Chapter 4.1.f. Dispensing Practice for Dangerous Drugs

Dangerous Drugs

drugs that are included in Schedule annexed to the 1961 Single Convention on Narcotic Drugs as amended by the 1972 Protocol

Special Prescription Form or “Yellow Prescription”

In dispensing dangerous drugs, it must be prescribed using __________________ in triplicate copies.

S-2 license

Prescribers that prescribed dangerous drugs are also required to have __________ granted by PDEA

Norephedrine/Phenylpropanolamine at doses of 25 mg or below

Licensed used in Prescribing Dangerous Drugs, drugs containing Controlled substances EXCEPT drugs containing ___________________________________.

S-3

Pharmacists must also secure a license in dispensing DD

Check

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1 = ?

Forged, unlawfully, or cancelled

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1.a. = ?

more than 60 days

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1.b. = ?

terminated

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1.c. = ?

outside the scope of practice

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1.d. = ?

Not complete

Dispensing Procedures for DDs

1. ________ if the prescription or order is:

a. ______________________________, in which case the pharmacist shall verify it with the prescriber.

b. Issued __________ before the presentation because the allowed patient use is for 30 day supply only, except for a multi-month’s prescription, the 60 days shall be based on the date indicated by the practitioner when the drug shall be obtained.

c. Already __________ by the discontinuance of the medication by the prescriber of death of the patient.

d. The prescription is _________________________ of the prescriber

e. ___________, legible, properly prepared, properly signed, or shows any signs of alteration or erasures

1.e. = ?

Dispensing Procedures for DDs

2. Check if the prescription or order contains only one dangerous drug or drug preparation containing a controlled chemical; the presence of multiple dangerous drugs is not allowed.

triplicate copies

Dispensing Procedures for DDs

3. If the case is out-patient, make sure that the prescription is issued in _________ in which the:

a. The original copy of the prescription (specifically marked as the original copy on the face of the prescription) shall be surrendered to the __________________ that dispensed the drug.

b. The duplicate copy (specifically marked as duplicate copy on the face of the prescription) will be a copy for ______________________.

c. The triplicate copy (specifically marked as triplicate copy on the face of the prescription) will be retained by the _________________.

3 = ?

drugstore or pharmacy

Dispensing Procedures for DDs

3. If the case is out-patient, make sure that the prescription is issued in _________ in which the:

a. The original copy of the prescription (specifically marked as the original copy on the face of the prescription) shall be surrendered to the __________________ that dispensed the drug.

b. The duplicate copy (specifically marked as duplicate copy on the face of the prescription) will be a copy for ______________________.

c. The triplicate copy (specifically marked as triplicate copy on the face of the prescription) will be retained by the _________________.

3.a. = ?

patient or purchaser-representative

Dispensing Procedures for DDs

3. If the case is out-patient, make sure that the prescription is issued in _________ in which the:

a. The original copy of the prescription (specifically marked as the original copy on the face of the prescription) shall be surrendered to the __________________ that dispensed the drug.

b. The duplicate copy (specifically marked as duplicate copy on the face of the prescription) will be a copy for ______________________.

c. The triplicate copy (specifically marked as triplicate copy on the face of the prescription) will be retained by the _________________.

3.b. = ?

prescribing practitioner

Dispensing Procedures for DDs

3. If the case is out-patient, make sure that the prescription is issued in _________ in which the:

a. The original copy of the prescription (specifically marked as the original copy on the face of the prescription) shall be surrendered to the __________________ that dispensed the drug.

b. The duplicate copy (specifically marked as duplicate copy on the face of the prescription) will be a copy for ______________________.

c. The triplicate copy (specifically marked as triplicate copy on the face of the prescription) will be retained by the _________________.

3.c. = ?

standard information

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4 = ?

prescriber

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.a. = ?

Patient

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.b. = ?

Date

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.c. = ?

Generic/Brand name

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.d. = ?

no refill

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.e. = ?

clear and specified

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.f. = ?

original signature

Dispensing Procedures for DDs

4. Ensure if the following ___________________ are present:

a. The full name, complete business address, telephone number/email address, current S-2 License number and validity of the license, and Professional Tax Receipt of the __________.

b. Complete name, age, and complete address of the ___________

c. __________ of the Rx

d. ____________________ of the preparation to be supplied, its dosage forms and strength and total number of dosage units or total quantity to be supplied in words and its numerical equivalent

e. The inscription of “___________” at the face of the Rx

f. The direction for use which is _________________ – “Take as directed” or “Take as required” is not authorized

g. The ________________ of the medical practitioner

4.g. = ?

valid government-issued ID with picture

Dispensing Procedures for DDs

5. Ask the buyer for a ________________________.

a. The _________________________ should be written at the back of the Rx along with full name and address of the buyer.

b. If foreigners, ask him/her to present the original and photocopy of ___________ or any valid government-issued ID and affix signature at the back of the Rx

5 = ?

type of ID and its number

Dispensing Procedures for DDs

5. Ask the buyer for a ________________________.

a. The _________________________ should be written at the back of the Rx along with full name and address of the buyer.

b. If foreigners, ask him/her to present the original and photocopy of ___________ or any valid government-issued ID and affix signature at the back of the Rx

5.a. = ?

passport

Dispensing Procedures for DDs

5. Ask the buyer for a ________________________.

a. The _________________________ should be written at the back of the Rx along with full name and address of the buyer.

b. If foreigners, ask him/her to present the original and photocopy of ___________ or any valid government-issued ID and affix signature at the back of the Rx

5.b. = ?

reused

Dispensing Procedures for DDs

6. Once dispensed, make sure that NO Rx,

a. once serve by the pharmacy shall be ________

b. nor any Rx once fully issued be ________

c. when a Rx is partially filled, the _ may be fully filled by the drugstore or pharmacy

6.a = ?

refiled

Dispensing Procedures for DDs

6. Once dispensed, make sure that NO Rx,

a. once serve by the pharmacy shall be ________

b. nor any Rx once fully issued be ________

c. when a Rx is partially filled, the _ may be fully filled by the drugstore or pharmacy

6.b = ?

balance

Dispensing Procedures for DDs

6. Once dispensed, make sure that NO Rx,

a. once serve by the pharmacy shall be ________

b. nor any Rx once fully issued be ________

c. when a Rx is partially filled, the ________ may be fully filled by the drugstore or pharmacy

6.c = ?

“USED IN FULL”

Dispensing Procedures for DDs

7. Whenever a Rx for DDs is fully filled up by the drugstore, STAMP the inscription _________________ in bold prints across the original copy of the said Rx.

BALANCE

Dispensing Practices for DDs

8. In case of partial filling, indicate clearly the ______________at the face of the Rx in words and its numerical equivalent.

signature

Dispensing Practices for DDs

9. Affix your ________________ on the face of the Rx.

Double-check

Dispensing Practices for DDs

10. _____________ the DD before finally handing it to the buyer

1 year

Dispensing Practices for DDs

11. Keep your copy of the Rx for _________ and log it in the DD book or PDEA report forms that can be downloaded and printed.

accountable

Dispensing Practices for DDs

12. Remember that you are held ________________ for any violation committed.

ordinary Rx

Dispensing of DDs in Emergency Situation

1. In emergency cases, the Pharmacist shall accept the use of an _____________.

a. Provided the Prescriber shall write to the ______________________________ as to where the emergency occurred and copy furnish with 7 days after issuing such ordinary Rx.

b. The Pharmacist shall also inform the PDEA with 7 days after _______________ and ensure that the back of Rx contains the date and nature of emergency conditions.

1 = ?

PDEA-Compliance Services or Regional Office

Dispensing of DDs in Emergency Situation

1. In emergency cases, the Pharmacist shall accept the use of an _____________.

a. Provided the Prescriber shall write to the ______________________________ as to where the emergency occurred and copy furnish with 7 days after issuing such ordinary Rx.

b. The Pharmacist shall also inform the PDEA with 7 days after _______________ and ensure that the back of Rx contains the date and nature of emergency conditions.

1.a. = ?

dispensing the DDs

Dispensing of DDs in Emergency Situation

1. In emergency cases, the Pharmacist shall accept the use of an _____________.

a. Provided the Prescriber shall write to the ______________________________ as to where the emergency occurred and copy furnish with 7 days after issuing such ordinary Rx.

b. The Pharmacist shall also inform the PDEA with 7 days after _______________ and ensure that the back of Rx contains the date and nature of emergency conditions.

1.b. = ?

verbal orders

Dispensing of DDs in Emergency Situation

2. In hospital setting, where the life of a patient is compromised by failure to respond quickly, the pharmacist can accept _____________, provided that he/she must record the order in the patient’s medical record including the prescribing practitioner’s name and affix to the record his/her own signature.

a. The Pharmacist shall also see to it that the recorded order shall have the inscription, “__________________________________________”

b. On the other hand, the Prescriber is required to sign the order with ___________ of the time it was given and provide the necessary Rx.

2 = ?

AUTHORIZATION FOR EMERGENCY DISPENSING

Dispensing of DDs in Emergency Situation

2. In hospital setting, where the life of a patient is compromised by failure to respond quickly, the pharmacist can accept _____________, provided that he/she must record the order in the patient’s medical record including the prescribing practitioner’s name and affix to the record his/her own signature.

a. The Pharmacist shall also see to it that the recorded order shall have the inscription, “__________________________________________”

b. On the other hand, the Prescriber is required to sign the order with ___________ of the time it was given and provide the necessary Rx.

2.a. = ?

24 hours

Dispensing of DDs in Emergency Situation

2. In hospital setting, where the life of a patient is compromised by failure to respond quickly, the pharmacist can accept _____________, provided that he/she must record the order in the patient’s medical record including the prescribing practitioner’s name and affix to the record his/her own signature.

a. The Pharmacist shall also see to it that the recorded order shall have the inscription, “__________________________________________”

b. On the other hand, the Prescriber is required to sign the order with ___________ of the time it was given and provide the necessary Rx.

2.b. = ?

Calamity area

Dispensing of DDs in Emergency Situation

3. In cases of emergency in a ______________ where life or health is at risk, the PHARMACIST shall accept DDs that are not in the prescribed form but duly signed by any of the following: City/Municipal Health Officer, Attending Medical practitioner, Senior medical officer, Police medical officer, Military doctor, and Any available medical practitioner supervising the medical-dental-veterinary team.

limited to the amount needed to treat the patient

Dispensing of DDs in Emergency Situation

3. In cases of emergency…

a. The pharmacist must consider if the drug order is ________________________ – that the inscription, “Authorization for Emergency Dispensing” is present on the face of the Rx order.

b. The Pharmacist shall notify immediately the _______ where the emergency occurred and shall report to PDEA-Compliance Service with 7 days.

3.a. = ?

PDEA

Dispensing of DDs in Emergency Situation

3. In cases of emergency…

a. The pharmacist must consider if the drug order is ________________________ – that the inscription, “Authorization for Emergency Dispensing” is present on the face of the Rx order.

b. The Pharmacist shall notify immediately the _______ where the emergency occurred and shall report to PDEA-Compliance Service with 7 days.

3.b. = ?

recreational purposes

Medication Counseling for DDs

1. Inform the patient that

a. DDs are not intended for __________________ and that they are only part of the management plan

b. __________________ is likely to occur with improper use

c. ____________________ may appear, including impairment of performance of skilled tasks and driving – the patient must know the signs and symptoms of medication impairment before getting behind the wheel and should NOT drive if impaired

d. Interactions with _______________________________________are potentially dangerous. Any plan of mixing medications must be checked first with the Pharmacist or Doctors

e. ___________________ may occur, and that there must be a support from the patient’s family, relatives, and friends

a = ?

Drug dependence

Medication Counseling for DDs

1. Inform the patient that

a. DDs are not intended for __________________ and that they are only part of the management plan

b. __________________ is likely to occur with improper use

c. ____________________ may appear, including impairment of performance of skilled tasks and driving – the patient must know the signs and symptoms of medication impairment before getting behind the wheel and should NOT drive if impaired

d. Interactions with _______________________________________are potentially dangerous. Any plan of mixing medications must be checked first with the Pharmacist or Doctors

e. _____________________ may occur, and that there must be a support from the patient’s family, relatives, and friends.

b = ?

Various adverse effects

Medication Counseling for DDs

1. Inform the patient that

a. DDs are not intended for __________________ and that they are only part of the management plan

b. __________________ is likely to occur with improper use

c. ____________________ may appear, including impairment of performance of skilled tasks and driving – the patient must know the signs and symptoms of medication impairment before getting behind the wheel and should NOT drive if impaired

d. Interactions with _______________________________________are potentially dangerous. Any plan of mixing medications must be checked first with the Pharmacist or Doctors

e. _____________________ may occur, and that there must be a support from the patient’s family, relatives, and friends.

c = ?

alcohol, other drugs, herbal products, and food

Medication Counseling for DDs

1. Inform the patient that

a. DDs are not intended for __________________ and that they are only part of the management plan

b. __________________ is likely to occur with improper use

c. ____________________ may appear, including impairment of performance of skilled tasks and driving – the patient must know the signs and symptoms of medication impairment before getting behind the wheel and should NOT drive if impaired

d. Interactions with _______________________________________are potentially dangerous. Any plan of mixing medications must be checked first with the Pharmacist or Doctors

e. _____________________ may occur, and that there must be a support from the patient’s family, relatives, and friends.

d = ?

Change of behavior

Medication Counseling for DDs

1. Inform the patient that

a. DDs are not intended for __________________ and that they are only part of the management plan

b. __________________ is likely to occur with improper use

c. ____________________ may appear, including impairment of performance of skilled tasks and driving – the patient must know the signs and symptoms of medication impairment before getting behind the wheel and should NOT drive if impaired

d. Interactions with _______________________________________are potentially dangerous. Any plan of mixing medications must be checked first with the Pharmacist or Doctors

e. _____________________ may occur, and that there must be a support from the patient’s family, relatives, and friends.

e = ?

life-threatening effects

Medication Counseling for DDS

2. Instruct the patient that occurrence of any _______________ during medications (allergic reaction, difficulty of breathing, and palpitations) must be reported to the physician immediately).

recommended dose

Medication Counseling for DDS

3. Stress to the patient never to take more than the _______________________.

children and drug users/abusers

Medication Counseling for DDS

4. Tell the patient to store the DD properly, especially away from ______________.

Document

Medication Counseling for DDS

5. ________________ the medication counseling session for future reference.

suspected irrational use

Monitoring DDs

a. The Pharmacist shall report any ________________________ of DDs.

b. The Pharmacist shall note any ________________________________. In the hospital setting, a good way to do this is to check floor stocks or e-cart.

c. In the hospital setting, the pharmacist shall monitor the use of DDs in _______ and by each doctor

d. DDs are strictly _____________ in the Philippines.

e. ________ shall see to it that all the provisions concerning DDs must be fully implemented.

a = ?

discrepancies in the inventory of DDs

Monitoring DDs

a. The Pharmacist shall report any ________________________ of DDs.

b. The Pharmacist shall note any ________________________________. In the hospital setting, a good way to do this is to check floor stocks or e-cart.

c. In the hospital setting, the pharmacist shall monitor the use of DDs in _______ and by each doctor

d. DDs are strictly _____________ in the Philippines.

e. ________ shall see to it that all the provisions concerning DDs must be fully implemented.

b = ?

each ward

Monitoring DDs

a. The Pharmacist shall report any ________________________ of DDs.

b. The Pharmacist shall note any ________________________________. In the hospital setting, a good way to do this is to check floor stocks or e-cart.

c. In the hospital setting, the pharmacist shall monitor the use of DDs in _______ and by each doctor

d. DDs are strictly _____________ in the Philippines.

e. ________ shall see to it that all the provisions concerning DDs must be fully implemented.

c = ?

regulated

Monitoring DDs

a. The Pharmacist shall report any ________________________ of DDs.

b. The Pharmacist shall note any ________________________________. In the hospital setting, a good way to do this is to check floor stocks or e-cart.

c. In the hospital setting, the pharmacist shall monitor the use of DDs in _______ and by each doctor

d. DDs are strictly _____________ in the Philippines.

e. ________ shall see to it that all the provisions concerning DDs must be fully implemented.

d = ?

PDEA

Monitoring DDs

a. The Pharmacist shall report any ________________________ of DDs.

b. The Pharmacist shall note any ________________________________. In the hospital setting, a good way to do this is to check floor stocks or e-cart.

c. In the hospital setting, the pharmacist shall monitor the use of DDs in _______ and by each doctor

d. DDs are strictly _____________ in the Philippines.

e. ________ shall see to it that all the provisions concerning DDs must be fully implemented.

e = ?