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

2. Introduction Clarification is needed at times
Pharmacist makes the call

3. 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

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

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

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

7. 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

8. 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

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

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

11. 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

12. 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)

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

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

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

21. 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

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

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