DISPENSING PROCEDURE

BY PHARM ADU FREMPONG

 DISPENSING
Dispensing is the process of preparation of medicine and
distributing them to users with provision of an appropriate
information, counselling and follow up.
Dispensing is one of the vital elements of rational use of
medicines.
It involves the correct interpretation of the order for prescribed
medicines and accurate preparation and labelling of medicines
for use by the patient.
The dispensing process includes all activities that occur between
the time the prescription or request for medicine presented up
to the time the medicine or prescribed items are issued to the
patient.
 GOOD DISPENSING PRACTICE
Good Dispensing Practice ensures the right medicines of
desired quality are delivered to the right patient with the
right dose, strength, frequency, dosage form and quantity,
together with clear instructions, both written and verbal
and with appropriate packaging suitable for maintaining
the quality and efficacy of the medicine.
A safe, clean and organized working environment
provides the basis for good dispensing practice. The
dispensing includes;
 Qualified or trained staff
 Appropriate physical surroundings
 Adequate shelving and storage areas
 Proper work surfaces
 Suitable equipment
 Necessary packaging materials

Responsibility for the accuracy and quality of the

medicines supplied lies on the persons overseeing
the dispensing process. It is important that the staff
dispensing medicines are trained and equipped with
the technical knowledge and the skills necessary to
dispense the range of medicines prescribed and to
communicate effectively with patients or caregivers.
 ROLES PHARMACY TECHNICIAN IN
DISPENSING

• Locating the correct medication for dispensing,

calculating quantities, re –packaging medication and
locating the corresponding patient medication
guide.
• Compounding prescription under supervision.
• Recording the dispensing of controlled drugs.
• Checking the work of other technicians as instructed
by the pharmacist.
• Referring patients to a pharmacist for
counselling on the uses of prescription
and over the counter medicines.

• Always ensuring the accuracy and safety

of the prescription by incorporating
quality control into every step in the
process.
 Preparation, labelling and Packaging

This is the stage of dispensing whereby the

patient’s medication is made readily available
In some cases the patients medicine may not be
readily available in the pharmacy and must be
compounded for the patient.
 Compounding
Medication compounding is the making of a
medication that meets the needs of a specific patient
by mixing, combining, altering, or removing various
ingredients of a drug or drugs
Two general classifications of compounding;
Sterile compounding; Is performed in an environment
that is free from infectious microorganisms such as
viruses and bacteria. This process is mostly used for
medications that will be administered into the eye or
parenterally
Non Sterile compounding; Is performed in an
environment that is safe and clean but not
completely free of all microorganisms. This
process is often used for oral medication(like
pills) that will be swallowed or a topical
medication that will be applied to the skin
Compounding is to produce or mix by combining two or
more part.

It can be as simple as combining two topical ingredients

to create a preparation.

In other cases compounding will be an extensive and

complex procedure of combining more than one active
ingredient with several excipients to produce a desired
product.
• Compounding has always been a basic part of
pharmacy practice.
• The pharmacist is responsible for preparing a
quality product, providing proper instructions
about its storage and advising the patient of
any adverse effects.
Compounding may have different meanings for;
 Conversion of dosage forms
 Preparation of dosage forms from bulk
chemicals
 Preparation for use of various drug devices
 Extemporaneous Compounding
Extemporaneous compounding is the preparation, mixing,
assembling, packaging and labelling of a drug product based
on a prescription order from a licensed practitioner for the
individual patient.
Extemporaneous preparations should only be prepared if
there is no equivalent product commercially and the product
has to be compounded based on the patients needs.
Compounding of extemporaneous preparation should only
be done on a patient specific basis.
Ingredients used for compounding sourced from recognized
pharmaceutical supplies.
Ensure that the preparation is prepared from a reputable
preference.
There should be worksheets for compounding which
should be checked by member knowledgeable in
compounding and counter checked by a pharmacist
or another qualified staff member.
Staff involved in compounding should be competent
to perform this task under the supervision of
pharmacist.
Availability of requisite facility and equipment which
are maintained in good order.
Once the preparation is ready label the product with
necessary particulars including expiry date or special
requirement for safe handling and storage.
Keep worksheets or record book for a
minimum of two years.
The document should contain information as
below;
 Formula
 Ingredients and quantity used
 Manufacturer batch number and expiry date
 Patient and prescription details
 Person(s) involved in compounding
 Date of compounding
Types of Compounding Pharmacies
• Independent Community pharmacies
• Chain Pharmacies
• Hospital Pharmacies
• Mail-order pharmacies
• Compounding Only pharmacies
• Nuclear Pharmacies
 Reasons for compounding
• The drug in particular dosage form is not commercially available
on the market.
• The extraordinarily low or high dose is needed for the
medication. Example dilution of adult doses for pediatric or as
suitable for geriatric

• When patient from an allergy of a specific excipient in a drug

formation

• A patient is unable to use a pharmaceutical product in its

commercially available form. Example conversion from solid
forms into liquids such as solution or suspensions for geriatric
patients
 Facilities Equipment Calculations and
Formulas
• Compounded prescription require a number
of calculations, a formula or recipe,
equipment and supplies and an area suitable
for compounding.
 Formula
• This is the list and quantities (either relative or
specific) of ingredients in a medicinal
preparation.

• These ingredients and their quantities are

usually written vertically in the official books.
(eg BNF, the Pharmacopoeias).
• Example 1
Magnesium trisilicate powder 50g
Light Magnesium Carbonate 50g
Sodium bicarbonate 50g
Peppermint emulsion 25ml
Double Strength chloroform Water 500ml
Purified water to 1000ml
• Example 2
Coal tar 6g
Zinc oxide, finely sifted 6g
Starch 38g
Emulsifying wax 5g
Yellow soft paraffin 45g

 Add up when only weights are involved

 Standards – BP, BNF, USP etc
 Scale Factor (S.F) and Formula writing
• Medicines are prepared according to amounts
required, hence, formulae are either scale up
or down

• The amount required divided by the amount

stated in the formula is termed the scale
factor.
• Example, Prepare 25g of zinc and coal
tar paste BNFOfficial Formula Amount
Ingredients
(x0.25)
required

Coal tar 6g 1.50g

Zinc oxide, Finely 6g 9.50g
sifted
Starch 38g 9.50g
Emulsifying Wax 5g 1.25g
Yellow soft Paraffin 45g 11.25g
• Solution

• Calculate the scale factor first

• Multiply every ingredient by the scale factor
• That is;
Scale factor = = = 0.25
• Note
• The quantities have been arranged in
orderly vertical columns. Errors caused
by misplacing the decimal point are
minimized by this procedure

• The sum of the amounts required

column is the correct fraction of the
sum of the Official amounts column
 Relative Quantities
• Formulas sometimes indicate relative
quantities of ingredients, or
proportional parts, to be used in
obtaining any desired total amounts.
Example
Salicylic acid 1part
Precipitated Sulphur 8 part
Hydrophilic ointment 91part
• x Total quantity of formula

• From the above formula, Calculate the quanti

salicylic acid to use in preparing 30g of ointme
• x 30g (formula desired)
= 0.3g
 Summary
• Rules in pharmaceutical calculations are
 Further check of the calculation by a second person is
always recommended
 Quantities should be arranged in orderly vertical columns
with the same number of figure(s) after the decimal points
 Adhere strictly to the method of calculating the scale factor.
 Check if to is in the formula
 Check if the sum of the amounts required column is correct
fraction of the sum of the Official amounts column
 Labelling

A label is a display of written, printed or graphic information

on immediate container or package of a drug container.
The prescription label provides information to the patient
recording to the dispensed medication and how take it.
Additionally the label includes information about the
pharmacy, the patient, the prescriber, the prescription or
transaction number assigned to the prescription.
As with prescription requirements for prescription label
vary from state to state.
 Importance of Label

All finished dosage forms are labelled to

serve the following functions;
• Identify contents of the container
• Ensure patients have clear and concise
information on how to use the medicine
• Satisfy legal Requirements
Appearance of a good label
• Correct position
• Clean
• Secure
Information of a label
• Legible
• Concise
• Adequate
• Intelligible
• Accurate
 Features of a label
• The Details that appear on the label of a finished
dosage form include
• Name of the preparation, strength and form
• Quantity
• Directions for use
• Precautions of handling and usage of product
• Warning or auxiliary labels
• Manufacturing and expiration date
• Manufacturer and distributor information
• In case of extemporaneously dispensed
medicines.

• Identification information of patients for

whom the medicine is dispensed

• Name of the address of the pharmacy

and expiry date indicating the
shortened shelf life should be included.
• The date dispensed
• The initials of the person who keyed the information into
the computer and often the hand written initials of the
pharmacist who checked the prescription
• Refill information
• The name of the prescriber
• Expiration date of the medication
• The name, quantity, strength, manufacturer and dosage
form of the medication dispensed.
• Directions for use that are clear accurate and
unambiguous
• The name of the patient for whom the medication is
dispensed.
• The name address and telephone number of the
pharmacy
 Directions For use
• Directions should start with a verb (take, instill,
inhale, insert, apply) and completely clearly and
accurately describe the administration of the
medication.
• Indicate the route of administration For example
take one capsule by mouth.
• Use whole words not abbreviations for example,
use tablets not tabs
• Use familiar words especially in measurement For
example use 10mls
Auxiliary Labels
• Coloured auxiliary labels may be applied to the
prescription container to provide additional
information to the patient. (shake well before
use).

Labelling the container correctly

• Placing the label on the container so it is parallel
to edges of the container so as to be easy to
locate and easy to read.
• Making sure the label sticks adequately to the
container and is without creases.
 Auxiliary label information
• Required by law, or necessary for
pharmaceutical reasons such as;
• To indicate restrictions on the use of the
preparation
• To give special instructions on the method of
use
• To specify storage conditions and shelf-life
Instructions restricting Use of preparation

• “For External Use Only”

• Used on all liquid, semi- solid and solid
preparations for external use
• Examples; Applications, creams, dusting
powders, Ear drops, Liniments, lotions,
ointments, pastes and certain solutions
 NOT TO BE TAKEN
Preparations not administered by mouth or on the skin
Preparations on which ‘for external use’ might worry a
patient because patient appears to use product
internally
Unit dose forms not intended for oral use eg pessaries,
suppositories
Solution tablets used to prepare disinfectant and
antiseptic solutions
SHAKE BOTTLE WELL BEFORE USE
Dispersed systems eg suspensions, emulsions,
several applications, liniments and lotions
Medicines in which precipitation or separation
could occur on storage eg mixtures containing
vegetable extract such as tinctures
 SPECIAL INSTRUCTIONS

• Dusting Powders – Not to be applied to open

wounds or raw or weeping surfaces
• Enemas – To be warmed to body temperature
before use
• Gargles and mouthwashes – Not to be taken,
Not to be swallowed in large amounts
• Inhalational – Add one teaspoonful to a pint
of hot not boiling water and inhale
• Linctus's – To be sipped and swallowed slowly
without the addition of water
TABLETS
To be chewed prior to swallowing eg compound
Magnesium Trisilicate tabs
To be crushed before swallowing eg Calcium and
Vitamin D tabs
To be dissolved slowly in the mouth eg Glyceryl
trinitrate tablets
To be dissolved in water before taking eg
Potassium chloride tablets
Instructions Indicating Storage Conditions and
Shelf-life
• Store in a cool Place – not more than 15
degree Celsius eg capsules, creams,
emulsions, ointments, suppositories,
pessaries
• Protect from light – for light sensitive
preparations
• Inflammable – for preparations containing
50% or more alcohol or other inflammable
solvent
 Storage Instructions as per WHO
Recommendations
• Do not store above 30 degree Celsius – Store from 2 degree to 30
degree Celsius
• Do not store above 25 degree Celsius – Store from 2degree Celsius to
25 degree Celsius
• Store in refrigerator – Store from 2 degree Celsius to 8degree Celsius
• Store in a Freezer – Store from -15 to -25 degree Celsius
• Do not refrigerate – In addition to do not store above 30 degree
Celsius, mainly for semisolid or liquid preparations that should not be
stored in a refrigerator
• Do not freeze – In addition to store in refrigerator mainly for semisolid
or liquid preparations that should not be frozen
 Protection from Children
• All dispensed medicines should carry a
warning indicating the importance of storage
in a place inaccessible to children
• A suitable wording is ‘For Safety’s Sake keep
out of reach of children’ and this should
appear on a separate label or as part of the
text of the main label.
 PACKAGING
The pharmacist is responsible for the appropriate
packaging of compounded formulations. The
appropriate container will depend on the physical and
chemical properties of the compounded formulations
and its intended use.

Packaging materials should not chemically react with

any drug or other packaging material should
considerations include, its strength, visibility, moisture
protection, ease of use and cost.
 Importance Of Packaging
• Quality

• Safety

• Stability of its content

• Although different pharmaceutical preparations will be
packaged in different containers depending on the product type
pharmaceutical packaging can largely be grouped into a few
main types
• Pharmaceutical packaging is a combination of components
necessary to contain, preserve, protect and deliver safe and
efficacious drug products. From contemporary definition,
primary packaging is composed of packaging components and
subcomponents that come into contact with product or those
that may have a different direct effect on product shelf life.
Typical packaging components are containers (ampoules, vials,
bottles, ointment jars)
• Light resistant containers( amber glass, aluminum foil or wraps)
• Primary packaging components include pouches, cups and
bottles.
Bottles are usually made of glass or plastic, often with screw
cap and liner and possibly with a tamper – resistant seal
Glass offers the following advantages;
• Are inert to most medicines
• Are impervious to air and moisture
• Can be amber coloured to protect light sensitive
medicine contents
• Provide ease of inspection
Disadvantages
• Are fragile
• Release alkali into container
• Are heavy
Plastics made of resin have been used as
primary and secondary packaging materials.
Plastics are available as plain or amber coloured
bottles to protect photosensitive agents
Advantages;
• They release few particles into the container
• Are flexible and lightweight
• Can be heat sealed and molded into various
shapes