Pharmaceutical examination of a prescription: concept, objectives and stages

Depending on the conditions of dispensing from the pharmacy, all drugs can be divided into two large groups. The first group is drugs for which a prescription is not required. These are drugs that are freely available. Their buyer is used to seeing in advertising, on pharmacy display cases and can purchase any of them without a doctor’s prescription.

The second group is represented by prescription drugs. Such drugs are not freely available. To get at least one of them, the patient needs to see a doctor or paramedic, who, if he sees fit, will write a prescription. Then it must be provided to the pharmacy, where a specialist with a pharmaceutical education will conduct an examination. In the case of a satisfactory result, the pharmacy worker will release the necessary medicine to the patient. Therefore, it is not enough to get a prescription from a doctor, it is necessary that it is still properly executed. This is the essence of the pharmaceutical examination of the prescription.

To understand this topic, you must have an idea of ​​what a recipe is and what are its main functions.

Recipe definition and function

A prescription is a written prescription of a doctor in a strictly established form. A prescription can only be written by a medical or veterinarian who has the right to do so.

The recipe has several functions:

1. Medical.
2. Technological.
3. Financial and economic.
4. Economic and statistical.
5. Legal

What are the prescription forms?

There are several forms of forms on which you can write a prescription. The choice of form directly depends on the drug on which it is prescribed.

1. No. 107 / y-NP - is a special form of prescription, because it is used if necessary to prescribe a patient a drug or psychotropic substance.
2. No. 148-1 / -88 - this form is used if such medicinal substances are prescribed as:

• poisonous, potent, psychotropic substances of the III list;
• substances of apomorphine, atropine, homotropin, dicain, pachycarpin and silver nitrate;
• ethanol;
• anabolics;
• combination drugs containing narcotic or psychotropic components (e.g. codeine) in small quantities.

1. No. 148-1 / -88 (04), No. 148-1 / -88 (06) - preferential forms. They are used in cases where a drug is prescribed for free dispensing of a drug from a pharmacy or for dispensing it at a discount. This happens in cases where the patient belongs to a privileged group and is entitled to free (or at a discount) medication.
2. No. 107-1 / - on this form of the form those substances are written out, the amount of which are not taken into account in the pharmacy organization.

In each of these forms, the presence of basic details is mandatory, which are the same for all. At the same time, each form of the form is characterized by its additional details, and this forms differ from each other. Lists of these details are presented below.

Stages of working with a prescription in a pharmacy

After the prescription goes to the pharmacy, it goes through several stages of handling it:

1. Pharmaceutical Examination Prescription.
2. Prescription taxation is the definition of the retail value of a drug.
3. Registration of the prescription in the relevant documents of the pharmacy organization.

Thus, pharmaceutical examination of a prescription is only one of the necessary steps for handling a form in a pharmacy.

The concept of pharmaceutical expertise

This examination is the process of establishing by the pharmacy worker the compliance of the prescribed drug with the form of the prescription form, verifying the correct design of the main and additional details, the correctness of the prescribed dose and the compatibility of the ingredients.

The main objectives of the pharmaceutical examination of a prescription are as follows:

1. Verification of the design of the prescription form.
2. Finding out whether the prescriber has the right to this manipulation.
3. Prevention of possible medical errors (excess dosage, the presence of incompatible components in one prescription, etc.). Of course, such situations arise extremely rarely, but due to the human factor, they are possible.

Who is responsible for conducting the pharmaceutical prescription examination?

The process of checking forms and dispensing prescription drugs is a very responsible job, requiring a huge amount of specialized knowledge and attention. Therefore, in order to do this, special education is necessary.

A pharmaceutical examination of a prescription is carried out by a pharmacy worker (a pharmacist is a person with a higher pharmaceutical education, or a pharmacist is a person with a secondary pharmaceutical education). In any case, in order to carry out such responsible work as the examination of prescription forms, a pharmacy worker must have a completed pharmaceutical education.

Algorithm of actions for a pharmacy worker

You can conduct a pharmaceutical examination of the prescription according to the algorithm presented below.

I. First of all, the correctness of the selected form of the prescription form is checked.

II. If the form of the form is presented correctly, the pharmacist must check the presence of all the details that relate to the main:

1. Stamp of a medical institution. It should be in the upper left corner and contain the following information: the detailed name of the medical organization, as well as its location and phone number.
2. The date the prescription was written by a doctor.
3. Surname, name, patronymic of the patient.
4. Also, on all forms of the prescription, except preferential ones, the age category of the patient (adult or child) and the number of years must be indicated. Preferential forms should instead indicate the date of birth of the patient.
5. Surname, name, patronymic of the doctor. They must be written in full, without the use of initials.
6. Signature of the doctor, as well as his personal seal. If the prescription is written out by a medical assistant, his full name and signature must also be indicated.

III. Anyone conducting a pharmaceutical prescription review should check the Rp box. Rp is the abbreviation of the Latin word recipe, which means "cook." In this column in Latin, the names of medicines must be indicated, and certain rules must be observed:

1. The name of drugs that are subject to registration in the pharmacy organization must be written first.
2. The amount of liquid substances should be indicated in ml, drops or grams.
3. It so happens that the list contains the substance to be recorded, and its indicated dose exceeds a single dose. In such cases, the doctor must indicate the required dosage in words and put an exclamation mark next to the indicated amount. If this is not done, the pharmacist must contact the doctor to determine the dose. If this is not possible, it is necessary to give the patient such an amount of medicine that will be equal to half the highest single dose.
4. Pharmaceutical examination of a prescription during dispensing includes checking the pharmacological compatibility of the ingredients.
5. If one of the prescribed components is poisonous or potent, the pharmaceutical worker must check whether the highest daily and single doses are exceeded.
6. You must also make sure that the amount of drugs for a single vacation is not exceeded.

IV. Conducting a pharmaceutical examination of a prescription also includes verifying the correctness of the signature designation - a section where the method of using the drug is indicated.

The signature must be written in Russian. If this is a special form, it must be issued in both Russian and the language of the republic. The method of use of the drug should be detailed in detail, indicating the time of administration, the required dosage, as well as the frequency with which it is necessary to take the medicine, and the duration of the treatment course. It is forbidden to write briefly - "Inside", "According to the scheme", etc.

V. Each recipe has its own term when it is valid. Therefore, the pharmaceutical examination of a prescription also consists in verifying that the prescription does not expire.

VI. In the case when the drug is required immediately, write cito (within two business days) or statim (within one business day) at the top of the prescription. During these periods, the pharmacy organization is obliged to provide the patient with the necessary medicine. This should also be noted.

When conducting a pharmaceutical examination of a prescription, the pharmacist (or pharmacist) must also remember that in the prescription the abbreviations stipulated by the annex to order 1175n are permissible.

VII. If all the main details are present and properly executed, it is necessary to check the correctness of the additional design.

Viii. You should also check the eligibility of the person who wrote the prescription.

After conducting a pharmaceutical examination, it is necessary to dispense the drug. Then the prescription is given back to the patient (form No. 107-1 / y) or remains at the pharmacy (all other forms). In the second case, the pharmaceutical worker must decide how long the prescription will be stored in the pharmacy organization (it depends on its form).

List of additional details for various forms of prescription forms

Form No. 107-1 / y-NP

A pharmaceutical examination during the dispensing of drugs that are narcotic or psychotropic substances provides for such a clause as checking additional details of a special form, namely:

1. The number of the compulsory health insurance policy, as well as its series.
2. The medical card number of the patient who is being treated as an outpatient.
3. Signature of the head of the medical organization or his deputy.
4. The presence of a hospital round stamp is also required.

Form No. 148-1 / y-88:

1. Blank number, blank series.
2. The address at which the patient resides, or the number of his medical record.
3. Print "for prescriptions", which should be in every medical organization.
4. On the reverse side should be present the columns "cooked", "checked", "released", which are filled in the pharmacy.

Preferential form No. 148-1 / -04 (l):

1. Form number and its series.
2. The code of the category of people who are entitled to free provision of medicines.
3. Medical Organization Code.
4. The code of the nosological form according to the ICD.
5. Mark on the source of financing (federal, regional, municipal).
6. Indication of the conditions under which the medicine is purchased by the patient (free or at a discount of 50%).
7. SNILS number and OMS policy.
8. The code of the doctor or paramedic who wrote the prescription.
9. On each form of this form below there is a part that must be filled in by the pharmacy worker when dispensing the medicine. One half of it remains in the pharmacy, the other is given to the patient in his arms.

Details of the prescription form No. 148-1 / -06 (l) are similar. But in this form there is still a barcode that is designed to automatically read information in a pharmacy organization.

Form No. 107-1 / y has no additional details.

And if the recipe is framed incorrectly?

Conducting a pharmaceutical examination during the dispensing of drugs provides for actions in situations where any errors were made during the execution of the form. A recipe in which one of the requisites is missing or incorrectly framed, in which dosages are exceeded or there is incompatibility of ingredients, etc., will not satisfy the requirements. A recipe that does not meet the requirements is considered invalid. In this case, the pharmacist or pharmacist has no right to release the required drug to the patient. The pharmacy employee must put the “prescription is invalid” stamp on such a form and register it in a special journal, where all incorrectly executed forms are marked.

Information on such forms should be reported to the head of the clinic in which the prescription was issued at least once a month (Ministry of Health Order No. 785).

Pharmaceutical examination of prescriptions. Examples

The following is one example of a recipe review:

The doctor prescribed a prescription for a patient who is a World War II veteran suffering from oncological pain:

Recipe: Solutionis morphini hydrochlorici 1% -1ml forty ampoules.

Signa: Drive intramuscularly 1 ml 3 times a day.

Pharmacist actions:

1. First of all, check the form of the form. Morphine is a narcotic drug, so it should be written out on form No. 107 / y-NP. This blank is pink in size 10 × 15 cm, it should have watermarks. In addition, such a prescription should be filled out in writing by the doctor, without the use of printing devices. Also, the required amount should be indicated in words, without numbers.

One form is intended for writing out only one drug on it, the presence of two or more kinds of drugs is in no case unacceptable.

1. Then the presence of the main details is checked, as well as the duration of the prescription, which is five days.
2. After that, additional details are checked, which must be present on the form 107 / -NP.
3. The amount of prescribed drug is checked. In this case, the doctor indicates forty ampoules of morphine, but the rate of release of morphine is twenty ampoules. The patient is oncologically ill, therefore, he can be released the drug in an amount that exceeds the rate of leave twice.
4. The pharmaceutical examination of prescriptions for dispensing drugs is completed. In the event that everything is framed correctly, the pharmacist must provide the necessary medicine to the patient, after asking his passport first.
5. After which the pharmacist or pharmacist must make a note that the drug is released. Be sure to indicate the last name, first name and patronymic of the person who released the medicine and put a signature. It is also necessary to put a round seal of the pharmacy and the stamp "medicine is released."
6. The prescription is necessarily left for storage in the pharmacy, and the patient is given a signature on his hands, where it must be prescribed how to take the drug correctly.
7. After that, the recipe is taxed and recorded in certain magazines.
8. Such a prescription is stored in a pharmacy for 10 years.

In this case, a pharmaceutical examination of the preferential prescription is also required. The fact is that the patient is an oncologically ill patient and a veteran of the Second World War, therefore he is prescribed a prescription of form No. 148-1 / -04 (l) or No. 148-1 / -06 (l). Pharmaceutical examination of a preferential prescription does not differ from that when checking all other forms of forms, with the exception of checking additional details.

Conclusion

The procedure for pharmaceutical examination of a prescription consists of many stages and requires a lot of knowledge in such disciplines as pharmacology, pharmacotherapy and managing the economy of pharmacy. Such responsible work requires a lot of attention and composure from its executor, therefore only trained people with special education can engage in examination. Pharmaceutical examination is an important stage in the process of obtaining the necessary medicine by the patient and is necessary when dispensing any prescription drug.