limiting ailments. List B Drugs:

Prescription drugs: ● Drugs requiring strict precautions

in their use.
Pharmaceutical products or drug ● The prescriber must write clearly
preparations that are dispensed only "List B" after the Rx symbol but
upon the written order of a licensed before the generic name.
physician, dentist, or veterinarian for the
management or treatment of a condition
or disease. Classification of Prescription:

Dangerous drugs: 1.) Based on the Number of Ingredients.

- Prohibited or regulated drugs that 2.) Compounded or Non-compounded
require a special prescription form Prescription.
usually obtained from the Dangerous 3.) New or Refill Prescription.
Drugs Board. 4.) Generic or Controlled Prescription.

❖ List A (Prohibited Drugs, Based on the Number of Ingredients

Regulated Drugs) [Crack]
❖ List B Drugs. [barbiturates] ● Simple Prescription
● Compound Prescription
● Polypharmacal Prescription –
shotgun Rx
Compounded or Non-compounded unserved, Name and address of the
Prescription: drugstore.

➔ Compounded Prescription: Generic or Controlled Prescription:

◆ Requires mixing of one or
more ingredients, including ● Generic Dispensing:
active medicaments, Dispensing the patient’s/buyer’s
excipients, vehicles, or choice from among generic
adjuncts to make the equivalents.
product.
◆ Distinct Portions: ● Dispensing of Controlled Drugs:
● Basis/Base Dispensing must be done by the
● Adjuvant pharmacist who shall affix
● Corrective or his/her signature on the
Coregent prescription filled.
● Vehicle
Requirements in Dispensing List A
➔ Non-compounded Prescription: Drugs:
◆ Prescription order that
● S-2 license of the physician
does not require mixing of
● Special DDB prescription form
two or more ingredients to
(Form No. 1-72) must be used
obtain a finished product.
● Recording system
New or Refill Prescription:
Other Types of PRESCRIPTIONS
● New Prescription
Original prescription order filled Magistral Rx:
the first time.
● A prescription that is very often
● Refill Prescription
prescribed by the same doctor, of
Any repeat filling of an original
the same ingredients and
prescription order.
compounded by the same
● Partial Filling of Prescription
pharmacist
Means dispensing less than the
number of units prescribed.
Coded Rx:
Information to include: The date of
● A prescription containing words
partial filling, The quantity served and
or symbols to represent the name
the balance of the prescription
of drugs.
Parts of a Typical Prescription Superscription:

● The Rx symbol, derived from the

Latin verb "recipe," meaning "take
thou" or "you take." Historically
believed to originate from the
sign of Jupiter, used by ancients
to request aid for healing.

Inscription:

● Contains the medication

prescribed, serving as the body or
principal part of the prescription
order.
Prescriber’s Information:

Subscription:
● Contains the name of the
physician or dentist, specialty,
● Provides dispensing directions to
clinic address, contact number,
the pharmacist, including
and clinic hours.
instructions for preparing and
labeling the prescription.
Patient’s Information:
Typically includes the quantity of
● Includes pertinent details about medication to be dispensed.
the patient such as name,
Transcription:
address, sex, age, weight, and
sometimes BSA (Body Surface
● Provides directions for the
Area).
patients, also known as
"signature" or "signa," meaning
Date:
"mark thou" or "let it be labeled."
● Prescriptions are dated at the Instructions are often written
time they are written and also using abbreviated forms of
when they are received and filled English or Latin terms.
in the pharmacy.
Refill Information:

● If refill information is not

supplied, it is generally assumed
that no refills are authorized.
Prescriber’s Signature and License ● Terminology: All terminology
Numbers: used, including units of measure
and Latin abbreviations, should
● Contains the signature of the be understood and interpreted
prescriber along with the doctor’s correctly.
license number, PTR number, and
sometimes S2 number. Evaluating the appropriateness
Prescription & Medication order
Forms of Prescription Order:
During evaluation, the following factors
● Prescription Blanks: Used for
should be considered:
individual prescriptions.
● Physician’s Order or Medication
● The patient’s disease or condition
Sheet: Orders for medications
requiring treatment.
intended for use in the
● The patient’s allergies or
institutional setting.
hypersensitivities.
● The pharmacological or
biological action of the
Understanding the Prescription & prescribed product.
Medication order ● The prescribed route of
administration.
● Name and Address: Both the ● Whether the prescribed product
patient and the prescriber's name might result in a drug interaction.
and address should be clearly ● Whether the dose, dosage form,
stated. and dosage regimen are safe and
● Patient’s Disease or Condition: likely to meet the needs of the
The prescription should specify patient.
the patient’s disease or condition
requiring treatment. Additionally, the following should also
● Reason for the Order: The be considered:
prescription should indicate why
the order is indicated, relative to ● Whether the patient will have any
the medical need of the patient. difficulties adhering to the
● Name of the Product: The name regimen and the potential impact
of the medication, along with the on the therapeutic outcome
quantity prescribed and desired.
instructions for use, should be ● Whether the total quantity of
clearly stated. medication prescribed is
sufficient to allow proper
 completion of a course of Violative, Erroneous, and Impossible
therapy. Prescriptions
● Whether a physical or chemical
incompatibility might result. Violative Prescriptions:
● Whether a licensed practitioner,
acting in the course and scope of ➢ Where the generic name is not
practice, issued the prescription written.
in good faith, for a legitimate ➢ Where the generic name is not
medical purpose. legible and a brand name is
legibly written.
Processing the Prescription Order ➢ Where the brand name is
indicated and instructions added
❖ 1. Receiving the Rx: (such as phrase "no
➢ It is desirable that the substitution").
patient presents the
prescription order directly Erroneous Prescription:
to the pharmacist.
➢ Greet the patient properly ➢ Where the brand name precedes
and ask politely what you the generic name.
can do for them. ➢ Where the generic name is the
❖ 2. Reading and Checking: one in parenthesis.
➢ Upon receiving the ➢ Where the brand name is not in
prescription, read it parenthesis.
completely and carefully. ➢ Where more than one drug
➢ Try to answer the following product is prescribed on one
questions: prescription form.
■ Is the prescription
legal? Impossible Prescription:
■ Who is it for?
➢ When only the generic name is
■ What is the name of
written but it is not legible.
the medication?
➢ When the generic name does not
■ What are the
correspond to the brand name.
instructions for the
➢ When both the generic name and
patient?
the brand name are not legible.
■ What quantity is to
➢ When the drug product
be dispensed?
prescribed is not registered with
the FDA.
 ❖ 3. Pricing ​ Professional Fee:
● Formula: SP = Cost of
Pricing Methods for Prescriptions: ingredients + Professional
fee
​ Percent Mark Up: ● A specified professional
● Formula: SP = Cost of fee is added to the cost of
ingredients + (cost x % ingredients.
mark-up)
● Desired profit percentage ​ Example: If the cost of a product
is applied to the cost of is P40.00 and a pharmacist
ingredients. applies a professional fee of
● Lower mark-up for P42.50:
higher-cost items, higher
mark-up for lower-cost SP = 40.00 + 42.50 = P82.50
items.
These pricing methods ensure
consistent and profitable operations
Example: If a pharmacist bought a bottle while covering costs and providing a
of syrup for P37.50 and wants a 50% reasonable profit margin.
profit:

SP = 37.50 + (37.50 x 0.50) = P56.25 ❖ 4. Numbering and Dating:

➢ It is legally required to assign a
​ Percent Mark Up Plus a Minimum number to the prescription order
Fee: and to match it with the label.
● Formula: SP = Cost of ➢ Dating the prescription when it's
ingredients + (cost x % filled is also mandatory, distinct
mark-up) + minimum fee from the date of prescription.
● Both a percentage mark-up
and a minimum fee are ❖ 5. Labeling:
added to the ingredient ➢ Labeling is crucial, especially for
cost. medications transferred to
non-original containers.
Example: If the cost of the drug is P4.00 ➢ A well-designed label reflects the
and a pharmacist applies a 40% mark-up professionalism of the
and a minimum fee of P2.25: dispensing pharmacist. It should
be neat, attractive and legible
SP = 4.00 + (4.00 x 0.40) + 2.25 = P6.65
It should include: ● Rechecking should occur at least
3 to 4 times:
○ Name and address of the ● Before retrieving from the
pharmacy shelf
○ Date of dispensing ● While preparing the
○ Prescription number product
○ Prescriber’s name ● When returning the
○ Patient’s name container
● Before dispensing the
❖ 6. Preparing: medication
● Pharmacists must decide on the
precise procedure for dispensing ❖ 9. Delivering and Patient
or compounding medications. Counseling:
● Pharmacists should hand the
❖ 7. Packaging: prescription directly to the patient
● Pharmacists select containers and provide instructions.
based on medication type, ● Reinforce patient awareness of
quantity, and method of use. instructions and provide
● Containers must protect contents additional information as needed.
from air, moisture, light, and
contaminants. ❖ 10. Recording and Filing:

Types of containers include: ● Prescriptions must be recorded in

appropriate books and files
● Round vials maintained by the pharmacy.
● Prescription bottles ● Prescription retention periods:
● Wide-mouth bottles ● Prescription drugs: 2 years
● Dropper bottles ● Dangerous drugs: 1 year
● Ointments jars and tubes ● Poisonous drugs: 5 years
● Sifter-top containers ● Abortive drugs: 5 years
● Hinged-lid or slide boxes
● Aerosol containers

❖ 8. Rechecking:
● Each prescription filled should
undergo multiple rechecks to
avoid errors.
LAWS AND ETHICAL POLICIES Violation on the Part of Dispensers and
GOVERNING PHARMACY Outlets:
PRACTICE
● Imposing a particular brand or
product on the buyer
Good Pharmacy Practice (GPP):
● Inaccurate dispensing
● Failure to post or make
A. GPP requires that a pharmacist's first
accessible the required
concern must be the welfare of the
information on drug products
patients in all settings.
● Failure to inform the buyer on
B. GPP requires that the core of the available products that meet the
pharmacy activity is the supply of prescription
medication and other health care ● Failure to indicate the generic
products, of assured quality, appropriate name on the label
information and advice for the patient, ● Failure to record and keep
and monitoring the effects of their use. prescription
● Failure to report to the nearest
C. GPP requires that an integral part of DOH office any cases of violative,
the pharmacist's contribution is the erroneous or impossible
promotion of rational and economic prescription
prescribing and appropriate medicine
use. Privilege of the Senior Citizens under
the Expanded Senior Citizens Act
D. GPP requires that the objective of Republic Act No. 9994
each element of pharmacy service is
relevant to the individual, is clearly 20% discount:
defined and is effective.
● On purchase of medicine
Philippine Pharmacy Act: anywhere in the country

● Republic Act No. 5921 (old) Comprehensive Dangerous Drugs Act of

● Republic Act No. 10918 (new) 2002:

Generics Law of 1988: ● Republic Act No. 9165

● Republic Act No. 6675 Universally Accessible Cheaper and

Quality Medicine Act of 2008:

● Republic Act No. 9502