Chapter 8 Prescription Processing Copyright © 2004 by Elsevier Inc.  All rights reserved.

Introduction Clarification is needed at times Pharmacist makes the call

Processing a Script: A Step-by-Step Approach Patient drops off prescription Pharmacy tech checks to make sure that the patient is on file. If not, a patient information sheet must be filled out. Pharmacy tech checks the prescriptions for completeness Pharmacy tech checks to ensure medication is in stock Pharmacy tech enters the prescription into the computer

Taking the Prescription Prescription arrives by various methods Written order Hand carried Faxed Called in

Taking the Prescription Computer generated prescriptions becoming more common May be provided to patients on discharge from hospitals or physician’s office

Patient Information Sheet Allergy information for new patient needed Contact information Insurance information

On the Rx Patient Information Provider's Information Name Name Phone number and address Phone number and address Insurance information, Provider's license number if applicable Age or date of birth Provider's DEA number if applicable Name of medication Strength Dosage form

Important Patient Information (continued) Provider's Information Route Quantity Route of administration Sig Refill information Provider's signature Date written "Brand necessary" if brand name drug is desired

Prescription Information DEA number is necessary for controlled substance Controlled drug written in ink or indelible pencil

Translation of an Order Look at whole order if difficult to decipher If in doubt, ask another person or pharmacist

Entering the Information into the Database-Inpatient Computers alert to drug interactions DUR (drug utilization review) warns of possible problems the pharmacist will have to address. checks for drug interactions and drug allergies Pharmacist calls physician to change order if necessary

Checking the Label Against the Script Label checked many times before it reaches patient Hold original script next to label to check for errors or discrepancies Look at names of drug, strength, dosage form, sig (directions)

Pulling the Correct Medication Take label to shelf when getting medication from the shelf Label helps you not to forget Can compare label with information on the bottle

Finding the Right Stock Bottle NDC (National Drug Code): is a unique eleven digit number that identifies each medication. 1st five digits identify the manufacturer Next four identify the drug product Final two digits represent package size and packaging

Counting and Filling the Medication Check label and script against bottle for accuracy Counting trays still used Digital counters and automated machines Baker cells used in larger pharmacies

Prescription Lid and Auxiliary Label Appropriate lid applied after medication is filled Problem for elderly patient–safety lid Elderly lose dexterity and strength Older patients do not want safety lids Can replace with snap-on lid

Applying the Label Professionalism is needed when applying label Do not place torn or crooked label on bottle Label not to cover lot and expiration date on full bottle prescriptions Auxiliary labels must be easily read

Auxiliary Labels Auxiliary labels usually printed with prescription label Drug classification, interactions, and side effects need to be known for auxiliary labels if not computerized

Package Insert Is drug information that is dispensed with each prescription medication. The information sheet includes indications, interactions, and possible side effects.

The Rights of a Patient Right dose Right medication Right route Right time Right price Right dosage form Right patient

Pharmacist Consultations: When and Who Needs Them First-time prescriptions flagged and pharmacist is alerted Patient needs consultation with new script Federal law–all new or changed prescriptions need consultation OBRA 1990

Billing No third-party coverage–patient charged full price Each type of insurance has limitations

Preventing Forgery Prescription pad may colored paper or water marking to prevent photocopying prescriptions Alert the pharmacist if you suspect forgery