Dispensing II
PHA 6130 | BATCH 2022
FACULTY OF PHARMACY – UNIVERSITY OF SANTO TOMAS
LECTURER: Mr. Solmuell M. Florano, RPh
TRANSRIBED BY: AZORES, 3FPH
REFERENCES: PPT, Lecture Video
PRESCRIPTION
• A written order and instruction from a licensed
prescriber to the pharmacist for the use of drug
product/s for a specific patient.
o This definition highlights the origin of the
prescription from the prescriber, its intended
recipient, the pharmacist, to provide supplies to
the patient which are necessary for therapy.
• It identifies the medication/s to be dispensed and
should be accompanied by directions on its proper
use.
(1) A prescription must have the prescriber’s information
including the name and contact details. Their signature must
also be seen in the prescription along with their license number
and other regulatory requirements. (2) It should also clearly
state to whom the prescription is intended for, along with
other pertinent patient details such as the age and weight, if
applicable, especially for our pediatric patients. (3) The date
is also included to determine the validity of the prescription.
(4) The Superscription, or the RX symbol signals the start of the
prescription instruction. (5) The inscription contains the name
of the medications prescribed, as well as the dosage form and
the strength. (6) Subscription contains the instructions to the
pharmacist dispensing the medication and (7) transcription
describes the patient instructions for the use of the
medication. Some prescriptions also have a (8) refill portion to
indicate how many times the prescription may be used legally.
TYPES OF PRESCRIPTION
1. Pre-compounding
o For a drug already prepared by pharmaceutical
manufacturers.
o are used for pharmaceutical preparations that
are commercially available in the prescribers
preferred dose, strength, or form.
2. Extemporaneous
o For medications to be compounded by the
pharmacist, according to the drug composition
and dosages as directed by the prescriber.
o Are prescriptions which are used for medicated
products which need to be compounded from
existing preparations or raw materials to
conform to the desired concentration or form of
DISPENSING 2| MEDICATION REVIEW
Medication Review
the physician based on the patient’s status and
indication. The pharmacist compounds the
desired preparation according to the instructions
provided by the physician.
ELECTRONIC PRESCRIPTION
• Computer-based prescription from a prescriber for a
specific patient that has elements of a proper paper
prescription.
• Are being used globally in use of paper prescriptions,
however, in the Philippines we only see a limited use
for electronic prescriptions.
• must still follow the guidelines set forth by the
authorities on proper prescribing.
• On March 17, 2020, the Philippine FDA has released
circular number 2020-007, which permits the use of
electronic prescriptions for vulnerable patients in,
light of the covid pandemic. This circular defines an
Electronic Prescription as an optical electronic data
(including PDF, JPEG or other photo format) issued by
or made by a licensed physician which is generated,
sent, received, or stored through email and messaging
applications. The use of an Electronic Prescription for
dangerous drugs was subsequently approved by the
Dangerous Drugs Board on March 18, 2020.
MEDICATION REVIEW
• Pharmaceutical Care Network Europe (PCNE): A
medication review is a structured evaluation of a
patient‘s medicines with the aim of optimizing
medicines use and improving health outcomes. This
entails detecting drug related problems and
recommending interventions.
PRESCRIPTION ASSESSMENT
• Upon receipt of a request from a prescriber for a
medication, the pharmacist must decide whether the
request is appropriate and reasonable and judge the
level of risk associated with proceeding with a
request.
• The presentation of the prescription by the patient to
the pharmacist signals the start of medication
transaction in most outpatient processes.
• The pharmacist must also consider the risk of not
supplying a medication which may lead to the patient
not receiving treatment.
1. INITIAL CHECK
• Prescription must be checked for completeness of
information, including the date, name of the patient,
details of the prescriber (name, contact information,
signature, license number, etc.), medication
information, refills (if any), etc.
• Check if the prescription abides by the prescribed by
the prescribing guidelines set forth by the FDA. If
there are technical errors in the prescription, we can
1|AZORES
 classify it as erroneous, impossible, or violative,
otherwise, the prescription is deemed appropriate
2. THERAPEUTIC CHECK
• In here we focus on the medication instruction and
prescription of the for the patient.
• Appropriateness must be checked:
o Drug: Correct generic name, dosage, dose, form
and route, including availability in the pharmacy
o Patient: Allergy, Contraindications based on
medical condition
▪ Pregnancy status, and other comorbidities
which may worsen with the use of the
medication intended to be dispense.
o Therapy: Duplication, interactions
▪ In order to perform therapeutic check, the
pharmacist must obtain a complete and
accurate medication history from our
patients, especially those who may be using
multiple prescriptions and other non-
prescription and herbal products for the
management of several conditions.
• If there are any discrepancies or problems noted
needing prescriber consult, the pharmacist may reach
out to the prescriber and verify the information or
otherwise provide recommendations regarding
therapy.
3. PREPARATION
• The pharmacist or other personnel delegated will fill
the prescription appropriately (brand name, dosage
strength, dosage form).
4. TECHNICAL CHECK
• Prior to dispensing, the picked medications need to
be validated for correctness by a separate individual,
usually the pharmacist, prior to dispensing.
• This limits the possibility of a dispensing error
committed. We check the actual medication to be
dispensed versus the details written on the
prescription. This is also the final check for the
expiration of the medication to be dispensed.
5. SUPPLY & EDUCATE
• Dispensing the medication to the patient must always
include education about the drug or therapy,
including indication, possible side effects, optimal
dosing time/schedule, etc.
• Only prescriptions deemed appropriate at all levels
will be dispensed by the pharmacist in order to
protect the patient and health care providers
involved.
• Documentation of problems identified and
recommendations, including referrals and accurate
transcript of communication, is vital.
• Also note that as most of our patients see pharmacies
are quick transactions, we need to do these steps of
prescription assessment in a timely manner.
• Experienced pharmacists can perform some steps at
the same time, which can save valuable seconds.
DISPENSING 2| MEDICATION REVIEW
Never give a medication if you do not have all of the
information that you need to give the medication safely.
• As medication experts, you must obtain information,
whether about the drug or the patient status, which
is vital in making sure medication safety is achieved.
PROCUREMENT & STORAGE
• Our accountability with proper medication review and
management does not begin and end with dispensing
alone. Pharmacists have responsibility in the
procurement and storage processes of medications,
and although both may be performed by other
personnel, they are still under the pharmacist
guidance and control.
• If not correctly performed, these two processes might
have important safety implications in the dispensing
process.
• Pharmacists must ensure that medication suppliers
are duly-registered with good standing in the industry.
• Storage plays a vital role in making sure that all
medications, especially those with special
considerations such as temperature, humidity and
light, retain their pharmaceutical qualities.
• This ensures the quality and safety of medications
procured from suppliers which are duly registered,
with good standing in the industry. In order to prevent
instances of storing and dispensing counterfeit
medications.
INVENTORY
• Proper inventory and record-keeping methods are also
important as these ensure correct turnover of
medications.
• Prior to dispensing a last check of the expiration date
is needed to assure quality of medications. As much
as possible for retail dispensing the individual dosages
dispensed must contain the expiration dates.
Dispensing near expiring medications first is also an
appropriate method of decreasing medication
wastage in the pharmacy.
• Regular and routine checking of expiration dates must
be done to eradicate the risk of dispensing possible
deteriorated drugs.
DISPOSAL
• Appropriate disposal methods must be maintained for
deteriorated medications or those which can no
longer be dispensed due to the expiration status.
• Pharmacists also serve as a great resource to educate
patients on the safe disposal of unwanted or
unneeded as well as expired medications through
medicine return or takeback programs. This can help
prevent medications from posing a harm to the
environment and prevent inappropriate distribution
and use of controlled substances and antibiotics.
IMPORTANCE
• There is always a risk of error in prescriptions,
whether intentional or not. Therefore, it is of great
importance that pharmacists conduct analysis of
prescriptions for appropriateness to protect patient
welfare and to promote proactive pharmaceutical
care.
2|AZORES
 • By consulting with the prescriber for solutions for may not be able to return to the prescriber soon, and
identified drug related problems in the prescription so we can escalate directly to the physician for a
we establish a relationship with them, centered on solution.
patient welfare. This allows the pharmacist to ensure • Dispensing the medication must only be done if it is
prescription appropriateness in a multi-disciplinary justified.
approach. • Documenting this process is also vital in order to
• Assessment of prescriptions and medication review provide safeguard for the pharmacists and as records
also promotes space of pharmacist interventions when of interventions done. It is best that we provide an
it comes to medication management, especially with accurate transcript of the conversation with the
the provision of quality patient education. patient or with the prescriber in the documentation
• Provides opportunities for pharmacist-initiated to provide a better picture.
evaluation and intervention
• Promotes patient safety in medication management
• Establishes the importance of pharmacist competency
in areas of direct patient care
• Medication Review is a function which prioritizes
patient safety as a goal in medication use, and it
creates a space in the health care system that a
pharmacist only can fail as a medication expert.

CONSEQUENCES OF NON-ASSESSMENT
• If a pharmacist simply dispenses medications as
prescribed without reviewing its validity and
appropriateness for the patient, we do not maximize
our potential as guardians of safety, especially in the
medication use process.
• Lower positive patient outcomes
o A patient may be exposed to higher risk of
medication misadventures leading to unintended
outcomes, such as therapy ineffectiveness,
toxicity, disability, or even death
• Potential litigious situations based on negligence or
incompetence
o This can also be detrimental to the practicing
pharmacist in terms of malpractice, which may
lead to lawsuits based on professional negligence
or incompetence.
• Promotion of static and outdated pharmacy practices
in modern healthcare
o As we move from our traditional role as
dispensaries, medication review is a
fundamental function carried out by the
pharmacist geared towards improving patient
care. By non-assessment, we are pushing back
this progress for our practice.

MANAGEMENT
• Problems in prescription which are identified during
assessment must be carefully communicated to the
patient and the prescriber.
o Depending on the problems identified, we may
provide recommendations to either the patient
to optimize their medication use such as
recommending dosing schedule, or it is a
prescriber, especially if changes in therapy may
be necessary.
• Elimination of risk for patient harm which may be
caused by dispensing the medication should be a
priority. This includes the assessment of patient
consequences of delayed dispensing of the drug.
• For particularly problematic prescriptions, we must
assess the risk posed for the patients if the
prescription is not filled right away. Some patients

DISPENSING 2| MEDICATION REVIEW 3|AZORES