Practical # 1
INTRODUCTION TO
DISPENSING PHARMACY
RETAIL
PHARMACY:The branch of pharmacy which deals with sale and
distribution of medicines and other products to consumers and patients on
prescription of physicians, dentists or veterinarians is called retail pharmacy.
TYPES
OF REATAIL PHARMACY: Following are the types of retail pharmacy :
·
COMMUNITY PHARMACY: The
branch of retail pharmacy which deals with health care facility that is able to
provide pharmaceutical services to people in local community is community
pharmacy. Also called as medical store.
·
WHOLE SALE PHARMACY: The
branch of pharmacy in which drugs are supplied from manufacturer to wholesalers
and from here it is supplied to community pharmacy is called wholesale pharmacy.
DISPENSING: Extemporaneous
compounding of the different dosage forms is called dispensing .Extemporaneous
compounding is defined as the preparation, mixing, assembling, packaging and
labeling of the medicinal product based on prescription ordered from licensed
practitioner for an individual patient.
DIFFERENCE
BETWEEN PHARMACY AND MEDICAL STORE
|
Pharmacy |
Medical store |
|
ü According
to Punjab drug rules,2007 pharmacy means premises where drugs are stored,
sold, compounded ,dispensed or prepared on prescription or distributed in
case of authorized agent of manufacturer ,indenter or importer . |
ü According
to Punjab drug rules, 2007 medical store means premises where drugs excluding
the drugs specified in Schedule G are stored, sold or offered for sale . |
|
ü Three
thousand rupees are required for a license of a pharmacy. |
ü Two
thousand rupees are required for a license of medical store. |
|
ü The
licensing authority shall issue a license of pharmacy in form 9. |
ü The licensing
authority shall issue a license of medical store in form 10 . |
|
ü In
case of pharmacy, the person shall display the word “Pharmacy” outside wall
of the pharmacy in white writing on green colored signboard having minimum
length of 5 feet and width of 2.5 feet. |
ü In
case of medical store, the person shall display the words “Medical Store” in
white writing on a blue colored signboard with the same minimum dimensions as
required for pharmacy. |
|
ü Pharmacy
use “Rx” logo. |
ü Medical
store does not use it. |
DISPENSING ROLE IN PHARMACY
Read
the prescription carefully .If necessary, find formula of preparations in an
appropriate source ,copy it to your hand book. Check the doses of internal
preparations. Correctly perform calculations of dose and quantity. Identify the
drug-drug interactions. Prepare labels and fix them to container .Wrap the
container and write patients name and address on wrapper. Make appropriate
records. Issue medicine to patients with clear instructions and advice.
REQUIREMENTS FOR OPENING
DISPENSING AREA IN PHARMACY:
Ø DISPENSING
ENVIRONMENT COVERAGE : It covers the following
areas:
·
Prescription counter
·
Waiting area
Ø PROTOCOLS
FOR PRESCRIPTION COUNTER: Ideal
prescription counter should be
·
Be cleaned.
·
Regular routine cleaning of shelves.
·
Daily cleaning of floor and work surfaces.
·
Be organized.
·
Have sufficient space.
·
Temperature and humidity should be controlled.
·
Accessible to the patients.
·
No loud music playing ,gossiping ,talking
,television ,cricket match or movie.
·
Medicines arranged in an organized way on
shelves in an alphabetical order.
Ø PROTOCOLS
FOR WAITING AREA :The
area where patients or clients wait for their prescription to be dispensed or
filled is called waiting area. Ideal waiting area should have following
requirements :
·
Comfortable chairs for at least for elders and
disabled patients.
·
Current popular health magazines and materials
related to good health.
·
Pamphlets and posters relate to public, family
and other individual health problems.
DISPENSED
LABELS :
Display
of written , printed or graphic matter upon immediate container or wrapper of
drug package.
REQUREMENTS
FOR LABELING A PATIENT’S PRESCRIBED MEDICATION:
Following are the protocols for dispensed labeling :
·
Patient name
·
Doctor’s
name
·
State the strength , name and quantity of
medication dispensed
·
Discard date of medication i-e date after which
medication should not be used
·
Prescription number
·
Name and address of pharmacy
·
Contact number
of pharmacy
·
Warnings and instructions
·
Use of active verbs such as
Ø Take
two - not - “ Two to be taken ”
Ø Use
one - not - “ One to be used ”
Ø Insert one - not -
“ One to be inserted “
·
Frequency and quantity of formulations should
be expressed in words rather than in numerals.
Example:
Take 1 capsule 2x a day (wrong)
Take one capsule two times a
day (right )
·
Drug
instructions should be appropriate.
Example: Never use “Take” if it is not use
for oral route.
Use “Apply”
DISPENSED LABELLS OF DIFFERENT
DOSAGE FORMS
PRESCRIPTION
It I an order of physician ,dentist, verterinarian or properly licensed medical practitioner for
supply of medicine ,medical dressing , or surgical appliances to patient.
PARTS OF PRESCRIPTION :
Following are the parts of prescription :
·
PATIENTS NAME ,AGE, SEX AND ADDRESS : For
identification of patient .
·
DATE OF PRESCRIPTION: For
the legal purpose and also for record.
·
SUPERSCRIPTION :This
is the sign “Rx”. It is an instruction to pharmacist.
·
INSCRIPTION:It is
the principal part of prescription
containing name , quantity and strength of prescribed drug.
·
SUBSCRIPTION: Order
to pharmacist including method of administration,dose of preparations ,number
of dosage units .
·
SIGNA: An instruction to the patient.
·
REFILL INSTRUCTIONS: An
instruction to the pharmacist to dispense once ,twice or thrice .
·
NAME AND SIGNATURE OF PRESCRIBER:For
identification of prescriber.
PROTOCOLS
FOR HANDLING PRESCRIPTION
Prescription handling is a part of professional relationship
between prescriber, pharmacist and patient.
·
RECEIVING THE PRESCRIPTION:
While receiving the prescription,
pharmacist should be alert ,focused and not to be detracted or engaged in
talking and chatting.
·
READING THE PRESCRIPTION:
Ø LEGALITY:
A prescription should be legal when it is written and signed by R.M.P
containing all the information required to be contained in all parts of
prescription.
Ø LEGIBILITY:
It is a problem requiring alertness and critical judgement on the part
of pharmacist.
Practical # 2
INVITRO DEMONSTRATION OF DRUG INCOMPATIBILATY
Introduction
In
vitro drug interactions may be defined as those interactions which occur
outside the body. Drug interactions which will be discussed in this chapter are
those which occur between drugs due to reasons of incompatibility (e.g.,
drug-drug interactions in an intravenous infusion), due to interaction of a
drug with its packaging (e.g., drug binding to an infusion bag), due to loss of
drugs during laboratory analyses (e.g., binding to laboratory equipment)
Requirements
·
beakers
·
measuring
cylinder
·
stirrer
·
filter
paper
Chemicals
·
phenol
·
distilled
water
·
sodium
sulphate
·
glycerin
Procedure
a) Dissolve phenol in 10ml of glycerin.
b) Dissolve sodium sulphate in small
quantity of water.
c) Add the above solution in to sodium
sulphate solution and observe change.
d) Make up volume then mix all three
ingredients thoroughly and observe change.
e) Clear preparation from all above
should b dispensed.
f) The preparations which contain
precipitation always show incompatibility.
|
Beaker
A |
Beaker
B |
Beaker
c |
|
Phenol+glycerin→1 Sodium
sulphate+water→2 Add
1 in 2 clear without turbidity |
Sodium
sulphate+water→1 Phenol+glycerine→2 Add
1 into 2 some turbidity is formed |
Phenol+sodiumsulphate+glycerin+water Turbidity
id present. |
Result
The
preparation of A was clear without turbidity, so this preparation of beaker a
is dispensed.
Practical # 3
PREPARATION
OF CALAMINE LOTION
Definition
Lotions are low-viscosity liquid aqueous preparations
intended for the application on skin mostly for protective effects. Their
application leads towards removal of water by leaving medicament on surface of
skin and also causes cooling effect on the same time. Lotions are applied to
external skin with bare hands, cotton wool or gauze and they are meant to
moisturize or soften the skin.
History
Calamine has been aroundsince the early 19thcentury
and known for its anti-pruritic and mild antiseptic qualities. The beneficial
properties of calamine speaks for itself as it is trusted for common skin
ailments for decades and also in September 2008 it was approved as a topical
over the counter skin protectant, both effective and safe for usage by U.S Food
& Drug Administration.
Principle
Tirturation and lavigation
Tirturation
Grinding of solid substance is done to a fine powder by
continuous stirring or rubbing of particles in a mortar and pestle.
Lavigation
Size reduction of solid particles which is carried out in
pestle and mortar in presence of small amount of liquid in which this material
is insoluble.
Apparatus
Beaker, weighing balance, chemicals, stirrer, pestle and
mortar
Ingredients
Calamine 8gm
Zinc
oxide 8gm
Glycerin 2
ml
Bentonite magma 25
ml
Calcium hydroxide q.s100 ml
Procedure
Dilute bentonite magma
with equal volume of Ca(OH)2 solution. Mix the powders with equal
volume of glycerin and about 10 ml of bentonite magma. Triturate this solution
and add remaining bentonite magma in it. Dilute the solution with 1% Ca(OH)2
to make 10 ml.
Bentonite magma: Bentonite50g
Purified water 1000 ml
Sprinkle the bentonite
on purified water 800 ml. Allow each of the portion of bentonite to get fully
wet without stirring. Allow it to stand with occasional stirring for 24 hours.
Stir until a dilute form of magma is obtained. Add purified water to make
volume up to 1000 ml and mix. The calamine lotion is ready. Now label and
dispense it.
Role of Ingredients
Calamine Soothing and protecting agent
Zinc oxide Antiseptic and mild astringent
Glycerin
Hygroscopic, keeps skin moist, Soothing effect on skin
Bentonitemagma Suspending agent and impart viscosity to
the solution
Calcium hydroxide Vehicle and
Preservative
Applications
·
It
produces soothing and cooling effect when applied topically to the skin.
·
It
is used in the treatment of pimples and chicken pox as an antiseptic.
·
It is effective on nappy
rash and other mild skin problems in infants.
·
It is used in shampoos
that eradicate lice as an agent to relieve itching.
·
It is recommended for
temporary relief of various skin irritations such as poison ivy, insect bites,
itching and sunburn.
·
It is used to treat skin
issues brought on by pregnancy and helps to smooth out stretch marks over a
course of time post pregnancy.
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