Pharmacy Practices and Regulations

Community Pharmacy

  • Products Offered:

    • Prescription drugs
    • Over-the-counter (OTC) medications
    • Health and beauty products

  • Increasing Role of Pharmacists:

    • Community pharmacists are increasingly involved in counseling and educating patients.

  • Customer Service in Pharmacy:

    • Pharmacy technicians must respond positively and courteously to customers.

  • Regulatory Knowledge:

    • Both pharmacists and pharmacy technicians need to understand federal and state regulations affecting pharmacy practices.

  • Pharmacy Organization Requirements:

    • Basic equipment includes:
    • Prescription counter
    • Proper drug storage areas
    • Designated refrigerators
    • Compounding equipment
    • Sink
    • Computer system
    • Dispensing areas

  • Prescription Processing:

    • New prescriptions require:
    • Patient information
    • Drug information
    • Billing information
    • Early refills for controlled substances necessitate pharmacist involvement.

  • Prescription Preparation:

    • Drug interaction alerts flagging must be reviewed by a pharmacist.
    • Each drug product has a unique 11-digit National Drug Code (NDC).
    • Safety caps are mandatory unless a patient requests otherwise.
    • Auxiliary labels offer critical usage information, including:
    • Administration guidance
    • Storage instructions
    • Side effects
    • Food-drug interactions
    • Final checks involve organizing documentation for pharmacist verification.
Customer Pick Up Procedures
  • Signature Requirements:
    • Customer signatures are required for:
    • Medicaid and many third-party prescriptions
    • Schedule V controlled substances
Additional Duties of Pharmacy Technicians

  • Stock Management:

    • Ordering stock and maintaining cleanliness of the pharmacy.

  • Over-the-Counter Products:

    • OTC items can be purchased freely but involve risks.
    • Technicians may guide customers but should involve pharmacists for recommendations.

  • Calculations for Pharmacy Business:

    • Selling price calculation uses formulas based on acquisition cost and professional fees.
    • Gross and net profits are crucial for understanding pharmacy financials.
Hospital Pharmacy

  • Patient Care Structure:

    • Patient rooms grouped into care units for similar medical issues.

  • Roles of Hospital Pharmacy Technicians:

    • Cross-trained to perform various tasks within the pharmacy.

  • Inpatient Pharmacy Functionality:

    • Responsible for medication preparation and distribution.

  • Hospital Formulary:

    • List of available medications for ordering.

  • Communication Systems:

    • Utilizes telephones, pneumatic tubes, emails, and personal communication.

  • Medical Records Management:

    • Maintain detailed patient history in paper or electronic format.

  • Medication Order Protocols:

    • Orders entered electronically via Computerized Physician Order Entry (CPOE) or on order forms.

  • Order Processing Essentials:

    • Pay attention to:
    • Drug name
    • Dosage form
    • Strength
    • Quantity
    • Special considerations for IV solutions and volumes.

  • Inventory Control Responsibilities:

    • Notify pharmacists during drug shortages and assist with alternatives.

  • Organization of Medications:

    • Medications organized alphabetically by generic names.

  • Unit Dose Systems:

    • Medications packed in individual doses for administration.

  • Sterile Product Preparation:

    • Technicians may prepare parenteral nutrition and chemotherapy preparations.

  • Infection Control Requirements:

    • Hand hygiene is vital to prevent infections.

  • Medication Safety Practices:

    • Extra caution required for high-alert medications and Look-Alike/Sound-Alike drugs.

  • Hospital Safety Guidelines:

    • Proper disposal of hazardous waste in designated containers is essential.

  • Hospital Emergency Protocols:

    • Disaster plans outline roles during bioterrorism or exposure hazards.

  • Pharmacy Calculations in Hospitals:

    • Routine calculations, including flow rates and dilutions, are critical for patient safety.
Other Pharmacy Environments

  • Mail Order Pharmacy:

    • Used for chronic conditions requiring maintenance therapy.
    • Complies with federal and state regulations but not always licensed in all states.
    • Highly automated and large scale operations.

  • Long-Term Care Facilities:

    • Typically contract out pharmacy services due to resource limitations.

  • Home Health Care Settings:

    • Supervised by registered nurses with multidisciplinary teams.
    • Home infusion becoming increasingly important, involving patient education on self-administration.

  • Nuclear Pharmacy Roles:

    • Prepares radiopharmaceuticals under federal regulation.

  • Compounding Pharmacies:

    • Approximately 7,500 specialized pharmacies in the U.S., regulated by multiple agencies.