DISPENSING

The function of a validly registered pharmacist, of taking

an order, compounding and preparing the drug or
medicine of a physician or dentist and the provision of
medication advice to the patient or representative of the DISPENSING GUIDELINES
patient upon delivery of the medications. 1. Proper management of the workplace
The dispensing area should have adequate
PRESCRIPTION lighting, comfortable temperature and controlled
A written order and instruction to the pharmacist humidity.
for the use of drugs products for a specific patient. The pharmacy environment is maintained at a
It identifies the medication/s to be dispensed and temperature appropriate to ensure correct storage
should be accompanied by directions on its proper of all medicines and the comfort of staff and
use. customers
Medication orders are orders for medication by an Ensure that the pharmacy temperature does not
individual authorized to prescribe and are exceed 30 degrees Celsius. This is the usual upper
intended for use in the institutional setting. limit for products required to be stored at room
temperature.
PARTS OF A PRESCRIPTION Ensure that medicines and therapeutic devices are
Date displayed in a manner that does not subject them
Patients information to temperature extremes (out of direct sunlight.)
Name There should be sufficient counter space free from
Age clutter all the time.
Gender The area should be designed so as to maintain
Address and Telephone number optimum workflow.
Superscription Adequate space should be allotted for each
Subscription medication and each strength.
Inscription Separate areas should be assigned to medications
Signa/Direction for use by different route.
Signature of the doctor Narcotics and opiates must be stored under lock
Licenses of the doctor PRC, PTR, S2 and key and accessed only by qualified
Address and Telephone number of the doctor pharmacists.
Drugs should be arranged systematically by
PARTS OF A MEDICATION ORDER therapeutic categories.
Date Sound alike, look alike drugs should be identified
Patients name and provisions such as auxiliary labeling should be
during storage and dispensing.
Time
Distractions such as conversations among
Bed Number
personnel in the dispensing area should be kept at
Name/s of drugs
a minimum.
Generic name A collection of updated references on drug
Brand name information and dispensing should be made
Dosage form and strength available in the area. Of importance are the latest
Route of administration editions of:
Frequency and duration American Hospital Formulary Systems
Signature of doctor. (AHFS)
United States Pharmacopeia Dispensing
PROCESSING OF A PRESCRIPTION Information (USPDI)
Receiving the prescription (USP-NF)
Reading and checking the prescription Drug Facts and Comparisons
Rx numbering and dating Physicians Desk Reference
Compounding/Preparation Merck Index
Labeling Merck Manual
Rechecking E-Facts software or Equivalent
Delivery Philippine National Drug Formulary
Patient counseling (PNDF)
Instruction to the patient/other health care Hospital Formulary
professionals. Remingtons Pharmaceutical Sciences
One computer must be dedicated to the access
PATIENT MEDICATION PROFILE and retrieval of medical and pharmaceutical
In lieu of Prescription Book. information from relevant internet websites and
Requirement based on Republic Act 10918. databases.
Important in monitoring patients medication 2. Workload for every pharmacy personnel should
history and other pertinent information about the be well defined.
patient. A job description should define the functions of
every pharmacy personnel. Position descriptions
exist for all staff positions, and these are used in
 staff recruitment, training, management and
performance appraisal.
Job descriptions should be reviewed on an annual
basis.
A staff development program for pharmacy
personnel should be provided on a quarterly basis.
Performance evaluation of each pharmacy
personnel should be done twice yearly. The
pharmacy should have a system to recognize,
reinforce and reward good performance by staff
must be developed. All staff should understand
the system and that recognition and reward are
provided fairly and consistently.
More than one pharmacist should be present in
any shift to ensure a consistent check system in
all aspects of the pharmacy operation.
Adequate number and mix of staff should man the
pharmacy on a 24-hour basis.
3. Adherence to standard dispensing procedures
by pharmacy personnel.
OPD dispensing
Prescription must be received and read by a
pharmacist.
The prescription must be assessed for
Illegible handwriting
Non-standard abbreviations
Incomplete information (patient, prescriber, drug
and instruction for use.)
The drug name drug dosage form, dosage
regimen and instruction on proper use must be
accurately read.
When in doubt about the accuracy of the
information on the prescription, the pharmacist
should verify it from the prescriber.
Dose limit must be checked [use of dose limit
chart USP. DI]
If there are more than one drug on the
prescription, a drug interaction review should be
performed. [use of drug interaction
software/chart]
Potential interaction between any medicine
currently being taken by the patient and drugs on
the prescription must also be checked.
Any significant adverse drug interaction detected
must be communicated with the prescriber for
proper action.
The patient medication history should be updated
on dispensing.
The patients known drug allergies and
sensitivities should be determined and taken into
account when dispensing a medicine.
Clinically significant drug-drug and food-drug
interactions and contraindications should be
checked and accounted for when prescription is
dispensed.
When taking drugs from the shelf, check the
names, strength, dosage form against the
prescription.
Count the number of drugs using proper
measuring/counting device.
Affix auxiliary labels to specific dosage forms
(extended release, sublingual tablets,
suspensions)
Prior to delivering the medication/s to the
patient/client re-check their labels against the
original prescription. This should be done by the
pharmacist.
Provide advice to the patient/client regarding the
proper use of the medicines and devices
dispensed.
All customers should have timely access to a
pharmacist for advice on health, health products
and medicines.
Ensure pharmacists are pro-active in providing
advice to customers on health-related matters,
health products and medicines.
Do not wait for the patient/client to ask
IN PATIENT DISPENSING
The medication order must be read by the
pharmacist.
Except for emergencies, nurses spoken request
for medication should not be accepted until the
pharmacy has received a copy of the order.
The medication order received must be assessed
for:
Illegible handwriting.
Non-standard abbreviations
Incomplete information (px, prescriber, drug
Instruction)
The drug name, dose, dosage form, dosage
regimen and instruction on proper use must be
accurately read.
When in doubt about the accuracy of information
on the medication order, the pharmacist should
verify it from the prescriber.
Dose limits must be checked using dose limit
charts or USP DI.
If there are more than one drug on the
prescription, a drug interaction review should be
performed and use for this Drug interaction
software or chart is advised.
Potential interaction between any medicine
currently being taken by the patient and drugs on
the prescription should also be checked.
Any significant adverse drug interaction detected
must be communicated with the prescriber for
proper action.
When taking drugs from the shelf, check the
names, strength, dosage form against the
medication order.
Count the number of drugs using proper
measuring/counting device.
If the ordered medication requires compounding, it
has to be performed by another pharmacist other
than the one processing the order.
The label of each medication should be printed
with the name of the drugs, its dosage strength,
dosage form, quantity directions for use and
number of refills and the prescribers name on it.
Affix auxiliary labels to specific dosage forms such
as extended release tablets, sublingual tablets,
suspensions, suppositories.
Examples of auxiliary label:
For external use only.
For the ear only.
Shake well before use.
Place under the tongue.
Prior to delivering the medication/s to the ward,
their labels must be re-checked against the
original medication order. A main label and any
appropriate auxiliary label is attached to each
 dispensed medicine by a pharmacist, or attached of patients paediatric, intensive care unit (ICU)
by a dispensary assistant and subsequently and Geriatric patients.
checked by a pharmacist prior to dispensing. Independent checks of the medication order must
The clinical pharmacist should provide advice to be done by at least two persons at all times.
the patient/client regarding the proper use of the Patient profiles should be checked for proper
medicines dispensed. The pharmacist should indication and contraindications.
evaluate the patients understanding of each Special attention must be given to drug
medication and supply additional information interactions and duplications of therapeutic
when the patients information is incorrect or classes.
insufficient. The pharmacist might need to advice The dose for any of these drugs must be checked
the patient regarding the proper dosage, for:
appearance, and name of the medication. Cut off for single dose.
Information about the route of administration, Cut off for total amount in a 24 hour period.
instruction for use, duration of use, and the reason Cut off for the entire course of therapy.
the product was prescribed may also be needed. Doses have to be re-computed and checked for
4. Installation of check systems or system of
accuracy especially for patients with renal and/or
redundancies for processing specific categories
liver dysfunction.
of drugs high alert drugs, chemotherapeutic
drugs and parenteral administration.
HEALTH CARE DELIVERY SYSTEMS
A list of high-alert drugs, chemotherapeutic drugs
Members of the Health Care Team
and parenteral admixtures must be available and Patient the focal point of our service.
easily accessible at dispensing areas and those
Physician prescribes drug therapy after
wards with clinical pharmacy services.
diagnosis.
Pre-printed order forms of specified concentrations
Pharmacist manages drug therapy.
and volumes should be used in ordering these
Nurse performs direct bedside care.
drugs. This will result to reduction of options.
The dose of these drugs must be checked for Medical Technologist does clinical test to aid
Cut off for single dose. diagnosis and disease and therapy management
decisions
Cut off for total amount in a 24 hour period.
Dietician - manages patients nutritional
Cut off for the entire course of therapy.
requirements.
Independent checks of the medication order must
Others
be done by at least two persons at all times.
Auxiliary labels must be affixed to drug containers
PHARMACY HEALTHCARE OBJECTIVES
to remind other health professionals to take extra Extend pharmaceutical care focused on achieving
caution in handling, delivering and administering
positive patient outcomes through drug therapy.
the medications concerned.
Provide services that foster the efficacy, safety
These drugs must not be placed under floor stock
and cost-effectiveness of drug use.
distribution but under unit dose dispensing
Contribute to programs and services that
system.
emphasize the health needs of the public and the
Patient profiles should be checked for proper
prevention of disease.
indication and contraindications.
Promote pharmacy as an essential component of
5. Installation of Check systems or system of
the health care team.
redundancies for drugs used for specific group