Good Dispensing Practices

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Opening Remarks
◦ Welcome and opening prayer

◦ Remarks by:

◦ 1.

◦ 2.

◦ 3.

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 Facilitator and Participants introduction

Prof Gustav Malangu is a public health, an International Health,

pharmacy practice specialist with more than 15 years experience as a
trainer, technical advisor and practising pharmacist

Participant to introduce themselves and state their names, qualification,

place of work, course expectations and favourite animal/plant and its three
characteristics

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 Course Objectives and Outputs

Upon completion of this course, participants will be able to:

◦ Explain the current understanding of pharmacist’ competencies
and professional responsibilities
◦ Describe components and aspects characterising Good Dispensing
Practices
◦ Describe systems to put in place to ensure the implementation of
GDPs
◦ Use tools for measuring performance, planning and improving
dispensing practices
◦ As outputs, each participant will have produced:
◦ A situational analysis of their pharmacy
◦ An improvement plan for their pharmacy
◦ A personal growth plan

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 Day 1:
Introduction to Pharmacist Core Competencies

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 Introduction to core competencies of a pharmacist

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 Pharmacy Competency Standards (India,
2003)
 Pharmacy has eight broad competency areas or functional
areas (FA). Associated with each of these is more detailed
information about the actual competency units, elements
and evidence cues which help in the assessing of the
competencies.
 FA1: Practise pharmacy in a professional & ethical manner
 FA2: Manage work issues and interpersonal relationships in
pharmacy practice
 FA3: Promote & contribute to optimal use of medicines
 FA4: Dispense medicines
 FA5: Prepare pharmaceutical products
 FA6: Provide primary health care
 FA7: Provide medicines & health information & education
 FA8: Apply organisational skills in the practice of pharmacy
Dispensing process and overview on a prescription
 Supervision

\Dr
.Galal M \By
AbdElghany
Yasser

Ibrahim

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 This medicine may Which work? I am
interfere with your work, unemployed for the
so be careful said the past 3 years!
Pharmacist

https://www.youtube.com/watch?
v=SFfPgCOn82I

This medicine my lower I own no machinery;

your abilities to handle the only one may be
machineries, like a car, … my cell phone!

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 VARIOUS ACTIVITIES INVOLVED IN DISPENSING ARE

RECEIVING AND CONFIRMING ORDER

CHECKING PRESCRIPTION AND

INTERPRETATION

VERIFYING AND CONSULTING IF REQUIRED

REMOVING MEDICINES FOR ISSUE AND

COMPOUNDING

ISSUING MEDICINES TO THE CLIENT WITH

CLEAR INSTRUCTIONS AND COUNSELING

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 DISPENSING CYCLE

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 What is a prescription
A written order by the doctor to a pharmacist
specifying the medications to be dispensed to a
specific patient and usually accompanied by
directions for use and administration.

"pre" - before
"script" - written
New definition
It is a request from….. to a pharmacist to dispense if
appropriate the medicines ordered for the named patient
It is a request, it can be refused as opposed to an order
If appropriate, because the pharmacist cannot dispense if it
is not!

Prescribers may be medical doctors, veterinarians, EMS

personnel, optometrists, …., even pharmacists depending
on the context
 Definition

Doctor

Pharmacy

Patient
Parts of prescription
1.Date
2.Name, Age, Sex and Address of the patient.
3.Superscription (Rx)
4.Inscription
5.Subscription
6.Signature
7.Renewal Instructions
8.Name, Signature & Registration no. of registered
physician
Date
It helps the pharmacist to find out the date of prescribing and the date of
prescription for filling. It also helps

-To know when the medicines were last dispensed

-To prevent the misuse of the drug by the patients.
The prescription which prescribes narcotic or other habit forming drugs must
bear the date so as to avoid the misuse of the prescription.

Name, age, sex and address of the patient

Name, age, sex and address of the patient must be written in the prescription
because it serves to identify the prescription. Age and sex of the patient
especially the children, help the pharmacist to check the prescribed dose of the
medicine.

Superscription
It is represented by the symbol Rx, which is written before writing the
prescription. Rx is an abbreviation of the Latin imperative verb, “recipe = take”
meaning “to take” (Take though).
Rx symbol
-It is an abbreviation of Latin term “Recipe”, meaning “to take” or “take thou”
Inscription
This is the main part of the prescription, contains the names and quantities of the
prescribed ingredients
The names of the ingredients are generally written in English but common
abbreviation used can be written both in English and Latin language. Extreme
care should be taken by the pharmacist during interpreting the abbreviations
otherwise can lead to serious errors.
Inscription is divided into following parts
Base: The active ingredients which are intended produce the therapeutic effect.
Adjuvant: It is included either to enhance the action of the medicament or to
improve the palatability of the preparation.
Correction: It is included to prevent or lessen any undesirable effect.
Vehicle: It is included in the prescription either to dissolve the solid ingredients
or to increase the volume of the prescription.

Subscription:It provides the direction to the pharmacist for the preparation of the
prescription information and the quantity and dosage form of the drug to be
dispensed.
Signature
This consists of the direction to be given to the patient regarding the
administration of the drugs.
The instruction may include
The quantity to be taken or the amount to be used.
The frequency and timing of drug administration
The route of drug administration
The special instruction such as dilution direction.
Renewal instruction
The prescriber indicates on every prescription, whether it may be renewed and if
so how many times. It is particularly important for the prescriptions containing
the narcotic and other habit forming drugs to prevent its misuse.
Name, signature, address & registration no. of the prescriber
The prescription must bear the signature of the prescriber along with the
registration number and address.
 Prescription Formatting

Heading
Body
Closing
Current Prescription Formatting

Heading
◦ Name, address, and telephone number of the prescriber
◦ Name, sex and age of the patient
◦ Date of the prescription

3
Current Prescription Formatting
Body
◦ The Rx symbol
◦ Name
◦ dose size or concentration (liquids) of the drug
◦ Amount to be dispensed
◦ Directions to the patient

4
Current Prescription Formatting

Closing
◦ Prescriber’s signature
◦ Refill instructions
◦ Generic substitution instructions

5
Handling of Prescription

Receiving
Dosage calculation
Compounding
Finishing
Pricing
Delivering
Receiving the Prescription:
Pharmacist should himself receive the
Prescription.

It includes
Reading the prescription
Checking the prescription
Reading the prescription:

Prescription should be completely and carefully

read from top to bottom.

Checking of prescription:

Prescription should be checked for any

appropriateness with regard to several aspects
Appropriateness criteria

1.For the presumed medical condition (Indications) - Clinical

Pharmacology and pharmacotherapeutics, STG if available and
applicable
2.For the dosage in relation to age and bodyweight of the patient
(Safety)-Special cautions and attention to be paid in case of the elderly,
severally sick, patients with known impairments and allergies, children,
…etc - Clinical Pharmacology and pharmacotherapeutics, STG if
available and applicable
3.For the health status and co-morbidities (Contra-indications)- As
above
4.For the possible interactions (drug-drug, drug-food, drug-work, drug-
others- Lifestyle)- As above and patient interview data
 Dose appropriateness in cases of Children and Elderly

For the elderly: dosage adjustment for renal function status, drug interactions,
bodyweights,…lifestyle

For children, check dosage appropriateness using formulas as shown below but
be mindful about the prescriber, if a specialist (pediatrician, …etc)

For adjustments due to particular conditions, specialist and specific references

are required (Martindale, …etc)
 Dosage calculation:

A child dosage form is calculated by

Young’s rule

Age × adult dose

Child dose =
Age + 12
Fried’s rule:
Age(month)
Child dose= × Adult dose
150
Finishing the prescription:

It includes

Packaging
Labeling
Rechecking
Filling