List

the duties of pharmacists, pharmacy

interns, and unlicensed persons

Understand how a community pharmacy is
organized
List the legal requirements of a prescription
order, patient prole and label
Collect necessary information to establish a
patient prole
Create a prescription label
List the steps to process a prescription

When we reference laws we are referring to

NYS rules and regulations laws for practice

dier from state to state.
The rules can CHANGE - you must always
keep up to date on the most current rules and
regulations
You will learn some introductory laws in this
course but you will have a whole class
devoted to Law next year.

Controlled Substances
Schedule IIs
Brand Medication
Generic Medication
DAW

RETAIL = COMMUNITY PHARMACY

STORE = PHARMACY
CUSTOMER = PATIENT

Who is back there?

 Assist in the process of preparing prescriptions

for dispensing.
Responsible for technical/ administrative
aspects of prescription preparation retrieving
medications from stock, counting dosage units,
labeling, ordering, answering phones, customer
service, etc.
NYS law limits the number of technicians to 2
per pharmacist

Are NOT permitted to:

Receive verbal prescription orders
Interpret or evaluate a prescription
Measure, weigh, compound or mix ingredients
Counsel patients
Make recommendations
Anything that requires professional judgment

must be deferred to pharmacist

No current legal requirements in NYS on eligibility/registration/

certication

Registered with the State must be 21 years

old and have completed their rst

professional year of a pharmacy program
Can perform *all* of the duties of a
pharmacist BUT must be supervised by a
pharmacist at all times.

Licensed and registered with the state

Review from 1st class
Professional responsibility and liability for all

that occurs within the pharmacy department

*Exception: cannot currently immunize in NYS

1.
2.
3.
4.

Receiving the prescription

Filling the prescription
Processing the prescription
Delivering the prescription to the patient

Electronically via approved e-Rx program

3/2015: ALL Rxs required to be e-prescribed with

few exceptions

In person patient brings a paper, serialized,

signed prescription

Verbally received by pharmacist or intern

from prescriber or representative

Fax- signed, serialized prescription DIRECTLY

from prescribers oce

Mail

 Greet the patient

Determine if they have a patient prole

already established

Have you had prescriptions lled at this

pharmacy before?

If yes, verify name, address, DOB and

prescriber and if there is anything new you

need to know
If no, collect information to create a patient
prole

For written

prescriptions

Without prescriber authorization

Patients address and/or Age
Prescriber's telephone number, state license and

profession

With prescribers authorization and proper

documentation

Strength and quantity of prescribed drug &

directions for use

Rell information
Maximum Daily Dose for controlled substances

First and Last Name

Complete address
DOB or Age
Gender
Phone Number
Known Allergies
Chronic diseases/
conditions

Medications,
supplements and
relevant devices
Any information
relevant to counseling
an individual on
prescriptions or over
the counter products
We will practice later

Patient Name
Patient Address
Patient Age
Date written
Name of Medication and Strength
Dosage form
Quantity prescribed (units or days acceptable)
Directions for use (AKA the SIG)
Prescribers name, address, telephone number,
profession (MD, DO, DDS, DMD, DVM, RPA, NP)
Prescribers Signature

Patients name
Prescribers name or signature
Medication name

Date the prescription was written

IF any of these are missing the prescriber

must be contacted. The prescription now
becomes a verbal order, state and federal
laws apply.

 Patient address and age must be WRITTEN

on paper Rx before ling

Prescription order is VOID after 30 days

Cannot dispense more than a 30 day

supply**

Once the prescription is deemed to meet all

legal requirements and contain all the proper

information it moves to the next step
2 parts to the process
1. Filling (technical)

If rells are permitted for that schedule,

2. Cognitive (professional judgment of

cannot exceed 5 rells within 6 months*

appropriateness and counseling)

*Further details will be given in your law classes.

For example: CIIs in NYS cannot have refills
**Some exemptions apply

Retrieve patient prole type in prescription

information
Obtain medication from stock (correct drug,
strength, dosage form, size)

How are the medications organized?

Count the necessary amount of units

Place in container
Label container immediate container should
be labeled whenever possible
Check to be sure everything was done correctly

Parata robot
ScriptPro Robot
RxMedic
Instymed

Name of the patient**

Patient address
Name & strength of
drug**

If generic, name of manufacturer

Directions for use in

FULL sentences**
Name, address, phone #
of the pharmacy
Name of the prescriber

Date prepared
Number of the Rx under
which it is recorded in the
pharmacist's les
Maximum daily dose for a
controlled substance

SJU Pharmacy
8000 Utopia Parkway
Queens, NY 11439
718-990-6161

Mary Smith

Rx#12234
9/5/2013

123 Main St. New City, NY 11783

Amoxicillin 500mg Capsules (TEVA)

Take 1 capsule by mouth 3 times a day

**Essential elements of
a label that must be
bolded or highlighted
and at least 12 point font

Dr. Mary Smith

(718)123-4678
RPH: Maria Mantione

#30

2 Refills

Provide additional information for the patient

Help highlight special information

Once prescription is processed and veried, the pharmacist

must cancel/ void the prescription order (for paper
prescriptions)
FOR C VIs: RPhs initials, date, Rx#, manu if generic
FOR CII-V: RPhs signature, date, Rx#, manu if generic

Prescription is placed and prepared for pick-up

How? Where?

Rx is then led in 1 of 3 les by prescription number

CII, CIII-V or CVI (for paper)

Stored in records for 5 years - electronic prescriptions

are stored electronically

VS.

A pharmacists responsibility is to ensure that

the prescription is appropriate for the patient

What does the pharmacist need to know
before lling a prescription?
What are we treating? Is this the best drug/

strength for that situation? Is the dose

appropriate?
Is the dosage form best for the patient?
How does this prescription work with their
other conditions/ medications

First and Last Name

Complete address
DOB or Age
Gender
Phone Number
Known Allergies
Chronic diseases/
conditions

Medications,
supplements and
relevant devices
Any information
relevant to counseling
an individual on
prescriptions or over
the counter products

The part of the process you cannot see

What is the pharmacist thinking when they

prepare a prescription for a patient?

Cognitive process is involved in EVERY STEP

Are there any contraindications?

Are there any warnings/ precautions for this

medication that relate to this patient?

Any drug interactions that need to be

handled?

Is the dose appropriate for their age? Renal

function?

If yes to any of thesethenhow do I handle

it?

Never
guess or assume anything!

What needs to be done?

Change the prescribed drug? Dose?

Frequency? Quantity?

Change a previous medication? Dose?

Frequency?

Counsel the patient to do something special

or dierent?

Does it require a call to the prescriber?

How urgent is it that I rectify it immediately?

 NYS Rules and Regulations (63.6 (8) e).:

Nothing in this subparagraph shall prevent

a pharmacist or pharmacy intern from

refusing to dispense a prescription if, in his or
her professional judgment, potential adverse
eects, interactions or other therapeutic
complications could endanger the health of
the patient.

Pharmacists controls how the directions for

use are printed on the label

Needs to consider many factors when

deciding how to label the directions

Understandability
Language
Specicity of instructions
Literacy

Directions should contain specic dosing times

Morning and evening vs. 2 times a day

Take one once daily

Use numbers instead of text

Take one-half teaspoonful twice a day

2 vs. two or twice

Use metric units for measurement

Apply to aected area three times daily

mL vs. teaspoons

Include special instructions if applicable

with breakfast or 30 minutes before breakfast
ISMP Prescription Label Guidelines

A pharmacist or pharmacy intern must

provide patient education (counseling):

Before dispensing a medication to a new patient

of the pharmacy
Before lling a new prescription for an existing

patient of the pharmacy

If the dose, strength, route of administration, or

directions for use has changed for an existing

prescription previously dispensed to an existing
patient of the pharmacy.

An oer to provide counseling must be made every

time a patient has a prescription relled or has a
prescription lled for a medication therapy that has
been reauthorized by a prescriber
Any member of the pharmacy sta can make the
oer to counsel
A pharmacist or pharmacy intern must be available
to provide counseling.
Patient Counseling and Medication Errors- from the
State Board Website

 More to follow

Form pairs and collect a patient prole for

your partner

Note how you each ask the questions

Jack Black
123 Main Street, Queens, NY 11439 DOB 3/3/73
Zaditor eye drops #5mL
Sig: 1 drop ou q8h
3 rells

Prescriber: John Smith, DO
45 Oak St. Queens, NY 11439

QUESTIONS

Lic 044567 NPI:1972694677