1. PRESCRIPTIONS
Chap. 5

2. Objectives
Understand the prescription process: steps including creation of prescription, patient pick up, and counseling.
Importance of preventing and identifying medication errors.
Identify different responsibilities between pharmacist and technician.
Importance of patient privacy.

3. Who can write scripts?? Medical Doctors Doctors of Osteopathy Primary
Dentists
DVMs
In most states, including NC
Physician Assistants
Nurse Practitioners
Pharmacists
Primary
Practitioners

4. The process Script order Arrives at pharmacy
Patient and prescriber information gathered
Script data entered into computer system
Insurance and billing information processed
Label generated
Script prepared
Pharmacist checks script
Patient receives
Pharmacist provides counseling

5. Where to get scripts? Institutional Pharmacy Community Pharmacy
Staff (usually nurses) administer medications to patients
Community Pharmacy
Dispense directly to patient, who is then expected to take medication as prescribed.

6. Required Script Information
Prescriber information
DEA Number
NPI Number (mandated by HIPAA, administered by NPPES)
Date
Drug name and strength
Quantity
Prescribers signature
Name and address of patient
Signa
Refill instructions
DAW/PSC

7. Additional Script Information
Date dispensed
NDC number
Script origin code
Script number
Patient insurance information
Price charged
Technician and pharmacist initials involved in filling script

8. Technician’s Role
Assist in routine, technical aspects of script filling
Treat each patient and medications with respect
Accept new scripts, obtaining information, and inputting into computer efficient and accurately
Alert pharmacist whenever a DUR warning screen appears
Faxing/ telephoning refill and clarification requests
Consulting formularies and responding appropriately to 3rd party adjudication messaging
Quick location of medication
Compounding meds under supervision
Recording of dispensing of controlled drugs
Referring the patient to pharmacist for counseling
ALWAYS ensuring accuracy/safety of scripts

9. Pharmacist’s Role
Ensure physicians’ orders are carried out accurately and safely by checking:
Correct medication, strength and dosage dispensed
Directions are clear and accurate
Patient knows how to take and refill medications
No potential problems with drug allergies, drug disease interactions. DUR warnings important here!!
Prescriber contacted if needed
Patient understands expected outcomes of medication including side effects
Accurately billed
ONLY pharmacist can counsel on the use of OTC medications
ONLY pharmacist can receive T.O. for new scripts

10. LABELS
Three types of labels: Prescription label Auxiliary labels Unit dose labels

11. Unit Dose Labels Widely used in institutional pharmacies.
Rules vary by institution; labels often contain only name, strength, manufacturer, lot number, expiration date, and dosage.

12. Auxiliary Labels Usually colored
They provide additional information to the patient
Many computerized systems will automatically print out appropriate labels
For Controlled Substances the following preprinted label must be adhered:
Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.

13. Script Label
Includes information about the pharmacy, patient, prescriber, the script, and transaction number.
Generally include all of the following:
Pharmacy name, address, and phone number
Script number
Patient name
Directions for use
Medication name, strength, quantity, dosage, and manufacturer
Drug expiration date
Name of prescriber
Refill information
Initials of person who entered information and pharmacist who checked

14. HIPAA
First in place in 1996 with many updates since. Has a large statue that concerns continuation of health insurance for workers who leave their jobs. Requires use of a NPI; is a 10 digit number. Each provider is assigned one that is theirs for life. Rules to cover PHI. All entities need to provide written notice of their written of their privacy practices to patients.

15. 2 pages of abbreviations
Chap 5 test on Thursday
Pages in book
2 pages of abbreviations
Quias open
Chap 5, 5.1, and 5.3