Activity 11

PHARMACY PHYSICAL SET-UP

Objective:
To know the prescribed physical set-up for a pharmacy particularly its size/ floor area as mandated by law and other requirements
such as facilities and equipment and their arrangement and condition.

Activities and Questions:

1. What is the minimum size/ floor area for a community pharmacy? Substantiate your answer by providing such requirement.
The minimum floor area is 15 m2 as said in the Administrative Order No. (Revised Regulations for the
Licensing of Drug Establishments and Outlets). The requirement is that the floor should be tiled or concrete but not raw soil.

2. What is the actual floor area of your Pharmacy? Is it pursuant to the requirement?
Since the pharmacist and the assistants doesnt know what the size of the pharmacy, we have measured the floor and
its 13 m2. This is actually the problem of the staff working there because it's really small. I can say that our branch is not
pursuant to the requirement.

3. (a) What is a prescription area? Describe the area. State its importance in the pharmacy.
A prescription area is the patient consultation area and the public areas of the pharmacy including all areas where
professional pharmacy services are accessed. It is where medicinal products that are subject to prescription, including
prescription veterinary products, as well as CD5 controlled drugs be stored and should not be accessible to the public for self-
selection. The boundary between the prescription area and the non-prescription medicines/other professional services area
should be appropriate in design, ensuring that the supervision of the sale and supply of all medicinal products and other
professional activity is facilitated, while also maintaining adequate security and confidentiality of the dispensary activity.

(b) Does your pharmacy have a prescription area? If yes, give an estimated floor size. If no, why? (Ask your
pharmacist/manager)
Yes, we do have a prescription area and it measured approximately 3 m2.

4. Give at least five (5) guidelines for proper placement/arrangement of cabinets in a pharmacy.
(a) Storage areas must have sufficient shelving constructed from a smooth, washable and impermeable material,
which is easy to maintain in a hygienic condition for the keeping of medicines above floor level.
(b) Storage areas for pharmaceuticals must be self-contained and secure.
(c) Storage areas must be large enough to allow for orderly arrangement of stock and proper stock rotation.
(d) Cabinets must place in an area at room temperature.
(e) Cabinets are arranged by manufacturers.

5. How are stocks arranged in a community pharmacy?

In our pharmacy, the stocks are arranged accordingly. If it is a prescription drug or of its a combination medicine, they
are arranged alphabetically according to their brand names while the rest are arranged according to their uses or its an over the
counter drug like cough and cold preparation, for pain, vitamins, antihistamines or for stomach.

6. Enumerate and give the use/s of the different apparatus/equipment ideally present in a pharmacy. Identify those found in
your drugstore.
1. REFERENCES AND INFORMATION MANAGEMENT
2. DISPENSING EQUIPMENT- The dispensing equipment in the pharmacy is stored in a clean place and kept in
good condition. The tablet and capsule counting aids are cleaned after use to avoid cross contamination. The
dispensing balance is periodically checked for accuracy.
3. CONTROLLED DRUGS CABINET
4. CONTAINERS- to protect medicines from environmental factors
5. LABELS- to identify the product easily.
6. WEIGHING SCALES- for patients, for the pharmacist to compute the dose.
7. LANDLINDE TELEPHONE
8. COMPUTER- to support effective workflow and operations of the pharmacy
9. REFRIGERATOR a refrigerator unit of storing products within a selected temperature range e.g. 2-8 degree
Celsius. The efficiency of this refrigerator should be daily checked with a Min/Max thermometer and a record
book of such place.
 Found in our pharmacy
COMPUTER
CONTAINERS
LABELS
DISPENSING EQUIPMENT
REFRIGERATOR
LANDLINE TELEPHONE

7. What are the different storage and sanitary facilities in a pharmacy? Are these present in your Pharmacy?
Suitable bins for unwanted medicines are available to store unwanted medicines safely.
Sink and adequate supply of water
Storage room
Refrigerator
Trash cans
Comfort Room
*In the set-up of our Pharmacy; The sink and comfort room are actually not inside the pharmacy. Storage room is not present
because we have limited space.
8. Illustrate or have an actual copy of the following:
a. Actual physical set-up of your pharmacy,

b. Prescription area in your pharmacy

*Drugs are arranged alphabetically
 c. A perspective physical set-up of a community pharmacy.

Learning Insights:
For the safety or cleanliness, if you are the owner of the pharmacy, you must provide the material needed in order to maintain
cleanliness. The arrangement also of products and stocks must arranged well so that the one who is dispensing will not get lost in
finding the product. Proper labels also are very important for identification.

Reference/s:

CURAMED PHARMACY, Upper Session Branch

https://www.google.com.ph/search?q=perspective+setting+up+for+a+community+pharmacy&biw=1600&bih=799&source=lnms&t
bm=isch&sa=X&ved=0ahUKEwi717Lvx_rNAhUFG5QKHSuuC2IQ_AUIBigB#tbm=isch&q=set+up+for+a+community+pharmacy&imgrc=
wriML-IT5WZI4M%3A
 Activity 12
LICENSES

Objectives:
(a) To know the different licenses needed for the operation of the community pharmacy.
(b) To learn how to apply for the license from BFAD.
(c) To know the proper posting or display of pharmacy licenses and their relevance to the profession.

Activities and Questions:

1. What are the licenses found in a pharmacy needed for its operation? State the relevance of each license in community
practice.
a. Certificate of Business Name Registration (DTI, SEC or CDA), Business Permits must be registered to Bureau of Internal
Revenue (BIR) for taxes and Franchise Agreement if franchised.
- This is the first step on having a business, by registering and securing a business name. Having a business name will give
confident in your customers and protect your business name against those who may wish to use it as well.
b. License to Operate (LTO)- Food and Drug Administrations (FDA) granting the License to Operate as a drugstore.
- This license contains all the requirements needed for a drugstore to operate. Meaning the drugstore will not be opened
unless it has passed all the requirements needed to ensure its safety.
c. Dangerous Drugs License (PDEA S-License)
- The issuance of this license is needed for the handlers of dangerous drugs or those drugs listed in schedules annexed to
the 1961 Single Convention on Narcotic Drugs, as amended by the 1972 Protocol, and in the Schedules annexed to the
1971 Single Convention on Psychotropic Substances as enumerated in the attached annex of RA9165.
d. Mayors Business Permit and Barangay Permit the exact registered business name and address.
- It is a legal document that offers proof of compliance within a city or state laws regulating structural appearances and
safety as well as the sale of products.
e. Fire safety inspection Certificate
- It is for the purpose of supervision and enforcement of existing rules and regulations on safety to the public.
f. Copies of the Pharmacist Board Certificate, valid PRC-ID, current PTR, Duties and Responsibilities of the pharmacist and
Certificate of Attendance of Owner/Pharmacist to an FDA sponsored/accredited Seminar on Licensing of Drug
Establishment and Outlets (AO#56 s. 1989) and Seminar on EDPMS (NCPAM)

*The licenses and permits mentioned above need to be considered to start-up a drugstore business for prescription and non-
prescription drugs.

2. Are these licenses found in your pharmacy?

Yes, all of these licenses are present in our internship site.

3. Obtain a copy (photocopy) of these licenses.

The copies are attached at the back of this activity.

4. Enumerate and describe the licenses obtained from the Dangerous Drugs Board (DBB)
S-1 (Retailer) - License to sell, procure, acquire, deal in or with specified drug preparations, containing controlled chemical
for retail, except drug preparation containing Norephedrine / Phenylpropanolamine at doses 25 mg or below [OTC drugs,
per BFAD AO 163, s. 2000].
S-2 License to prescribe DD/DDPs, &/or DP/s containing Controlled chemical/s
S-3 (Retailer) License to sell, procure, acquire, deal in or with specified (a) dangerous drugs preparations in any form; or, (b)
drug preparations containing controlled chemical for retail, except drug preparation containing Norephedrine /
Phenylpropanolamine at doses 25 mg or below [OTC drugs, per BFAD AO 163, s. 2000]. Covers activities granted to S-1
License Holders.
S-4 (Wholesaler) - License to sell, procure, acquire, deal in or with specified (a) dangerous drugs and their preparations in
any form; (b) drug preparations, containing controlled chemicals for wholesale distribution to license holders, except drug
preparation containing Norephedrine / Phenylpropanolamine at doses 25 mg or below [OTC drugs, per BFAD AO 163, s.
2000]; and (c) controlled chemicals used in the manufacture of drugs preparations The license holder need not obtain
another license of the same nature of activity for such controlled chemicals.
S-5C (Manufacturer) License to manufacture specified (a) dangerous drugs and their preparations in any form; and (b) drug
preparations containing controlled chemicals provided, that the license shall not apply to the compounding and filling of
prescription in drugstores, clinics and hospitals.
 S-5E (Exporter) License to export specified (a) dangerous drugs and their preparations in any form; and/or (b) drug
preparation containing controlled chemicals: to foreign license holders.
S-5I (Importer) License to import specified (a) dangerous drugs and their preparations in any form; (b) drug preparations
containing controlled chemicals, except drug preparation containing Norephedrine / Phenylpropanolamine at doses 25 mg
or below [OTC drugs, per BFAD AO 163, s. 2000]; (c) controlled chemicals used in the manufacture of drugs preparations;
and, (d) in vitro diagnostic reagents, buffers and analytical standards, test kits containing dangerous drug. The license
holder need not obtain another license of the same nature of activity for such controlled chemicals. May engage in
wholesale distribution of that substance or class for which license was issued; may not distribute any substance or class for
which not licensed].
S-6 (Research/Analysis/ Instructional program) License to conduct laboratory analysis or technical research or instructional
/ training program, using controlled substances or drugs containing controlled chemicals or plant sources of controlled
substances. May procure, acquire syringe, scientific apparatus or laboratory equipment

5. (a) Outline the steps on how to apply for the License to Operate (LTO) from BFAD
Before applying for a License to Operate in BFAD, a registration to the Client Management should be made to acquire your
account number which will enable you to access the web portal of BFAD. The web portal serves as a way of transacting to BFAD.
Once the registration has been made, application for the initial LTO is now possible through the Client Management Console.
Classification of Products- BFAD created a classification of product that they regulate. It is called Product Classes.
Classification of establishments- classification of establishments depends on the activities it is engaged with.
Decision on what LTO Type is required on your establishment- depending on the product class, the establishment category and type
of establishment, the LTO type required is determined. Your LTO may be food distributor/importer, food manufacture/exporter or
others.
Decision on the type of application- the application type to be applied for is determined after determining on the LTO type.

(b) Show a filled-up application form/document.

6. Where should these licenses be posted? Is this evident in your pharmacy? Have a documentation to prove your answer.
These licenses should be posted in front of the drugstore where it can be seen by the people or customers.

Learning Insights:

In this activity, I have learned the importance of licenses in pharmacy practice. This is to ensure that this business follows
the rules of the law and that we should avoid any conspiracies regarding our practice to provide medications to the
consumers.
Reference/s:
http://pdea.gov.ph/images/ComplianceService/ISOOther_S_License.pdf

http://rxistsource.blogspot.com/2012/10/requirements-to-set-up-drugstore-in.html

http://pinoybusiness.org/2009/06/28/how-to-apply-for-license-to-operate-lto-to-bfad/

(Shanery Polon Abellera, Pharmacist)

 Activity 13
Community Pharmacy References
Objectives:
(a.) To know the references, books, and the titles present in a community pharmacy.
(b.) To know more updates on these references.
Activities and Questions:
1. Enumerate all the references present in a community pharmacy. Give a brief description of each.
Drug Facts and Comparisons (F&C): This is one of the drug information resources best known by pharmacist. Although it is
available in many different formats (i.e., bound books, CD-ROM, Web access), the most commons source utilized is the
loose-leaf binder that offers monthly updates to provide the most recent FDA-approved and off-label information regarding
prescription and OTC medications.
USP Dispensing Information (USP DI): For years, the USP DI has been a common resource utilized by community
pharmacists. This reference includes three volumes: I. For the Healthcare Professional; II. Advice for the Patient (in lay
language); and III. Approved Drug products and the legal Requirements. This three-volume set has been published annually,
but beginning in 2008 this series will only be available online and as a PDA Program. Volumes I and II have been renamed
Drug-Points and Detailed Drug Information for the Consumer, respectively.
Drug Information Handbook: MIMS Drug Information reference is one of the most compact text references available for
pharmacists. This respirce contains abbreviated monographs on prescription medications and is well known for its useful
charts and comparison tables. It is easy to use and is organized in alphabetical order according to a drugs brand name. The
handbook provides useful information when looking for a quick response to a simple drug information request, such as
indications, dosages, general adverse effects, and drug interactions. The main disadvantage to this reference is its
conciseness, which results in the elimination of some details from the monographs. The Drug Information Handbook
provides an updated edition annually to include new drugs and updates to current medications.
Physicians Deck Reference (PDR): The PDR is a compilation of drug package inserts. It does not include all prescription
medications because of space limitations. A new PDR is published every year, however, it is important to note that the
information may not be updated with each annual publication. It is also important to note that only FDA-approved
indications and dosages can be found within the PDR.
Red Book: The Red Book is an extremely useful tool when inquiring about dosage forms, package sizes, average wholesale
price (AWP), and manufactures contact information. It also contains poison control center numbers and a list of sugar-free
and alcohol-free medications. The reference is published annually and contains useful tables to assist in finding information.
WEB-BASED RESOURCES
Micromedex: Micromedex is a popular Web-based resource. Using one search box, a clinician is able to search many
different databases that included detailed and summarized drug information, toxicology, alternative medicine, and
reproductive risk evaluation. Micromedexs detailed information highlights Drugdex, PDR, and Martindales (for use in
searching foreign medications).

WEB SITES
The Internet is being increasingly used as a resource when answering drug information questions, and it is
especially useful when timely information is required. While many reputable Web sites are useful for obtaining information,
one should be aware that not all Web sites are reputable.
Food and Drug Administration: The FDAs Web site is an important source of information regarding the most recent drug-
related news, including drug approvals, recalls, and safety warnings.
Centers for Disease Control and Prevention (CDC): The CDC Web site is an essential resource when looking for information
regarding prevention and treatment of infectious diseases. There is an abundance of information to be found on topics
regarding infectious disease, including annually updated immunization recommendations and scheduling, travelers health,
and treatment guidelines for infectious diseases.
Medscape: Medscape is a free Internet resource that provides health care professional-specific information. It is organized
into sections by medical specialty, including one for pharmacists. The Web site provides numerous items f evidence-based
information, including free access to some journals and many useful review articles.

2. Give the latest edition or copy of these references.

a. United States Pharmacopeia dispensing Information: USP DI 2007 27 th edition
b. MIMS drug Reference 2015 issue 1
c. Physicians desk reference boxed edition 2014
d. Red book 2015 edition

3. What are the references found in your pharmacy? Give the edition
a. MIMS 2015
 b. Jurisprudence
c. PDR 2014

4. Make a compilation of the front covers/ title pages (photocopy, scanned image, or download image) of the latest editions
of the references.

5. Make a search on updates on community pharmacy practice from pharmacy journals.

The following articles are updates on community pharmacy practice from different journals:
a.) The Abbott Government is continuing to work closely with the entire pharmaceutical supply chain, including
consumers, to deliver an overarching reform package that ensures people to continue to get access to affordable
medicines when and where they need them now and into future.
Part of this includes negotiating a Sixth Community Pharmacy Agreement.

b.) Sept 2014: Shortage of pharmacists especially in community drugstore here in the Philippines.
The Drugstores Association of the Philippines has noted the warning number of students taking up pharmacy
education, which the group said could be a threat to the pharmaceutical industry.
The industry should now act and do more in strengthening the profession of pharmacists and adjusting to the changes
that the ASEAN integration may bring.
Pharmacists are qualified healthcare professionals who do a variety of tasks in the healthcare industry. They are also
able to manage drugstores, dispense drugs, give pharmaceutical care and advise customers in proper use of
medications.

c.) Update: Community pharmacy

September 10, 2014
By B. Douglas Hoey, RPh, MBA
Last year, NCPA asked the membership to tell us what its top legislative priorities were, going into 2014. Two issues
stood head and shoulders above the rest: exclusionary preferred pharmacy networks and lagging MAC updates to
generic drug reimbursement. Significant progress has been made on both fronts, but still there is much more to do.
Congress recently returned to Washington from its annual summer access. During their time back home, lawmakers
heard from pharmacists, patients, and other stakeholders about preferred networks limiting patient access to
community pharmacies. In light of this recent flurry of grassroots activity, now is a fitting time to reflect on the year so
far and the work that remains. In January, Medicare officials reacted to longstanding concerns raised by NCPA and its
members by proposing a regulation addressing several important issues. A few months later, Medicare finalized a
revised version of the regulation. It included a requirement that, starting in 2016, drug plans/pharmacy benefit
managers (PBMs) must update maximum allowable cost (MAC) lists once every seven days to ensure that pharmacies
are reimbursed appropriately for generic drugs. Although more work is needed to resolve the issue caused by delayed
MAC payment updates, this is a major advance.
A bioartisan bill is pending that would strengthen the aforementioned MAC reforms that Medicare is implementing.
H.R. 4437, the Generic Drug Pricing Fairness Act would codify the Medicare regulation and would add additional
patient protections.
Unfortunately, Medicare delayed, at least for now, its proposals to increase access for beneficiaries to medication
therapy management (MTM) and require that any willing pharmacy be allowed to participate as a preferred
pharmacy.

Learning Insights:
I have learned that all pharmacies need and should have these kinds of references in their establishments in order for
the staffs to perform and serve with the right information needed for the fast recovery of their patients. These references will
serve as their guide in doing their job and in addressing their patients needs. Also, some patients would ask about their
medications and these references can be a help in answering their question if sometimes they dont remember most
information about that drug.

References:
http://www.pharmaceutical-journal.com/news-and-analysis/news/prescription-items-dispensed-in-england-rise-by-3-in-
2014/20068925.article
Curamed pharmacy
 Activity 14
Expanded Senior Citizen Act of 2003 (RA 9257)

Objectives:
To be familiar with the provisions of the expanded Senior Citizens Act (RA 9257).
To know the provisions of the law covering community pharmacy practice.
To understand the role of a community pharmacist in the implementation of the RA 9257, specifically in meeting the policies and
objectives of this law.

Activities and Questions:

1. Read and understand the provisions of the RA 9257, specifically the following:
a. Declaration and Policies and objectives (Sec 1)
b. Privileges for the Senior Citizen

2. Enumerate the requirements to be presented to avail of the privilege of a senior citizen in a purchase of his/her medicine.
Present the national identification (ID) card and your purchase slip booklet duly approved by the OSCA chairman.
Doctor's prescription pad should have the following information:
Patient name, age, address, and date
Generic name of the medicine prescribed
Name and address of the doctor; his PTR number and S2 license (if prohibited and regulated drug)
*Those who cannot afford the consultation fee of a private doctor can consult at their nearest health center or government hospital
and get a prescription free of charge.
Any single dispensing should not be more than one week's supply. However, when drugs are for chronic conditions requiring
continuous use for more than a month, such as hypertension, diabetes, Parkinson's disease, arthritis, TB, cancer, psychosis, a
maximum of one month's supply may be dispensed at a time.
*The following should be recorded in a special record Book for Senior Citizens Discount provided under RA 7432:
Name
Address
National ID number of Senior Citizen
Generic Name of the drug/medicine
Number of units dispensed

3. Present through a flow chart the steps on how to avail of the senior citizens privilege in a community pharmacy.

other documents that

Get an ID issued by the city Get the passport of the establish that the senior
or municipal mayor or of elderly person or senior citizen or elderly person
the barangay captain of the citizen concerned and is a citizen of the
place where the senior Republic and is at least
pass to the SC office.
citizen or the elderly sixty (60) years of age
resides; and pass to the DOH.

4. Interview the pharmacist and/or the head of the pharmaceutical establishment regarding the effect of the law on the
operations of the pharmacy.
According to the pharmacist, it is a loss for the drugstore if a senior citizen will get his/her privilege because the government did not
give them a fund allotted for this discount, the 20% subtracted to the total amount of bills plus the VAT is a very big amount that will
be taken from their sales. The effect of this, if the drugstore is not that big, there will be a probability that the drugstore will get
bankrupt.

Learning Insights:
I have learned that, senior citizens are lucky to have a discount but as I noticed during my internship, Some Senior citizens have
a bad characteristic wherein they are so demanding in the sense that they want to get their discount even if the requirements are
incomplete knowing that the government did not give the drugstore any amount for this privilege. So, I learned that, we must
strictly follow the rules and requirements in order for us to get the benefit.

Reference:
CURAMED Pharmacy, Upper Session branch (Shanery P. Abellera, RPh)
 Activity 15
Pricing and Prescription
Objectives:
(a.) To know the basic factors affecting the prices of medicines and prescription pricing.
(b.) To be familiar with the price-range of the common drugs.
(c.) To develop skills and attitudes in dealing with drug/ prescription pricing.

Activities:
1. Make a literature search on the factors affecting the prices of drugs and prescription.
The theory of determining prices
The history of economics, and therefore much of economic thought, is dominated by discussion of the theory of prices and
how they are determined. This theory is underscored by the behavior of market participants buyers and sellers. A scarcity
of resources requires that buyers and sellers make choices about how resources will be used, whereas abundance allows
limitless production and consumption. However, resources are always limited, and using a resource in one way means it is
no longer available for alternative uses.
In competitive markets, producers need to decide, for a given amount of resources, what and how much to produce, while
consumers, with a given amount of income, need to choose what and how much they will buy. Producers and consumers
come together in the marketplace, and under certain assumptions, their interaction determined market prices.
Demand and supply
Demand is generated by consumers, while the supply is provided by producers. Critical to the theory is an understanding of
what drives each group, because consumers and producers are not driven by the same forces. Demand: Market theory
places the consumer in the lead role for determining what will be produced. Consumers want to maximize their welfare
through the total bundle of goods and services they buy with their income. The bundles of goods that consumers choose to
buy at given prices tell producers what to produce. In theory, consumers make rational choices as to what is included in the
bundle of goods; however, nothing in the theory suggests that these preferences are equitable or socially desirable, only
that they represent choices. Prices of complementary products or substitute products affect demand, as does the number
of consumers in the market and their desire for example, if a consumer prefers to buy a branded medicine over a generic
and is willing to pay more. Associated with the role of creating demand is the consumers ability to vote with money on
what will be produced. Therefore, individuals with the greater income have proportionally more votes (Bannock et al.
1984).
Supply: Producers want to maximize their profit. Profits are determined by the cost of production and the firms total
revenue (or sales). To maximize profit, the seller has an incentive to use resources in the production process in the least
costly way. In a perfectly competitive marketplace, firms receive normal profits; that is, they cover the cost of all
production costs plus the minimum return required to keep them in business. If the firms returns were greater than its
minimum, new firms would be encouraged to enter the market, and the competition would drive profits downward until
normal profits were reached. If the returns were less than the minimum, low profitability would encourage firms to leave
market, raising the profits of the remaining business until they achieved normal profits. Other factors that affect the supply
curve include the number of producers, which increases competition; technology, which can initially represent a cost to the
producer but ultimately increase efficiency; and the cost of inputs
Elasticity of prices
The intersection of supply and demand provides the tool for understanding price determination. However, a further aspect
of supply and demand helps explain behavior, that is, how responsive each is to changes in price.
Elasticity of demand: on the demand side, if consumers really need a product to the extent that a significant price increase
has a little effect on the quantity demanded, demand is non-responsive to price and is said to be price inelastic. The reverse
situation is where demand is very responsive to price, such that is rise causes a proportionally larger fall in demand.
Pharmaceutical demand varied across countries. It is also relatively income inelastic, meaning that a persons income
affects pharmaceutical purchases less than other factors. The four determinants of price elasticity of demand are
substitutability, proportion of income committed to the purchase, whether the item is a luxury or necessity, and market
timing.
Elasticity of supply: On the Supply side, if suppliers do not respond to price changes, they are price inelastic, whereas
suppliers who do respond are said to be price elastic. The determinants of the price elasticity of supply depend on timing
(Jackson and McConnell 1989). In the immediate market period, say on the day of a significant price rise, producers may not
be physically able to increase production. However, over time and assuming demand is maintained, suppliers will seek to
increase production by using existing excess capacity and ultimately by expanding their production capabilities by
increasing capital and labor.
 2. List the prices or price-ranges of common drugs. (At least ten Branded &/ Generic drugs).
Name of drugs Price
Amlodipine besilate 16.00
Amoxicillin (500mg capsule) 1.08 6.90
Ibuprofen tablet(40 mg) 5.94
Mefenamic acid(500 mg) 2.80
Multivitamins tablet 4.90
Paracetamol tablet(500 mg) 2.86
Diclofenac(50 mg) 0.22 21.77
Montelukast (10 mg) 8.15 23.50
Bisacodyl (10mg suppository) 12.22 149.80
Aspirin (80 mg tablet) 8.15 23.50

3. State the specific part of the code of ethics influencing the pricing of prescription.
VIII. A Pharmacist seeks justice in the distribution of health resources.
When health resources are allocated, a pharmacist is fair and equitable, balancing the needs of patients and society.

4. Comment on the following situation:

A mother is buying a prescribed medicine but cannot afford its price. The said medicine is badly needed. As a
pharmacist, how would you deal with the costumer?
Offer a generic equivalence since cost-saving generic medications are available for many prescription medications.

Learning Insights:

The determination of medications retail price is complex and not transparent to the public. Prescription drug
prices can vary from pharmacy to pharmacy. Generic drugs offer the same quality as brand name medications. They work just like
brand name equivalents in dosage, strength, performance and use. Generic drugs are required to meet the same quality and safety
standards set by the U.S Food and Drug Administration. Generic drugs are just as effective, and they offer an average of 30%-80%
savings over their brand name counterparts.

References:
http://apps.who.int/medicinedocs/documents/s19585en/s19585en.pdf
http://www.doh.gov.ph/sites/default/files/DPR2013.pdf
 Activity 16

Recording of prescription

Ojectives: (a) To be familiar with the record books and its content present in a community pharmacy

(b) To learn proper recording prescriptions

Activities and questions:

1. What are the different official record books present in a pharmacy? Enumerate their respective contents.
a. Prescription book
Name of the manufacturer
Original stock
Lot and control numbers of the main ingredient in the prescription
Name of physician
b. Account record book
Records of all money entering the establishment
Cashier in charge
Records on auditing and monitoring
c. Dangerous drug book
Name of the patient
Address of the patient
DDB form serial number
S2 license
Practitioners information: Name, Address
d. Poison book
Date and hour purchased
Name of the poison
Use of the poison
Buyers name
Pharmacist and buyers signature
2. Give at least three (3) specific prescribed drugs for each books.
a. Prescription book
Amoxiciliin trihydrate (Amoxil) 500 mg Antibiotic
Co-amoxiclav (Augmentin) 625 mg Antibiotic
Clindamycin (Dalacin C) 300 mg - Antibiotic
b. Dangerous drug book
Alphazolam (Xanor) 250 mcg
Alphazolam (Altrox) 250 mcg
Diazepam (Valium) 10 mg
c. Poison drug book
3. Illustrate a sample entry on a record book.
 b. Dangerous drug book

c. How long are these books to be retained in the pharmacy?

The prescription book shall be open for inspection by the proper authorities at any time and any day when the pharmacy is
open to the public and must be preserved of not less than 2 years the last entry it has been made. For dangerous drug, it
should be kept for at least 1 year and for the poison drug book it should be kept for 5 years.
All the prescription shall be attached to the said book for the prescription and number consecutively and shall be preserved
for the same length of time as the prescription book.
d. Enumerate the record books found in your pharmacy.
Prescription book
Learning Insights:

In this activity, I have learned that a pharmacist should be very careful in recording the correct prescription and
dangerous drugs in their respective books, for they are being monitored by the PDEA. A pharmacist should also be
attentive in identifying whether the following prescriptions are correct, erroneous, impossible or violative. The
amount of drugs and the drug being dispensed should be recorded correctly in order to assure the safety of the
patient.

References:

www.lahil.net/statutes/repacts/RA1969/RA_5921_1969.html

Curamed Pharmacy
 Activity 17

DRUG PROCUREMENT AND INVENTORY CONTROL

Objectives:

To know the reputable drug resources or drug companies.

To learn the basic skills and guidelines of drug inventory.

Activities:

1. Enumerate the top ten (10) drug companies and present the following for each:
A. Logo/s &/or trademarks
B. Identity color &/or design,
C. At least five (5) leading drugs/products, and
D. Slogans or tag lines from commercials.
1. Pfizer
A. Logo

B. Identity color &/or design

C. 5 leading drugs
1. Celebrex
2. Lipitor
3. Lyrica
4. Norvasc
5. Viagra
D. Slogans or tag lines
Tatak Tiwala,
Tatak Sulit,
Tatak Pfizer

2. AstraZeneca Philippines
A. Logo

B. Identity Colorv

C. 5 leading drugs
1. Crestor
2. Logimax
3. Nexium
4. Seroquel
5. Symbicort
D. Slogans or Tag lines
Health Connects Us All

3. Eli Lilly and Company

A. Logo

B. Identity color

C. 5 leading drugs
1. Cymbalta
2. Effient
3. Humalog
4. Humulin
 5. Zyprexa
D. Slogans or Tag lines

4. GlaxosmithKline
A. Logo

B. Identity color

C. 5 leading drugs
1. Amordi
2. Augmentin
3. Turns
4. Seretida
5. Ventolin

D. Slogans or Tag Lines

Answers that matter
5. Novartis
A. Logo

B. Identity Color
C. 5 leading drug
1. Gilenya
2. Glivec
3. Lucentis
4. Sandostatin
5. Tasigna
D. Slogans or Tag lines
Our Mission is to Care and Cure
6. Roche
A. Logo

B. Identity color

C. 5 leading drugs
1. Avastin
2. Cellcept
3. Herceptin
4. Mabthera
5. Pegays
D. Slogans or Tag Lines
Doing Now What Patients Need Next
7. Sanofi-Aventis Philippines
A. Logo

B. Identity Color
C. 5 leading drugs
1. Aprovel
2. Lactacyd
3. Lantus
4. Maalox
D. Slogans or Tag lines
Because Health Matters
8. UNILAB
A. Logo

B. Identity Color

C. 5 leading drugs
1. Alaxan
2. Bioflu
3. Ceelin
4. Enervon
5. Neozep
D. Slogans or Tag lines

Husay-Malasakit, Unilab yan!

9. Abbott
A. Logo

B. Identity color
 C. 5 leading drugs
1. Depakote
2. Duphalac
3. Isoptin
4. Klaricid
5. Lipanthyl
D. Slogans or Tag lines
A Promise for Life
10. Merck
A. Logo

B. Identity color

C. 5 leading drugs
1. Cozaar
2. Janumet
3. Proscar
4. Sinemet
5. Timoptol
D. Slogans or Tag lines
MSD, May Solusyon Dito

2. Describe the drug inventory in a community pharmacy.

The drug inventory is used in the proper management of the inventory, with balancing inventory levels to satisfy patients
needs while minimizing costs. This may not be met when inventory is managed without careful planning and analysis. Some methods
of controlling inventory may result in meeting the objective of appropriate patient care but also a result in excess levels of inventory
sitting on the shelves and represent a waste of money. Appropriate level of resources to be committed to inventory should also be
considered. It should be recognized that inventory is included on the balance sheet as a current asset. Most use automated systems
that require less effort but the underlying principled and goals of inventory management must still be understand.

3. Describe the following terms:

e. Maximum stock level

The maximum stock level is the quantity of material above which the stock of an item should not normally exceed. This
level is fixed after taking into account such factor as: capital, rate of consumption of materials, storage space available, insurance
cost, risk of deterioration and obsolescence and economic order quality.

b. Reorder level

The reorder level is the point at which stock on a particular item has diminished to appoint where it needs to be
replenished. The re-order level takes into account the following ongoing usage of item, and lag time between the stocks is ordered
and the time in which it is delivered.

f. Turnover

Stock turnover is a measure of operational efficiency. It tells how many times stock or inventory is being sold and purchased
over a given period of time. A low turnover rate may point to overstocking, obsolescence, or deficiencies in the product line or
marketing effort. A high turnover rate may indicate inadequate inventory levels, which may lead to a loss in business.

4. How is drug inventory conducted in your pharmacy? Interview your pharmacist/or manager.

Drug inventory is done by using IPOS on the computer. Records on the available and remaining products are kept here.
They also manually count and check the number of products available and the expiration dates. This is done by book shelf which is
arranged by the drug manufacturers. The employees write and record these in the stock control book.

5. What is the role of the pharmacist in the drug inventory?

The pharmacists supervise and remind the other employees to do their drug inventory to which they are assigned to. They
also keep a record on their own respective books/areas. They also check that the records are both correct on the IPOS and stock
control book.

Learning Insights:

Every pharmaceutical company has its own strategy to promote their product, they have their own unique logos and products to
distinguish them from other companies.

References:

https://finance.mapsofworld.com/company/pharmaceutical/philippines.html

Shanery Abellera, RPh

 Activity 18

COMMUNITY PHARMACY PROBLEMS/MALPRACTICES

Objectives:

To learn about the actual problems in community pharmacy practice and to learn how to solve such through case to case basis.

Activities and Questions:

1. Interview your pharmacist &/or manager regarding a problem that they have encountered in the community pharmacy.

2. Present a brief discussion of this problem and include the solution/s that they have performed.

Nowadays, many people do not know the effect of antibiotic to their body. One of the major problem that our
pharmacist encountered is that many people insist to buy antibiotic even if they do not have prescription and if the pharmacist
do not give them they will get angry and throw bad words to the pharmacist. So, the solution that our pharmacist did is that,
she will dispense the complete dose of antibiotic but if the patient does not want to buy the complete dose, she will not
dispense and she also made a tarpaulin wherein the tarpaulin consist the effect of improper use of antibiotic ad post it in front
the drugstore.

3. Make an investigation on the actual community pharmacy practice (in your pharmacy, in other drug stores, or through
literature search), and present a community pharmacy malpractice observed or researched.

A pharmacist has a degree and holds himself or herself out as having the training and ability to accurately fill
prescriptions. Pharmacists are, therefore, held to a high duty of care (standard of care) that requires absolute accuracy in order
processing. When a pharmacist makes a medication error while filling a prescription, there is a presumption of negligence (a breach
of the duty of care). In a pharmacist malpractice lawsuit, the attorney needs to prove that the pharmacist gave the patient the
wrong medication, the wrong dose of the medication, the wrong directions for taking the medication or some other error.

Here is some malpractice on a drugstore.

o The patient was given another patients prescription.

o The patient was given a medication that had a name similar to the prescribed medication (for example, Toprol and
Tegretol). This is one of the most common reasons for pharmacist error involving the dispensing of the wrong medication.
o The pharmacist misread the prescribing doctors handwriting. This still happens, and both the pharmacist and the
prescribing doctor can be found liable is these cases.
o A patient is given the wrong dose.
o A patient is given a medication that has been compounded incorrectly. Some medications are compounded by
pharmacies. A pharmacy error can occur if the medication has been compounded with a larger dosage of the medication
than intended. For example, a case involving compounded colchicine where the dosage was 10 times the intended
dosage. Three people died.
o The patient is given the right drug but the wrong directions.

4. With such community pharmacy malpractice, present the following:

(a) Law/Regulated violated. Cite specific provision of law or regulation.

(Rep. Act No. 6675): Sections 4 and 7, Phase 3 of Administrative Order No. 62, Series of 1989 dated March 9, 1989, of the
respondent Secretary of Health.

(b) A goal to solve such problem or malpractice.

More focus and optimistic on work.

(c) Three to five (3-5) objectives

*To do the job well.

*Read and Prescribe the proper medication.

*Gain more confidence and trust to myself.

(d) Resources needed

Books and Internet.

Learning insights:

It is so important to follow the law in dispensing antibiotics for the sake of your patient. In the future, wherein I am already a
medical expert, I will try to explain to my patient the effect of the drug to them for them to understand and know what is the right
thing to do.

Reference:

CURAMED PHARMACY, Upper Session branch

http://www.lawphil.net/judjuris/juri1989/dec1989/gr_88265_1989.html
 Activity 19

GHOST PHARMACIST: A REACTION

Objective: To be aware of the ghost pharmacist malpractice, its effects, and other related pertinent legal and professional
information.

Activities and Questions:

1. Cite the specific provision pertaining to the legal matters of the Ghost pharmacist malpractice.

Republic Act No. 5921

AN ACT REGULATING THE PRACTICE OF PHARMACY AND SETTING OF PHARMACEUTICAL EDUCATION IN THE PHILIPPINES AND FOR
OTHER PURPOSES.

Section 27. Pharmacist required and compensation. Every pharmacy or hospital pharmacy whether owned by the government or a
private person or firm shall at all times when open for business be under the personal and immediate supervision of a registered
pharmacist. Provided that no pharmacist shall have personal supervision of more than one establishment. In cases where a drug
establishment operates in more than one shift must be under the supervision and control of a registered pharmacist. Every
pharmacist employed as such in any establishments mentioned in this section whose capitalization is not less than ten thousand
pesos shall receive not withstanding any provisions of law to the contrary, a minimum compensation similar to that of government
pharmacist.

2. State the specific section on the Code of Ethics pertaining to the professional matters of the said malpractice.

REPUBLIC ACT NO. 5921

AN ACT REGULATING THE PRACTICE OF PHARMACY AND SETTING OF PHARMACEUTICAL EDUCATION IN THE PHILIPPINES AND FOR
OTHER PURPOSES.

Section 13. Grounds for reprimand, suspension or revocation of registrant certificate. Any of the following shall be sufficient ground
for reprimanding a pharmacist, or for suspending or revoking his certificate of registration:

Conviction by a court of competent jurisdiction of any violation as penalized in sections 40 and 41

Immoral or dishonorable conduct which includes conviction by a competent court of any criminal offense involving moral turpitude

Fraud or deceit in the acquisition of the certificate of registration

Gross negligence, ignorance or incompetence in the practice of his profession resulting in the injury damage or death of another

Malpractice, including aiding or abetting the commission of criminal abortion or sex crimes through illegal compounding, dispensing
or sale of abortive or sex drugs as the case may be

Acting as a dummy of an alien of a person who is not qualified to establish and operate a retail drugstore

Addiction to alcoholic beverage or to any habit-forming drug rendering him incompetent to practice his profession

Insanity

False or extravagant or unethical advertisements wherein other things than his name, profession, limitation of practice, office and
home address and the like are mentioned

Violations of any provision of the Code of Ethics which may be adopted as part of the Rules and Regulations of the Board.
Section 41. Other Penalties. Any pharmacist who shall violate the provisions of Sections 28, 30, 31, 32, 33, 34, 35, 36, 37 and 38 of
this act or any pharmacist after his certificate of registration has been lawfully suspended or revoked, who continues to engage in
the practice of pharmacy shall be sentenced to a fine of not less than one hundred pesos but shall not exceed five hundred pesos or
to an imprisonment of not less than 30 days but not more than 4 months in the discretion of the court.

3. Interview the following people regarding their insights of the ghost pharmacist malpractice:

Pharmacy Student

As a student following the Code of ethics and with a proper knowledge about what is and what should be, Ghost pharmacist
should not be practiced because it is against the law and we should know the right for the name of our profession.

A Community Pharmacist

The issue concerning ghost pharmacist should not be practiced because we have our proper knowledge and separate
abilities compared to other about this profession and we have the responsibility to monitor drug therapy and create a positive
outcome.

An ordinary Person

For the sake of the community, a pharmacist should be present in every drugstore to make sure that every drug that will be
dispensed is right.

4. State the effects of ghost pharmacy practice on:

Community Health

Due to the absence of a pharmacist in the community practice of pharmacy, the person in charge in dispensing the
medicine can either give the correct medicine to the consumer or can give the wrong drug. In this case, it can make the situation of
the patient worst for example a Category X drug can be given to a pregnant woman.

Another effect is that it can lead to drug misuse especially to persons that are not reading instructions. Due to the absence of a
pharmacist who should be giving instructions and he should counsel the patient also about the side effects of the drug.

Pharmacy profession

The Pharmacist who was reported in the malpractice of the profession will be lawfully suspended or revoked.

Learning Insight/s:

I, as pharmacy student become more aware of the ghost pharmacist malpractice, its effects, and other related pertinent legal and
professional information.

Reference/s:

http://www.lawphil.net

http://www.bermansimmons.com/article_detail_tort_law_pharmacist.html