PHARM 202

Dispensing 1

POST LABORATORY NOTES

ACTIVITY TITLE PAGE
ACTIVITY 1
ACTIVITY 2 Calculation of Doses 1
ACTIVITY 3 Understanding Prescription Errors and E-Prescribing 2
ACTIVITY 4 Yellow Prescription and Dispensing Regulated Drugs 3
ACTIVITY 5 Interpreting Medical Prescriptions 8
ACTIVITY 6 Reading and Interpreting a Prescription and Medication Order
ACTIVITY 7 Auxiliary Labels
ACTIVITY 8 Pharmaceutical Pictograms
ACTIVITY 9 Drug Categories
ACTIVITY 10 Utilization of Drug Information Sources

A2: Calculation of Doses

A3: Understanding Prescription Errors and E-Prescribing
I. Types of Incorrect Prescription
a. Erroneous Prescription
• Brand name precedes the generic name
o e.g., (Biogesic) Paracetamol
• Generic name is in parenthesis
o e.g., (Paracetamol) Biogesic
• Brand name is not in parenthesis
o e.g., Paracetamol Biogesic
• More than 1 drug product is written
Steps to Address Erroneous Prescriptions:
Fill the prescription
Report the error to the Department of Health (DOH)
Submit for appropriate actions

b. Violative Prescription
• Generic name is not written
• Generic name is not legible, but brand name is legible
• Brand name is written with additional instructions such as "No Substitution"
Generics Act – rules prescriptions
Steps to Address Violative Prescriptions:
✓ Do not fill the prescription
✓ Report the violation to DOH (Xerox then file then report)
✓ Submit the prescription for appropriate actions
✓ Advise the prescriber about the issue or instruct the patient to obtain the correct prescription

c. Impossible Prescription
• Generic name is not legible (cannot read prescription)
• Generic name does not correspond with the brand name Paracetamol (Himox) – an antibiotic
• Both the generic and brand names are not legible
• Drug product is not registered with the FDA
Steps to Address Impossible Prescriptions:
✓ Do not fill the prescription
✓ Report the issue to DOH
✓ Submit the prescription for appropriate actions
✓ Advise the prescriber about the issue or instruct the patient to obtain the correct prescription

I. E-Prescription (Electronic Prescription)

A. Primary Goals of E-Prescribing
1. Support Safe and Effective Therapy – EP are believed to reduce errors caused by illegible handwriting
2. Support Cost Management for Payers – Managing costs and insurance
3. Support Business Needs of Physician Practices and Pharmacies – Improves efficiency of healthcare operation

B. Components of an E-Prescribing System

a. Registration – Name, Age, d/se, Allergies, Medication History, Benefits.
b. New Prescription Entry – To see better drug treatment for alternatives or new drugs
c. Prescription Transmission - Efficient
d. Refill Authorization – monitoring of refill medication
e. Medication Profile Management – ADR, Allergies are recorded reduces Polypharmacy (where Dr. outlooks the
prescriptions due to numerous medications prescribed)
C. Benefits of Using E-Prescription
1. Reduction of Errors and Improved Efficiency
2. Reduced Call-backs and Increased Patient Compliance
3. ePrescribing Fill Status Notification
D. Sources of Error in E-Prescription
Common sources of errors include selection errors from lists, mistyped numbers, wrong patient selection,
unintended entries, and setup errors.

E. Pharmacist’s Role in E-Prescribing

• Pharmacists play a crucial role in medication therapy management, ensuring safe and effective use of
medications.
• The importance of cognitive services provided by pharmacists is recognized, leading to efforts for
reimbursement of these services.
A4: Yellow Prescription and Dispensing Regulated Drugs
I. Yellow Prescription
A yellow prescription is a unique type of prescription that is crucial for the dispensing of dangerous drug
preparations. It is issued by a current PDEA licensed practitioner and is presented in three copies with specific
usage instructions:

• Original Copy (Drugstore Copy): This copy is submitted to the pharmacy that dispenses the drug.
• Duplicate Copy (Patient Copy): Patients or their representatives retain this copy.
• Triplicate Copy (Prescriber Copy): The prescribing practitioner holds onto this copy.
II. Who Can Prescribe Using a Yellow Prescription?
Only prescribers with a valid S2-license are authorized to prescribe dangerous drugs. The S2 license is
granted by the Philippine Drug Enforcement Agency (PDEA) to recognized practitioners. Veterinarians, when
prescribing for animal use, should provide additional specific information.
III. Parts of a Yellow Prescription
A complete yellow prescription should encompass the following key elements:
1. Full Name of the Prescriber:
Use: Identifies the medical practitioner
Importance: For verification purposes
2. Complete Business Address:
Use: Identify location of practitioner
Importance: Communication and Clarification for prescription related problems
4. Telephone Number/Email Address:
Use: Direct contact information of the prescriber
Importance: quick communication to confirm the details
5. Current S2 License Number and Validity:
Use: Unique identifier of the Prescriber.
Importance; Legitimacy and Confirm the qualification of the Dr.
6. PTR of the Prescribing Practitioner:
Use: Additional identifier, required for legal and regulatory purposes
Importance: extra layer of authentication
7. Complete Name of the Patient:
Use: recipient
Importance: to give the right prescription for the right patience
8. Age:
Use: dosing consideration
Importance: to assess if dose is appropriate to that age
9. Complete Address:
Use: identify the residence of px, relevant to px counselling, for delivery, for follow up
Importance: record keeping
10. Date of the Prescription:
Use: date when the prescription was issued
Importance: validity of prescription
11. Generic and Brand Name of the Preparation to be Supplied:
Use: specifies the medication that px should receive
Importance: for accurate dispensing
12. Dosage Strength and Form:
Use: to specify the strength and formulation
Importance: to ensure accuracy of ds and f given to px
13. Total Number of Dosage Units or Total Quantity of the Preparation:
Use: specifies Total Number of Dosage Units or Total Quantity of the Preparation
Importance: prevents the pharmacist from over dispensing/ under dispensing
14. Direction of Use:
Use: instructions to how the px should take the medication
Importance: ensures px takes the drug accurately to ensure optimum therapeutic effect
15. Inscription "NO REFILL":
Use: the prescription cannot be refilled
Importance: to emphasize that a new prescription is need for subsequent doses
16. Original Signature of the Medical Practitioner:
Use: for authenticity of prescription
Importance: validates the prescription itself
Several important guidelines must be followed when dispensing regulated drugs:
• No prescription, once filled by the pharmacist shall be refilled;
• Stamp or write the words “USED IN FULL” or “FS” on the original copy of the prescription if full quantity of
the drug is purchased;
o For partial purchase or drugs that were not fully dispensed, write the remaining balance on
the prescription signed by the dispensing pharmacist. Do not return the original copy to
the patient. Instruct the patient to come back for the remaining balance. (w/ date and
signature)
• After dispensing, record immediately in the dangerous drugs book (DDB)
• A yellow prescription is valid for 30 days only. If the prescription has exceeded 1 month from the
prescribed date, do not fill. Advise the patient to return to the prescriber.
• pharmacist has the right not to supply a dangerous drug and/or preparation on presentation of a
prescription, if she/he knows or has reason to believe that the prescription order was
o Forged, unlawfully altered, or cancelled; in which case the pharmacist shall contact the
prescribing practitioner for verification;
o Issued more than 30 days before presentation, the 30 days shall be based on the date
indicated by the practitioner when the drug shall have been obtained; except for that multi-
month prescription such as those in long-term care, hospice and oncology patients, it
should not exceed 30 days’ supply PER prescription or a total of 90 days’ supply all dated
on the day of issue and with written instruction on the second prescription of when to obtain
the medicine. It such cases, the prescriber shall indicate on the face of the prescription, the
number of prescriptions issued to the patient i.e., one of 3 R, two of 3 Rx and three of 3
Rx.
o Already terminated by the discontinuance of the medication by the prescriber or death of the
patient;
o The prescription is outside the scope of practice of the prescriber; (e.g., Dentists prescribes for
Depression)
o Not complete, legible, properly prepared, properly signed or shows any signs of alterations
or erasure.
• The practitioner may prescribe a 60-day supply of Philippine Schedule 4 drugs for the treatment of epilepsy
and dystonia.
• The pharmacist must require the person who shall receive the drug to indicate their complete name and
address, valid government-issued ID with picture, or in case of foreigners, present the original and
photocopy of passport or any valid government issued ID and affix signature at the back of the prescription.
• All dangerous drugs must be kept in a locked container which is constructed and maintained to prevent
unauthorized access to the drugs and can only be opened by the licensed pharmacist.

IV. Dangerous Drugs Book

A log book for the dispensed dangerous drugs.
• The pharmacist will write the name of the patient, age, and address then the name of the prescriber and S2
license.
• There are different pages for each dangerous drug, i.e., all dispensed Morphine Sulfate will be recorded in
a specific page.
• The DDB is valid for 2 years.
• This is checked annually by the PDEA
• The name of the drug, strength and dosage form should be written also with its Balance
• Only the pharmacist can write in the DDB o If there are errors in the DDB, cross out the error and the
pharmacist must affix their signature. Do not use white ink to cover it.

Dangerous Drugs
Item Type of License Description
(i) S-2 License to prescribe dangerous drugs or preparations in any form,
Prescribers except its preparations containing Norephedrine/Phenylpropanolamine
at doses 25 mg or below [OTC drugs, per BFAD AO 163, s. 2000].

(ii) S-3 License to sell, procure, acquire, deal in, dispense, and retail
Distributors or dangerous drugs or its preparations in any form, except preparations
dispensers containing Norephedrine/Phenylpropanolamine at doses 25 mg or
below [OTC drugs, per BFAD AO 163, s. 2000].

Covers activities granted to S-1 License Holders.

(iii) S-4 License to sell, procure, acquire, deal in and distribute dangerous drugs
Wholesale or its preparations in any form, except preparations containing
Norephedrine/Phenylpropanolamine at doses 25 mg or below [OTC
drugs, per BFAD AO 163, s. 2000].

(iv) S-5-I License to import specified (a) dangerous drugs or its preparations in
Importer any form, except preparations containing
Norephedrine/Phenylpropanolamine at doses 25 mg or below [OTC
drugs, per BFAD AO 163, s. 2000]; (b) in vitro diagnostic reagents,
buffers and analytical standards, test kits containing dangerous drugs.

(v) S-5-C License to manufacture specified dangerous drugs and its preparations
Manufacturer in any form. The license, however, shall not apply to the compounding
and filling of prescriptions in drugstores, clinics and hospitals.

The licensee need not obtain another license of the same nature of
activity for CPECs that will be used in the manufacture of DDs or its
preparations. May procure, acquire scientific apparatus or controlled
laboratory equipment for manufacture of DDs or its preparations. May
distribute DDs or its preparations, but may not retail the same.
(vi) S-5-E License to export specified dangerous drugs and its preparations in any
Exporter form to foreign entities duly licensed or authorized by their respective
countries or jurisdictions.
(vii) S-5-D License for bulk depot or storage of specified (a) dangerous drugs and
Bulk its preparations in any form, except preparations containing
depot/storage Norephedrine/Phenylpropanolamine at doses 25 mg or below [OTC
drugs, per BFAD AO 163, s. 2000].; (b) CPECs used in the manufacture
of preparations; and when such address is separate and distinct from
the office address of the license holder.
(viii) S-5-B License to bring into the Philippines in transit or transship Dangerous
Transhipper Drugs or its Preparations.
(viii) S-7 License to deal with or transact matters involving Dangerous Drugs or
Brokers its Preparations as brokerage firms, entities, or individual broker.

Item Type of License Description

(i) P-1 License to sell, procure, acquire, deal in, specified CPECs or its
Retail distributor preparations for retail purposes only. (Codeine containing
preparations)
(ii) P-3 End-user of specified CPECs or its preparations. Not authorized to
End-User resell the same. Authorized to purchase from local sources only.

(iii) P-4 License to sell, procure, acquire, deal in specified CPECs and its
Wholesale preparations for wholesale distribution to licensees.
distributor
(iv) P-5-I License to import specified CPECs and its preparations. May
Importer distribute the same for which license was issued. May not distribute
any substance for which license was not issued.
(v) P-5-C License to manufacture or recycle specified CPECs and its
Manufacturer preparations. May distribute that substance or class for which
license was issued; may not distribute any substance or class which
are not licensed.

May procure, acquire scientific apparatus or controlled laboratory

equipment for manufacture of DDs or its preparations. May
distribute CPECs or its preparations, but may not retail the same.
(vii) P-5-E License to export specified CPECs and its preparations.
Exporter
(viii) P-5-D Bulk License for bulk depot/storage of CPECs and its preparations if the
depot/storage address of which is separate and distinct from the office address of
the licensee.
 (ix) P-5-IM License to import specified CPECs or its preparations, as Enduser.
Importer/Endorser Acquisition of CPECs or its preparations shall be made through
importation. The license holder is authorized also to acquire the
same from local sources but is not authorized to resell them.

(viii) P-5-B License to bring into the Philippines in transit or transship Controlled
Transhipper Precursors and Essential Chemicals and its preparations.

(viii) P-7 License to deal with or transact matters involving Controlled

Broker Precursors and Essential Chemicals or its preparations as
brokerage firms, entities, or individual broker;
Item Type of License Description
(i) S -6 or P-6 License to acquire, procure, import, export, manufacture, cultivate,
Research/Analysis/ for the purpose of conducting laboratory analysis for technical
Instructional research or instructional/training programs, including K-9 or X-ray,
program DDs and CPECS or their preparations. May procure or acquire
syringe, scientific apparatus or laboratory equipment.

VI. Comprehensive Dangerous Drugs Act of 2002

Regulatory Authorities:
The Philippine Drug Enforcement Agency (PDEA) is the primary regulatory authority responsible for enforcing
the provisions of the act. Pharmacy students should be aware of PDEA's role in combating illegal drug
activities and its collaboration with other law enforcement agencies.
DRUG SCHEDULES
a. Schedule I:
Drugs classified under Schedule I have a high potential for abuse and have no accepted medical use in
treatment in the Philippines.
Examples: Heroin, LSD (lysergic acid diethylamide), MDMA (Ecstasy or Molly), Methaqualone

b. Schedule II:
Drugs classified under Schedule II have a high potential for abuse but may have accepted medical uses
with severe restrictions.
Examples: Methamphetamine. Cocaine, Opium, Morphine

c. Schedule III:
Drugs classified under Schedule III have a potential for abuse less than those in Schedules I and II. They
have accepted medical uses, but their abuse may lead to moderate or low physical dependence or high
psychological dependence.
Examples: Ketamine(analgesic), Anabolic steroids, Codeine preparations

d. Schedule IV:
Drugs classified under Schedule IV have a lower potential for abuse compared to those in Schedules I-III.
They have accepted medical uses, and their abuse may lead to limited physical or psychological
dependence.
Examples: Alprazolam, Diazepam, Lorazepam

e. Schedule V:
Drugs classified under Schedule V have a low potential for abuse relative to substances listed in Schedules
I-IV. They have accepted medical uses, and their abuse may lead to limited physical or psychological
dependence.
Examples: Cough preparations w/ less than 200mg codeine per 100 ml or 100 g, Loperamide

Provisions and Penalties

1. Possession of Dangerous Drugs (Section 11):
• Penalty: Imprisonment ranging from 6 months and 1 day to 4 years and a fine ranging from ₱10,000
to ₱50,000.
• Aggravating Circumstances: Possession of drugs within 100 meters of schools, colleges,
universities, or other drug-free zones may result in increased penalties.

2. Possession of Equipment, Instrument, Apparatus, and Other Paraphernalia for Dangerous Drugs
Use (Section 12):
• Penalty: Imprisonment ranging from 6 months and 1 day to 4 years and a fine ranging from ₱10,000
to ₱50,000.
 • Aggravating Circumstances: Possession of paraphernalia within drug-free zones can lead to higher
penalties.

3. Possession of Dangerous Drugs During Parties, Social Gatherings, or Meetings (Section 13):
• Penalty: Imprisonment ranging from 12 years and 1 day to 20 years and a fine ranging from ₱100,000
to ₱500,000.

4. Sale, Trading, Administration, Dispensation, Delivery, Distribution, and Transportation of

Dangerous Drugs and/or Controlled Precursors and Essential Chemicals (Section 5 and Section
26): (Drug pushers)
• Penalty: Life imprisonment to death and a fine ranging from ₱500,000 to ₱10 million.
• Aggravating Circumstances: Trafficking of drugs to minors, pregnant women, or mentally
incapacitated individuals can lead to increased penalties.

5. Maintenance of a Den, Dive or Resort (Section 29):

• Penalty: Life imprisonment to death and a fine ranging from ₱500,000 to ₱10 million.
• Aggravating Circumstances: If minors are present in the den, the penalty can be increased.

6. Possession of Equipment, Instrument, Apparatus, and Other Paraphernalia for Dangerous Drugs
Manufacture (Section 13):
• Penalty: Life imprisonment to death and a fine ranging from ₱500,000 to ₱10 million.

7. Illegal Manufacture of Dangerous Drugs (Section 15):

• Penalty: Life imprisonment to death and a fine ranging from ₱500,000 to ₱10 million.
• Aggravating Circumstances: If the manufacture occurs within 100 meters of schools, colleges,
universities, or other drug-free zones, penalties increase.

8. Cultivation or Culture of Plants Classified as Dangerous Drugs or are Sources Thereof (Section 16):
• Penalty: Life imprisonment to death and a fine ranging from ₱500,000 to ₱10 million.
• Aggravating Circumstances: Cultivation within drug-free zones results in higher penalties.

9. Criminal Liability of Officers and Employees of Juridical Persons (Section 32):

• Penalty: Imprisonment of 12 years and 1 day to 20 years and a fine ranging from ₱100,000 to
₱500,000.
• Liability: Officers, employees, or any person acting on behalf of corporations or juridical entities found
guilty of violating drug-related provisions will face penalties

10. Unnecessary Prescription of Dangerous Drugs (Section 28):

• Penalty: Imprisonment ranging from 6 months and 1 day to 2 years and a fine ranging from ₱10,000 to
₱50,000.
• Aggravating Circumstances: If the violation is committed by a physician or dentist, the penalty can
increase to
imprisonment of 4 to 6 years and a fine ranging from ₱50,000 to ₱200,000.

Ps. Updated List of Regulated Drugs is uploaded in Separate file in your Google Class.
Ps. Di na post
A5: INTERPRETING MEDICAL ABBREVIATIONS
Abbreviation From the Latin Meaning
aa ana of each
ad ad up to
a.c. ante cibum before meals
a.d. aurio dextra right ear
ad lib. ad libitum use as much as one desires; freely

admov. admove apply

agit agita stir/shake
alt. h. alternis horis every other hour
a.m. ante meridiem morning, before noon
amp ampule
amt amount
aq aqua water
a.l., a.s. aurio laeva, aurio sinister left ear
A.T.C. around the clock
a.u. auris utrae both ears
bis bis twice
b.i.d. bis in die twice daily
B.M. bowel movement
bol. bolus as a large single dose (usually intravenously)

B.S. blood sugar

B.S.A body surface areas
cap., caps. capsula capsule
c cum with (usually written with a bar on top of the “c”)

cib. cibos food

cc cum cibos with food, (but also cubic centimetre)

cf with food
comp. compound
cr., crm cream
D5W dextrose 5% solution
(sometimes written as D 5 W)
D5NS dextrose 5% in normal saline (0.9%)

D.A.W. dispense as written

dc, D/C, disc discontinue
dieb. alt. diebus alternis every other day
dil. dilute
disp. dispense
div. divide
d.t.d. dentur tales doses give of such doses
D.W. distilled water
elix. elixir
e.m.p. ex modo prescripto as directed
emuls. emulsum emulsion
et et and
ex aq ex aqua in water
fl., fld. fluid
ft. fiat make; let it be made
g gram
gr grain
gtt(s) gutta(e) drop(s)
H hypodermic
h, hr hora hour
h.s. hora somni at bedtime
ID intradermal
IM intramuscular (with respect to injections)

inj. injectio injection

IP intraperitoneal
IV intravenous
IVP intravenous push
IVPB intravenous piggyback
L.A.S. label as such
LCD coal tar solution
lin linimentum liniment
liq liquor solution
lot. lotion
M. misce mix
m, min minimum a minimum
mcg microgram
mEq milliequivalent
mg milligram
mist. mistura mix
mitte mitte send
mL millilitre
nebul nebula a spray
N.M.T. not more than
noct. nocte at night
non rep. non repetatur no repeats
NS normal saline (0.9%)
1/2NS half normal saline (0.45%)
N.T.E. not to exceed
o_2 both eyes, sometimes written as o 2

o.d. oculus dexter right eye

o.s. oculus sinister left eye
o.u. oculus uterque both eyes
oz ounce
per per by or through
p.c. post cibum after meals
p.m. post meridiem evening or afternoon
prn pro re nata as needed
p.o. per os by mouth or orally
p.r. by rectum
pulv. pulvis powder
q quaque every
q.a.d. quoque alternis die every other day
q.a.m. quaque die ante meridiem every day before noon
q.h. quaque hora every hour
q.h.s. quaque hora somni every night at bedtime
q.1h quaque 1 hora every 1 hour; (can replace “1” with other
numbers)
q.d. quaque die every day
q.i.d. quater in die four times a day
q.o.d. every other day
 qqh quater quaque hora every four hours
q.s. quantum sufficiat a sufficient quantity
R rectal
rep., rept. repetatur repeats
RL, R/L Ringer’s lactate
s sine without (usually written with a bar on top of the
s)
s.a. secundum artum use your judgement
SC, subc, subcutaneous
subq, subcut
sig write on label
SL sublingually, under the tongue

sol solutio solution

s.o.s., si op. si opus sit if there is a need
sit
ss semis one half
stat statim immediately
supp suppositorium suppository
susp suspension
syr syrupus syrup
tab tabella tablet
tal., t talus such
tbsp tablespoon
troche trochiscus lozenge
tsp teaspoon
t.i.d. ter in die three times a day
t.d.s. ter die sumendum three times a day
t.i.w. three times a week
top. topical
T.P.N. total parenteral nutrition
tr, tinc., tinct. tincture
u.d., ut. dict. ut dictum as directed
ung. unguentum ointment
U.S.P. United States Pharmacopoeia
vag vaginally
w with
w/o without
X times
Y.O. years old