HANDLING OF PRESCRIPTION (PRESCRIPTION PROCEDURE)

📌 Receiving the prescription:

A pharmacist while receiving the prescription should not change his/her faces expression which gives an idea to the patient that, he/she is confused after seeing the prescription.

• By patient himself (Personal): Physician writes the prescription and hand over it to patient. The patient carries it to prescription department and hand over to pharmacist.

• By telephone: Prescription department has more than one telephone for receiving prescription. Only experienced pharmacists could answer on telephone.

• By delivery service: It does not offer this service on a regular basis; it should provide at least on emergency basis. Prescription processed according to normal routine.

• By mail: It is used in case of refills. Patients who use mail to order refills are advised to obtain authorization of physician.

📌 Reading and checking the prescription:

On receiving a prescription, always check it, that it is written in a proper format i.e. doctor’s pad or OPD slip of the hospital/nursing home and signed by the prescriber along with date. A prescription should always be screened behind the counter. Check the legibility of patient’s Name, Age, Address and dose. Any difficulty in reading or any distrust regarding the prescription ingredients or directions, the pharmacist should consult the other pharmacist or the prescriber. Pharmacist should never guess about the meaning of any illegal or confused word. Sometimes prescription is received on telephone by senior pharmacist. Take down the prescription without spelling mistakes. The same pronunciation and spelling are available in the market.

E.g.:

Prednisone Prednisolone

Digoxin Digitoxin

Althrocin Eltroxin

Doridon Doxidon

Vincristine Vinblastine

📌 Refusal of Prescription:

The Pharmacist should refuse to dispense a prescription if,

• An ingredient is not in stock.

• Essential information is missing or doubtful.

• Safety of prescription is doubtful.

📌 Collecting and weighing the materials:

• Before compounding the prescription, all the materials required for it, should be collected on 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 three times in order to 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.

📌 Compounding the prescription:

As compounding, the prescription is the most important phase. The prescription department should be clean, neat, lightened and well ventilated. Neatness, accuracy and speed arequalities that must be developed by Pharmacist. Mistakes in compounding are best avoided by personal care. The compounded medicaments should be filled in suitable containers depending on its quantity and use.

📌 Finishing the prescription:

The filled containers are suitably labelled. White plain paper of good quality should be used for labelling the containers. The size of the label should be proportional to the size of the container. The label should be fixed with a good quality of adhesive. Write label first and check it for accuracy before attaching to final container. The container is polished so as to remove the finger prints. At the time of delivering the prescription to the patient, the pharmacist must explain the way of administration, direction for use and storage.

📌 Checking the product:

A prescription should be checked other than compounder. The checker examines the written prescription for legibility, safety etc. The contents of the container should be examined for color and odour. Pharmacists can read with each other to understand the prescription.

📌 Recording the information:

When prescription is compounded certain information should be recorded in register or/on prescription for easy reference in refilling the prescription.

- Date of compounding

- The price charged and manner of mixing in code system.

- The size and type of container used.

- Size and type of capsules used.

- Signature of original compounder and checker of the prescription.

📌 Pricing the prescription:

It is very difficult to fix the price as there are large variation in time, service, cost and over heads. It is impossible to make uniform pricing system which could be applicable to all types of pharmacies in all part of any locality.

-Different systems are as follows:

a) Flat rate:

It depends upon the number of dosage units dispensed for internal use, or upon weight or volume of preparation for external application.

b) Summation:

Sum of all costs + profit = Dispensing price.

c) Mark-up(M.U):

• (Cost of ingredients) + (cost of ingredients) x % M.U = Dispensing price.

• Mark-up represents all costs and profit except cost of ingredients.

d) Mark-up(M.U) + Minimum fees:

• (Cost of ingredients) + (cost of ingredients) x % M.U + minimum fees = Dispensing price.

• Minimum fees represent the average combined costs of container labour, overhead and professional services. It does not include cost of ingredient or profit.

e) Professional fees:

• (Cost of ingredients) + (Professional fees) = Dispensing prices.

• Professional fees included all dispensing costs and professional remuneration.

• The price of a prescription is often coded employing 10 letters without duplication of any letter.

• E.g: P H A R M O C I S T

• 1 2 3 4 5 6 7 8 9 0

• Thus price of Rs 4.85 shall be indicated the by code R.IM.

📌 Filing the prescription:

• Original prescription should be filled in numerical order.

• There should be two files – One for Narcotic prescription and other for regular prescriptions.

• Micro filling methods are used in modern pharmacies.

📌 Delivering the product:

• Deliver the container in carton which is neater. Wrap the carton with plain white paper on which a brief professional advertisement may appear.

Methods of delivery:

• By patient: Most of the prescriptions are delivered to the pharmacist by patient.

• Home delivery: Used frequently.

• In case of telephone order of refills, home delivery may arranged with postal department or use one’s own personal vehicle.