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Chapter 6

Chapter 6. Dispensing Medications in the Community Pharmacy. Presentation Topics. Operations of a Community Pharmacy The Patient Profile Components of a Prescription Other Types of Prescriptions. Presentation Topics. Pharmacist Verification and DUR Evaluation

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Chapter 6

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  1. Chapter 6 Dispensing Medications in the Community Pharmacy © Paradigm Publishing, Inc.

  2. Presentation Topics • Operations of a Community Pharmacy • The Patient Profile • Components of a Prescription • Other Types of Prescriptions © Paradigm Publishing, Inc.

  3. Presentation Topics • Pharmacist Verification and DUR Evaluation • Medication Selection and Preparation • Medication Information for the Patient © Paradigm Publishing, Inc.

  4. Presentation Topics • The Final Check of the Prescription • Delivering the Filled Prescription to the Patient © Paradigm Publishing, Inc.

  5. Learning Objectives • Discuss overall community pharmacy operations, including • Restricted area • Hours of operation • Drive-through options • General responsibilities of the pharmacy technician with regard to dispensing prescription drugs © Paradigm Publishing, Inc.

  6. Learning Objectives • Identify the parts of a patient profile, detail the steps required to select a patient from the database, and discuss the importance of including up-to-date allergy and adverse drug reaction information. © Paradigm Publishing, Inc.

  7. Learning Objectives • Describe the parts of a prescription and identify the most commonly used abbreviations for • Amounts • Dosage forms • Times of administration • Sites of administration © Paradigm Publishing, Inc.

  8. Learning Objectives • Describe controls necessary for reviewing prescriptions of scheduled drugs, including the identification of possible forgeries. • Explain the typical procedures for processing new and refill prescription orders. © Paradigm Publishing, Inc.

  9. Learning Objectives • Identify the parts of a prescription stock label and know the importance of comparing NDC numbers in medication selection and filling. • Describe the parts of a typical medication container label. © Paradigm Publishing, Inc.

  10. Learning Objectives • Contrast the purposes of the patient medication information sheet and leaflet with those of the medication guide. • Discuss the importance of a final check and verification by the pharmacist prior to dispensing to the patient. © Paradigm Publishing, Inc.

  11. Operations of a Community Pharmacy A community pharmacy is a business designed to serve the needs of its customers, where customer service and convenience is important. © Paradigm Publishing, Inc.

  12. Discussion Where are the majority of prescriptions filled? In chain or independent community pharmacies © Paradigm Publishing, Inc.

  13. Operations of a Community Pharmacy In the community pharmacy, the pharmacy technician performs many near-simultaneous tasks, with • Focused care • Attention to detail © Paradigm Publishing, Inc.

  14. Discussion Which pharmacy technician duties listed in Table 6.1 (page 153) do you think seem the most challenging? Why? © Paradigm Publishing, Inc.

  15. Operations of a Community Pharmacy The area of the pharmacy where the prescription medications are stored and prepared is • Secured by code or key • Off-limits to the public © Paradigm Publishing, Inc.

  16. Terms to Remember • prescription • an order written by a qualified, licensed practitioner for a medication to be filled by a pharmacist in order to treat a qualified medical condition © Paradigm Publishing, Inc.

  17. Operations of a Community Pharmacy The critical path of a new prescription • Starts with receipt of prescription • Ends with dispensing to patient • Takes about 5 to 10 minutes • Has many phases that are completed by the pharmacy technician © Paradigm Publishing, Inc.

  18. Critical Path of a New Prescription 1. The pharmacy technician checks the prescription to make certain it is complete and authentic. (See Table 6.2) © Paradigm Publishing, Inc.

  19. Critical Path of a New Prescription 2. The pharmacy technician verifies that the patient information is contained in the pharmacy database. If not, then the technician obtains necessary demographic, insurance, allergy, and health information from the patient and enters the information into the computer. © Paradigm Publishing, Inc.

  20. Critical Path of a New Prescription 3. The pharmacy technician enters (or scans) the prescription into the computer database, billing the insurance company or calculating the cost to the patient. © Paradigm Publishing, Inc.

  21. Critical Path of a New Prescription 4. The pharmacist verifies the accuracy of the technician’s computerized entry against the original prescription (or a photocopied image) and generates the medication container label. © Paradigm Publishing, Inc.

  22. Critical Path of a New Prescription 5. When required, the pharmacy technician asks the pharmacist to check the drug utilization review (DUR) or drug interaction warning screen. © Paradigm Publishing, Inc.

  23. Critical Path of a New Prescription 6. The pharmacy technician selects the appropriate medication and verifies the National Drug Code (NDC) number on the drug stock bottle against the computer-generated medication container label. © Paradigm Publishing, Inc.

  24. Critical Path of a New Prescription 7. The pharmacy technician prepares the medication: • The prescribed number of tablets or capsules are counted or the prescribed amount of liquid is measured. • Controlled drugs are often double-counted and initialed. © Paradigm Publishing, Inc.

  25. Critical Path of a New Prescription 8. The pharmacy technician packages the medication in the appropriate container. © Paradigm Publishing, Inc.

  26. Critical Path of a New Prescription 9. The pharmacy technician labels the prescription container with the computer-generated medication container label. (In some states the law requires the pharmacist to affix the label to the container.) © Paradigm Publishing, Inc.

  27. Critical Path of a New Prescription 10. The pharmacy technician prepares the filled prescription (including original prescription, drug stock bottle, medication container label, and medication container) for the pharmacist to check. © Paradigm Publishing, Inc.

  28. Critical Path of a New Prescription 11. The pharmacist checks the prescription and may initial the label and prescription. © Paradigm Publishing, Inc.

  29. Critical Path of a New Prescription 12. The pharmacist or pharmacy technician bags the approved prescription for patient sale and attaches an information sheet about the prescription, including • Indications • Interactions • Possible side effects © Paradigm Publishing, Inc.

  30. Critical Path of a New Prescription 13. The pharmacy technician returns the drug stock bottle to the shelf. If the bottle is opened, then the bottle is so marked or labeled for inventory ordering. © Paradigm Publishing, Inc.

  31. Critical Path of a New Prescription 14. The pharmacy technician delivers the packaged prescription to the cash register area for patient pickup (or storage) and pharmacist counseling: • Verify that the correct patient is receiving the prescription (ask for address or birth date). • Photo ID may be required. © Paradigm Publishing, Inc.

  32. Critical Path of a New Prescription 15. If payment is due, then the patient pays by cash, credit card, or check. Most insurance providers require the patient to sign a form verifying that the prescription was picked up. © Paradigm Publishing, Inc.

  33. Discussion • Why is customer service and convenience important in a community pharmacy? • What are some of the key duties of the pharmacy technician in a community pharmacy? © Paradigm Publishing, Inc.

  34. The Patient Profile • A patient-specific record of • All prescriptions that have been dispensed in the past at the pharmacy • Relevant demographic information • May be shared nationally among chain pharmacies © Paradigm Publishing, Inc.

  35. The Patient Profile • Identifying information • Insurance and billing information • Medical and allergy history • Medication and prescription history • Prescription preferences • HIPAA confidentiality statement © Paradigm Publishing, Inc.

  36. The Patient Profile New pharmacy customers require new patient profiles: • created at the time the prescription is submitted to the pharmacy • if phoned in, created prior to dispensing the medication(s) tothe patient © Paradigm Publishing, Inc.

  37. The Patient Profile If a patient profile already exists for a patient, then it is important for the pharmacy technician to verify that the correct profile is selected. © Paradigm Publishing, Inc.

  38. The Patient Profile Obtaining information from the patient • Customers may complete a hard-copy form. • The pharmacy technician may need to interview the patient to obtain the necessary information. (See Figure 6.2) © Paradigm Publishing, Inc.

  39. The Patient Profile • It is extremely important for the pharmacy technician to ask the patient about • Allergies to medications • Past adverse drug reactions • All allergies must be documented and entered into the patient profile. © Paradigm Publishing, Inc.

  40. Documenting Drug Allergies and Adverse Drug Reactions Inquire about allergies every time a patient comes to the pharmacy with a prescription for an antibiotic. © Paradigm Publishing, Inc.

  41. Discussion Why is it important to inquire about allergies every time a patient comes to the pharmacy with a prescription for an antibiotic? Patients can develop allergies to antibiotics, even if they have taken antibiotics without adverse reactions in the past. © Paradigm Publishing, Inc.

  42. Documenting Drug Allergies and Adverse Drug Reactions Some food allergies may cross-react with medications: • Eggs • Peanuts • Gluten (wheat) • Dyes • Soy © Paradigm Publishing, Inc.

  43. Documenting Drug Allergies and Adverse Drug Reactions Once a patient profile contains allergy-related information, the computer software will “warn” the pharmacist that a potential allergy or hypersensitivity reaction may occur if a prescription is filled for that drug. © Paradigm Publishing, Inc.

  44. Terms to Remember • patient profile • a record kept by the pharmacy listing a patient’s identifying information, insurance information, medical and prescription history, and prescription preferences © Paradigm Publishing, Inc.

  45. Terms to Remember • allergy • a hypersensitivity to a specific substance, manifested in a physiological disorder © Paradigm Publishing, Inc.

  46. Discussion • How is the patient profile used in a community pharmacy? • How are patient profiles kept up-to-date? © Paradigm Publishing, Inc.

  47. Components of a Prescription Pharmacy technicians check prescriptions to confirm • The prescription is complete • Medication information is documented accurately © Paradigm Publishing, Inc.

  48. Prescriber information Date Patient information Rx Inscription Subscription Signa Additional instructions Signature Components of a Prescription © Paradigm Publishing, Inc. © Paradigm Publishing, Inc.

  49. Components of a Prescription © Paradigm Publishing, Inc.

  50. Terms to Remember • e-prescribing • transmission of a prescription via electronic means © Paradigm Publishing, Inc.

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