The dispensing of medicine involves interpretation of the prescription instruction, technical knowledge required to carry out the instructions and delivers with accuracy and safety to the patient by an authorized and qualified pharmacy professional.
There are a considerable variety of factors that require close attention in dispensing, and proficiency requires the establishment of a routine system which can be followed safely even under stress. In fact, for OTCs, dispensers may be involved in selection of medicines for their users.
Step 1. Receive and validate prescription or verbal request
Upon receiving a prescription, the dispenser should confirm the name of the patient by asking the patient to give his/her name and check the name with that on the prescription. If in doubt ask for identification card.
Step 2: Evaluation and interpretation of a prescription To make sure that all important parts of the prescription are correct and complete. Arrange prescriptions in order so as to prevent possibility of confusion
Step 3: Selection and manipulation of the medicine Select stock container of pre-pack reading the label and cross matching the medicine name and strength against the prescription. Read the container label at least twice during the dispensing process. Do not select the prescribed medicine according to the color or location of container, without consciously reading the label. Do not open many stock containers at the same time. This trend will lead to errors and/or expose the medicines to air and eventually leads to deterioration in quality. Open and close containers once at a time.
Step 4: Labeling and packaging of the medicine in an appropriate container The containers used for dispensing must be appropriate for the product dispensed. All containers intended for medicinal products must be protected and kept free from contamination. Medicines must be suitably contained, protected and labeled from the time of manufacture until they are used by the patient.
The container must maintain the quality, safety and stability of the medicine throughout this period. Labeling of dispensed medicines should be clear and legible, and a familiar language should be used. Use separate plastic boxes for different patient’s requirements of medicines.
Step 5: The provision of information and instruction to client
All medicines should be dispensed with adequate and appropriate information and counseling. Information must be structured to meet the needs of individual patients and questions and answers should be used to check the patient understands.
Written information should be provided to supplement verbal communication as appropriate. Counseling should ensure that the patient has an unequivocal understanding of the instructions for use, and any distinct characteristics or requirements of the medicine.
Step 6: Recording the transaction Prescriptions should be recorded and documented as proof of transaction between the patient and the dispenser. Prescriptions can therefore be traced back if any need arises. All dispensing units should have a standardized Prescription Registration Book (PRB) for recording every pharmaceutical issued to a patient.
A computerized dispensing and registration system may also be used, but should always be supported by paper back up. The registration book should be completed at the time of dispensing or at the close of the working day. The prescription registration book should be used both when prescriptions are retained in the pharmacy and when they are returned to the patient.
For a prescription which is returned to a patient because all the items in the original prescription could not be filled, the medicines that have been dispensed from the pharmacy should be copied on a blank prescription and the prescription should be filed appropriately. On the original prescription, which is retained by the patient, the word “dispensed” should be stamped adjacent to those items which have been dispensed.
For prescriptions which are to be refilled on a later date, the dispensing information should be entered into the registration book before returning the prescription to the patient. The official seal of the pharmacy/Health institution, name and signature of the dispenser, the date of dispensing and the next refill date should be written on the back of the prescription.
Medicine is any substance or mixture of substances used in the diagnosis, treatment, mitigation or prevention of a disease in human and includes narcotic drugs, psychotropic substances and precursor chemicals, traditional medicines, complementary or alternative medicine; poisons, blood and blood products, vaccine, radioactive pharmaceuticals, cosmetics and sanitary items and medical instruments.
Medical Prescription: Any order for medicine written and signed by a duly licensed or authorized practitioner issued to a patient in order to collect medicine from dispensing outlet
Medicines Good Dispensing Practice
Dispensing refers to the act of preparing medicines and/or medical supplies and distributing to users with adequate information, counseling and appropriate follow up. Any person who is licensed or authorized by the appropriate body to dispense medicines and/or medical supplies is called a medical dispenser
Refers to the delivery of the correct medicine to the right patient, in the required dosage and quantities, in the package that maintains acceptable potency and quality for the specified period, clear medicine information counseling and appropriate follow up
• Good dispensing practice ensures that the correct medicine is delivered to the right patient, in the required dosage and quantities, with clear instructions, and in package that maintains an acceptable potency and quality of the medicine.
• Dispensing includes all the activities that occur between the time the prescription or oral request of the patient or care provider is presented and the medicine or other items are issued to them. This process may take place in health institutions and community medicines retail outlets. It is often carried out by pharmacy professionals
• No matter where dispensing takes place or who does it, any error or failure in the dispensing process can seriously affect the care of the patient mainly with medical and economic consequences. Therefore, the dispenser plays a crucial role in the therapeutic process. The quality of dispensing may be determined by the training and supervision the dispenser has received and the medicine information available to the dispenser.
• A shortage of dispensing materials and insufficient dispensing time due to heavy patients load may also have adverse impacts on dispensing. One good way to reduce the dispensing time and potential errors is to prepack and label commonly used medicines. Another way to prevent staff from making errors when working under pressure is to organize the work so that more than one individual is involved in the dispensing process for each prescription.
• Pharmacy professionals involved in dispensing of medicines have the need for medicines information in order to keep themselves up to date with developments related to medicines and to provide such information to patients, other health professionals and to the general public.
• Because of an increasing number and complexity of medicines, the need for up-to-date information is greater than ever. The provision of medicines information to prescribers and other professionals is mainly directed at improving prescribing and medicines administration
• On the other hand, because counseling of patients on medications is an integral part of the medicines dispensing process, medicine dispensers should be adequately equipped with up-to-date medicine information. Lack of knowledge and information by patients about the medicines they take leads to incorrect use which in turn results in loss of efficacy or occurrence of adverse effects.
• Communication skills are very important for dispensers dealing with patients or health care professionals to convey relevant medicine information effectively and clearly, which can be done verbally and/or in written form. Medicine dispensers must have the ability to explain information clearly by the language the patient or care provider can understand and check whether the information is being understood
Dispensing: The act of preparing medicines and medical supplies and distribute to the users with clear information, counselling and adequate follow up
Dispenser: Any person who is authorized by the appropriate body to dispense medicine and/ or medical supplies.
Label: Any material which is printed to provide the necessary information about the medicine and includes an insert.
Medical instrument: Any instrument or supply that maybe used on the inner or outer part of the body for diagnosis or treatment of a disease in human or animals, it includes surgical instruments, dental instruments, laboratory instruments and various diagnostic instruments.
Medicine: Any substance or mixture of substances used in diagnosis, treatment, mitigation or prevention of disease in human and include narcotic drugs, psychotropic substances and precursor chemicals.
Over the counter medicines: Medicines that can be dispensed without prescription
Repacking: Packing of any processed or semi processed medicine by a different manufacturing company in any other way
Shelf life: The length of time a medicine product may remain on the shelf in the original package and under usual environmental conditions and retain an acceptable level of its original potency and overall quality.
Stock: The amount of medicine available in legal medicine retail outlet
Stock solution: A solution of high strength medicine that requires dilution before use.
Packaging: Material or any article that maybe used for wrapping or packing medicines and includes immediate containers
Adverse drug reaction: A noxious and unintended effect of medicine that occurs in doses normally used in human or animal
Patient /client: Any person presenting to an authorized health care provider to promote health, prevent or treat disease
Pre-packing: Repacking of medicines into usable quantities before they are requested by the patient
Prescriber: Any medical practitioner who is authorized by the appropriate body to write a prescription.
Prescription medicines: Medicines dispensed only with prescription
Medical prescription: Any order for medicine written and signed by a dully licensed medical practitioner issued to the patient in order to collect medicines from dispensing outlet.