What are the fundamental operations in compounding?
- Weights and measures
- Size reduction
- Size separation
- Filtration
Choosing the container
Filling the product
Label preparation
Rechecking of the product
Preparation of items for issue is the central part of the ————–?
Dispensing process,
How to ensure accuracy at filling procedure?
Self-checking
counter- checking
When filling process begins ?
After the prescription is clearly understood and the quantity has been calculated.
Note: It is good practice to write the label at this point as a form of self-checking.
True or False
A good dispenser selects the item by reading the label and cross matching the product name and strength against the prescription.
True
FIFO means ??
(first-in/first-out)
what practices need to be avoid? ?
- Selecting according to the color or location of the container, without consciously reading the label.
- is having many stocks container open at the same time.
- exposed med to the air which eventually deteriorate in quality.
The main functions of a label on a dispensed medicine are?
- Identify the contents of the container.
- Ensure that patients have clear and concise information about the use of the medicine.
labels should be ?
- unambiguous م في غموض
- clear
- legible مقروءة
- indelible م تنمسح
When producing a label, you should ensure that the information on the label is?
- KEEP IT SIMPLE
- Indelible and legible. (KEEP IT CLEAR)
- Of the size and type of lettering appropriate to the patient’s needs.
- In a uniform colour contrasting strongly with a uniform background. Directions such as “Not to be taken”and “For External Use Only” may be in red lettering.
- Not in the address panel or any other place where it could obstruct or be hidden by other information.
- Is placed on the label in lines parallel to the base of container.
- Is placed on the primary container – this is the container that the patient will be using not the box that they will throw away.
- Free of errors and overtypes. (KEEP IT CLEAN)
- Free of unnecessary decoration (KEEP IT PLAIN)
Additional labels are pasted basically for two reasons ?
- Labels which are required by Law
- Labels which are necessary for pharmaceutical reasons
The labels which are required by Law are ?
- For external use only
- on liquid preparations which are used externally. For example Liniment. - Not to be taken
- products which are packed in greater quantity more than 3 L . They are antiseptic of disinfectant solutions.
Discard date for internal and external preparation?
- Internal Preparations
- without a preservative 7 days
- with a preservative 14 days - External Preparations
- Diluted from a pre-formulated product 14 days
- Extemporaneously compounded 1 month (with a preservative)
labels necessary for pharmaceutical reasons are ?
- For external use only:
it must be on all preparations which are intended to be used externally not to be taken orally. - Some Special labels are also mentioned on the preparations. These help the patients by making it more understandable and legible.
Give examples for special labelling :
- to indicate the restrictions on use of preparations:
- For pediatric patients only.
- For adults only.
- Not to apply.
- Not to be taken. - assist in the use of medication to a specific site in the body.
- For nasal use only for nasal drops.
- For rectal use only for rectal suppositories.
- For otic use only for ear drops. - give specific instructions to the patient regarding to the formulation. (Understanding the method of use of the formulation).
- For Poultice - apply with suitable dressing.
- For dusting powder - not to apply on open wounds.
- For Lotion - apply without rubbing.
- For liniment - apply with rubbing. - specify the storage conditions for the formulation.:
- Keep away from naked flame.
- Store below 15°C or store at cool place.
- Protect is from light. - Special labels are applied for safety and protection of children.
- Keep out of reach of children.
Labelling Cautions ?
- Try to avoid having the number to be taken and the times of taking adjacent.
- Fractions should be expressed in words rather than in figures. (or write both)
- TWO AND A HALF ML rather than 2.5 mL - Distinguish between different drug delivery forms.
- “Swallow whole” - Sustained release preparations - Give” is preferred for a young child .
- provide with the medicine, where appropriate, a measuring device for the patient for.
- a 5mL medicine spoon or an oral syringe.
6.Measures: Only metric measures may be used, imperial must not be used.
How to make final check?
- Checking against the prescription and against the stock containers used by other staff member.
- The final check should include reading and interpreting the prescription before looking at the dispensed medicines.
- Checking the appropriateness of doses prescribed
- Checking for drug interactions.
- Checking the identity of the medicine dispensed.
- Checking the labels.
- Finally, counter signing the prescription.
(Record the action taken):
what are the 3 different methods to record dispensed medicines?
1.Retained prescription: dispenser should initial and annotate the prescription with strength and quantities dispensed.
file it or enter the details into a record book as soon as time is available.
- When the prescription is returned to the patient, details of the medicines dispensed.
must be entered into a record book before the items are issued to the patient. date, the name and age, the medicine name and strength, the amount issued, and the dispenser’s name should be entered into the register. - When dispensers use computers to record the dispensing details, the computer program
should retain the information which can then be recalled generating summary report.
What kind of advice pharmacist must give the patient before giving the medication?
- When to take the medicine :(particularly in relation to food and other medicines)
- How to take the medicine :(chewed, swallowed whole, taken with plenty of water, etc.)
- How to store the medicine :(Refrigerator)
Warnings about possible side effects should be given
cautiously:
- Common but harmless side effects should be mentioned.
- (nausea, mild diarrhea, urine changing color). - Serious side effects should be mentioned only with the agreement of the prescriber. (Pioglitazone (Actos), TRT, Risperdal)
- Every effort must be made to confirm that the patient understands the instruction.
- (repeat back to instructions).
Benefits of prepackaging?
- More accurate and efficient prescribing.
- Simplified dispensing for multidrug therapies.
- Easier and more accurate recording of inventory .
4- Provide protection from the environment
Example of prepackaging of medicines?
Unit dose blister packs
