Notes on Pharmacy Services on

NC 2
 Definition of Terms
• Dispensing – preparation and distribution of medicines
• Dispensary – a place in a hospital; a pharmacist’s shop
• Dispensing Area – place where a pharmacist’s shop is located
• Housekeeping – routine maintenance of the pharmacist’s
shop
• Stock – goods stored in a pharmacist’s shop
• Dose Administration Containers – receptacles of medicines
for administration
• Drug – any chemical compound or biological substance, other
than food, intended for use in the treatment, prevention or
diagnosis of disease in a man or animals
• Label - a slip of paper, cloth, metal attached to anything to
provide information about its nature, contents, ownership
• Medication – a drug or other substance that is used as a medicine
• Orders – arrangements, method, a request to supply something
• Pack or Pre-pack Products – a load or bundle; put together in a
bundle
• Pharmaceutical Products –medicines or drugs
• Pharmacy – is the professional practice of discovering, preparing,
dispensing, monitoring, and educating about drugs.
• Pharmacist – means any person who is registered and entitled
under the laws of Philippines to practice the profession of
pharmacy.
• Prescription – is the written order and instruction of a validly-
registered physician, dentist or veterinarian for the use of a specific
drug product for a specific patient or, the doctor’s order on the
patient’s chart for the use of specific drug(s)
• Stock – goods on hand
• Stock Control– checking / regulation of goods on hand
• Waste Disposal – disposing of rubbish, trash, junks
Practice Good Housekeeping
• For Shelves:
1. Clean the sides of the shelf in outward
direction
2. Clean the top Portion (outward direction
3. Clean the bottom part of the shelf (outward
direction)
2

1 1
3
• For Refrigerator
1. Prepare the ICE BUCKET to maintain the cold
chain when transferring the medicines
2. Do not unplug the refrigerator. Wait until all
the medicines are transferred.
3. Maintain the temperature all the time
» 2-8 °C (Cold temp)
Expirations
• Suspension (Refrigerated): 14 days/ 2 weeks
• Suspension (Not Refrigerated): 7 days/ 1 week
• Loose Tablets: 6 months expiry
– Write the exact date (not the month of expiry only)
– If the expiry of the loose bottle come first, choose it than the 6
months period of expiry

• Creams/ Ointments: 3 months expiry after opening

• Sterile Eye, Ear, Nose Drops: 28 days expiry after
opening
-- Sensitive to pH
 DRUGS
• Articles intended for use in the diagnosis,
cure, mitigation, treatment or prevention of
disease

• Articles intended to affect the structure or any

function of the body of man or other animals
 Cure vs. Treat
• Cure: there is certainty that a medical
condition will not be present after a medical
intervention
• Treat: undergoes a process to manage the
disease or disorder and improve outcomes

Cure or Treat?
1.Asthma- _______
2.Diabetes- ______
3.Cough- _______
CLASSIFICATION OF DRUGS
 Synthetic vs. Natural
 Synthetic Drugs- are Natural Drugs-
created using man- extracted from plant or
made chemicals rather animal resources
than natural ingredients
 Generic vs. Innovator
 Generic Drugs  Innovator/ Comparator
- Drugs that have the same Drug
active pharmaceutical - drugs with an active
ingredient as the innovator pharmaceutical ingredient or
drugs and are not covered by molecule that was first or
patent protection. originally marketed anywhere in
the world
- International non-proprietary
or generic name

- With or without
brand name (Branded Generic)
 Unibranded Generic Drugs
• Generic medicines sold with a single corporate
brand to assure the public of their safety,
quality and efficacy
 FDA Centers
1. Center for Drugs
- Prescription Drugs
- OTC Medicines
- Home Remedy
2. Center for Devices
- Medical Devices
3. Center for Cosmetics
- Cosmetics
4. Center for Food
- Food supplies
 Over- the- Counter Drugs
• Do not require a prescription or the approval
of medical, pharmacy or veterinary
professional.
• Safe and effective when the directions on the
label are followed or as directed by a health
care professional
• For symptomatic relief of minor illness
 Prescription Drugs/ Ethical Drugs
• Legally requires a Physician’s/ Veterinarian’s or
a Dentist’s to be presented to the pharmacy
prior to dispensing

- This is because it may cause one or more of the

following:
- Adverse reaction w/o the physician’s diagnosis and advice
- May cause undesirable and dangerous after effects
- Therapeutic failure when used at the wrong dose
- Addiction to the drug due to psychoactive properties
Food Supplements
CRITERIA Food Supplements

Clinical Therapeutic Indication Dietary Supplement

or claims made for the
preparation
Strength/ Concentration/ <105% of Recommended
Dosage form
Form Pharmaceutical dosage forms
except parenteral or non-
pharmaceutical form
Purity Natural Product or purified

Additional Pharmacologically Absent

Active Ingredients
 DOSE vs. DOSAGE
DOSE DOSAGE
- Refers to the specified - Refers to administering
amount of medication a specific amount,
taken at one time number, and
frequency of doses
over a specified period
of time; duration;
dosage regimen

Example:
Biogesic- Adult and Pedia > 12yrs old: 1
tab every 4-6 hours as needed
 DOSAGE FORM
• Refers to the pharmaceutical form of the
preparation based on official pharmacopoeia

 The proper design and formulation of a

dosage form requires consideration of the
physical , chemical and biologic characteristic
of all the drug substances and excipients
 Classification of Dosage Forms
• Solid Dosage Forms:
Powders and Granules

Capsules
-Hard Gelatin

- Soft Gelatin
 Classification of Dosage Forms
• Solid Dosage Forms:
Tablets

Solid Oral Modified-Release Drug forms

Others: Lozenge Pills

 Classification of Dosage Forms
• Semi-Solid Dosage Forms:
Ointments: Medicated or non-medicated, semi-
solid preparations intended for external
application to the skin and mucous membranes
- For DRY WOUNDS
 Classification of Dosage Forms
• Semi-Solid Dosage Forms:
Gels: consists of dispersions of small or large
molecules in an aqueous liquid vehicle rendered
jelly-like by the addition of a gelling agent
 Classification of Dosage Forms
• Semi-Solid Dosage Forms:
Creams: contain one or more medicinal agents
dissolved in either—
Water in oil Emulsion
Oil in Water Emulsion
- Or in another type
 Classification of Dosage Forms
• Liquid Dosage Forms:
Syrup: sugar + water
Elixirs: Sugar + alcohol
Tincture: Water + Alcohol
Liniments: Oil based
 Classification of Dosage Forms
• Dispersed Systems:
Suspension: Solid in Liquid
Emulsion: Liquid in Liquid (oil and water)
Aerosol: Solid or Liquid in Gas
 Drug Product Stability
• The extent to which a product retains within
specified limits and throughout its period of
storage and use, the same properties and
characteristics that it possessed at the time of
its manufacture

• This is critical to product quality, safety and

effectiveness
 Types of Product Stability
• Physical Stability: appearance, color, odor, taste or texture
• Chemical Stability
• Microbiologic Stability
• Therapeutic Stability
• Toxicologic Stability
 SIGNS OF DEGRADATION OF SPECIFIC
DOSAGE FORMS
• TABLETS: • CAPSULES: • Oral Powders:
– Cracking – Shape – Appearance
– Chipping – Moisture – Color
– Mottling – Tackiness – Odor
– Clumping – Brittleness – Moisture

• Oral Solutions and Suspensions:

– Precipitation
– Odor
– pH
– Clarity
– Redispersibility
 SIGNS OF DEGRADATION OF SPECIFIC
DOSAGE FORMS
• SUPPOSITORIES: • Creams, Ointments,
– Softening Range Lotions, Gels:
– Appearance – Appearance
– Melting – Color
– Homogeneity
– Odor
– pH
– Consistency
– Resuspendability
 SIGNS OF DEGRADATION OF SPECIFIC
DOSAGE FORMS
• EMULSIONS: • Controlled-release
– Phase Separations membrane Drug Delivery
– Color
System:
– Odor
– pH – Seal
– Viscosity – Strength
– Membrane Integrity
– Drug release rate
 ROUTES OF ADMINISTRATION

Oral Mouth

Sublingual Mouth (under the tongue)

Parenteral Intravenous (IV), Intramuscular (IM)

Transdermal/ Topical Skin / Under the skin

Intraocular Eyes

Intranasal Nose

Aural Ears

Rectal Anus

Vaginal Vagina
 Drug Packaging
• Packaging Material
– Any material, including printed material,
employed in the packaging of a pharmaceutical
product, excluding any outer packaging used for
transportation or shipment

Monitoring Quality in Packaging:

-Check if broken or ripped
 Packaging Material
1. Primary Packaging
-the material that has immediate and
direct contact with the product
2. Secondary Packaging
- not in direct contact with the product;
Holds the product in its primary container for
additional protection, identification or
marketing purposes
 Parts of the Drug Label
• Product Name
• Dosage Form and Strength
• Pharmaceutical Category
• Indication
• Contraindication, Precaution, Warning
• Interaction
• Undesirable effects
• Overdose and Treatment
• Storage Condition
• Net Content
 Parts of the Drug Label
• Name and Address of Marketing Authorization
Holder and Manufacturer
• Rx Symbol (if product is a prescription drug)
• Adverse Drug Reaction Reporting Number
• Batch Number and Lot Number
• Expiration Date
 Product Name
• Product name shall indicate the brand name
and generic name
• Generic name shall be based on the
International Non-proprietary Name.
• Generic name shall appear prominent with an
outline box
 Contraindication
• Refers to the statement regarding the
conditions where in the use of the product
may cause harm to the patient

Precaution
• Refers to the instruction and special care
required in the use of the product to avoid
undesired effects and to ensure the safe and
effective use of the drug
 Warning
• Refers to the statement regarding the
occurrence of potential hazards and side
effects associated with the use of the product
and the limitation of its use

Interactions
• Drug-drug, Drug-food, drug-laboratory testing
interactions as well as other relevant
interactions if applicable
 Undesirable Effects
• The label shall include detailed information on
adverse event for a drug product

Overdose & Treatment

• Label shall include signs and symptoms of
overdose, as well as proper treatment
 Storing
• The storing of Pharmaceutical products and
materials up to their point of use.
– Security
– Sufficient space and capacity
– Good storage conditions
– Clean and free from accumulated wastes and
pests
– Organized and clearly marked
• Normal Storage Conditions
– Store in dry, well-ventilated premises at
temperatures of 15- 25°C
– Extraneous odors and other indications of
contamination and intense light must be excluded
 Receiving medicines for Storage
• Ensure there is sufficient storage space
• Prepare and Clean the area
• Inspect Packages
 Storage Temperature
• Excessive heat- Above 40°C
• Room Temperature- 20°C to 25°C
• Warm- 30°C to 40°C
• Cold – 2°C to 8°C
• Cool- 8°C to 15°C
• Freezing- -25°C and -10°C
• PROTECT LIGHT SENSITIVE PRODUCTS FROM
EXPOSURE TO SUNLIGHT
– Example: Multiple Vitamins, Furosemide,
Chlorphenamine maleate, Hydrocortisone, Latex
products such as condoms, surgical gloves, etc.

• Inside the Storage room:

– Use of pallets
– Not more than its capacity
– Follow the manufacturer or shipper’s direction when stacking
Orderly Arrangement of Drug Products
• Alphabetical order by generic name
• Therapeutic or Pharmacologic Category
• Dosage form
• Frequency of use
• Legal Classification according to FDA
• Expiration date (FEFO)
• Take note of Sound Alike- Look Alike Drugs
 Monitoring Supply / Inventory of
Pharmaceutical Products
• Unit covers on skills and knowledge on key
areas of distribution and retail specifically—
selection, procurement, and receiving and
delivery of stocks.
 Daily/ Weekly Tasks
• Monitor Storage conditions
• Clean receiving, storage, packaging and
shipping areas
• Sweep or Scrub the floors
• Remove Garbage
• Clean bins, shelves, and cupboard if needed
• Ensure that aisles are clean
• Ensure adequate ventilation and cooling
 Monthly/ Quarterly Tasks
• Conduct physical inventory or cycle count and
update stock-keeping records
• Use established procedures to dispose of
damaged or expired products
• If products are DAMAGED or EXPIRED:
1. Separate the damaged or expired stock from
the usable
2. If damage or expiry is discovered while the
delivery truck is still at your site, refuse to
accept the products and note the problem on
the delivery note
3. If damage or expiry is discovered after the
delivery truck has departed, follow SOP
• If products are NOT DAMAGE nor EXPIRED
1. Count the number of units for each product
received and compare to issued voucher.
2. Record the date and quantity received on
stock card and bin card
3. Ensure expiry date
• If using pallets or Stacking Cartons:
– At least 10cm (4 inches) off the floor
– At least 30cm (1 foot) away from the walls and
other stacks
– No more than 8 feet high
– Follow the manufacturer’s or shipper’s directions
when stacking
– Follow labels for storage conditions
– Place liquid products on lower positions
 Pharmaceutical Techniques,
Terminologies, and Calculations for
Pharmacy Assistants
• Correctly interpret and use Pharmacy
concepts and terminologies
• Apply understanding of pharmacy techniques,
terminologies and calculations in practical
scenarios in the pharmacy
• Patient Counselling
• Analyze the problem
• Do not overthink

• Pharmaceutical Care
• Right Patient
• Right Route
• Right Drug
• Right Time
• Right Dose
 High Alert Medicines (HAMS)
• Medicines that bear heightened risk of
causing significant patient harm when these
medications are used improperly
– RECOMMENDATIONS:
• Use sticker that indicates HAMS
• Inform about HAMS
• HAMS are dispensed by Pharmacists only
1.Duties of Pharmacy Aide
May include but are not limited to:
1. Perform routine procedures on computers
2. Perform clerical functions associated with prescription dispensing
3. Order, receive, unpack, check and put away dispensing stock
4. Check expiry dates and rotate stock
5. Prepare Health Care Benefits Scheme claims
6. Pack stock from large containers into smaller containers
7. Select pre-packed stock from shelves under direction of pharmacist
8. Stamp and collate prescription forms
9. Prepare and attach dispensing labels to containers
10.Organize all documentation and medicines for checking by pharmacist
11.Prepare medication into dose administration containers, provided it is
checked by a pharmacist.
2.Limitations to the role of the pharmacy aide/pharmacy assistant
May include but are not limited to:
1. Receive prescriptions over the telephone
2. Interpret prescriptions and dispense prescriptions
3. Discuss or counsel a client/patient concerning any aspect of the
content of a prescription
4. Prepare any medicine prescribed for a client/patient requiring
extemporaneous production, including the reconstitution of mixtures,
eye drops
5. Enter prescription records into a prescription recording system until a
pharmacist personally checks each client’s/patient’s medication
history before the dispensed medicine is supplied
6. Decide the brand to be used in dispensing generic prescriptions
7. Select or alter the storage conditions of medicines