Medication Pathway (Prescription) PDF

PHARCARE 4: DISPENSING AND
MEDICATION COUNSELING
OUTLINE
I. Dispensing
II. The Medication Pathway
III. The Prescription
IV. Legal Provisions Affecting Dispensing
Practice in the Philippines
I. DISPENSING
Dispensing
• pharmacist’s function of taking an order
or prescription;
• preparing the drug/s according to the
instructions of a physician or dentist and
• delivering it to the patient or client with
proper instructions.
Dispensing
Sec. 5 (l) of Philippine Pharmacy Act (RA 10918)
defines:
Dispensing refers to the sum of processes
performed by a PHARMACIST
- from reading, validating, and interpreting
prescriptions; preparing; packaging;
labeling; record keeping; dose calculations;
and counseling or giving information,
Dispensing
Sec. 5 (l) of Philippine Pharmacy Act (RA 10918)
defines:
Dispensing refers to the sum of processes
performed by a PHARMACIST
- in relation to the sale or transfer of
pharmaceutical products,
- with or without a prescription or
medication order.
Dispensing
What is the degree of care needed in dispensing?

In one case decided by the Supreme Court, the court declared that as active
players in the field of dispensing medicines to the public, the HIGHEST
DEGREE OF CARE AND DILIGENCE is expected of pharmacists.
Dispensing
What is the degree of care needed in dispensing?
This means highest practicable degree of prudence, thoughtfulness, and

vigilance and the most exact and reliable safeguards consistent with the
conduct of the profession.
II. THE MEDICATION PATHWAY
The Medication Pathway
PRESCRIBING ADMINISTRATION
is associated of medicine is
with around associated with
half of all about 1/3 of all
avoidable DISPENSING errors account avoidable
medication for over 10% of all avoidable medication errors.
errors. medication errors.
THE MEDICATION THERAPY
Doctor - Prescribing
Step 4
Step 3
Step 2 Consider
Step 1 Choose drug
Decide on suitability of Step 5
Make an based on
medication choice and Write
accurate efficacy, safety,
versus other dose of prescription
diagnosis convenience,
treatment individual
cost
patient
Lack of awareness of best Disregard for a patient’s history

practice recommendations of allergy to the same
medication class
Failure to alter drug therapy in
the face of altered physiology Prescription of the wrong drug
such as renal or liver
impairment
Illegible writing Transcription duplications and

omissions in complex hospital
Inadequate monitoring or follow- medication charts
up
Poor communication with the
Discontinuity of pre-hospital and patient &/or other members of
post-hospital medications the health team
Pharmacist - Dispensing
Step 6 Step 7 Step 8

Review Prepare and Deliver
prescription dispense medication/s
Failure to understand doctors Fails to check prescription against

prescription (especially if allergy history, existing drugs,
handwritten) possible interactions, etc.
Fails to ask if medication record is
complete
Dispenses wrong drug Poor communication with the

patient &/or other members of the
Wrong patient health team
Wrong instructions
Nurse - Administration
Step 9
Prepare to Step 10 Step 11 Step 12
administer Administered to Recorded to Monitor patient
medication to patient patient chart response
patient
Wrong patient Wrong dose (problem with

calculations)
Wrong drug
Wrong route of administration
Wrong time
Administration not documented; Inadequate monitoring or follow-

given twice up
Poor patient communication
III. THE PRESCRIPTION
THE PRESCRIPTION
2 TYPES OF MEDICATION ORDER
2 Types of Medication Order

1. Prescription
2. Inpatient Medication Order
PRESCRIPTION
It is a set of specific directions issued by a medical practitioner to a

pharmacist for the appropriate use of medications in a particular patient.
Prescriptions maybe communicated in writing, verbally or transmitted

electronically.
PRESCRIPTION
It serves as the framework for the processes involved in pharmaceutical

care running through, and facilitating, all areas of clinical and dispensing
operations for medications.
Rx identifies the medication/s to be dispensed accompanied by directions on

its proper use.
PRESCRIPTION
It connects the pharmacist with prescribers, other healthcare

professionals, and, most importantly, the patient.
the Rx can facilitate the professional relationship between the GP and the
RPh for the delivery of quality pharmaceutical care to meet patient needs.
PRESCRIPTION
RPh can offer advise to the GP related to drug product selection based on
clinical protocol, drug formularies or patient financial considerations.
In return, RPh. May consult the prescriber as to other patient specific
knowledge like allergies, ADR, and medication histories.
PRESCRIPTION
Medical Practitioners who can

issue prescriptions:
Physicians
Veterinarians
Dentists
Nurse Practitioners
Physician Assistants
Pharmacists
INPATIENT MEDICATION ORDERS
Used in hospitals and other institutions.
Written by the physician on forms called the

“Physician Order Sheet” or are entered directly
into the institution’s computer system.
The orders are sent directly to the pharmacy

serving that institution to be screened, processed
and dispensed.
THE PRESCRIPTION
PARTS OF THE PRESCRIPTION

1. Prescriber’s Information
2. Patient Information
3. Date
4. Superscription
5. Inscription
6. Subscription
7. Signatura
8. Refill number
9. Prescriber’s signature
PRESCRIBER’S INFORMATION AND

SIGNATURE
1. Prescriber’s name
2. Address
3. Telephone number
4. Name of the institutional affiliation
or office
5. PRC License number
6. S-2 license No.
7. Prescriber’s signature
PATIENT INFORMATION
1. Full name
2. Address
3. Date of birth
4. Allergy information
5. Age
6. Weight or BSA
DATE
Prescriptions are dated at the time
they were written and also when
they are received and filled in the
pharmacy.
This is important in establishing the

treatment history for the patient.
SUPERSCRIPTION
a.k.a. the Rx symbol which is the
contraction of the Latin verb recipe.
This means ‘take thou or you take.’
It serves as the beginning of the
direct order of the prescriber to the
pharmacist to fill the order and
dispense the prescription.
INSCRIPTION
States the medication/s prescribed
It is the body or principal part of the

prescription that contains:
Names
Dose per unit
Quantities of the prescribed medications
or ingredients.
For compounded prescriptions, they

contain the names and quantities of
each ingredient as part of the
inscription.
INSCRIPTION
Dosages or quantities for
commercially available products or
listed ingredients for compounded
prescription may be expressed as a
concentration or unit of measure
using the metric or Apothecary
system of weights and measure.
Problems concerning inscription:

Use of Tailing Zeros
Failure to use leading zeros.
INSCRIPTION
Dosages or quantities for

commercially available products or
listed ingredients for compounded
prescription may be expressed as a
concentration or unit of measure
using the metric or Apothecary
system of weights and measure.
Problems concerning inscription:

Use of Tailing Zeros
Failure to use leading zeros.
SUBSCRIPTION
Dispensing direction to pharmacist.

For commercially manufactured
products, subscription serves merely
to designate the dosage form, and
the number of dosage units to be
dispensed.
SIGNATURA
Problematic abbreviations in the

Signa:
Abbreviation of drug names.
Abbreviation of administration routes.
Abbreviation of administration
frequency.
Pharmacists are crucial part of the
solution to eliminating the use of
these error-prone abbreviations
through editorial intervention and
provider education.
IV. LEGAL PROVISIONS AFFECTING DISPENSING
PRACTICE IN THE PHILIPPINES
Outline RA 6675: Generics Act of 1988
AO 2016-0008: Revised Rules and Regulations Governing the
Generic Labeling Requirements of Drug Products for Human use
AO 62 s. 1989: Rules and Regulations to Implement Prescribing
Requirements under the Generics Act of 1988 (RA 6675)
AO 63 s. 1989: Rules and Regulations to Implement Dispensing
RA 9165: Comprehensive Dangerous Drug Act of 2002
RA 9502: Universally Accessible Cheaper and Quality Medicines Act
of 2008
Senior Citizen’s Benefits
RA 10963: The TRAIN LAW
RA 6675: Generics Act of 1988
Legal Provisions
Affecting Dispensing
Practice in the
RA 6675: GENERICS ACT OF 1988 Philippines
An act to promote, require, and ensure the production of a

adequate supply, distribution, use, and acceptance of drugs and
medicines identified by their generic name
Approval date: Sept. 13, 1998
Legal Provisions
RA 6675: GENERICS ACT OF 1988 Practice in the
Philippines
SALIENT FEATURES
Section 2. Statement of Policy

To promote, encourage and require the use of generic
terminology in the importation, manufacture,
distribution, marketing, advertising and promotion,
prescription and dispensing of drugs;
To ensure the adequate supply of drugs with generic
names at the lowest possible cost and endeavor to make
them available for free to indigent patients;
Legal Provisions
Practice in the
RA 6675: GENERICS ACT OF 1988 Philippines
SALIENT FEATURES
Section 2. Statement of Policy

To encourage the extensive use of drugs with generic names through
a rational system of procurement and distribution;
To emphasize the scientific basis for the use of drugs, in order that
health professionals may become more aware and cognizant of their
therapeutic effectiveness; and
To promote drug safety by minimizing duplication in medications
and/or use of drugs with potentially adverse drug interactions.
RA 6675: GENERICS ACT OF 1988
Section 3. Definition of Terms
Generic Name or Generic Terminology - identification of
drugs and medicines by their scientifically and
internationally recognize active ingredients or by their
official generic name as determined by the Bureau of
Food and Drugs (now FDA) of the Department of Health.
Active Ingredient - the chemical component responsible
for the claimed therapeutic effect of the pharmaceutical
product
Legal Provisions Affecting Dispensing Practice in the Philippines
SALIENT FEATURES

Brand Name - proprietary name given by the manufacturer to distinguish its
production from those of competitors
Chemical Name - is the description of chemical structure of the drug or
medicine and serves as the complete identification of a compound
EDL or NDF (Essential Drug List or National Drug Formulary) - A
list of alternative drugs prepared and periodically updated by
DOH on the basis of health conditions obtained in the
Philippines, as well as on internationally accepted criteria. It is
consist of a core list and a complimentary list.
Core List - A list of drugs that meet the health care needs of the
majority of the population (i.e. Carbamazepine, Digoxin,
Metoprolol, Propranolol, Quinidine, Warfarin, Metformin)

Complimentary List - A list of alternative drugs used when there
is no response to the core essential drug, when there is
hypersensitivity reaction of if it cannot be given (i.e. Atenolol,
Diltiazem, anhydrous Theophylline, Verapamil, Propranolol)
Generic Drug - Are drugs not covered by patent protection and
which are labeled solely by their INN (International
Nonproprietary Name) or Generic Name
Who Shall Use Generic Terminology
Who Shall Use Generic Terminology
amendment introduced by
RA 9502 on 2008
Legal Provisions Affecting Dispensing Practice in
the Philippines
When buying medicines, CHECK

✓ If the product is registered in PH FDA
✓ If the product complies with the
Generic Labeling Requirements
the Philippines
When buying medicines, CHECK if
the product is registered in PH FDA.
the Philippines
What is the drug’s name?

When does the patient take the
medicine?
How much dosage does the patient
take?
For how long does the patient take the
medicine?
How should the medicine be taken?
AO 2016-0008: Revised Rules and Regulations Governing the Generic

Labeling Requirements of Drug Products for Human use





Two Broad Legal Classification of

Medications
1. Prescription or Ethical Drugs
2. Non-Prescription Drugs or OTC
Drugs
Prescription or Ethical Drugs

Pharmaceutical products or dug
preparations dispensed upon written order
of a validly registered licensed physician,
dentist or veterinarian
For the management or treatment of a
condition or disease

All antibiotics except some ointment (i.e.
Bactroban Ointment)
All injectables (ampules or vials)

Legal Provisions Affecting Dispensing Practice in the Philipp

Cough syrup containing any amount of narcotics (i.e.
Pseudoephedrine, a decongestant)

Vitamin products containing more than 10,000
units vitamin A.
Highly potent drugs for special medication (i.e.
steroid, digitoxin)
Paregoric Elixir (in emergency cases, 1 dose
may be dispensed without a prescription
All drugs bearing the Rx symbol on their
labels.

Non-Prescription or OTC Drugs
Pharmaceutical products or drug
preparation that can be
dispensed even without the
written order of a validly
registered licensed physician,
dentist or veterinarian
For the use consumers for the
prevention or symptomatic relief
of minor or self limiting ailments

Multivitamin product of low
dosage
Anti-TB drugs except injectables
Cough syrup containing
Dextromethorphan
Household remedies except
paregoric
Simple Analgesic (Aspirin,
Acetaminophen) 500mg (>600mg
requires Rx)
DRHR-743
DRHR – product
classified as
home remedies

Dangerous Drugs The following shall be observed:
List A: Prohibited Drugs and Dispensing must be done by the
Regulated Drugs pharmacist who shall affix his/her
signature on the prescription filled.
Require a special prescription form,
The order and instructions of the
the use of which is monitored by doctor as written on the
the Dangerous Drug Board. prescription, must be precisely
followed.
Partial filling of prescription for
drugs belonging to List A shall not
be allowed.
Dangerous Drugs (List A: Prohibited Drugs)

Includes:
Opium and its active components and derivatives: Heroine and Morphine
Coca Leaf and its derivatives
Cocaine (alpha and beta Eucaine)
Hallucinogenic Drugs - Mescaline, Lysergic acid diethylamide (LSD) and other
substance producing similar effect
Indian Hemp and its derivatives
All preparation made from any of the foregoing
Other drugs, natural or synthetic, with the physiological effect of a narcotic
Dangerous Drugs (List A: Prohibited Drugs)
Brown Mixture Tablet Morphine Sulfate H.T
Brown Mixture Liquid Morphine with Atropine Tablet
Codeine Sulfate H.T Morphine Sulfate Ampule
Codeine Sulfate T.T Morphine Sulfate Tablet
Demerol Ampule Sublimaze Injection
Demerol Tablet Rapifen Injection
Demerol Vial Codevite Syrup
Dolo-Adamon Supplement Deka Syrup
Dolo-Adamon Tablet Endotussin Syrup
Elixir Paregoric Raminon Syrup
Innovar Injection Tussionex Suspension

Dangerous Drugs (List A: Regulated Drugs)

Includes:
Sleep-inducing sedatives
Secobarbital, Phenobarbital, Barbital, Amobarbital
Other drugs which contain a salt or derivative of salt of barbituric acid
Any salt, isomer or salt of an isomer of amphetamine
Benzedrine or Dexedrine
Any drug which produces a pharmacologic action similar to amphetamine
Hypnotic drugs
Methaqualone or any other compound producing similar pharmacologic effect
Amytal Sodium Tablet Desozyn Tablet
Amytal Sodium Capsule Dexamyl Spansule No. 1
Amytal Sodium Ampule Dexedrine Spansule
Benzedrine Tablet Doloxene Compound
Butisol Sodium Tablet Doloxene Plan Tablet
Calcidrine Syrup Drinalfa Vial
Circuline Forte Tablet Gadexyl Tablet
Daprisal Tablet Mandrax Tablet
Nembutal Sodium Vial Plexonal Tablet
Noctec Liquid Robypnol
Noludar Tablet Seconal Sodium Capsule
Nuberene Tablet Sosegon Ampule
Paraldehyde Ampule Sosegon Tablet
Pentothal Sodium Valium Thiopental Sodium Vial
Placidyl Capsule Valamin Tablet
Requirements in the dispensing & compounding of dangerous drugs
They should be prescribed in special Rx The pharmacist must keep these
forms issued by the DDB. dangerous drugs in a locked cabinet.
The pharmacist must record them in The pharmacist must keep and file the
the Dangerous Drugs Book in original Rx.
accordance with the form prescribed by Quarterly report covering 3 calendar
the DDB. months of all transaction (copy of 2) to
The pharmacist must check all the be submitted to the Municipal Health
required data as opium license number Officer within 15 days following the last
of the physician, professional license day of every quarter of the year.
number and the residence certificate of
the buyer.
Nembutal Sodium Vial Plexonal Tablet
Noctec Liquid Robypnol
Noludar Tablet Seconal Sodium Capsule
Nuberene Tablet Sosegon Ampule
Paraldehyde Ampule Sosegon Tablet
Pentothal Sodium Valium Thiopental Sodium Vial
Placidyl Capsule Valamin Tablet

List B: Products Requiring Strict Precaution in Prescribing, Dispensing and Use
Aminophylline: Suppository/Tablet Dexamethasone: Tablet
Amitriptyline Hydrochloride: Tablet Dexamethasone Acetate: Injectable
Betamethasone: Tablet Dicumarol: Capsule/Tablet
Busulfan: Tablet Epinephrine: Injectable
Chlorambucin: Tablet Estrogens, Conjugated: Injectable
Chlorpropamide: Tablet Ethinyl Estradiol: Tablet
Chlorthalidone: Tablet Ethosuximide: Capsule
Cyclophosphamide: Tablet Furazolidone: Suspension/Tablet

Hydrochlorothiazide: Tablet Methylergonovine Maleate: Tablet
Hydrocortisone: Injectable Nitrofurantoin: Capsule/Suspension/Tablet
Imipramine Hydrochloride: Tablet Perphenazine: Suppository/Syrup/Tablet/CR
Tablet
Menadione: Tablet Phenylbutazone: Capsule/Tablet
Menadione Sod. Bisulfate: Tablet Phenytoin: Suspension
Mephenytoin: Tablet Phenytoin Sodium, Extended: Capsule
Methdilazine Hydrochloride: Tablet Phenytoin Sodium, Prompt: Capsule
Methotrexate: Tablet Probenecid: Tablet

Procainamide Hydrochloride: Theophylline: CR Capsule/CR Capsule
Capsule/Tablet/CR Tablet (Sprinkles)/ Suspension/CR Tablet
Pyrazinamide: Tablet Thioridazine Hydrochloride: Tablet
Quinidine Sulfate: Capsule/Tablet/CR Tablet Thyroglobulin: Tablet
Spironolactone: Tablet Tolbutamide: Tablet
Sulfadiazine, Sulfamerazine, Sulfamethazine: Triamcinolone: Tablet
Tablet
Sulfamethizole: Suspension/Tablet Warfarin Sodium: Tablet
Sulfisoxazole: Suspension/Tablet
Guidelines on Prescribing
Only validly-registered medical, dental and veterinary
practitioners are authorized to prescribe drugs
All Rx must contain the following information
Name of prescriber, office and address, professional
registration no., PTR, Patient’s name, age, sex, and date
of Rx
For drugs in List A as approved by the DDB, the
following are required:
Prescriber must have S2 license
Special DDB Rx form must be used
Recording system following pertinent DDB regulations
must be observed
Additional Guidelines on Prescribing to Implement

the Generics Act of 1988
Generic name shall be used in all prescriptions:
For drugs with a single active ingredient, the generic
name of that active ingredient shall be used in
prescribing.
For drugs with two or more active ingredients, the
generic name as determined by BFAD (now FDA)
shall be used in prescribing.
The generic name must be written in full but salt
or chemical form may be abbreviated.

Additional Guidelines on Prescribing to
Implement the Generics Act of 1988
The generic name of the drug ordered must be
clearly written on the prescription immediately
after the Rx symbol, or on the order chart
In addition to the generic name, a brand
name may also be written enclosed in
parenthesis shall be below the generic name
If written on a patient’s chart, the brand
name enclosed in parenthesis shall be
written after the generic name

Only ONE Drug shall be Prescribed on
One Prescription Form
AO 90 s. 1990: Amendment to A.O. 62 s.

1989 re: Rules and Regulations To
Implement Prescribing Requirements
Permits the writing of the generic names
of more than one drug product in one
prescription form.

In prescribing drugs enumerated in
List B which needs strict precaution in
their use, the prescriber must comply
with the following:
After the Rx symbol but before the
generic name, he must write clearly
"(List B)".
He must ensure that the following
information are accurately written on the
prescription:
The generic name of the active ingredient(s) and
the specific salt or chemical form.
The manufacturer
The brand name, if so desired
The strength or dose level using units of the metric
system.
The delivery mode or delivery system:
quick‐dissolve, sustained release, etc. and the
corresponding appropriate dose frequency or dose
interval.
INCORRECT PRESCRIPTION
1. Violative Prescriptions
2. Erroneous Prescriptions
3. Impossible Prescriptions
VIOLATIVE PRESCRIPTION
Where the generic name is

not written.


not legible and a brand
name which is legible is
written.
Where the brand name

is indicated and
instructions added
(such as the phrase “NO
SUBSTITUTION”) which
tend to obstruct, hinder
or prevent proper
generic dispensing.

What to do with violative
prescriptions?
Shall NOT be filled
Shall be kept and reported
by the pharmacist of the drug outlet or
any other interested party to the nearest
DOH Office for appropriate actions.
Pharmacist shall advise the prescriber of
the problem and/or instruct the customer
to get the proper prescription.

ERRONEOUS PRESCRIPTION
Where the brand name

precedes the generic name.


the one in parenthesis.

Where the brand name is

not in parenthesis.

AO 90 s. 1990: Amendment
to A.O. 62 s. 1989 re: Rules
and Regulations To
Where more than
Implement Prescribing
one drug product is
prescribe on one
Requirements
prescription form.
Permits the writing of the
generic names of more than
one drug product in one
prescription form.
What to do with erroneous

prescriptions?
Shall be filled
by the pharmacist of the drug
outlet or
any other interested party to the
nearest DOH Office for appropriate
actions.
IMPOSSIBLE PRESCRIPTION
When only the generic

name is written but is not
legible.
When the generic name does not

correspond to the brand name.
generic name brand name


When both the generic

name and the brand name
are not legible.

When the drug product

prescribed is not registered
with the BFAD (now FDA).

What to do with impossible
prescriptions?
Shall NOT be filled
by the pharmacist of the drug outlet or
any other interested party to the nearest
DOH Office for appropriate actions.
Pharmacist shall advise the prescriber of
the problem and/or instruct the
customer to get the proper prescription.
The local DOH Office shall be

responsible for giving
written notice to the erring
doctor concerned and for
transmitting through
channels the report of
violation/error to
Professional Regulation
Commission (PRC) or to the
fiscal’s office for appropriate
action.

Dispensing – the act by a validly-registered
pharmacist of filling a prescription or
doctor's order on the patient's chart
Generic Dispensing – dispensing the

patient's/buyer's choice from among generic
equivalents, i.e., finished pharmaceutical
products having the same active
ingredient(s), same dosage form and same
strength as the prescribed drug

Partial filling of prescription –
dispensing less than the total number of
units prescribed.
Drug Outlet – means drugstore,

pharmacy and other business establishment
which sells drugs or medicines.
RECORD BOOK RETENTION

Poison Book - 5 Years
Prescription Book - 2 Years
Dangerous Drug Book - 1 Year

All drug outlets are required to

practice generic dispensing.

Drugstores, Boticas and other Drug Outlets
In order to ensure the informed choice and use of
drugs by the patient/buyer, the outlets are required
to:
Inform the patient/buyer of all the available drug
products generically equivalent to the one
prescribed with their corresponding prices
Shall not favor or suggest any particular product so
that the patient/buyer may fully and adequately
exercise the option to choose

Drugstores, Boticas and other Drug Outlets
Post in a conspicuous place in their establishment
a list of drug product using generic names with
their corresponding brand names, if any, and
their corresponding current prices
Provide a handbook or directory containing the
above required information readily accessible to
the patient/ buyer

Hospital Pharmacies
Those operating on the acceptable
formulary system and pricing policy and
using generic terminology in
procurement, prescribing, dispensing, and
recording of drugs, shall be exempted
from the following:
Recording of prescriptions filled in the
prescription book, provided such
prescriptions shall be kept in file for
two years.

Hospital Pharmacies
Individually informing the
patient/buyer on the available generic
equivalents and their corresponding
prices
DISPENSARY LABEL
PARTIAL FILLING
PARTIAL FILLING
Dispensing Drugs in List A and List B
Additional Requirements:
1. The prescriber must have an S-2 license.
2. The special DDB Rx form must be used.
3. A recording system following pertinent DDB
regulation must be covered
Dispensing of FDC Products


VIOLATIONS on the part of dispensers and
outlets
Imposing a particular brand or product on the buyer.
Inaccurate dispensing i.e. dispensing a drug product
which does not meet the prescription as to any or all
of the following: active ingredient, dosage form and
strength.
Failure to post or make accessible the required up-to-
date information on drug products

outlets
Failure to adequately inform the buyer on available
products that meet the prescription.
Failure to indicate the generic name/official name
designated by BFAD and other required information
on the drug outlet's label of the dispensed drug.

outlets
Failure to record and keep prescriptions filled.
Failure to report to the nearest DOH office cases of
violative, erroneous, and/or wrong prescriptions
within three months after receipt of such prescription
RA 9165: Comprehensive Dangerous Drug Act

of 2002

of 2002
A certified true copy of such record

covering a period of six (6) months,
duly signed by the pharmacist or the
owner of the drugstore, pharmacy or
chemical establishment, shall be
forwarded to the Board within fifteen
(15) days following the last day of
June and December of each year, with
a copy thereof furnished the city or
municipal health officer concerned.

of 2002
A physician, dentist,
veterinarian or practitioner
authorized to prescribe any
dangerous drug shall issue
the prescription therefor in
one (1) original and two (2)
duplicate copies.

of 2002
The original, after the
prescription has been filled, shall
be retained by the pharmacist
for a period of one (1) year from
the date of sale or delivery of
such drug.
One (1) copy shall be retained
by the buyer or by the person to
whom the drug is delivered until
such drug is consumed, while
the second copy shall be
retained by the person issuing
the prescription.

of 2002
All prescriptions issued by the medical
practitioners shall be written on forms
exclusively issued by and obtainable
from the DOH.
Such forms shall be made of a special
kind of paper.
Such forms shall only be issued by the
DOH through its authorized employees
to licensed physicians, dentists,
veterinarians and practitioners.

of 2002
The prescribing physician, dentist,
veterinarian or practitioner shall,
within three (3) days after issuing
such prescription, inform the DOH
of the same in writing.
No prescription once served by the
drugstore or pharmacy be reused
nor any prescription once issued be
refilled.

of 2002
All manufacturers, wholesalers, distributors,
importers, dealers and retailers of dangerous
drugs and/or controlled precursors and essential
chemicals shall keep a record of all inventories,
sales, purchases, acquisitions and deliveries of the
same as well as the names, addresses and licenses
of the persons from whom such items were
purchased or acquired or to whom such items
were sold or delivered, the name and quantity of
the same and the date of the transactions. Such
records may be subjected anytime for review by
the Board.
of 2002
Dangerous Drugs Board (DDB)
The Board shall be the policy-making and strategy-

formulating body in the planning and formulation of
policies and programs on drug prevention and control.
It shall develop and adopt a comprehensive,
integrated, unified and balanced national drug abuse
prevention and control strategy. It shall be under the
Office of the President.

of 2002
Philippine Drug Enforcement Agency
(PDEA)
PDEA serves as the implementing arm of

the DDB, and shall be responsible for the
efficient and effective law enforcement
of all the provisions on any dangerous
drug and/or controlled precursor and
essential chemical as provided in this Act.
Philippines Schedules of Dangerous Drugs
Philippines Schedules of Dangerous Drugs
RA 9165: Comprehensive Dangerous Drug Act of 2002 Licenses and/or Permits
Licenses and/or Permits
RA 9502: Universally Accessible Cheaper and Quality
Medicines Act of 2008
The Law intends to achieve better health outcomes for the Filipino people:
protect public health
promote and ensure access to affordable quality drugs and medicines for
all
Primary instrument in the attainment of the above policy
– an effective competition policy in the supply and demand of quality
affordable drugs and medicines
In the event that full competition is not effective
– regulation of prices of drugs and medicines may be implemented.
Issues to be considered when facing the problem of access to
medicines:
Rational drug use
Public perception on generics
Health professional behavior on prescribing and
dispensing medicines
Information asymmetry and exercising informed choice
Pricing
Supply and distribution
Procurement systems’ transparency
Respect for patent rights vis-à-vis access by the poor,
quality assurance, and many others
The Law and its IRR intend to make
medicines more accessible &
affordable to Filipinos by enforcing
provisions that
improve market competition
availability
contain costs
improve healthcare provider and
consumers behavior
when instances so require, even
regulate prices
A. Interventions to Improve Competition:
i. Parallel Importation of patented
Medicines
ii. Required Production of Generic
Drugs
iii. Promotion of quality generic drugs
iv. Enforcement of the Early working or
Bolar Provision for patented
medicines
Parallel Importation
Parallel importation (Sec. 7), as applied to the local
setting, is when a patented drug is brought into the
country by Government or any private third party even
without the consent of the patent holder as long as any
of the 2 condition is met:
a. It has been introduced in
the Philippines by the
patent holder, or
b. It has been introduced
anywhere in the world by
the patent owner.
Parallel Importation
It allows for an importer to “shop around” for a good price for a patented
product, bring this into the country and sell it to a more competitive and
affordable price than the prevailing price of the same patented product
sourced locally from the innovator company.
Example: a drug sold here at 45 pesos per tablet and sold at 8 pesos in
another country, an importer may now bring the quality cheaper medicine in
the country and sell it cheaper for our countrymen.
EARLY WORKING OR BOLAR PROVISION
This allows development, testing, and experimental work for the registration of
a generic medicine to take place during the patent period of the innovator
product. Such development, testing, and experimental work may last from 6
months to 2 years.
By exerting the early workings provision for
patented medicines:
– generic competition is facilitated
– cheaper yet quality counterparts for
expensive innovators become available
earlier in the market
B. Interventions to Improve Availability
i. Compulsory Licensing for patented
Medicines
ii. Special Compulsory Licensing for
patented Medicines
iii. Government Use of Patented Medicines
iv. Mandatory Carry for patented parallel
imports
v. Non-traditional outlets like Convenience
Stores and supermarkets allowed to sell
Over-the-Counter drugs
C. Cost Containment Measures
i. PhilHealth Reimbursements
ii. Government Pooled Procurement
iii. Consignment
Only drugs and medicines in the latest

edition of the PNDF can be procured
by government agencies or
reimbursed by PhilHealth
E. Interventions to Regulate
Prices
i. Imposition of Maximum
Retail Prices
ii. Drug Price Monitoring by
the Government
List of Drugs and Medicines that are Subject to Price Regulation.
benefits
Benefits and privileges are provided in the

following legislations:
Republic Act No. 7432, or the Expanded Senior
Citizens Act of 2003
RA 9994, an amendment to RA 7432 to include
additional services
RA 10645, an amendment to RA 9994 to provide
mandatory PhilHealth coverage for all senior
citizens.
20% DISCOUNT ON:

Medical-related privileges
Medicine and drug purchases
Medical supplies, accessories and equipment
Medical and dental services
Professional fees of attending physician
Professional fees of licensed health workers
providing home health care services
EXPRESS LANES
Express lanes shall be provided
in all private, banking,
commercial and government
establishments; priority shall be
given in their absence.
VALUE-ADDED TAX (VAT)

Value-Added Tax (VAT) is a form of sales
tax. It is a tax on consumption levied on
the sale, barter, exchange or lease of
goods or properties and services in the
Philippines and on importation of goods
into the Philippines. It is an indirect tax,
which may be shifted or passed on to
the buyer, transferee or lessee of goods,
properties or services
VAT-EXEMPT TRANSACTIONS
Sale of drugs and medicines prescribed
for DIABETES, HIGH CHOLESTEROL, and
HYPERTENSION beginning January 1,
2019;

Medication Pathway (Prescription) PDF

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PHARCARE 4: DISPENSING AND

What is the degree of care needed in dispensing?

What is the degree of care needed in dispensing?

This means highest practicable degree of prudence, thoughtfulness, and

Lack of awareness of best Disregard for a patient’s history

Illegible writing Transcription duplications and

Step 6 Step 7 Step 8

Failure to understand doctors Fails to check prescription against

Dispenses wrong drug Poor communication with the

Wrong patient Wrong dose (problem with

Administration not documented; Inadequate monitoring or follow-

2 TYPES OF MEDICATION ORDER

2 Types of Medication Order

It is a set of specific directions issued by a medical practitioner to a

Prescriptions maybe communicated in writing, verbally or transmitted

It serves as the framework for the processes involved in pharmaceutical

Rx identifies the medication/s to be dispensed accompanied by directions on

It connects the pharmacist with prescribers, other healthcare

Medical Practitioners who can

INPATIENT MEDICATION ORDERS

Used in hospitals and other institutions.

Written by the physician on forms called the

The orders are sent directly to the pharmacy

PARTS OF THE PRESCRIPTION

PRESCRIBER’S INFORMATION AND

This is important in establishing the

It is the body or principal part of the

For compounded prescriptions, they

Problems concerning inscription:

Dosages or quantities for

Problems concerning inscription:

Dispensing direction to pharmacist.

Problematic abbreviations in the

An act to promote, require, and ensure the production of a

Section 2. Statement of Policy

Section 2. Statement of Policy

Section 3. Definition of Terms

Section 3. Definition of Terms

When buying medicines, CHECK

What is the drug’s name?

AO 2016-0008: Revised Rules and Regulations Governing the Generic

AO 2016-0008: Revised Rules and Regulations Governing the Generic

AO 2016-0008: Revised Rules and Regulations Governing the Generic

AO 2016-0008: Revised Rules and Regulations Governing the Generic

AO 2016-0008: Revised Rules and Regulations Governing the Generic

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

Two Broad Legal Classification of

Prescription or Ethical Drugs

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

All injectables (ampules or vials)

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

Prescription or Ethical Drugs

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

Dangerous Drugs (List A: Prohibited Drugs)

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

Dangerous Drugs (List A: Regulated Drugs)

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

AO 62 s. 1989: Rules and Regulations to Implement Prescribing

List B: Products Requiring Strict Precaution in Prescribing, Dispensing and Use

Additional Guidelines on Prescribing to Implement

AO 62 s. 1989: Rules and Regulations to Implement Prescribing