HANDLING OF PRESCRIPTION

1. Receiving the prescription

2. Reading and checking the prescription
3. compounding
4. Packaging and labeling the product
5. Dispensing
6. Recording
7. Refilling

1. Receiving
• The prescription should be received from the patient by the pharmacist himself.
• While receiving a prescription, a pharmacist should not change his facial expression
which gives an impression to the patient that he is surprised or confused after seeing the
prescription.
2. Reading and checking

• On receiving a prescription, always check it that it is written in proper format. i.e, doctor’s
pad or OPD slip of the hospital nursing home and signed by the prescriber.

• A prescription should always be screened behind the counter. In case of any doubt
regarding the prescription ingredients or directions, the pharmacist should consult the
other pharmacists or the prescriber.

• But under no circumstance patient should come to know about it. Pharmacist should
never guess about the meaning of any illegal or confused word. It may lead to serious
consequences.

• Sometimes prescription is received on telephone by senior pharmacist. In such case, after

taking down the prescription, it should be verified by repeating it on phone to the
prescriber. It is very important because nowadays, the number of drugs with almost the
same pronunciation and spelling are available in the market.
Example
 Acidin –Apidin
 Prednisone –Prednisolone
 Digoxin-Digitoxin
 Althrocin-Eltroxin
If there is any omission of any important particulars such as the dose, the prescriber should be
contacted.
3. Collecting and weighing the material
• Before compounding the prescription, all the materials required for it, should be
collected on the left hand side of the balance.
• After weighing the material, it should be shifted to right hand side of the balance.
• This gives a check of ingredients which have been weighed.
 • While compounding the label of every stock bottle should be read at least 3 times in
order avoid any error.
 When taken from the shelf or drawer.
 When the contents are removed for weighing and measuring.
 When the containers are returned back to its proper place.
4. Compounding, labeling and packaging:
• Compounding should be carried out in a neat place. All the equipment etc... required
should be thoroughly cleaned and dried.

• Only one prescription should be compounded at one time.

• All the ingredients should be compounded according to the directions of the prescriber or
according to the pharmaceutical art.

• The compounded medicament should be filled in suitable containers

depending on its quantity and use.

• The filled containers are suitably labelled.

• White plain paper of good quality should be used for labelling the container.
• The size of the label should be proportional to the size of the container which is written or
typed, giving all the desired information.

• The label should be fixed with a good quality of adhesive, almost in the centre leaving
equal space from bottom and top of the container.

• The container is polished so as to remove the finger prints.

• While delivering the prescription to the patient, the pharmacist should explain the mode of
administration, direction for use, and storage
5. Dispensing

 Preparation should be checked thoroughly before dispensing.

 Proper medicines should be dispensed to the patient in a polite manner.
 Patient should be directed about the dosage schedule, mode of use and storage of the
preparation.

6. Recording
 Pharmacist should record all the preparations compounded by him in a register. Such recording
should consist of the following details.
(i) Date of dispensing
(ii) Name and address of the prescriber
(iii) Name of the drugs and their quantities
(iv) Name of the patient
(v) Pharmacist’s signature
 In case of drugs supplied in their original containers, details should be entered in a cash or
credit memo book.

 In case of schedule C and Schedule H drugs, name of the manufacturer, batch number and date
 of expiry, if any should be noted.

7. Refilling

 Prescription refilling is the process of refilling an existing prescription either by going to the
pharmacy in person or by calling the pharmacy.
 Upon request from an individual for refilling a prescription, the pharmacist should collect the
following particulars from the patient.
(a) Name and phone number of the patient
(b) Serial number of the prescription
(c) Name and concentration of the drugs
(d) Name of the physician
 After obtaining the above details from the patient, pharmacist is required to submit a refill
request to the prescriber either by sending a duplicate copy of the prescription electronically or
by calling the prescriber’s office.
 Refilling of prescription for controlled substances should not be done for more than 5 times
and after 6 months from the date of their first issue.
 The prescription number is used to record the following details.
(i) Name and amount of the medication dispensed
(ii) Dosage form of the drug
(iii) Filled or refilled date of prescription
(iv) Initials of the pharmacist for each refill
(v) Total number of refills done for that prescription
 If the reverse side of the prescription has been signed and dated by a pharmacist, then it implies
that the entire prescription has been dispensed.
 Following conditions should be satisfied for oral authorization of additional refilling of
Schedule III or IV controlled substances once the refill period has expired or allowed limit of
refills has been reached.

(i) Pharmacist attending the oral authorization call should enter the date of such authorization,
quantity of refill and number of additional refills authorized along with his initials on the
reverse side of original prescription.

(ii) The amount of each additional refill should be equal to or less than the amount authorized
for the initial filling of the original prescription.

(iii) New and separate prescription should be issued by the prescriber.

 Refill information for prescriptions can also be obtained through an automated data processing
system.

Online retrieval of the following data for the prescriptions currently authorized for refilling
should be possible using these automated systems,
(i) Serial number and date of the original prescription
(ii) Name and address of the patient
(iii) Name, address and registration number of the medical practitioner
(iv) Name and dosage form of the prescribed drug
(v) Amount and strength of the prescribed drug
(vi) Total number of refills authorized by the prescriber.

• Online retrieval of the current refill history of prescriptions for Schedule III or IV controlled
 substances that has been authorized for refill during the last six months, should be possible
using these systems. Details of the current refill history include
(i) Name and amount of the drug dispensed

(ii) Date of refill

(iii) Name or identification code or initials of the dispensing pharmacist for each refill

(iv) Total number of refills done for that prescription till date.
 Entry of details in computer pertaining to prescription refilling must be verified by the
pharmacist(s) who has dispensed the refill. Printout of these details should be taken, verified,
dated and signed by the dispensing pharmacist(s). This ensures the correctness of the data
entered. Pharmacists can also maintain a separate log book in which they sign a statement of
verification and review of data entered in the computer. Printouts or log books should be
maintained in the pharmacy for a period of two years from the date of dispensing of refill.
 In order to fulfil the above provision, the system should be capable of producing printouts.
Details to be included in the printout are,

(i) Name of the prescriber

(ii) Name and address of the patient

(iii) Serial number of the original prescription

(iv) Amount dispensed and the date of dispensing of each refill

 Identification code or name of the dispensing pharmacist.

 There should be an alternate procedure for checking the authorization of refills and whether the
refill limit has exceeded in case of non-functioning of automated system. This alternate system
should also ensure retaining of data till its entry in the computer.

PRESCRIPTION ERRORS

Types of Prescription Errors

Errors in prescription cause inconvenience to both, the patient and the pharmacist. There are two
types of prescription errors.

1. Errors of Omission

These errors occur due to incomplete information in the prescription.

Examples

(a) Absence of dose or dosage form

(b) Absence of dosage regimen or strength of the drug

(c) Absence of quantity or treatment duration.

These errors can be overcome by the pharmacist by consulting the prescriber.

 2. Errors of Commission

These arise due to incorrect information given by the prescriber in the prescription. If the
pharmacist dispenses without checking the prescription, then it may prove to be troublesome to the
patient. These errors are less easy to identify than omission errors.

Examples

(a) Incorrect dose or dosage form

(b) Incorrect dosage regimen or strength of the drug

(c) Duplicate therapy

(d) Drug interactions

(e) Contraindicated therapy.