1. Good Dispensing Practices
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2. Opening Remarks Welcome and opening prayer Remarks by: 1. 2. 3.
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3. 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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4. 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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5. Day 1: Introduction to Pharmacist Core Competencies
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6. Introduction to core competencies of a pharmacist
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33. 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

34. Dispensing process and overview on a prescription

35. Supervision
Dr\
Galal M.
AbdElghany
By\
Yasser
Ibrahim
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36. Which work? I am unemployed for the past 3 years!
This medicine may interfere with your work, so be careful said the Pharmacist
This medicine my lower your abilities to handle machineries, like a car, …
I own no machinery; the only one may be my cell phone!
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37. 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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38. DISPENSING CYCLE
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39. 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

40. 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

41. Definition
Doctor
Pharmacy
Patient

42. Parts of prescription
Date
Name, Age, Sex and Address of the patient.
Superscription (Rx)
Inscription
Subscription
Signature
Renewal Instructions
Name, Signature & Registration no. of registered physician

45. 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”

46. 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.

47. 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.

48. Prescription Formatting
Heading
Body
Closing

49. Current Prescription Formatting
Heading
Name, address, and telephone number of the prescriber
Name, sex and age of the patient
Date of the prescription 3

50. 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

51. Current Prescription Formatting
Closing
Prescriber’s signature
Refill instructions
Generic substitution instructions 5

52. Handling of Prescription
Receiving
Dosage calculation
Compounding
Finishing
Pricing
Delivering

53. Receiving the Prescription:
Pharmacist should himself receive the
Prescription.
It includes
Reading the prescription
Checking the prescription

54. 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

55. 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

56. 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)

57. Dosage calculation: A child dosage form is calculated by Young’s rule
Age × adult dose
Child dose =
Age + 12

58. Fried’s rule:
Age(month)
Child dose= × Adult dose
150

59. Finishing the prescription:
It includes
Packaging
Labeling
Rechecking
Filling