23 terms

Medication Order Entry & Fill Process

Medication order
An order written by a prescriber for a patient in a hospital or other inpatient setting
Admission order
A type of medication order written by a physician if a if a patient should be admitted into the hospital; this order is sometimes written when a patient has visited the emergency room and, after a physicians assessment, it is decided that he or she should be admitted into the facility.

Will contain:
- Drugs the patient is currently taking
- Drugs the patient should continue taking
- New medications the physician has ordered for the patient
- Lab tests ordered, and any results obtained while in the ER
- Suspected diagnosis
- Any allergies
- Weight and height of patient (for dosing)
- Medical record number
- Room number
Stat order
A type of medication order sent to the pharmacy that must be filled immediately
Discharge order
A medication order that gives instructions for a patient who is being discharged from the hospital; it should include all at-home information and prescription instructions for the patient until follow-up with a primary care physician can occur.
PRN order
A medication order given on an "as needed" basis for specific signs and symptoms exhibited by a patient; some examples of symptoms requiring a PRN medication could be:
- fever
- pain
- anxiety or restlessness
- itching
- coughing
- sneezing
Unit dose
A drug used in a hospital or other inpatient setting that is prepackaged from bulk for a single administration for one patient. Benefits of unit dose are:
- Easy for nurse dispensing to patients
- Cuts down on medication errors (each unit dose may be bar-coded)
- Less waste of medication
Unite dose labels
To be repackaged from bulk, the labeling of unit doses must contain specific information:
- drug name
- strength of medication
- name of original manufacturer
- original lot number and expiration date of manufacturer (for tracking in the event of a recall)
- bar code
- facility expiration date - cannot exceed date given by manufacturer
Floor stock
Drugs that are stored on each unit of the hospital that are frequently prescribed for that unit; most floor stocks are stored in automated dispensing cabinets
Automated dispensing cabinets
A secure storage device that contains medication used by specific patient care units; access is limited to authorized individuals who have patient orders that need to be filled
Examples of ADCs:
- Pyxis (Cardinal Health)
- AcuDose-Rx (McKesson)
- Omnicell
- Rx-Station (Cerner)
- Med Select (Amerisource Bergen)
An order written for a patient by a licensed practitioner to be filled by a pharmacist.
Parts of the prescription:
- Inscription
- Signa
- Subscription
- Superscription
Part of the prescription that includes the name and strength of the medication prescribe and the amount to be dispensed.

Example: Lipitor (atorvastatin) 10 mg #30
Also known as the sig; directions to the patient

Example: Take 1 tablet by mouth daily
Part of the prescription that includes directions to the pharmacist for dispensing the medication

Example: Number of refills permitted
Part of the prescription that includes the information at the top: the patient's name and address, date of birth, date the prescription was written, and Rx symbol
Dispense as written (DAW)
A part of a prescription that when checked indicates that the generic of a drug must not be dispensed; brand name is required
Patient Profile
A database of information stored in a pharmacy system for each patient; should be continually updated by the pharmacy technician.
Contains the following information:
- Name
- Address
- Phone number
- Birth date
- Gender
- Allergy information
- Medical information (preexisting conditions or diagnoses)
- Insurance information
- Prescriptions filled
- Preference for child-resistant containers
- May contain other preferences, such as generic substitution or large-print labels
Auxiliary label
Bright, colorful label placed on a bottle label to provide information in addition to what is on the bottle label; alerts patients to specific information to which careful attention should be paid
Prescription container label
Label should be affixed to the medication container and match the prescription exactly. Specific information is required to be printed on the label, including:
- pharmacy name, address, & telephone number
- patient's name
- date prescription was filled
- prescriber's name
- prescription Rx number (unique to pharmacy)
- medication name and strength
- direction for use
- quantity of medication (if controlled, should be spelled out)
- expiration date
- refills allowed (if any)
- initials of pharmacist dispensing prescription
Counting tray
A device used to count tablets, or other solid oral medications and transfer these dosage forms from the stock bottle to the patient's medication bottle.

- A spatula is used to count in quantities of FIVE
- A tray should be cleaned with 70% IPA after medications with a powdery residue to prevent cross-contamination of medications
- Pharmacies may have separate trays for counting penicillin derivatives and chemotherapy agents
Tablet splitter
A device used to split tablets in half
Scored tablets
Tablets that have a line or crevice to make splitting easier
Refills can be easily handled by a technician when a patient calls in and refills remain on the patient profile for that medication.

Some situations require more attention:
Early refill
- Dosage may have changed or patient may be requiring a vacation fill - insurance company may need to be contacted
No refills
- A patient may be out of refills and the physician must be called for a refill authorization request
- The prescription may be older than 12 months
Controlled substance
- C-II cannot be refilled
- C-III and C-IV can only be refilled five times within a 6-month period
Packaging provided by the manufacturer in the most commonly-dispensed unit.

- A package of 30 tablets of a medication taken every day
- A monthly pack of birth control
- A four-pack of a medication taken once a week for one month

Pharmacy technicians can place the label directly on these packages and help minimize the case of medication errors and counting mistakes