Good Dispensing Practice
Dispensation
The dispensation of medicines is the major therapeutic act carried out by the pharmacist in a legally authorized establishment.
It is the professional act by which the right medicine is given to the right patient at the right moment, with additional information on the proper use of the drug and the achievement of the therapeutical goals pursued.
This definition is applicable to prescription medicines, over the counter medicines, physician control recommended medicines, therapeutical devices and other health care products. It includes advice to prevent incompatibilities with other drugs used by the patient and the recommendation to seek medical advice when necessary.
The dispensation may be delegated to pharmacy assistants, who should receive permanent training and updating under the surveillance of the Head Technical Pharmacist.
Stages in the dispensation process
1 - First contact with the patient
Greet the patient and introduce yourself
2 - Evaluation of the request
Over the counter and physician control recommended medicines
Find out:
Who is the patient
What are the symptoms
How long have the symptoms been present
Action taken already
Medication taken for other indications
Find out whether it is the first time the patient is taking the medicine and the name of the doctor who prescribed it.
Dispensation of prescription medicines
It is necessary to check the following: prescription validity, identification of the prescriber (signature and seal), accordance with legal regulations in force (generic name of the drug, concentration, pharmaceutical form, dosage) and patient's identification.
If any information is missing, request it to the patient or the physician. Make sure that the patient understands the proper use of the medicine.
In case of doubt about the validity of the prescription, or lack of clarity thereof, ask the patient or the physician.
If the situation remains unsolved, the medicine (or healthcare product) should not be dispensed and the physician should be notified.
If it is a prescription medicine and the prescription is not submitted, the medicine should not be dispensed.
3 - Choosing the medicine
Offer the patient all the commercial options available.
Confirm that the active principle, the concentration, the pharmaceutical form and the presentation of the medicine are those requested by the patient.
4 –Pharmaceutical advice
The dispensation of medicines should be accompanied by verbal and written essential information for the rational use of the medicine.
The information has to include correct storage conditions, cautions and prevention of side effects and interactions.
In case of over the counter or physician control recommended medicines, advice should also be given that a prescriber should be consulted should the symptoms persist beyond a stated time.
Make sure that the patient understands the information given and invite him to come back to the pharmacy if he has any further questions about the medicinal product or needs further information.
Giving pharmaceutical advice is a very important function which should be carried out by the pharmacist; the assistant staff can only give pharmaceutical advice about topics under protocol, otherwise it is necessary to derive the patient to the pharmacist.
5- Visual inspection
Check that the medicine has not expired and that the package conditions are adequate.
6 – Packaging and delivery
The medicine should be delivered in its original package, without breaking the package up, taking into account the storage conditions and the cold chain when necessary.
7- Documentation
The documentation of the dispensation process is focused on keeping written records of the prescription medicines dispensed (…… and narcotics) and of the pharmaceutical interventions (formulas designed either by physicians or according to the legal regulations in force).
References
Marco Regulatorio de los productos farmacéuticos y afines. Asociación de Química y Farmacia del Uruguay. Decreto 493/990 y Decreto 18/989.
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El rol del farmacéutico en la atención de salud. OMS/OPS. Ginebra ,1990.
"Farmacia Clínica en la Farmacia Oficinal". Confederación Farmacéutica Argentina,1994.
Organización Mundial de la Salud "El papel del farmacéutico en el sistema de atención de salud". Publicación de la OMS - OPS/HSS/HSE/95.1,1995.
Normas de calidad de los Servicios Farmacéuticos: "Buenas Practicas de Farmacia." Declaración de Tokio, FIP ,1995.
Rantucci M. "Guía del consejo del farmacéutico al paciente". Masson, Williams y Wilkins, 1997.
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XI reunión de Ministros de Salud del Mercosur, Bolivia y Chile. "Políticas de medicamentos para el Mercosur, Bolivia y Chile". San Pablo, 2000.
Paura A. "Guía de Pautas Básicas en Atención Farmacéutica". Colegio de Farmacéuticos de la Provincia de Buenos Aires, 2001.
Armando P., Correa Saide V., Costa E. Semería N. y Tenllado I. "Atención Farmacéutica: Principios y experiencias", Curso a distancia. Colegio de Farmacéuticos de la Provincia de Córdoba, 2001.
Organización Técnica Iberoamericana del Medicamento de España (OTTIME), "Curso Iberoamericano de Atención Farmacéutica", Universidad Complutense de Madrid, 2001.
Paura A. y Gurisatti C. "Introducción a la Atención Farmacéutica". Curso de posgrado on line a distancia de Atención Farmacéutica. UBA, UNLP, Fundación Biosfera, Colegio de Farmacéuticos de la Provincia de Buenos Aires,2002. www.atencion.farmaceutica.org.ar
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I Seminario Nacional de Políticas del medicamento
