Dispensing Pharmacy By Ashish Jain & Dr S Nayak

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1 Dispensing Pharmacy Dr S. Nayak Ashish Jain Principal & Professor Assistant Professor BANSAL COLLEGE OF PHARMACY, BHOPAL principal.bcp@gmail.com www.bansalpharmacy.com

Dispensing:

2 Dispensing Dispensing is an important part of the practice of pharmacy, in which the pharmacist or the pharmacy technician (under the direct supervision of the pharmacist) interprets the physician's requirements on the prescription and accordingly supplies medicines for the treatment of his patient (s). This usually involves interpreting a written prescription but may, on occasions, also include taking instructions given by word of mouth or by telephone from the physician.

The various activities involved in Dispensing are: :

3 The various activities involved in Dispensing are:

Dispensing modules for good pharmacy practice:

4 Dispensing modules for good pharmacy practice 1. Dispensing environment 1.1 Prescription Counter 1.2 Waiting Area 1.3 Requirements of a good dispensing environment 1.4 Barriers, noise and distractions that can affect dispensing 2. Handling of Prescriptions 2.1 Receiving the prescription 2.2 Reading the prescription and checking for A. Legality B. Legibility C. Completeness and correctness 3. Processing a prescription 3.1 Filling a prescription Removal of medicines from shelves. Assembling of medicines. Billing. Packing. 3.2 Refilling a prescription 4. Other aspects of dispensing 4.1 Dispensing errors 4.2 Role of pharmacists in promoting correct dispensing 4.3 Refusal to dispense prescriptions 4.4 Alternatives to conventional prescriptions.

DISPENSING ENVIRONMENT :

5 DISPENSING ENVIRONMENT 1.1 Prescription counter

1.2 Waiting Area :

6 1.2 Waiting Area

1.3 Requirements of a Good Dispensing Environment :

7 1.3 Requirements of a Good Dispensing Environment 1 Be clean: To give a professional impression and outlook to the pharmacy. 2 Be organized: To provide for a safe and efficient working area. (Such that things are found in the right place at the right times and there are minimum obstructions and hurdles). 3 Have sufficient space For easy movement of personnel in the pharmacy, and to prevent congestion and physical contact among staff while working. 4 Temperature and humidity controlled As appropriate temperature and humidity are necessary for stability of medicines till the expiry date. 5 No loud music playing, gossiping, talking, or television (e.g. a cricket match or a movie) :To avoid distractions during dispensing. 6 Have medicines stored in an organized way on shelves in alphabetical order or using the method normally employed in that particular pharmacy: To ensure quick, but safe selection of the correct medicines from the shelves to minimize dispensing errors. BE CLEAN, GET ORGANISED!! GIVE THE PHARMACY A PROFESSIONAL LOOK

Maintaining a clean environment requires :

8 Maintaining a clean environment requires A regular routine of cleaning shelves, medicines/products, and a daily cleaning of floors. A regular schedule for checking, cleaning and defrosting the refrigerator. Immediate wiping of accidental spills due to breakage, etc, during dispensing.

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10 Working in a clean and an organized environment in a pharmacy, aids in accuracy while dispensing, and also gives a professional look to the pharmacy. Presence of a separate prescription counter and waiting area can further Highlight professionalism and competence of the pharmacist. Pharmacists handle medicines, and a slight dispensing error could result in serious consequences i.e. health -wise for the patient, and for the pharmacy – a loss of reputation. Thus a good dispensing environment is recomm ended for every pharmacy.

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(2) HANDLING PRESCRIPTIONS :

12 (2) HANDLING PRESCRIPTIONS 2.1 Receiving the Prescription As clients come into the pharmacy, they must be made to feel attended to and comfortable by : Friendly gestures. A smile. Eye-to-eye contact. A friendly welcome. A cozy ambience. Courtesy. Feeling of caring . Communication should be initiated in such a manner that it encourages the client to convey his/her needs by producing a prescription or by asking for other products or advice .

Upon receiving the prescription, the pharmacist should confirm::

13 Upon receiving the prescription, the pharmacist should confirm: : ( i) Whether the client is the patient himself or has come on the patient's behalf. (ii) The relation of the client with the patient. The client may politely be requested to wait, while the pharmacist reviews the prescription for: 1. Legality and completeness of prescription. 2. Therapeutic aspects 3. Appropriateness for the individual .

2.2 Reading the Prescription and Checking for Completeness and Correctness: :

14 2.2 Reading the Prescription and Checking for Completeness and Correctness: While reading and checking the prescription, the pharmacist Should · Be alert, and concentrate on the prescription. . Not be distracted. . Not engage in talking or chatting. . Engage/ use his professional/ experience in assessing the prescription.

After receiving the prescription, it is important for the pharmacist to read the prescription to verify whether :

15 After receiving the prescription, it is important for the pharmacist to read the prescription to verify whether 1 . It is legal and complete with respect to the various parts of the prescription, and therefore 2. It can be dispensed as such, or not. Legality A prescription is legal when : 1. It is written (can also be typed) by a R.M.P. 2. Signed by the R.M.P. 3. Has all the information required to be contained with respect to parts of prescription.

PARTS OF THE PRESCRIPTION: :

16 PARTS OF THE PRESCRIPTION :

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18 Superscription : The 'Rx' symbol is called the superscription. It is used as an abbreviation of the Latin word recipe, which means, “Take thou” or “you take”, the imperative form of the Latin word recipio, i.e, “I take”. Inscription: Inscription is the part of the prescription that comprises of a list of medicines and their strengths. E.g. Daonil 5 mg, Novamox 250 mg. Subscription : This part of the prescription consists of directions given to the pharmacist with respect to the dosage form and the number of dosage units/quantity to be supplied. E.g. Tab. Calcium ---- (50) [Means dispense 50 tablets of calcium] E.g. Liq Digene--------1 bottle

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19 Signatura : Signatura refers to the directions given by the doctor to the patient. In this portion, the physician indicates to the patient, how he/she should take the prescribed medicine/s. The directions are usually written using abbreviated forms of English and Latin. E.g., 1 tds means take one tablet thrice a day. Signature of the doctor : The signature of the doctor in his own handwriting is essential to mark the legality of the prescription. Refill information: In certain cases, a single course of therapy may not be sufficient for effective treatment of the patient. Under such circumstances, the physician may decide to repeat the course of therapy, and indicate the same on the prescription. This information is called refill information.

Legibility:

20 Legibility a) Handwritten names of patients and medicines are often difficult to read. In case of illegibility of name, age, etc, ask the patient for the correct spelling tactfully. For example the pharmacist may ask…

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21 Legibility is a problem requiring alertness and critical judgment on the part of the pharmacist. Careless handwriting and similarity in spelling of names of different drugs add to the difficulty. Example of a Reading error : Arlidin and Artidin - Due to illegible handwriting of doctors, Artidin could be read as Arlidin. Artidin is a brand containing Diclofenac whereas Arlidin contains Nylidrin two different drugs used for two different conditions. When handwriting is illegible, the best thing to do is to contact the physician over the phone and confirm. Remember, you are dealing with medicines and thus, the lives of patients so be sure of what you are dispensing. Imagine the disastrous consequences of dispensing the wrong medicine ‘NEVER DISPENSE GUESS WORK’ .

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22 b) The dosage form, the dosage and the quantity to be dispensed have to be legible so that dispensing becomes easier for the pharmacist. The instructions written for administration should state clearly what the physician expects from the patient so that the pharmacist can counsel the patients efficiently. All terminology, including units of measures (metric, apothecary or English) and Latin abbreviations should be properly interpreted.

C. Completeness and correctness :

23 C. Completeness and correctness The prescription serves as a vehicle for communication from the licensed practitioner to the pharmacist about the pharmaceutical care of the patient. Details to be checked for i) Physician's details. ii) Patient's details. iii) Check the product details Checking the product details will include checking : Ø Name of the product. Ø Dosage form. Ø Strength/ potency of the medicine. Ø Total amount to be dispensed and its availability. Ø Dosage and directions for use. Ø Frequency of administration.

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24 Thank you Dr S. Nayak Ashish Jain Principal & Professor Assistant professor BANSAL COLLEGE OF PHARMACY, BHOPAL Principal.bcp@gmail.com www.bansalpharmacy.com

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