IPS1: Dispensing - Part 1 - Introduction

Administrative Order No. 63 s. of 1989

Rules and Regulations to Implement Dispensing Requirements under the Generics Act of 1988 (RA 6675)

Dispensing

act validly-registered pharmacist of filling a prescription or a doctor's order on the patient's chart

George Urdang

the first person to study the prescription of today

prae + scribe

prescription is from two latin words which include

prae

meaning before

scribe

meaning I write

B

serves as the professional relationship among the physician, pharmacist and patient

a. patient record

b. prescription

c. health literatures

d. patient request

B

vehicle for communication from the prescriber to the pharmacist about the needs of the patient

a. patient record

b. prescription

c. health literatures

d. nurse record

Over-the-counter drugs

Are pharmaceutical products or drug preparations that can be dispensed even without the written order of a validly registered licensed physician, dentist or veterinarian, for the use of consumers for the prevention or symptomatic relief of minor or self-limiting ailments

OTC drugs

Biogesic for fever

Solmux for cough

Neozep for colds

Gaviscon for hyperacidity

Imodium for diarrhea

Prescription drugs

Ethical or Legend drugs

Are pharmaceutical products or drug preparations that are to be dispensed only upon written order of a validly registered physician, dentist or veterinarian for the management or treatment of a condition or disease

Prescription drugs

Lifezar for hypertension

Glumet for diabetes

Lipitor for hyperlipidemia

Colchicine for gout

Amoxil for bacterial infection

Dangerous drugs

pharmaceutical products referring to either prohibited or regulated drugs which require a special prescription form usually obtained from the Dangerous Drugs Boards.

List A drugs

include prohibited and regulated drugs

Prohibited drugs

opium and its active components and derivatives;

coca leaf and its derivatives;

hallucinogenic drugs;

other preparations containing physiological effects of a narcotic drug

Prohibited drugs examples

Morphine

Codeine

Fentanyl

Hydrocodone

Pethidine

Regulated drugs

sedative-hypnotics and drugs which contain a salt derivative of a salt of an isomer of amphetamine

Regulated drugs examples

Amphetamine

Chloral hydrate

Etchlorvynol

Pentothal

Methamphetamine

List B Drugs

drugs requiring strict precautions in their use;

the prescriber must write clearly “List B” after the Rx symbol but before the generic name.

List B drugs

Amiodarone

Clonazepam

Dexamethasone

Lithium carbonate

Warfarin

Type of Medication based on Prescription Requirements

C

Requirement in prescribing list A drugs include

I. S2- license of physician

II. Form 1-72

III. Special DOH prescription form

IV. Recording system

a. I and II

b. I, II, III

c. I, II, IV

d. I, II, III, IV

D

Prohibited drugs except

a. Morphine

b. Pethidine

c. Hydrocodone

d. Etchlorvynol

C

Regulated drugs except

a. Amphetamine

b. Choral hydrate

c. Pethidine

d. Pentothal

C

Also known as shotgun prescription which contain more than two ingredients.

a. Compound prescription

b. Controlled prescription

c. Polypharmacal prescription

d. Simple prescription

Compounded prescription

Requires mixing of one or more ingredients including one or more active medicaments with one or more excipients, vehicles or other adjuncts to make the product.

Distinct portion of compounded prescription

Basis/Base

Adjuvant

Corrective or Corregent

Vehicle

Base

contains API, responsible for therapeutic action

Adjuvant

aids or assist the base

Corrective or corregent

qualifies the action of the base and adjuvant

Vehicle

dilutes the active ingredient

Partial filling of prescription

means dispensing less than the number of units prescribe

Shall be written on the face of prescription of partial filling

Date of partial filling

Quantity served and balance of unserved

Name and address of the drugstore

Magistral prescription

A prescription that is very often prescribed by the same doctor, of the same ingredients and compounded by the same pharmacist

Coded Rx

A prescription containing words or symbols to represent the name of drugs, it is also known as "blind prescription"

Generic dispensing

means dispensing the patient's/buyer's choice from among generic equivalents

Dispensing of controlled drugs

partial filling is not allowed

dispensing must be done by the pharmacist who shall affix his/her signature on the prescription filled

Physician's order or Medication Sheet

order for medications by an individual authorized to prescribe and are intended for use in the institutional setting

A

Dating of prescription is also a legal requirement.

a. True

b. False

A

Rechecking should be done at least 3-4 times

a. True

b. False

B

Prescription book shall be kept how many years after the last entry

a. 1 year

b. 2 years

c. 3 years

d. 5 years

D

Poison book shall be kept how many years after the last entry

a. 1 year

b. 2 years

c. 3 years

d. 5 years

A

Dangerous drugs book shall be kept how many years after the last entry

a. 1 year

b. 2 years

c. 3 years

d. 5 years

Label of Dispensed Medicines

Section 36 of RA 10918

A

Universally Accessible Cheaper and Quality Medicines Act of 2008

a. RA 9502

b. RA 9503

c. RA 6675

d. RA 7856

D

May cause drowsiness

a. antihistamines

b. sedative hypnotics

c. narcotics

d. all of these

D

Require "Do not drink alcohol" label except

a. disulfiram

b. metronidazole

c. chlorpropamide

d. tetracycline

D

Avoid sun exposure

I. Tetracyclines

II. Sulphonamides

III. Macrolides

IV. Thiazides

a. I, IV

b. I, II, III, IV

c. III, IV

d. I, II, IV

D

Best to be taken with food

a. Erythromycin

b. NSAIDS

c. Paracetamol

d. A and B only

e. A, B, and C

C

Taken on an empty stomach

a. tetracyclines

b. ampicillin

c. both a and b

d. none of these

D

Take with Plenty of Water

a. sulfonamides, expectorants

b. bulk laxatives, potassium supplements

c. chloral hydrate, antibiotic, theophylline

d. all of these

C

Should not be taken with milk and antacids except

a. tetracyclines

b. EC tablets

c. rifampin

C

Drugs that should be protected from light include

a. furosemide

b. sodium nitroprusside

c. both choices

d. none of the choices

Medication error

any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional or patient, or consumer

by United States National Coordinating Council for Medication Error Reporting and Prevention

Medication error

reduction in the probability of treatment being timely and effective, or an increase in the risk of harm relating to medicines and prescribing compared with generally accepted practice

A

Errors occurs from mistakes made when planning action

I. Knowledge-based errors

II. Rule-based errors

III. Action-based errors or slips

IV. Memory-based errors or lapses

a. I and II

b. II and III

c. III, IV

d. I and IV

C

Errors occurs in the execution of appropriately planned action

I. Knowledge-based errors

II. Rule-based errors

III. Action-based errors or slips

IV. Memory-based errors or lapses

a. I and II

b. II and III

c. III, IV

d. I and IV

A

Giving Penicillin, without having established whether the patient is allergic

a. Knowledge-based error

b. Rule-based error

c. Slip

d. Lapse

B

Injecting diclofenac into the lateral thigh rather than the buttock.

a. Knowledge-based error

b. Rule-based error

c. Slip

d. Lapse

C

Picking up a bottle containing diazepam from the pharmacy shelf when intending to take one containing diltiazem.

a. Knowledge-based error

b. Rule-based error

c. Slip

d. Lapse

Technical Error

subset of action base error or slips

can be prevented by the use of checklists, fail-safe systems and computerized reminders

E

Putting the wrong amount of potassium chloride into an infusion bottle.

a. Knowledge-based error

b. Rule-based error

c. Slip

d. Lapse

e. Technical error

D

Giving penicillin, knowing the patient to be allergic, but forgetting.

a. Knowledge-based error

b. Rule-based error

c. Slip

d. Lapse

e. Technical error

Root Cause Analysis

Logical and systematic process used to identify critical underlying reasons for the occurrence of an adverse event or close call

Steps in RCA

a. Charter the team

b. Document and research

c. Identify root causes

d. Develop actions

e. Establish outcome measures