Dispensing and Patient Counselling
Dispensing and Patient Counselling tests the legal and clinical check of a prescription, accurate preparation and labelling, and counselling that changes patient behaviour. The exam favours concrete steps: screen, calculate, label, demonstrate, and confirm understanding.
Core rules
- Screen every prescription for patient identity, prescriber details, date, drug, strength, dose, route, frequency, duration, allergies, interactions, duplication, and appropriateness.
- Use weight-based paediatric doses and verify concentrations; convert teaspoons to millilitres (1 tsp = 5 mL) and avoid household spoons.
- Counsel with open questions, explain the purpose and key adverse effects, demonstrate devices, and use teach-back.
- Reconstituted antibiotics and many suspensions require shaking, refrigeration where specified, and a beyond-use date; write the date on the bottle.
- For inhalers, check technique: exhale, seal lips, actuate during slow deep inhalation, hold breath, rinse mouth after ICS.
Worked example
A child is prescribed amoxicillin 375 mg PO three times daily for 10 days. The stock suspension is 250 mg/5 mL. Each dose = (375/250) × 5 = 7.5 mL. Total volume = 7.5 mL × 3 × 10 = 225 mL. If bottles contain 100 mL, dispense 3 bottles and label 7.5 mL TID for 10 days. Confirm the reconstituted beyond-use date (commonly 14 days refrigerated) and tell the parent to shake well and complete the course. Reasoning: calculate dose volume, total volume, bottle count, and stability together.
Traps
- Dispensing 225 mL from two 100-mL bottles without checking the shortfall.
- Writing 'take as directed' instead of explicit dose and frequency.
- Forgetting to shake a suspension or to refrigerate it when required.
- Counselling only the patient when a caregiver administers the medicine.
- Missing that a child's weight or age makes the prescribed dose unsafe.