LORCAN MEDICAL COLLEGE

Pharmacy Department

Program: Level IV TVET

APPLY GOOD DISPENSING PRINCIPLES
Course code: HLT PHS4 03 1121

BY: Dagninet A.
November,
2024
11/18/2024 1
LO1. Accepting prescription for dispensing

11/18/2024 2
 Outline

☻ Prescription
☻ Types of prescription
☻ Steps to dispensing prescribed medications

11/18/2024 3
 Objectives

At the end of this topic you will be able to;

☺ Define prescription and dispensing

☺ Identify types of prescriptions
☺ Know general steps for good medicine
dispensing practices
☺ Be familiar with labeling and packaging

11/18/2024 4
 1.1. Introduction
 Dispensing refers to the process of preparing medicines
and distributing to users with:
 Provision of an appropriate information,
 Counseling and
 Follow up.
 It may be based on a prescription or an oral request
(OTC) of users (patients or care providers) depending on
the type of medicines to be dispensed.

11/18/2024 5
 What good medicine dispensing practice refers to?
The delivery of the correct medicine to
 The right patient,
 In the required dosage and quantities,
 In the package that maintains acceptable potency and
quality for the specified period,
 With clear medicine information counseling and
 Appropriate follow up.

11/18/2024 6
1.2. Prescription and types of prescription
Prescription;
 Is an order for medicine, written and signed by a duly
licensed or authorized practitioner, and issued to a patient
in order to collect medicine from dispensing outlet.
 It is an instruction from a prescriber to a dispenser.
 It is a written therapeutic transaction between the
physician and dispenser on how the drug should be
dispensed.

11/18/2024 7
 Cont…
 It serves as a means of communication among the

prescriber, dispenser and medicines consumer

pertaining to treatment or prophylaxis.

 It should be written on a standard prescription blank

legibly and clearly in ink and in generic names of the

medicine(s).

11/18/2024 8
 Cont…
 Significant number of prescriptions lack information
regarding
♠ The methods of drug administration,
♠ The interval of administration
♠ The duration of treatment.
 These malpractices could result;
♠ Administration of drugs in the wrong route,
♠ Unwanted shorter or longer interval of drug
administration,
♠ Incorrect duration of treatment,
♠ Dispensing of wrong drug,
♠ Wrong high or low dosage etc.…
11/18/2024 9
 Cont…
A Prescription should be:
 Kept simple
 Abbreviations free (if necessary Latin abbreviations
should be used)
 Trailing zeros should be avoided, Leading zeros must
be added
 It should provide clear and specific directions
 Should be in legible hand writing
 Signed by authorized person etc.…

11/18/2024 10
 Cont…
A prescription is legal when:
⁕It is written or typed and signed by an authorized
prescriber.
⁕NPS prescription (Narcotic and psychotropic
prescription) for Controlled drugs.
⁕The medicines are written on the right prescription such
as normal, NPS...
⁕Date of issue not exceeding 15 days for narcotic drugs
and psychotropic substances and 30 days for other
medicines.
⁕Has all the information required to be contained with
respect to parts of prescription.
11/18/2024 11
 Prescription paper
PRESCRIPTION PAPER
XYZ Hospital: Tel +251 2 21 11 24 24
Patient’s full Name: Bizunesh Tesema
Sex: F Age: 39 Weight: ____68_____ Card No. ____10964/98___
Region: Oromia Town:_Ariti Woreda: Robi Kebele: 01
House No. 6245_ Tel. No: 0912334567  Inpatient X Outpatient

Diagnosis, if not ICD ___osteo myelitis, Vaginal candidiasis, minor skin

infection

11/18/2024 12
Cont…

11/18/2024 13
 Parts of prescription
A prescription paper has six main parts:
1. Date and patient information:
The date on which the prescription is written,
The name, age, sex, and address of the patient.
This information is vital for identifying who the prescription
is for and can help pharmacists verify dosages, especially in
pediatric cases where age and sex may influence dosing
decisions.

Represented by the symbol “℞”, which comes from the Latin

2.Superscription:

word “recipe,” meaning “take thou.” This symbol indicates

that what follows is a directive to take or dispense medication.
11/18/2024 14
 Cont…
3. Inscription
The inscription contains the names and quantities of the
ingredients prescribed. It details what medications are being
ordered, including their specific formulations (e.g., tablet,
liquid).
4. Subscription
This part provides directions to the pharmacist regarding
how to prepare or compound the medication and specifies
how many doses should be dispensed.
5. Signatura (Sig)
The signatura gives instructions for how the patient should
take the medication. These instructions are often transferred
to the label on the medication container so that patients can
follow them easily.
11/18/2024 15
 Cont…
6. Prescriber information

※ Finally, this includes details about the prescriber such as

their name, signature, address, and registration number (or
license number).

※ This information verifies that a licensed professional has

authorized the medication.

※ Understanding these components helps ensure safe and

effective use of prescriptions in medical practice .

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 Types of prescriptions
 We use a variety of prescription types to provide
medication to patients. Below are some explanations of the
different types of prescriptions we use:
A. Based on type of drug to be dispensed:
1. Ordinary prescription:
Ordinary prescription paper is commonly used prescription
found in all health centers and are used to prescribe
medications which are not controlled drugs.
Used to provide all necessary information to dispense
medications safely and correctly.

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 Cont…
2. A special prescription
 It refers to a specific type of prescription form required for
the dispensing of controlled substances including narcotics
and psychotropic medications.
 These forms are often mandated by government regulations
in various countries to ensure that the prescribing and
dispensing of these potentially dangerous drugs are
closely monitored and controlled.
 The primary purpose of special prescriptions is to prevent
misuse, abuse, and illegal distribution of controlled
substances.
 It is characterized by controlled distribution, triplicate
11/18/2024 18
Cont…
B. Based on readiness of prescribed drug:

1. Pre compounding prescription:

 Prescription for already prepared drug (by
pharmaceutical companies) e.g. Cap. Ciprofloxacin (500
mg) etc.

2. Extemporaneous prescription:
 The pharmacists prepare the medication according to the
drugs and dosages directed by the physician.

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 Cont…
C. Based on frequency of treatment:
1. Repeat prescriptions:
Repeat prescriptions is for medication you take for long
term such as tablets. For example: a statin tablet once a day.
2. Variable use prescriptions:
Variable use prescriptions are for medications that you do
not use every day, or the amounts you use will change. For
example eczema cream.
3. Acute prescriptions:
Acute prescriptions are for one off or short term medication.
For example antibiotics to treat an infection.
They are also used when starting a new medication if there
needs to be a review before you start taking it long term.
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1.2 Steps in dispensing of prescribed medications
 The process of dispensing should involve;
⁕The correct interpretation of prescription or oral
request,
⁕Accurate preparation and labeling of medicines
⁕With provision of appropriate information and follow
up.
 The medicine should be dispensed in a safe and hygienic

manner, making sure that the patient or care provider

understands and appreciates the value of taking specific
medicines for specific indications.
11/18/2024 21
 Pre-dispensing activities

Getting prepared for dispensing

Check the following:
 The room, shelves and dispensing counter are clean and

organized.
 Wear a clean and white gown.

 Attach your identification tag on the gown in such a way

that it is visible to clients.

11/18/2024 22
 Cont…
 Availability of dispensing aid, (counting tray, labeling

materials, packaging materials, sufficient number of

spoons etc.)
 Availability of updated drug list, OTC list, good

dispensing manual, STG, formulary, prescription

registration book.

11/18/2024 23
 Reception
As clients come into the pharmacy section, they must be
made to feel attended to and comfortable by:
♠ Friendly gestures
♠ A smile
♠ Eye-to-eye contact
♠ A friendly welcome
♠ Politeness
♠ Feeling of caring
NB. Verbal request can be done only for OTCs with
justification.
11/18/2024 24
 Steps in dispensing prescribed medications

11/18/2024 25
 1. Receive and validate prescription or verbal request

Validation
 The pharmacy professionals should confirm:

 Legality

A prescription is legal when:

It is written (can also be typed) and signed by an

authorized prescriber.
NPS prescription (Narcotic and Psychotropic

Prescription) for controlled drugs.

11/18/2024 26
 Cont…
The medicines are written on the right prescription such

as normal, NPS and ART.

Date of issue not exceeding 15 days for narcotic

drugs and psychotropic substances and 30 days for other

medicines.
Has all the information required to be contained with

respect to parts of prescription.

11/18/2024 27
 Cont…
Legibility
 A brief examination of each prescription should be made

immediately upon receiving it from the patient to

ascertain the legibility of various parts of the prescription.
 Pharmacy professional must examine the prescription

only behind the dispensing counter, and must not allow

themselves to be distracted while doing so.

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 Cont…
Any doubt regarding the reading of the prescription (i.e.

name of the medicines or directions, or if it appears that

an error has been made by the prescriber), should be
examined closely and, if necessary discussed/consulted
with other pharmacists or the prescriber himself/herself
without arousing doubts or fears in the patient.

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 Cont…
 Handwritten names of patients and medicines are often

difficult to read.
 In case of illegibility of name, age, etc., ask the patient for

the correct spelling tactfully.

 For example: The pharmacy professional may ask

“Excuse me, is the first name Meseret or Mahelet?”

Always use ‘please’, ‘excuse me’ etc. and be polite.

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 Cont…
 Every prescription should be read and understood

thoroughly before attempting to dispense it.

 Every word, abbreviation, has a meaning.

 To assume that an illegible or confusing word is

unimportant is inviting a costly mistake. In case of doubt,

consult another pharmacy professional or the prescriber.

‘NEVER DISPENSE GUSS WORK’

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 Cont…
Example of a Reading Error:
 Medoprazole and Mebendazole - due to illegible

handwriting of prescribers, Medoprazole could be read

as Mebendazole.
 Medoprazole is a brand containing omeprazole whereas

mebendazole is an anthelmintic, two different medicines

used for two different conditions.
 When handwriting is illegible, the best thing to do is to

contact the prescriber over the phone and confirm.

11/18/2024 32
 Cont…

Remember, you are dealing with medicines and thus,

the lives of patients. So be sure of what you are
dispensing.
Imagine the disastrous consequences of dispensing the
wrong medicine.
The dosage form, the dosage and the quantity to be
dispensed have to be legible so that dispensing becomes
easier for the pharmacy professional.
11/18/2024 33
 Cont…

 The instructions written for administration should state

clearly what the prescriber expects from the patient so

that the pharmacy professionals can counsel the patients
efficiently.
 All terminology, including units of measures and Latin

abbreviations should be properly interpreted and

checked.

11/18/2024 34
 Completeness of the prescription

The prescription serves as a vehicle for communication

from the licensed medical practitioner to the pharmacy

professionals about the pharmaceutical care of the
patient.
Details to be checked for completeness of the
prescription:
 Seal of the health institution or header

11/18/2024 35
 Cont…
 Patient's details (Patient Name, Patient Address,

Sex, Age, Weight and Diagnosis)

 Medicine details

 Prescriber’s details (Name of Prescriber’s,

Qualification, Signature and Date)

11/18/2024 36
Checking the medicine details will include checking:
 Name of the medicine
 Dosage form
 Strength/ potency of the medicine
 Total amount to be dispensed and its availability
 Dosage and directions for use
 Frequency of administration and duration of the treatment
 Identify and drug-drug interactions

11/18/2024 37
 1. Name of the medicine
 Must be legible and correct without a doubt.

 Since many brands sound alike, brand confusion is quite

common especially if the handwriting is illegible and the

pharmacy professionals proceeds on the basis of

guesswork.

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  The prescriber should ideally write the generic name

in parentheses against the brand name or write the

generic name alone.

 This makes it easier if the pharmacy professional is

not familiar with the brand prescribed.

 It would also aid in avoiding brand confusion.

11/18/2024 39
 2. Dosage form
 Some medicines are available in many different
formulations.
 It is essential to check that the product on the prescription

is available in the correct formulation, and to correctly

choose the formulation.

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 3. Strength/potency of the medicine
 The pharmacy professionals should check that the
strength is mentioned.
 If no strength is mentioned, it cannot be assumed that the

lowest or highest strength has to be dispensed.

 This is because many times the lower strength may not

be sufficient to treat the condition or higher strength may

lead to toxicity.

11/18/2024 41
 The prescriber prescribes a combination of amoxycillin

and clavulanate and mentions the dose as take 5ml twice a

day.
 It is available as Amoxicillin 125mg+ Clavulanic acid

31.25mg and Amoxicillin 200mg+ Clavulanic acid

28.5mg.
 Which one to dispense?

11/18/2024 42
 4. Quantity to be dispensed
֎ The prescription should lead to arrive at the exact
number of the total quantity to be supplied to the patient.
֎ The pharmacy professional should check this quantity to
confirm that it is appropriate for the patient, and that the
product can be supplied in such quantity.
֎ For any product with a short expiry period, ensure that
the quantity dispensed will not last longer than the expiry
date.
11/18/2024 43
 Cont…
֎ For example, if the prescription reads ‘Glibenclamide
5mg tablets p.o per day for 3 months’ for a chronic
patient who has been taking the medicine since 3 years
ago, on may 15, 2011, and the stock available of
Glibenclamide in the pharmacy has an expiry date of July
2011, and no fresh stock is available,
֎ what to do?

11/18/2024 44
 5. Dosage and directions for use
 A knowledgeable and an alert pharmacy professional can

be a great asset and a life saver especially if the

prescriber makes mistakes (at times major ones) while
prescribing.

11/18/2024 45
 6. Correctness of the prescription
A. Double medication: (same medicine or different
medicine with same pharmaco-therapeutic effect)
concurrently prescribed by the same or different prescribers
to the same patient undergoing treatment.

11/18/2024 46
 Cont…
Example:
 If a patient has been prescribed diclofenac for fever,

and if the dentist has prescribed other NSAIDs for the

same patient, it could lead to overdosing of NSAIDs, and
result in the risk of GI bleeding and may aggravate
hypertension.

11/18/2024 47
 B. Drug interaction
C. Check for overwriting:
 Overwriting can be done by the patient, to buy extra

medicines (especially habit forming medicines or

medicines of abuse).

11/18/2024 48
 D. Fake/false prescription:

 Pharmacy professionals should be alert to detect misuse of

prescription blanks by clients (obtained by stealing from

private practitioners or from Government hospital OPDs,

where blanks are often left lying around).

 Pharmacy professionals should also be alert to fake

prescriptions written/ printed by the patient or client coming

to the pharmacy.
11/18/2024 49
 Cont…
 If the handwriting is not the usual handwriting of the

prescriber or you notice it to be unusual otherwise,

confirm with a senior colleague or call the prescriber to

confirm.

 Do not dispense such prescriptions, and be sure to alert

the prescriber about the misuse.

11/18/2024 50
 E. Abbreviations
 Although widely used in prescription writing,
abbreviations can kill!! This is because in health care
there are no recognized standards for abbreviations, and
most of the time, prescribers invent their own.
 Secondly, different individuals/pharmacy professionals
may assume or interpret abbreviations differently.

11/18/2024 51
 Cont…
Examples:-
 ‘HCT’ 25mg was intended to mean Hydrocortisone 25mg,
but hydrochlorothiazide was dispensed.
 ‘CPZ’ may refer to Chlorpromazine, an antipsychotic or to
Carbamazepine, which is an anticonvulsant.
 ‘CPM’ can mean Chlorpromazine or Chlorpheniramine.

NEVER HINT ON ABBREVIATIONS. BE SURE TO

CONFIRM WITH THE PRESCRIBER.

11/18/2024 52
2. Interpretation of prescription or verbal request (OTC)

Correctly interpret any abbreviations used by the prescriber

Correctly perform any calculations of dose and the quantity to be

issued

Call the Prescriber

If any details are illegible, missing or incomplete, this prevents any

mistakes/ errors while dispensing.

The pharmacy professional can assure himself as well as the patient

that the medicines dispensed by him/her are according to the

prescription.
11/18/2024 53
 3. Prepare items for issue

This includes:

Select stock container of pre-pack reading the label and

cross matching the medicine name and strength against

the prescription.

Read the container label at least twice during the

dispensing process.

11/18/2024 54
 Cont…

Do not select the prescribed medicine according to the

color or location of container.

Do not open many stock containers at the same time. This

trend will lead to errors and/or expose the medicines to air

and eventually leads to deterioration in quality.

Open and close containers once at a time.

11/18/2024 55
 Cont…
While counting, pouring or measuring, the following

points should be noted:

 Short and/or over counting should be avoided

 Clean counting tray and/or spoon used

 Graduated measuring cylinder and/or flask must be used

for measuring liquid reduction.

11/18/2024 56
 Cont…
In dispensing tablets and capsules:
 Do not use fingers to count tablets as this can lead to

contamination of medicines
 Use a spoon to put tablets and capsules onto a counting tray

 Count and put them in a labeled medicine container or pack

 Close stock containers tightly after dispensing

 Keep the spoon clean at all times

 Do not keep the spoon inside the container

11/18/2024 57
 Cont…
4. Labeling and packaging of medicines
Packaging of Medicines
Medicines must be suitably contained, protected and labeled

from the time of manufacture until they are used by the patient.
The container must maintain the quality, safety and stability of

the medicine throughout this period.

Because original containers may contain large amount of

medicines, repackaging of medicines into another container

may be necessary in order to dispense medicines for patients.
11/18/2024 58
 Cont…
The selection of packaging for medicines depends on:
Nature of the medicine

 Type of patient

 Dosage form

 Method of administering the medicine

 Required shelf-life

Use, such as for dispensing.

11/18/2024 59
 Cont…

Prepackaging:

It is the process by which the pharmacy professional

transfers a medication manually from a manufacturer's

original commercial container to another type of container
in advance (before clients come to medicine retail out
lets).

11/18/2024 60
 Cont…
The following guidelines are recommended in
prepackaging of medicines:
 Prepackaging procedures must comply with laws and

regulations
 The prepackaging operations and area must be clean and

separate from other pharmacy activities.

Only one medicine product at a time should be

prepackaged in a specific work area.

11/18/2024 61
 Cont…
Before beginning a prepackaging run, a physical

evaluation (color, odor, appearance, and markings) of the

medicine product being prepackage should be made to
assure product integrity.
The bulk container should also be examined for evidence

of damage, contamination, and other deleterious effects.

 All prepackaging equipment and systems should be

operated and used in accordance with the manufacturers

or other established instructions.
11/18/2024 62
 Cont…
The main advantages of prepackage in medicines is that it

allows enough time for patient counseling and minimizes

dispensing errors resulting from hectic operation due to
heavy patient load.
Unfortunately, the materials commonly used for

repackaging in many medicine retail outlets of Ethiopia

are ordinary papers and the labeling is incomplete.
In such cases, repackaging of medicines is likely to have

many disadvantages than advantages.

11/18/2024 63
 Cont…
Packaging aids and materials
The materials used for repackaging include: glass

bottles, plastic bottles, collapsible tubes, paper envelops,

plastic envelops, etc.
Paper has the least value as the primary packaging

material in terms of maintaining the quality, safety and

stability of packaged medicine.

11/18/2024 64
 Case study 1

Ato Kebede went to a pharmacy with a prescription for

nitroglycerin sublingual tablets. The pharmacy worker

repackaged the prescribed number of tablets in paper
envelops and dispensed with appropriate instructions for
use.
Some other day, Ato Kebede consulted the pharmacy

professional about decreasing efficacy of the medicine

dispensed. What is your Comment?
11/18/2024 65
 Discussion:
Nitroglycerin is volatile medicine. It should be

packaged in tightly closed containers (bottles).

The use of paper envelops for repackaging leads to a

reduced efficacy of nitroglycerin, a possible reason for

the complaint of Ato Kebede.

11/18/2024 66
 Case study 2
 The pharmacy professional received a prescription with the

following information:
 Tabs Ibuprofen 400mg

 Mitte 60

 One t.i.d.

 The pharmacy professional dispensed 60 tablets of ibuprofen

400mg and wrote a label that the patient should take three
tablets daily with or after food. Comment on dosage.
11/18/2024 67
 Discussion:
The prescription was to take one tablet three times a day.

The information on the label is not clear. Accordingly, the

patient may take three tablets at a time, which may lead

to an occurrence of adverse effects or loss of efficacy.
Understanding the meaning of Latin abbreviations that

may appear on the prescription papers is important.

11/18/2024 68
 Labeling of Medicines
 The main functions of a label on a dispensed medicine

are to uniquely identify the contents of the container and

to ensure that patients have clear and concise information
about the use of the medicine.
 All medicines to be dispensed should be labeled and the

labels should be unambiguous, clear, legible and

indelible.
 If possible lettering should be printed.
11/18/2024 69
 Cont…
Minimum drug label information should include the following:

Patient name

Generic name, strength and dosage form of the medicine

Dose, frequency and duration of use of the medicines

Quantity of the medicine dispensed

How to take or administer the medicine?

Storage condition

If the medicine has been prepared extemporaneously, a batch

number may be included

11/18/2024 70
 Cont…

11/18/2024 71
 Cont…

11/18/2024 72
 5. Issue drugs to patients
 The prepared, packaged and labeled medicine is handed

over to the right patient or client or care provider with

appropriate medicine information.
The information in the form of verbal and/or written

instructions should include the following:

How much and how often to take the medicine.

When to take the medicine (e.g. before or after meals)

11/18/2024 73
 Cont…
 How long the treatment is to last (e.g. why the entire course of

an antibiotic treatment must be taken).

 How to take the medicine (e.g. with water, chewing or

swallowing).
 How to store the medicine (e.g., avoid heat, light and dampness).

 Not to share medicines with other persons.

 Which types of foods and beverages should avoid while taking

the medicine.
 To keep medicines out of reach of children.
11/18/2024 74
 6. Documentation and reporting
 Prescriptions should be recorded and documented as proof of

transaction between the client and the dispenser. Prescriptions

can therefore be traced back if any need arises.
 All dispensing units should have a standardized.

 Prescription Registration Book (PRB) for recording every

pharmaceutical issued to a client.

 A computerized dispensing and registration system may also

be used, but should always be supported by paper back up.

11/18/2024 75
 Cont…
 The registration book should be completed at the time of

dispensing or at the close of the working day.

 The prescription registration book should be used both when

prescriptions are retained in the pharmacy and when they are

returned to the patient.
 For a prescription which is returned to a patient because all the

items in the original prescription could not be filled, the

medicines that have been dispensed from the pharmacy should be
copied on a blank prescription and the prescription should be filed
appropriately.

11/18/2024 76
 Cont…
 On the original prescription, which is retained by the patient,

the word “dispensed” should be stamped adjacent to those

items which have been dispensed.
 For prescriptions which are to be refilled on a later date, the

dispensing information should be entered into the registration

book before returning the prescription to the patient.
 The official seal of the pharmacy/Health institution, name and

signature of the dispenser, the date of dispensing and the next

refill date should be written on the back of the prescription.
11/18/2024 77
 Cont…
 The receipts for requisition, receiving as well as the

prescription registration book should be kept properly.

 Blank prescription should be kept carefully, only

prescribers have access to them.

 Filled prescription should be kept as a receipt.

 Prescriptions for narcotic and psychotropic Substances

should be kept for 5 years and other prescriptions for 2

years.
11/18/2024 78
 Cont…
 Thereafter, they should be disposed carefully in the

presence of appropriate body

The record should contain information like:

Name, date and age

The medicines name and strength

Amount issued

Dispensers name

11/18/2024 79
 Cont…

11/18/2024 80
 Dispensing errors

Dispensing errors are errors that occur during the

dispensing process in the pharmacy.

They are different from prescribing errors or errors

during consumption of medicine.

11/18/2024 81
 Common dispensing errors

11/18/2024 82
 Cont…

11/18/2024 83
 Picking errors
Sometimes manufacturer's packs of different medicines

can be of similar design, and may lead to picking errors.

11/18/2024 84
 Reason for picking errors
 Not concentrating on the work/task and thinking/dreaming of

something else.
 Distractions due to gossiping, talking with other staff, friends at

the counter, or watching TV in the pharmacy.

 Extra workload, doing things at very high speed, or in confusion.

 Assuming that a box picked up is correct, and not verifying it

while picking.
 A different medicine placed in the usual place of the required

medicine.
11/18/2024 85
Dispensing errors

11/18/2024 86
 Refusal to dispense prescriptions

The pharmacy professionals should politely refuse to

dispense a prescription if:

 Essential information is missing or doubtful, and the

prescriber cannot be contacted.

 Safety of the medicines is doubtful.

The prescription does not conform to legal requirements.

fake or illegal alteration of the prescription is suspected,

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 Case study 3

 Ato Abebe, pharmacist, has filled some prescriptions for

carbimazole on one working day. On the same day a

customer, epileptic patient, presented him a prescription
for carbamazepine. Glancing at it, Abebe thinks it is
carbimazole once again, and that is what he dispensed.
The patient went to his prescriber with complaints of no
improvement. Comment on this case.

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 Discussion:
 Ato Abebe, the pharmacist, failed to read and understand

the prescription correctly. This has led to failure of

treatment regimen prescribed for the epileptic patient.
Because of the existence of similarity with the names of
some medicines, it is important to read and understand the
prescribed medicines carefully and correctly.

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 Case study 4
 W/ro Aster went to a medicine shop and made verbal

request for ampicillin and cough syrup for her 8 years old
daughter with complaints of cough and poor appetite.
 As she did not have enough amount of money, she wanted

to purchase only ten capsules of ampicillin and one bottle

of cough syrup suspension. The dispenser fulfilled her
request. Comment.

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 Discussion:
 W/ro Aster made a verbal request for a prescription

medicine (ampicillin) and an OTC cough syrup.

 The dispenser should have asked her a prescription at

least for ampicillin.

 Secondly, dispensing inadequate quantity of ampicillin

even with prescription is irrational. Such clients should

be referred to authorized prescribers.

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 Case study 5
 A prescription that calls for atenolol 50 mg. tablets is

presented to a pharmacy. The total quantity to be

dispensed is not indicated. One Tab. BID po for 4 weeks
is written after Sig.
 All other information is complete. The pharmacy

professional dispensed 28 atenolol 50 mg tablets.

Comment.

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 Discussion:
 The total quantity dispensed is not correct. According to

the prescription 56 tablets (2 tablets a day for 4 weeks or

28 days) should be dispensed.

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 Case study 6

A client presented an ordinary prescription that calls

for 20 diazepam 10 mg. and 10 paracetamol 500 mg.

tablets to a pharmacy. The pharmacy professional
dispensed both medicines with appropriate instructions
for use. Comment.

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 Discussion:
 Diazepam is a psychotropic medicine that should be

prescribed by using prescription paper for narcotic and

psychotropic medicines.
 The pharmacy professionals should not dispense such

medicines based on ordinary prescriptions or verbal

requests.

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 Case study 7
 A male patient that had chlamydial infection and

dyspepsia came to a pharmacy with a prescription for

tetracycline capsules and an antacid (magnesium
hydroxide suspension). Because the dispenser was busy,
no instruction about the usage was given to the patient.
 After two weeks, the patient consulted his prescriber for

no improvement of the chlamydial infection although he

was taking both medicines together for the specified
duration. Comment.
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 Discussion:
Tetracycline and antacid were prescribed for chlamydial
infection and dyspepsia, respectively. Loss of the efficacy
of tetracycline was possibly due to its interaction with
magnesium hydroxide, which decreases the absorption of
tetracycline when taken together. Therefore, instruction on
how to take medicines is important for avoiding such type
of medicine interactions.

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 End of LO1

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 Quiz 1
1. Suppose you receive a prescription with an order for drug
“X” 500 mg tab po bid for the first 3 days q.d. for the next 3
days and qod for the last 4 days. How many tabs of the drug
with the given strength should be dispensed for the patient?
A) 15 B) 25 C) 11 D) 10

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2. A 70 year old man is prescribed with Amoxicillin 500
mg capsule PO TID for 10 days. If you have Amoxicillin
125mg/5ml suspension, the unit dose and total dose are
_____and _______respectively.
A) 20 ml and 600 ml B) 20 ml and 300 ml
C) 1O ml and 600 ml D) None

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3. A liquid medicine is supplied in concentration of
20mg /5ml. a patient requires 40mg orally three times
daily for five days and then 20mg once daily for five days.
Which of following is the volume of liquid medicine that
you will need to dispense?
A) 600ml B) 300ml C) 200ml D) 60 ml

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 Quiz 2
Choose the best answer for the following questions.
1.A prescription is legal when:
A. Signed by authorized person B. Clear hand writing
C. Careless hand writing D. Illegibility

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2.Which types of drug may not be dispensed by
pharmacist without prescription.
A. Controlled drug B. Over the counter drug C. Legend
drug
3. Drug do not require prescription is____
A. Legend B. Controlled drug C. Over the counter drug

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4.Which types of prescription used for controlled
substances?
A. Special prescription B. Ordinary prescription
5. Narcotic drug need:
A. Special prescription B. Ordinary prescription

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 Matching
Column A Column B
1. Legality A. frequency of administration
2. Correctness B. checking for over writing
3. Completeness C. clear writing
4. legibility D. correct type of prescription

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 ተፈላጊና በታካሚዎች የሚወደድ ሐኪም/ጤና ባለሞያ መሆን ትመኛለህ?
እነዚህን ሰባት መርሆዎች ዕለት ዕለት ተለማመዷቸው።

1. ራስህን በሚገባ ከታካሚውና ቤተሰቡ ጋር አስተዋውቅ

 ራስህን ከአዳዲስ ታካሚዎችና ደንበኞች ጋር እንዴት ማስተዋወቅ ትችላለህ?

 ራሳችሁን ከአዳዲስ ታካሚዎችና ደንበኞች ጋር ስታስተዋውቁ፣ በራስ መተማመን

እና በቀላሉ መቅረብ አስፈላጊ ነው።

 በወዳጃዊ ፈገግታ እና በመጨባበጥ (በአካል ከሆነ) ወይም ጨዋ በሆነ ሰላምታ

በመስጠት መጀመር ይቻላል (#ፈገግታውን_እንዳይረሱ_ፈዋሽ_ነውና)።

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 ከዚያም ስምህን እና ሙያህን ካልደበረህ ስንት አመት በሙያው ዓለም

እንደቆየህ በመናገር እራስህን ማስተዋወቅ ትችላለህ። ይህ ታካሚው ባንተ

እንዲተማመን ያደርጋል ።
 አስተውል :- ራስህን ማስተዋወቅ ጉራ አይደለም !

ለምሳሌ :- በተረጋጋና ለዛ ባለው ድምፅ በቀላሉ :-__ እባላለሁ።

የመድሃኒት ባለሙያና በሙያዬ _አመት ያህል አገልግያለው ማለት ትችላለህ።

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 2.ጥሩ አዳማጭ ሁን
 ጥሩ አዳማጭ ስትሆን በታካሚዎች የሚሰጥህ ቦታ ከፍ ያለ ነው። በኛ ሀገር

አብዛኛውን ጊዜ ታካሚዎች ችግራቸውን (Medical History)

ሲነግሩህ ሊያንዛዙት ይችላሉ ወይም ከአሁን ችግራቸው ጋር የሚገናኝ
የመሰላቸውን ክስተት ወደ ኃላ አስር አመት ሄደው ሊያይዙ ይሞክራሉ።
 በዚህን ጊዜ በጥሞና በማድመጥ አሁን በይበልጥ የሚሰማቸውን የህመም ስሜት

ማወጣጣት ያስፈልጋል።
 አንዳንድ ሀኪሞች የሚሰሩት ስህተት :- በቁጣ '' የአሁን ችግርህን ንገረኝ!

'' በማለት ማስቸኮልና ቆሌ መግፈፍ : ይህም ታካሚው እንዲጠላንና በእኛ

እንዳይተማመን ያደርጋል።
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 3. ታካሚውንና ቤተሰቦቹን በሚገባ አክብር
 ተገልጋዮችን (ታካሚዎችን ) መረዳት÷ማክበርና መከታተል ለህክምና

አገልግሎትህ ቁልፍ ጉዳይ ነው።

 ታካሚዎችን በሚገባ የሚያከብር እንዲሁም አስታማሚን በትዕግሥት

የሚያዳምጥ ሀኪም በሰፈረው ቁና እንዲሉ ከህብረተሰቡ ዘንድ ከፍተኛ

ተወዳጅነትንና ከበሬታን ይቸረዋል።
 ምሳሌ:- አንድ ሚድዋይፈሪ በህብረተሰቡ ከመወደዱ የተነሳ ጥቂት

የማይባሉ ያዋለዳቸው እናቶች ልጆቻቸውን በስሙ ሰይመውለታል።

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 4. በበቂ ሁኔታ ተዘጋጅ::
 የጤና ባለሙያ ሁሌም አንባቢና የተዘጋጀ መሆን ይኖርበታል። በታካሚህ ፊት

በራስ መተማመንህ መቀነስ የለበትም።

 ለጊዜው ያልደረስክበት የጤና ችግር የገጠመው ታካሚ ቢገጥምህ ጊዜ ወስደህ

ማንበብና ጉዳዮን ከፍ ላሉት ሀኪሞች አማክረህ (after

Consultation) እንደምትመልስለት ሳታፍር ንገረው።
 ይህም የህክምና ጥራትን የመጨመር ÷ከህክምና ስህተት መከላከል ጥቅም

ያለውና ደንበኛህ እርግጠኛ ያልሆንከውን ህክምና እንደማትሰጠው ስለሚያስብ

ባንተ ይተማመናል።

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 5.ሃይማኖታዊ ልምዱን ÷ዕምነቱንና ባህሉን አክብርለት
 ታካሚዎች ለፈውስ አገልግሎት ወደ ፀበል ÷ ፀሎት ቤትና መስጊድ በመሄድ

ለችግራቸው መፍትሄ እየፈለጉ እንደሆነ ሊነግሩህ ይችላሉ።

 በዚህን ጊዜ በጥንቃቄ በማዳመጥ ፈጣሪ እንደሚረዳቸው

መናገርና÷ህክምናቸውንና መድሃኒቱን ሳያቋርጡ በፀሎታቸው እንዲበረቱ

አስረዳቸው።
 ማንኛውም ሃይማኖታዊ ልምምድንና ባህልን የሚያንቋሽሽ ተግባር መፈፀም

የለብህም።

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 6. አሳታፊነትና በቂ ማብራርያ መስጠት
 ታካሚው ስለገጠመው ጤና እክልና ህክምና ሂደት በሚገባ ማብራርያ

መስጠትና ስለሚሰጠው ህክምና አማራጭ በማሳተፍ ውሳኔ ስጥ።

 ይህም ታካሚው ስለችግሩ በቂ ግንዛቤ እንዲኖረው ከማገዙም በላይ

የህክምና ክትትሉ ላይ አዎንታዊ ሚና ይኖረዋል።

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 7. ካለህ አካፍል
 አንዳንድ ጊዜ ታካሚዎች ገንዘብ ሊያጥራቸው ይችላል።

 መድሃኒት እንድትገዛ ወደ ፋርማሲ የመጣች እናት'' 5 ብር ጎደለኝ ''

ልትልህ ትችላለች።
 ወይም ደግሞ ምንም አይነት ምግብ ለመመገብ ገንዘብ እንደሌላትና ተጎሳቁላ

ልታገኛት ትችላለህ::
 ከኪስህ መርዳት ካልሆነ ደግሞ ሌሎቹን አስተባብሮ ጊዚያዊ ችግርን

ለመፍታት ራስህን አበርታ።

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