Prescription Processing, Dispensing, Labeling, Counseling, and Patient Care
A valid prescription
Screen for the essential elements: patient identity, drug, strength, dosage form, quantity, directions, date, prescriber identity and signature (or valid electronic signature), and refills authorized. An electronic prescription for a controlled substance requires EPCS-compliant two-factor authentication and an audit trail. A pharmacist may not add or change a prescriber-authored element; missing essential information makes the prescription invalid until the prescriber supplies it.
Label versus labeling
Label means the container label; labeling means everything else that accompanies the product. The label must carry the pharmacy name and address, prescription number, date, prescriber, patient, directions, and required cautionary statements; state boards add items. Counseling duties usually arise as an offer to counsel on every new prescription, with documentation when the patient declines. OBRA-90 mandates prospective drug utilization review and an offer to counsel for Medicaid; most states require it for all patients. Medication Guides and REMS materials follow the product, not the payer.
Traps
Do not confuse refill-too-soon adjudication edits with legal authority, or quantity with days' supply. Red flags for controlled substances (early refills, cash payment, distance, pattern prescribing) trigger a duty to resolve before dispensing. Document clarifications, counseling refusals, and prescriber conversations. Remember that partial fills are lawful for non-controlled prescriptions and have their own controlled substance rules.
Rule of thumb
When a required element is missing or a red flag is unresolved, do not fix it yourself: contact the prescriber and document the resolution before dispensing.