Notes compiled by Osiyoye Kehinde

1. PCT 212 LECTURE NOTES
WEEK ONE
SCOPE OF HOSPITAL DISPENSING PRACTICE
Dispensing is defined as the review of a prescription and the preparation,
packaging, labeling, record keeping and transfer of the prescribed medicine
including counseling to a patient, their agent, or another person who is responsible
for the administration of the medicine to that patient.
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, clear medicine
information counseling and appropriate follow up. This practice is a key step for
effective treatment outcome. Though rational medicine therapy requires the
concerted efforts of all health care professionals, the role of pharmacy professional
is immense.
Traditionally, pharmacy professionals’ primary responsibility has been stocking,
distributing and maintaining quality of medicines dispensed. Nowadays, this role
has emphasized more on advising the prescribers and other health professionals
about medicine therapy, counseling patients about medicines and monitoring
medicine use. Pharmacy professionals bridge the gap between the prescriber and
the patient and serve as the gate-keepers of medicine supply system.
The dispenser plays a very important role in ensuring that medicines are used
appropriately and that patients benefit from treatment. All efforts and resources to
make medicines available at health facilities will be wasted if the patient is not
given the correct medicine, dose, and information needed to make sure that he or
she takes the medicines correctly.
Dispensing includes all the activities that occur between the time the dispenser
receives the prescription and when the dispenser hands it to the patient. Good
dispensing takes time. Good dispensing practices ensure that each patient receives:
 His/her correct medicine

2.  The correct dosage and quantity
 Correctly labelled, well-packaged container to maintain medicine quality
A safe, clean, and organized working environment provides a basis for good
practice. Dispensing must be performed accurately and should be done in an
orderly manner, with disciplined use of effective procedures. Care should be taken
to read labels accurately. The dispenser must count and measure carefully and
guard against contamination of medicines by using clean equipment and never
allowing skin contact with the medicines. The dispensing environment includes:
 Staff
 Physical surroundings
 Shelving and storage areas
 Surfaces used during work
 Equipment and packaging materials.
Staff members who dispense must be trained in the knowledge, skills, and
practices necessary to dispense the range of medicines prescribed at the facility.
Their performance should be regularly monitored.
Ensuring patients understanding of how to take their medicines is a primary
responsibility of dispensers. Dispensers should check understanding by asking
each patient to repeat instructions.
Good records, though sometimes neglected, are an essential part of dispensing;
they facilitate good management and monitoring of services provided.
Differences between Dispensing and Compounding
COMPOUNDING DISPENSING
It involves preparation, mixing,
lebelling and packing of a
drug/medicine.
It involves giving already available
packed medicine/drug manufactured by
pharmaceutical manufacturers to patient
or patient’s caretaker by evaluation of

3. prescription.
Compounding could be performed only
in pharmacy.
Dispensing is performed in pharmacy
and chemist.
Technical knowledge is required for
compounding, so it must be carried out
by pharmacist itself.
It doesn’t require deep technical
knowledge, so it can be carried out by
helper under supervision of pharmacist.
Standard references should be followed
during compounding and compounded
medicines should be labeled properly.
It doesn’t necessarily need standard
reference to follow because already
packed medicines/drug involves in the
process.
WHAT IS PRESCRIPTION?
A Prescription is the written medication ordered by a doctor, dentist, surgeon,
veterinarian or any other registered medical prescriber to the pharmacist, for the
supply of a medicine, dressing or surgical appliance to a patient.
Pharmacists are increasingly being given prescribing privileges by enactment of
sate collaborative drug therapy management ( CDTM) legislation. This
allows pharmacists to order new medication or change the dose of existing
medications under established protocols or guidelines agreed upon by the
pharmacist and physician.
Prescriptions may be written, presented orally (by telephone), or presented
electronically (i.e., via fax or computer network) to the pharmacist. The
prescription serves as a vehicle for communication from the prescriber to the
pharmacist about the needs of the patient.

4. WEEK TWO
HISTORY OF PHARMACY PRACTICE IN NIGERIA
The pharmacy profession did not originate from Nigeria. Pharmacy practice
technically was the first form of science when humans use nature e.g herbs to treat
diseases. The pharmacy program was part of medical science. It went a separate
way from medical science in the year 1240 by the emperor of the Holy Roman
Empire, Federick II of Hohenstaufen. The first ever know pharmacy shop in the
world was in Baghdad, Iraq during the 8th
century. It took centuries before the
first ever pharmacy shop came to Nigeria.
Early Years of European Pharmacy Practice
This era covers the period from the late 19th
century to the first few decades of the
20th
century. Pharmacy education during this period started with training of
Nigerians in dispensing through apprenticeship under physicians, to prepare simple
solutions and mixtures and subsequently either serving as dispensers in the
hospitals or opening medicine shops to serve Nigerian community. An example of
such early shops was that of Mr Richard Zaccheus Bailey, which was opened in
1887 along Balogun Street in Lagos.
Later on experienced dispensers and reputed pharmaceutical companies were
allowed to train others. Again, Mr Bailey was an example of such early trainer of
dispensers. With time apprenticeship training in hospitals under physicians became
more formal and regular. By the beginning of the 3rd
decade of the 20th
century (i.e
the 1920’s). it became clear that the apprenticeship programme could no longer
meet the need for pharmacy services in nigeria, and preparations were made
through legislation to open school of pharmacy for training of dispensers. This plan
materialized through the establishment of a school of pharmacy at Yaba, Lagos for
the purpose in 1925.
Hospital Pharmacy Practice
A clear majority of the “pharmacists” in the early part of this era were actually
“dispensers”. The hospitals or dispensaries were managed under the supervision of

5. the medical officers in charge of such hospitals in Nigeria as at 1990. These
hospitals were located in Lagos, Asaba, Abeokuta, and Calabar, three of which
were government hospitals and one, a mission (catholic) hospital. These hospitals
used a common hospital formulary. There were also a number of mission medical
set-ups before this date in some coastal towns, which could not be described as
hospitals. However, there was a steady growth in the number of hospitals both
government and mission between 1900 – 1960.
Community Pharmacy Practice
In community practice, the first medicine shop was opened in 1887 by Mr
Richard Zaccheus Bailey in present day Balogun street of Lagos state. It was
primarily to cater for his European clients and a few African elites. Other retail
pharmacies did not come into existence until the 1920’s and much later. The West
African drug Company Ltd was established in 1924, while commercial Medicine
stores (by Chief S.T. Hunponu-Wusu and Mr Robert Olatunji Adebowale) and
Phillips Medicine Stores (by Thomas King Ekundayo Phillips) were established in
the 1940’s all in lagos. Several years went by before retail pharmacies were opened
in the towns of the old Western, eastern and Northern regions of Nigeria. By the
end of 1960, as many as 150 community pharmacy shops had been established
while a total number of registered pharmacists (many of who were not in
community or general pharmacy practice) was 542.
Industrial Pharmacy Practice
Industrial pharmacy was evident with the arrival of May and Baker in 1944, Glaxo
and Pfizer in 1954. These pharmaceutical companies were mainly into importation
and marketing of pharmaceuticals. Large-scale drug production began in the 60’s
involving governmental agencies, multinational companies and private
enterpreneurs. Presently, there are more than 115 registered pharmaceutical
manufacturers in Nigeria. These companies manufacture various pharmaceutical
dosage forms cutting across various therapeutic classes. In addition to providing
dependence high – quality pharmaceutical products to medical professionals and

6. patients in various communities in Nigeria and west Africa, they have also
contributed greatly to the economic growth of the nation.
HOSPITAL PHARMACY PERSONNEL AND THEIR FUNCTIONS
1. Chief Pharmacist
 Implementation of decision of Therapeutic Committee
 Dispensing of drugs, pharmaceuticals and chemicals to different areas.
 Maintenance of approved stock of emergency drugs and antidotes.
 Dispensing of narcotic drugs and accounting.
 Specification for various fluids
 Inspection of drugs at various points of use
 Preparation of indents, issue and receipt voucher
 Inventory control
 Maintenance of stores, ledgers and records
 Provision of alternate electricity supply
 Inspection and quality control
 Teaching and training of pharmacist
 Periodic utilization report of pharmacy
 Patient education.
2. Records and Registrars
 Stock ledger of different group of drugs
 Indent and receipt voucher
 Drug inspection report
 index registrar and bin cards
 Expiry date registrar
 Adverse reaction record
 File of correspondence with suppliers and units
 Ledger account for payment of vouchers
 Condemnation record for non-consumables and consumables
 Annual stock verification record

7.  Hospital formulary
 Antibiotic policy.
3. Hospital Pharmacists
 Check prescriptions to make sure there are no errors and that they’re
appropriate and safe for the individual patient.
 Provide advice on the dosage of medicines and the most appropriate
form of medication, for example, tablet, injection, ointment or inhaler;
 Participate in ward rounds to take patient drug histories;
 Liaise with other medical staff on problems patients may experience
when taking their medicines.
 Discuss treatments with patients’ relatives, community pharmacists and
GPs;
 Make sure medicines are stored appropriately and securely
 Supervise work of less experienced and less qualified staff.
 Keep up to date with, and contribute to, research and development;
 Write guidelines for drug use within the hospital and implement hospital
regulations.
4. Pharmacy Technicians / Assistant Pharmacists
 Assisting the pharmacists to prepare medications for patients
 Receiving and verifying the prescriptions
 Pricing and filling of prescriptions
 Obtaining pharmacist’s approval
 Completing patient paperwork related to the filling of prescription
 Assisting with insurance claims processing (usually a pharmacist will
handle this, but assistant’s help will be needed – the entire process is
done online)
 Stocking and pricing of medications in inventory
 Ensuring availability of drugs by delivering them to patients or facilities
 Maintaining pharmacy’s (and its patients’ employees’) safety by adhering
to infection-control procedures, policies and regulations.

8. ORGANOGRAM OF A HOSPITAL PHARMACY
Assignment
1. Differentiate between community pharmacy and hospital pharmacy.
2. Outline the organogram of a community pharmacy.
3. Who is a dispenser?
WEEK THREE
UNDERSTANDING PARTS OF PRESCRIPTION
PARTS OF A PRESCRIPTION
The prescription contains the following information:

9. 1. Date of the Prescription:
 This is necessary for the prevention of misuse of prescription,
especially the ones which contain narcotics and controlled drugs.
 It also helps the pharmacist to keep day-day Patient’s record in
chronological order which helps the pharmacist or a physician to refer
the old case in future.
 The pharmacist should advice the patients to visit the doctor again.
2. The Patient’s Name, Age, Sex and Address:
 Name, Age, Sex and Address of the patient must be written on the
prescription.
 Name helps the pharmacist to identify the correct Patients avoiding
any chance of giving the medicine to a person other than the one it is
dispensed for.
 Note: patient’s full name must be written instead of nicknames or
surnames.

10.  Age of the patient becomes important in the case of the Pediatric
(children) and Geriatric (old people) cases. Because the dose of drugs
in such cases varies (due to their differences in ability to metabolize
drugs).
 Hence dose of the drugs are calculated based on the age factor in such
cases.
 Note: In some cases, weight and height of the patients are also
required.
 Sex/Gender of the patient also plays major role in prescription
because the dose of drugs may also vary based on the sex/gender of
the patients (as their abilities to metabolize/response towards drugs
may vary in many cases).
 Address of the patient is generally recorded to contact the person at
the later stage or to deliver the medication personally.
3. Superscription:
 This part of the prescription is represented by the symbol RX.
 In the ancient times it is considered as a prayer to Jupiter the God of
healing for the fast recovery of the patient.
 Nowadays, it is used as an abbreviation for the Latin term “Take
Thou” which means ‘you take”.
4. Inscription:
 This is considered as the main part of the prescription order.
 It contains the names and quantities of the prescribed ingredients.
 The name of each ingredient is written on a separate along with its
quantity.
 In the complex prescription containing several ingredients the
inscription can be divided into the following parts:
 Base (active medicament of therapeutic action)
 Adjuvants (substances added to increase action of
medicament/its palatability).
 Vehicle (substances used to dissolve medicament/increase
volume of prescription).
5. Subscription:

11.  This part of prescription contains directions of the prescriber to the
pharmacist regarding the type and compounding of dosage form
along with number of doses to be dispensed.
 This is important because dose of drug also depends on the type of
the dosage form.
6. Signatura:
 This part of the prescription contains directions to the patient
regarding the administration of drugs.
 It is generally represented as ‘Sig’ on the prescription.
 The instructions for the patient may include:
 The method of administration and application
 The dose if the preparation is for internal use.
 The time of administration or application
 The diluents (e.g water) if relevant, or means of application
(e.g. brush).
 The part of body where the preparation is to be applied, in case
of external use.
7. Renewal instructions:
 In this part, the prescriber whether the prescription can be renewed or
not.
 It also should include the specifications like how many times it can be
renewed.
 It is of utmost importance incase of narcotic/other habitat forming
drugs.
8. Signature, Address and Regd.no of the prescriber:
 The signature and Regd.no of the prescriber turns the prescription
into legal and authentic order to the pharmacist.
 This helps in preventing the use of spurious drugs.
 Regd.no is of utmost importance in prescription containing narcotic
drugs.

12. PRESCRIPTION ORDER SAMPLE
ASSIGNMENT:
Mention the roles of the following in dispensing and prescription.
1. Medical practitioner
2. Veterinary surgeon
3. Pharmacist
4. Pharmaceutical technologist
5. Pharmacy assistant
6. Nurse attendant.