DISPENSING

PROCESS

PREPARED BY:

CUARTEROS
FORDAN
ELEVADO
CONSTANTINO
DEL ROSARIO
CAMBRONERO
 CONTENTS
 Introduction
 The Dispenser
 Qualities of good drug dispenser
 Dispensing environment
 Dispensing process
 Dispensing errors
 Strategies to minimize dispensing errors
 Investigating drug dispensing process
 Conclusion
 INTRODUCTION
 Dispensing refers to

“process of preparing medicines and distributing

them to users with provision of an appropriate
information, counselling and follow-up”
 All the resources involved in patient care prior to
dispensing may be wasted if dispensing does not
result in the delivery of medicines in an effective
form.

 Dispensing is one of the vital elements of the

rational use of medicines.
 Good dispensing practice ensures that the right
medicines at desired quantity are delivered to the
right patient with the right dose, strength, frequency,
dosage form together with clear instructions with
appropriate packaging and counselling.

 Staff dispensing medicines should be trained and

equipped with the technical knowledge and skills
necessary to dispense medicines and communicate
patient effectively.
 THE DISPENSER
 Dispenser is any person who is licensed or
authorized by the professional body to dispense
medicines or medical supplies.
 Since the dispenser is often the last person to see
the patient before the medicine is used, it is
important that the dispensing process be efficient,
as it affects medicine use.
 In India, pharmacy should be managed under the
overall supervision of pharmacist

Pharmacist working in the pharmacy should:

1. Hold at least Diploma in pharmacy and preferably

a degree in pharmacy.
2. Be registered as a pharmacist with the pharmacy
council of state in which he is practicing.
3. Have undergone adequate practical training in a
community pharmacy.
4. Undergone in house training as per the
organization’s staff training policy.

5. Have a communication skills and capabilities to

give adequate and proper advise to the patients
on appropriate use of medicines, illness etc. to
achieve optimal patient compliance
QUALITIES OF GOOD DRUG DISPENSER

 Good knowledge about medicines.

 Good calculation and arithmetic skills
 Skills in assessing the quality of prescriptions
 Attitudes and skills required to communicate
effectively with patients
 Knowledge about relation with other health
care professionals
 Respect to pharmacy law and professions
code of ethics
 Good knowledge on medicine supply
management
 Knowledge on quality assurance of services
 Good clinical knowledge
DISPENSING ENVIRONMENT
Good dispensing environment includes following:

 Staff
 Physical surrounding
 Equipments and other facilities
 Staff:

Staff members involved in dispensing must

maintain good personal hygiene. and should wear
a neat apron. All pharmacists should wear a
badge displaying their name and the word
“pharmacist”.
 Physical surrounding:

The physical surrounding must be kept clean

and dust free. Dispensary should be designed so
that access to dispensary area should restricted to
only authorized persons
 Equipments and materials:

Pharmacy should have all the equipments required to

perform dispensing process. All the equipments should
be kept clean and should check for cleanliness prior to
each use.
Pharmacy should have:
 A dispensing bench or dispensing counter
 Tablets or capsule counter
 A refrigerator equipped with a maximum/minimum
thermometer
 Range of dispensing container for pharmaceutical
products
 Adequate shelves or lockable cabinets
 Reference material
 Patient information leaflets
 Some basic instruments like sphygmomanometer,
glucometer, stethoscope, weight and height scale
DRUG DISPENSING PROCESS
RECEIVE AND VALIDATE THE PRESCRIPTION

UNDERSTAND AND INTERPRET THE PRESCRIPTION

SELECT AND LABEL MEDICINE FOR ISSUE

 MAKE A FINAL CHECK

RECORD THE ACTION TAKEN

ISSUE MEDICINES TO THE PATIENT WITH CLEAR INSTRUCTION

AND ADVICE
Receive and validate the prescription

Pharmacist should ensure that prescription should

have following information:

 Patient information: name, age and ID of patient

 Rx symbol in the upper left corner

 Name, strength, dose form, frequency, route of

administration and duration of treatment.

 Any additional instructions for the pharmacist
regarding preparation and supply of
medicine. •
 Refill instructions (in case of long term
therapy)
 Name and signature of prescriber
Understand and interpret the prescription

 Correctly interpret any abbreviations used by the

prescriber
 Confirm dose, frequency and duration of each

medicine
 Confirm that the doses prescribed are in the

normal range for the patient

 Correctly perform any calculations of dose and

quantity to be issued
 Identify any common drug-drug interactions and

contraindications.
Selecting the medicines:

 An appropriate system should be established for

selecting the medicines to prevent any medication error.
 Double check should be done to ensure that correct
medicine is selected.
 Check the expiry date of dispensed medicines to ensure
that they remain unexpired for the duration of supply
course.
 Choose the oldest stock (first-in/first-out)
 Tablets/capsules should not be removed from the
strips/blisters when dispensing

 Medicines which need to be packed should be

packed into a clean, dry container or plastic
envelop which will not compromise the quality of
the product after dispensing
Labelling of medicine

Label should include following information:

 Patient name
 Generic name, strength and dose form of the medicine
 Frequency and duration
 Quantity of medicine dispensed
 How to take medicine
 Storage conditions
Counter checking
It can be done as a self-check but it is valuable to
have final check done by other staff member
The countercheck should include:
 Reading and interpreting the prescription without
looking at medicines dispensed. •
 Checking the appropriateness of doses
prescribed.
 Checking for drug interaction
 Checking the medicines dispensed
 Checking the label
 Finally counter signing the prescription
Record the action taken

Following details of the medicines should be

recorded:
 Date of dispensing
 Patient details like name, age and sex
 Medicine name
 Strength
 Amount issued
 Dispenser’s name
Issue medicine to the patient with clear instruction and advice

Tell name and indication of Tell how many times and when to
medicine refill
Tell route and frequency of each Emphasize benefits of the medicine
medicine
Tell how long to take medicine Discuss major side effects of medicine

Ask for any allergy Discuss drug-drug, drug-food, drug-

disease and drug-herb interaction

Tailor medicine to daily regimen Discuss precautions and measure to

be taken to improve treatment
outcomes.
Ask if patient have any problem in Discuss storage recommendations
taking medicine
Tell how long it will take for the Demonstrate and provide adequate
medicine to show an effect information about special dosage
forms
Educate techniques for self monitoring Ask patient to repeat key information
to check his understanding
 DISPENSING ERRORS
 Dispensing error are errors that can occur at any
stage of dispensing process

 Dispensing error can be defined as any

discrepancy between a prescription and the
medicine that pharmacist deliver to the patient
Types of dispensing errors

Dispensing medicines to the wrong patient

Dispensing the wrong medicine to the patient

Dispensing the wrong drug strength

Dispensing at the wrong time

Dispensing the wrong dosage form

Dispensing an expired medicine

Omission ( failure to dispense )

Dispensing of medicine of inferior quality

Dispensing an incorrectly compounded medicine

Dispensing with the wrong information on label

Dispensing with wrong verbal information to the patients

STRATEGIES TO MINIMIZE DISPENSING
ERRORS
 Confirm that prescription is complete and correct:
check the prescription for its completeness and
correctness
 Name of the drug: One-third of dispensing errors
are due to similar drug names

Amantadine Amioderone
Amiloride Amlodepine
Amoxicillin Amphotericin
Betamethasone Beclomethasone
Bupropion Buspirone
Indocin Lincocin
Methadone Methylphenidate
 Abbreviations

Misinterpretation of abbreviations is common

cause of dispensing errors
AD, AS, AU (right ear, left ear, OD, OS, OU (right eye, left eye,
each ear) each eye)
qod (every other day) qd (daily), qid (4 times a day)
Trailing Zero (1.0mg) 1.0 mg mistaken as 10 mg
Naked decimal points (.5mg) .5 mg mistaken as 5 mg
Drug name and dose run Mistaken as Inderal 140 mg
together (Inderal40)
AZT (zidovudine) Mistaken as azathiopurine or
azetreonam
 Workplace
 Distraction on work place
 Workload
 Patient education
INVESTIGATING DRUG DISPENSING PRACTICES

 Quality indicators:
Good drug dispensing guidelines of WHO recommended
following indicators to investigate drug dispensing
practices:
1. Average dispensing communication time
2. Percentage of prescribed items actually dispensed
3. Percentage of prescribed medication that are
adequately labelled
4. Patient knowledge provided to patient
Average dispensing communication time

 Purpose:

To measure the average time that personnel

dispensing drugs spend with patient.

Formula:

Total time for dispensing drugs to a series of patients

X 100
Total number of encounters
Percentage of prescribed medicines actually dispensed

 Purpose:
To measure the degree to which health
facilities are able to provide the drugs which
are prescribed

Formula:
Number of drugs dispensed
×100
Total number of drugs prescribed
Percentage of prescribed medication that are adequately labelled

 Purpose:

To measure the degree to which dispenser’s record

essential information on the drug package they dispense

Formula:

Number of drug packages containing at least patient

name, drug name and when the drug should be taken
×100
Total number of drug packages dispensed
Percentage of patient knowledge of correct dosage

Purpose:
To measure the effectiveness of the
information given to patient on the dosage
schedule of the drugs they received

Formula:

Number of patients who can adequately report

the dosage schedule for all drugs
×100
Total number of patients interviewed
 CONCLUSION
Dispensing is one of the vital elements of the
rational use of medicines. Safe, clean and organized
dispensing environment provides a basis for good
dispensing practices. Dispensing process to go right
or wrong depends on the dispensing personnel. It is
therefore dispensing staff should be competent
enough and well equipped with all the knowledge
needed for the dispensing process.
THANKYOU