Receiving and Filling Prescriptions

Question 1

• First step in the dispensing process
• The actual receipt of the prescription from the patient or a representative

Answer 1

RECEIVING

Question 2

Check for legalities of prescription (validity and completeness)

mandated by law

may differ from one country to another

Answer 2

Legal Check

Question 3

Check for clinical appropriateness of prescription (correctness and appropriateness)

Determined by individual patient characteristics

Answer 3

Clinical Check

Question 4

Legal Check

Answer 4

1. Date/Duration
2. Drug Classification
3. Prescription Limit
4. Prescription Errors
5. Parts of a Prescription

Question 5

Date/Duration: 1 month

Answer 5

Ordinary Prescription:

Question 6

Date/Duration: 7 days

Answer 6

Antibiotic prescription:

Question 7

Date/Duration: 1 month (no refills)

Answer 7

Dangerous Drug prescription:

Question 8

Period of validity may be longer in case of ___________ and ___________ for chronic conditions

Answer 8

maintenance drugs; prescription refills

Question 9

2. Drug Classification

Answer 9

• Over- the-counter Drugs
• Beyond- the-counter Drugs
• Prescription Drugs
• Regulated Drugs

Question 10

-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.

Answer 10

Over- the-counter Drugs

Question 11

may be sold without a prescription but must either be sold by a pharmacist or at least not displayed to the public.

Answer 11

Beyond- the-counter Drugs

Question 12

-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.”

Answer 12

Prescription Drugs

Question 13

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.

Answer 13

Regulated Drugs

Question 14

Regulated Drugs

Answer 14

Examples:
alprazolam,
fentanyl,
morphine,
phenobarbital,
oxycodone

Question 15

Prescription Drugs

Answer 15

Examples:

antibiotics,
ibuprofen 800 mg,
mefenamic 500 mg

Question 16

Beyond- the-counter Drugs

Answer 16

Examples: contraceptive pills

Question 17

Over- the-counter Drugs

Answer 17

Examples:

cetirizine,
loperamide,
ibuprofen 400 mg,
mefenamic 250 mg,

Question 18

Prescription Limit: Benzodiazepines

Answer 18

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

Question 19

Prescription Limit: Phenobarbital

Answer 19

2 weeks supply
2 bottles (100 tabs/bottle) for epilepsy

Question 20

Prescription Limit: Pethidine

Answer 20

3 amp

Question 21

Prescription Limit: Ephedrine

Answer 21

1 vial

Question 22

Prescription Limit: Other DDs (ordinary)

Answer 22

1 vial

Question 23

Prescription Limit: Morphine sulfate

Answer 23

3,000 mg (tab)
448 mg (amp/vial)

Question 24

Prescription Limit: Fentanyl

Answer 24

30 patches 25/hr
15 patches 50/hr
10 amp x 1 ml
3 amp x 2 ml
50 amp (PCA machine)

Question 25

Prescription Limit: Oxycodone HCl

Answer 25

1200 mg

Question 26

Prescription Limit: Pethidine HCl

Answer 26

14 vials

Question 27

Prescription Limit: Other DDs (cancer)

Answer 27

20 amps 40 tabs 40 caps

Question 28

If BN precedes GN GN is the only one in parenthesis BN is not in parenthesis

Answer 28

Erroneous

Question 29

If only BN is written If BN is written but the GN not legible Terms that hinder generic dispensing

Answer 29

Violative

Question 30

GN is written but not legible or both are not legible GN not equal with BN

Answer 30

Impossible

Question 31

Action: Erroneous

Answer 31

Fill Keep Report

Question 32

Action: Violative

Answer 32

Keep Report

Question 33

Action: Impossible

Answer 33

Keep Report

Question 34

Parts of a Prescription

Answer 34

▪ 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

Question 35

Clinical Check

Answer 35

1. Interactions 2. Dose 3. Evidence of Harm/Benefit 4. Appropriate 5. Legal and Complete 6. Cost-effective 7. Acceptable to patient 8. Safe 9. Effective/Evidence-based

Question 36

Interactions

Answer 36

Drug-Drug Drug-Food Drug-Disease Drug-Herb Drug-Lab Test

Question 37

-calculated based on age, weight and height, BMI and, co-morbidities/condition

Answer 37

Dose

Question 38

-monitoring parameters to check for adverse effects and evidence of improvement -benefits must outweigh the risk/harm

Answer 38

Evidence of Harm/Benefit

Question 39

-checks for the specifics of the drug to know if it is the most appropriate considering all factors

Answer 39

Appropriate

Question 40

Appropriate: 5 Rights

Answer 40

Right patient Right drug Right dose Right route Right time

Question 41

compliance to laws, signed and dated, genuine

Answer 41

Legal and Complete

Question 42

weigh the overall cost of treatment compared to the benefits the patient might get

Answer 42

Cost-effective

Question 43

- check patient’s capability/preference in taking medications - ease of administration (size/amount of drug), religion (Halal), price, generic/branded

Answer 43

Acceptable to patient

Question 44

checks if treatment coincides with available clinical practice guidelines and protocols

Answer 44

Effective/Evidence-based

Question 45

- Aka: assembly of the product - May be carried out by humans (pharmacists, pharmacy technicians) or robots - May involve extemporaneous (small-scale) compounding

Answer 45

FILLING

Question 46

FEFO

Answer 46

First Expiry, First Out

Question 47

SALAD

Answer 47

Sound-alike, Look-alike Drugs

Question 48

Salad Example Read

Answer 48

vinBLAStine - vinCRIStine CIMETidine – CETIrizine PENTObarbital – PHENObarbital NIFEdipine – NICARdipine medroxyPROGESTerone – methylPREDNIsolone hydrALAZINE – hydroxyzine ePHEDrine – EPINEPHrine ceFAZolin - cefoTEtan – cefOXitin – cefTAZidime – cefTRIAXone