Good Dispensing Practice

1. Good dispensing practice
May, 2019
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2. Outlines
• Definition and terminologies
• Good dispensing practice
• Rational drug use
• Steps of good dispensing practice
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3. Terminologies
• Drug: means any substance or mixture of
substances having a marked physiological
effect when taken into the body
• It’s useful in the diagnosis, treatment,
mitigation or prevention of a disease in man or
animal.
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4. Terminology ….
• Prescription: any written order for drug and
signed by a duly licensed or authorized medical
practitioner & issued to a patient in order to
collect drug from dispensing unit.
• Prescriber: means any medical practitioner who
is licensed or authorized to write prescription.
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5. Terminology ….
• Dispensing: to prepare drugs and/or medical
supplies and distribute them to their users.
• Dispenser: any person who is licensed or
authorized to dispense drugs and/or medical
supplies.
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6. Termino……
• Prescription drugs: drugs which are
dispensed with prescription only.
• Over-the-counter drugs (OTC): means drugs
which are dispensed even without prescription.
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7. Other terminologies….
• Rational prescribing vs
• Rational dispensing vs
Rational drug use vs
Irrational prescribing
Irrational dispensing
Irrational drug use
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• Poly-pharmacy
Rational drug use Irrational drug use

8. Good dispensing practice (GDP)
• Refers to the delivery of the correct drug and medical
supply to the right patient, in the required dosage and
quantities, in the package that maintains acceptable
potency and quality for the specified period, and clear
drug information.  Rational Drug Use
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9. • Rational use of drugs is a complex issue
demanding mainly an integrated action of drug
prescribers, dispensers and users and/or
patients.
• GDP targets to patient Compliance /Adherence
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10. Prescription
• A prescription is a written therapeutic transaction /an
instruction/ from a prescriber to a dispenser.
• It tells the dispenser how the drug should be dispensed.
• It serves as a means of communication among the
prescriber & dispenser
• A prescription should be written on a standard
prescription blank, in ink and in generic name
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11. Directions for use:
• Directions specifying
• The route
• Dose and
• Frequency should be clear and explicit
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13. Rational drug dispensing
• The correct drug is delivered
 To the right patient
 In the right dosage and quantities
 With clear information, and
 In package that maintains an acceptable potency and
quality of the drug.
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14. Good Dispensing Process
• Steps in dispensing of prescribed medications
1. Receive and validate prescription or verbal request
2. Understanding and interpreting prescription
3. Prepare items for issue
4. Labeling and packaging of medicines
5. Issue drugs to Patient
6. Documentation
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15. 1. Receive and validate prescription
• Upon receiving the prescription , the Pharmacist should
confirm:
 Identity of the client and providing greeting
 Whether the prescription is presented by the client
himself or by someone on the client’s behalf.
 Take simple history about the condition
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16. Cont…
• The client politely requested to wait while the
pharmacist review the prescription for:
 Therapeutic aspects (pharmaceutical vs pharmacological)
 Appropriate for an individual
 Economic aspects
 Legality & completeness of prescription
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17. Cont…
• Prescription should be complete with regard to:
Name of the Doctor, his /her address and registration number.
Name, address, age, sex of the patient
Name(s) of the medicine(s), potency, dosage, total amount of
the medicines to be supplied
Instruction to the patient
Refill information if any
Prescribed Doctors’ usual signature
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18. Cont…
• The prescription should be checked for:
Dosage: check within the standard min and max dose range.
Double medication (same drug or different drug with same
pharmacotherapeutic effect)
Interaction between the currently prescribed medicines, OTC
Contraindication: age, sex, disease(s)
History of overuse, under use, or misuse of medicines by the
patient.
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19. Validating of a Prescription
• Legality of a prescription
• Legibility of a prescription
• Completeness of a prescription
• Correctness of the prescription
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20. Legality
A prescription is legal when
• It is written (typed) & signed by authorized prescriber
• Date of issuing is not exceeding 15 days for narcotic
& psychotics and 30 days for normals
• Medicines are written on the right i.e. normal,
Narcotic and Psychotic
• Has all information in all parts of prescription
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21. Legibility
• Handwriting → readable
• The dosage form, dose and quantity be legible
• Unit of measure, Latin abbreviations readily
interpreted
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22. Completeness
• Seal
• Prescriber’s detail (name, qualification, sign, date)
• Patient detail
• Medicine detail
 Name (generic substitution)
 Dosage form and route
 Strength/potency
 Dose and direction
 Frequency and duration
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23. Correctness
Pharmacy professional should Check
• Double medication (same or d/t drug having with same
therapeutic effect concurrently prescribed for a single pt.
• Medicines interaction
• History of overuse, under use or misuse of medicines
• Check for overwriting – pt may take extra medicines by
itself
• Fake/false prescription
• Therapeutic window of the drug
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24. 2. Retrieval
• The dispenser should:
→ Read the label on the drug container carefully
→ Counter check the drug against the prescription
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25. Ctnd…
• During this step, pharmacist intervene to decrease
occurrence of dispensing errors includes:
 Care in selecting appropriate medicine; there are
some medicines that have very similar names
 Care in selecting the appropriate strength
 Care in selecting the appropriate dosage form
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26. 3. Understanding and Interpreting prescription, &
receipt
• Interpret the common abbreviations
• Cross check the prescription with its receipt
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27. Common Abbreviations
Latin Term Common Abbreviation Translation
alternis horis alt. h. every other hour
agita agit shake, stir
ante a. before
ante cibum a.c. before food, before meals
amp. ampule
auris dexter a.d. right ear
aurix laevus a.l. left ear
auris sinister a.s. left ear
auris utro a.u. each ear
bis b. twice
bis in die b.i.d. twice a day
hora h at the hour of
hora somni h.s. at bedtime
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28. Latin term Abbreviation Translation
oculus o. eye
oculus dexter o.d. right eye
oculus laevus o.l. left eye
oculus sinister o.s. left eye
oculus utro o.u. both eyes, each eye
per os p.o. by mouth
post cibum p.c. after meals
pro re nata p.r.n. as needed
quater in die q.i.d. four times a day
quaque q. each, every
quaque die q.d. every day
quaque hora q.h. every hour
quantum sufficiat q.s. a sufficient quantity
quantum sufficiat ad q.s. ad a sufficient quantity to make
Ter in die t.i.d. to be taken three times daily
stat At once/ immediately
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29. 4. Prepare items to dispense
• Make ready the drug from the shelf
• Read the label at least three times during the
dispensing process:
 When picking out from the shelf
 When preparing/processing and
 When returning the product to the shelf
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30. 5. Issue Drugs to Patient
• Issue the properly packaged drug products to patients.
• Issue with relevant information (oral & written)
• Provide clear instruction
• Show the real medication (tab, cap, bottle….)
• Re-ask how it should be taken & re-inform
• Allow to ask un-cleared instructions
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31. Cont….
• Demonstrate on how to administer the dispensed
drugs. E.g.
 Inhaler administration
 Suppository application
• Counsel patients on how to take their medication,
about their illness, precaution to be taken, etc…
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32. The five rights for correct drug administration
1. Right Patient: Always verify the patient name before
dispensing medicines
2. Right Drug: Always check the medication against the
original prescription and the patient's disease state. The
medication label contains important information about the
drug that will be dispensed to the patient.
3. Right Strength: Check the original prescription for this
information and pay attention to the age of the patient.
Pediatric or elderly patient can easily get the wrong dose.

33. Cont…
4. Right Route: Check that the physician¡¦s order
agrees with the drug’s specified route of
administration. Many medications can be given by
a variety of routes and the route of administration
can affect the medication’s absorption.
5. Right Time: Check the prescription to determine
the appropriate time for the medication to be
administrated.

34. 6. Labeling of Medicines:
• There is a legal requirement to be added on the label of
any prescribed or over the counter medicine:
Generic name
Total quantity
Directions for use
Route of administration
Precautions relating to the use, and
Storage of medicine
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35. 7. Recording, documentation and reporting
• Keep blank prescription papers carefully.
• Filled prescription papers are the receipt of the pharmacy
section and they should be kept in this section.
• Register filled prescription paper of Narcotic drugs and
Psychotropic substances on a Separate Patient Prescription
Registration Book.
• Keep carefully the prescriptions
– Normal Prescription  2yrs
– Special prescription 5 yrs
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36. Ctnd…
• Keep Patient Prescription Registration Book, receiving
and issuing vouchers and other related documents
properly.
• Review and summarize Patient Prescription Registration
Book regularly, in order to:
• calculate actual drug consumption
• determine the prevalent diseases
• select drugs on the basis of the prevalent diseases
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37. Ctnd…
• Assess drug utilization to know whether prescribing
practice is rational or irrational
• Determine drug budget
• Give clear picture of fast moving drugs in terms of
proper consumption
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38. Ctnd…
• Prepare regular reports on:
 Drug consumption
 Prevalent health problems
 Prescription pattern and
• Submit the report to the appropriate bodies.
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40. References
• Ethiopian Medicines Formulary 2013
• Good dispensing manual for Ethiopia, DACA 2005
• Manual for Medicines Good Dispensing Practice 2nd edition
2012
• Practical guideline for dispensing at higher level health centers
2015
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