General Pharmacy Practice and Dispensing
This domain tests the operational core of pharmacy: receiving a prescription, confirming it is legal and clinically sound, preparing the correct product, and releasing it with the information the patient needs. Questions are usually scenario-based - a quantity to calculate, a label to check, or a discrepancy to spot.
The prescription as two documents
Every prescription is simultaneously a legal order and a clinical recommendation. Checks run in three layers: authenticity (prescriber identity and signature, no alteration, date within validity), legality (required elements present, controlled-drug rules met) and clinical appropriateness (indication, dose, route, frequency, duration, allergies, interactions, renal and hepatic function).
The dispensing sequence
Interpret → screen → select and measure → compound if required → label → independent double-check → counsel → document. High-alert medicines (insulin, anticoagulants, opioids, concentrated electrolytes, chemotherapy) require a second checker and, where available, tall-man lettering and barcode verification. A dispensed label carries patient name, drug, strength, directions, quantity, date, pharmacy identifiers and auxiliary warnings.
Worked example
A prescription reads: prednisone 5 mg tablets - 40 mg daily for 3 days, then 20 mg daily for 3 days, then 10 mg daily for 3 days. Tablet counts per day are 8, 4 and 2. Total = (8 + 4 + 2) × 3 = 42 tablets. Dispensing a 30-tablet bottle short-changes the patient by 12 tablets and breaks the taper; the correct dispense is 42 tablets.
Traps that cost marks
- Confusing mg and mL, or dropping a leading zero (write 0.5 mg, never .5 mg; write 5 mg, never 5.0 mg).
- Forgetting that a PRN order still needs a maximum dose and frequency.
- Filling a legally valid but clinically unsafe order without contacting the prescriber.
- Passing over sound-alike pairs (hydrOXYzine/hydrALAZINE, Losec/Lasix) without confirmation.