Study the prescription carefully and ensure that the drug prescribed is in fact reasonable, that its amount or dosage is realistic as compared to the patients age, and that the quantity of the medication is a practical one. A prescription calling for 1,000 tetracycline tablets or a pint of paregoric, for instance, warrants further inquiry.
If, in this process of verification, you feel that there is a discrepancy, an ambiguity, or an incompatibility, or if for any reason it is necessary to consult the prescriber, never allow the patient to suspect that anything is amiss. You should never fill a prescription you do not completely understand or you feel is incorrect. What appears to be an overdose may be the desired dose for a specific patient, but the prescriber will appreciate being called for verification of the dose.
When you are sure you understand the prescription and are satisfied that it is in all respects correct, you should give its filling your undivided attention. Most mistakes are made when the person filling the prescription is either interrupted while doing so or is trying to accomplish more than one chore at a time.
Always type the label before you fill the prescription, since it affords more time for considering the manner of compounding and the doses involved. Read the labels on the containers used in filling the prescriptions three times:
1. When the container is taken from the shelf
2. Before the contents are removed from the container
3. Before the container is returned to the shelf
The proper labeling of a prescription is as important as filling it correctly. It is reasonable to assume that if a great deal of accuracy is necessary to properly compound a prescription, it is just as important that the patient take the correct amount of medication in the right manner to receive its maximum benefits. Improperly written or misunderstood directions on a prescription label can be disastrous. Ensure that all labels are typed clearly and their directions translated into simple laymans language. Keep in mind that the prescription label serves two purposes. First and most important, it gives the patient directions pertaining to the medication; second, in case of misuse or error, it is the quickest means by which the contents of the prescription container, the person who wrote the prescription, and the person who filled it can be traced. Consequently, always include the following information on the label (fig. 4-3):
1. The name and phone number of the dispensing facility
2. The prescription number (must correspond to the number on the prescription)
3. The date the prescription is filled
4. The patients namein sufficient detail for identification
5. The directions to the patient, transcribed accurately from the prescription, in clear, concise laymans language
6. The prescribers name and rate or rank in sufficient detail for identification
7. The initials of the compounder
8. Authorized refills, if any
9. The expiration date, if applicable
10. Name, strength, and quantity of medication dispensed
Other information that may need to be attached to the prescription container are labels reading Shake Well Before Using or For External Use Only. Poison labels are best omitted when a preparation is intended for external use, as many physicians prefer the "For External Use Only" labels.