NTA Level 4 • Semester 1 • PST04101

Dispensing Procedures in Pharmacy

Dispensing • Source Session/Topic 7

Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 7: Dispensing Procedures in Pharmacy

Total Session Time: 120 minutes

Prerequisites

• Session 1

Learning Tasks

By the end of this session students are expected to be able to:

• Define dispensing, dispenser, medicine and good dispensing procedures

• Explain good dispensing procedures

• Demonstrate good dispensing procedures

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board, chalk, and whiteboard markers

• Worksheet 7.1: Demonstration on Good Dispensing Procedures

• Worksheet 7.2: Sample Prescription Serial No. 001

SESSION OVERVIEW

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing.

Step 2: Define Dispensing, Dispenser, Medicine and Good Dispensing

Procedures (10 minutes)

• Dispensing: The act of preparing medicines and/or medical supplies and

distributing to users with adequate information, counseling and

appropriate follow up

• Dispenser: Any person who is licensed or authorized by the appropriate

body to dispense medicines and/or medical supplies

• Medicine: Any substance or mixture of substances used in the diagnosis,

treatment, mitigation or prevention of a disease in human

o Medicines include narcotic drugs, psychotropic substances and precursor

chemicals, traditional medicines, complementary or alternative

medicine; poisons, blood and blood products, vaccine, radioactive

pharmaceuticals, cosmetics and sanitary items and medical instruments

• Good Dispensing Procedures: Refers to the delivery of the correct

medicine to the right patient, in the required dosage and quantities, in

the package that maintains acceptable potency and quality for the

specified period, clear medicine information counseling and appropriate

follow up

STEP 3: Good Dispensing Procedures (35 minutes)

|Activity: Brainstorming (5 minutes) |

| |

|Ask students to brainstorm on the following question: |

| |

|What procedures to follow in Good Dispensing? |

| |

|ALLOW few students to respond? |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

Dispensing Procedures

• Procedure 1: Evaluation and interpretation of a prescription

In this step a dispenser should do the following after welcoming and

greeting the patient;

o Make sure that all important parts of the prescription are correct

and complete (refer session 1)

o Arrange prescriptions in order so as to prevent possibility of

confusion

o Dispenser should have knowledge of transcribing the prescription

o Make sure that the name of the medicine, dose, dosage, duration

are correct

o The prescription should be in writing or typed but must be signed

by the prescriber in ink

• Procedure 2: Selection and handling of the medicine. This includes:

o Select stock container of pre-pack reading the label and cross

matching the medicine name and strength against the prescription

o Read the container label at least twice during the dispensing

process.

o Do not select the prescribed medicine according to the color or

location of container

o Do not open many stock containers at the same time

▪ This trend will lead to errors and/or expose the medicines

to air and eventually leads to deterioration in quality

o Open and close containers once at a time

o While counting, pouring or measuring, the following points should

be noted:

▪ Short and/or over counting should be avoided

▪ Clean counting tray and/or spoon used

▪ Graduated measuring cylinder and/or flask must be used for

measuring liquid reduction

▪ If small volume is to be measured, small measuring

cylinder/flask has to be used (if compounding is performed in

the pharmacy) provide appropriate bottles with caps for

repackaging liquid preparations

o Dispense liquid preparations in suitable container

▪ Do not use patient’s own bottle

▪ Dispense each medicine in a different bottle

In dispensing tablets and capsules:

• Do not use fingers to count tablets as this can lead to contamination

of medicines

• Use a spoon to put tablets and capsules onto a counting tray

• Count and put them in a labeled medicine container or pack

• Close stock containers tightly after dispensing

• Keep the spoon clean at all times

• Do not keep the spoon inside the container

• Labeling of dispensed medicines should be clear and legible

• Use separate plastic boxes for different patient's requirements of

medicines

• To avoid mix-ups of medicines of different patients, it is a good

procedure to assemble medicines of different patients in

separate/different boxes, till they are billed and packed

• Procedure 3: Labeling and packaging of the medicine in an

appropriate container

o The containers used for dispensing must be appropriate for the product

dispensed

o All containers intended for medicinal products must be protected and

kept free from contamination

o Medicines must be suitably contained, protected and labeled from the

time of manufacture until they are used by the patient

o The container must maintain the quality, safety and stability of the

medicine throughout this period

• Procedure 4: The provision of information and instruction to

client

o All medicines should be dispensed with adequate and appropriate

information and counseling. Information must be structured to meet the

needs of individual patients and questions and answers should be used

to check the patient understands.

o Written information should be provided to supplement verbal

communication as appropriate.

▪ Counseling should ensure that the patient has an unequivocal

understanding of the instructions for use, and any distinct

characteristics or requirements of the medicine.

o Counseling should cover matters that will enhance or optimize medicine

therapy. The information in the form of verbal and/or written

instructions should include the following:

▪ How much and how often to take the medicine

▪ When to take the medicine (e.g., before or after meals)

▪ How long the treatment is to last (e.g., why the entire course of

an antibiotic treatment must be taken)

▪ How to take the medicine (e.g., with water, chewing or

swallowing)

▪ How to store the medicine (e.g., avoid heat, light and dampness,

keep out of reach of children)

▪ Not to share medicines with other persons

▪ Which types of foods and beverages should avoid while taking the

medicine

▪ One has to demonstrate to the patient on how to administer the

dispensed medications in case of inhaled administration and

suppository application

▪ Patients should also be informed not to stop treatment when side

effects occur or in the absence of response without consulting the

prescriber or dispenser

▪ Finally, check whether patients have understood the information

• Procedure 5: Recording the transaction

o Prescriptions should be recorded and documented as proof of transaction

between the patient and the dispenser

▪ Prescriptions can therefore be traced back if any need arises

▪ All dispensing units should have a standardized Prescription

Registration Book (PRB) for recording every pharmaceutical issued to a

patient

o A computerized dispensing and registration system may also be used, but

should always be supported by paper back up

▪ The registration book should be completed at the time of dispensing

or at the close of the working day

o The prescription registration book should be used both when

prescriptions are retained in the pharmacy and when they are returned

to the patient

▪ For a prescription which is returned to a patient because all the

items in the original prescription could not be filled, the medicines

that have been dispensed from the pharmacy should be copied on a blank

prescription and the prescription should be filed appropriately

o On the original prescription, which is retained by the patient, the

word “dispensed” should be stamped adjacent to those items which have

been dispensed

o For prescriptions which are to be refilled on a later date, the

dispensing information should be entered into the registration book

before returning the prescription to the patient

▪ The official seal of the pharmacy/Health institution, name and

signature of the dispenser, the date of dispensing and the next

refill date should be written on the back of the prescription

[pic]

Source: FMHACA (2012)

Figure 1: Pictorial presentation of dspensing procedure

STEP 4: Demonstration of Good Dispensing Procedure (60 minutes)

Activity: Role Play (30 minutes)

EXPLAIN that this will be a role play between a patient and a dispenser.

One volunteer student will play as dispenser and will demonstrate the

necessary steps of Good Dispensing Procedures through and dispensing

medicines to the patient, who will be another student volunteer.

ASK two students to volunteer playing as dispenser and patient

respectively.

TELL the rest of students to observe carefully on the procedures of Good

Dispensing

EXPLAIN that the patient will handle the prescription to the dispenser and

wait for the medicine. The dispenser should follow all Good Dispensing

procedures for dispensing medicine..

EMPHASIZE that the Dispenser should follow all the guides and steps of Good

Dispensing procedures.

START the role play.

LEAD a discussion after the role play.

DE-ROLE all the students, once the role play is over.

ASK students if they have any questions about the role play.

[pic]Refer student volunteer to Worksheet 7.1: Demonstration so that

he/she can read the description of the dispenser

[pic] Refer students to Worksheet 7.2: Sample Prescription Serial No. 001

STEP 5: Key Points (5 minutes)

• Dispensing refers to the process of preparing medicines and

distributing to users with provision of an appropriate

information, counseling and follow up

• Good dispensing procedures ensure that the correct medicine is

delivered to the right patient, in the required dosage and

quantities, with clear instructions, and in package that

maintains an acceptable potency and quality of the medicine

• The medicine should be dispensed in a safe and hygienic manner, making

sure that the patient or care provider understands and appreciates the

value of taking specific medicines for specific indications

STEP 6: Evaluation (5 minutes)

• What is dispensing?

• What is Medicine ?

• Which are the Good Dispensing Procedures?

References

Cooper, J. W., Gunn, C., & Carter, S. J. (2008). Cooper and Gunn's

dispensing for pharmaceutical students (12th ed.). New Delhi, India:

CBS.

FMHACA of Ethiopia (2012). Manual for Medicine Good Dispensing practices.

(2nd ed.). Ethiopia

GoT (1998). Tanzania National Formulary (1st ed.). Dar es salaam, Tanzania:

MOHSW.

|[pic] |Worksheet 7 .1: Role Play Demonstration on Good Dispensing |

| |Procedures |

|Script: |

|Your role is to dispense the medicines to a patient who hands the |

|prescription. you should follow all good dispensing procedures |

|principles as you receive the prescription from the patient. |

|Greet the patient |

|Receive the prescription from the patient |

|Read the prescription and interpret and understand |

|Prepare and select medicines as per given prescription |

|Erythromycin Tablets 500mg qid 7/7 |

|Paracetamol Tablets 1g tds 3/7 |

|Calculate total quantity of each medicine |

|Erythromycin Tablets: 2 Tablets X 4 times a day X 7 days = Pack 56 |

|Tablets |

|Paracetamol Tablets: 2 Tablets X 3 times a day X 3 days = Pack 18 |

|Tablets |

|Write a label for each medicine then pack according to calculations |

|above |

|Record in dispensing register |

|Call a patient by name and give instructions on how to use medicines |

|Erythromycin Tablets: Take two tablets after every 6 hours for 7 days, |

|swallow with water after meals. |

|Paracetamol Tablets: Take two tablets after every 8 hours for 5 days, |

|swallow with water. |

|You may experience stomach upsets because of medicines given unless is |

|severe report back to hospital |

|Ask the patient to repeat information given for checking understanding |

|Wish a patient quick recovery |

|[pic] |Worksheet 7.2: Sample Pescription Serial No. 001 |

|Serial Na. 001 |

|KIHESA HEALTH CENTER |

|P.O. Box |

|IRINGA |

|Name: |John Kalunde |

|Gender: |Me |

|Age: |20Yrs |

|Weight: |60kg |

|Rx |Erythromycin tabs 500mg q.i.d 7/7 |

| |Paracetamol Tabs 1g tds 3/7 |

|Prescriber’s |Masige Kahwa Malimbo |

|name |MO |

|qualification | |

|Signature |[pic] |

← Previous Topic Next Topic →View all Dispensing topics Open Complete Full Notes

PDF / OFFLINE NOTES

Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP

WhatsApp: 255620339260