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.