Processing Prescriptions and Medications Orders
An environment that limits distractions and disruptions will assist in increasing the accuracy of this process.
Automation and the use of pharmacy technicians allow the pharmacist to oversee these functions. The time saved allows the pharmacist greater time for patient-focused activities, such as counseling and patient education.
A. The following information should be recorded on the prescription:
- The prescription number (for initial filling)
- The original date of filling
- The product and quantity dispensed
- The pharmacist’s initials
B. Product selection. Generic substitution statutes, as well as formulary and therapeutic substitution policies, might provide direction in product selection.
C. Product preparation for use by the patient. The following might be necessary:
- Obtaining the proper amount of medication to be dispensed
- Reconstitution (the addition of liquid to make a solution or suspension)
- Extemporaneous compounding
- Assembly of the medication delivery unit
D. Selection of the proper package or container is required to ensure product stability, to promote patient compliance, and to comply with legal requirements.
E. Labeling the prescribed product
1. The prescription label typically contains the following information:
- Name and address of the pharmacy
- Patient’s name
- Original date of filling
- Prescription number
- Directions for use
- Product’s brand name or generic name and manufacturer
- Product strength (if available in more than one strength)
- Quantity of medication dispensed
- Prescriber’s name
- Expiration date of the medication
2. Unit-dose packages contain one dose or one unit of medication. For a medication order that is dispensed in unit-dose packages, the label should identify the product’s brand or generic name, strength, lot number, and expiration date.
3. Auxiliary and cautionary labels ensure proper medication use, storage, and compliance and reinforce information provided during counseling.
4. For medication in Schedules II to IV, a federal transfer warning is required.
F. Record keeping and confidentiality. The pharmacist is required to maintain prescription files and records in accordance with standards of sound practice and statutory requirements. The implementation of the Healthcare Insurance Portability and Accountability Act (HIPAA) has put additional requirements on all health professionals who have access to health information.
State prescription monitoring programs may require pharmacists to collect and provide information regarding the use of controlled substances. A patient profile contains patient demographic information and a complete chronological record of all medication use and services provided in the delivery of pharmaceutical care.
1. The patient profile should contain the following patient information:
- Patient’s name
- Patient’s address (or room number in institutional settings)
- Any known allergies, sensitivities, or history of idiosyncratic reactions to previous medications
- Birth date (i.e., to assess the appropriateness of the dose)
- Clinical condition(s) (to help assess the appropriateness of the medication and to prevent drug–disease interactions)
- Weight (to assess the appropriateness of the dose)
- Occupation (to detect conditions associated with a particular occupation and to help determine if the patient will be able to comply with the regimen)
- Nonprescription medication use (to prevent drug interactions, to assess medication effectiveness, and to detect possible adverse effects)
2. In addition, the patient profile should contain the following information from each prescription or medication order:
- Name of the medication
- Medication strength
- Dosage form
- Quantity dispensed
- Directions for use
- Prescription number
- Dispensing date
- Number of refills authorized and remaining
- Prescriber’s name
- Pharmacist’s initials
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