CHAPTER 5

G. Identify and communicate appropriate information

regarding packaging, storage, handling,
administration, and disposal of medications.
a. Packaging
1. The Poison Prevention Act of 1970 states
that child resistant closures must be on
prescription containers unless the
prescription is for an exempted drug or if
the patient has authorized easy-open
packaging.
2. Examples of exemptions from this rule are
sublingual dosage forms of nitroglycerin,
potassium supplements in unit dose forms,
and oral contraceptives in mnemonic
packaging.
b. Storage
1. Expiration date: The expiration date of a
medication as determined by USP states that
the expiration date must be no later than the
expiration date on the manufacturers
container or one year from the date the drug
is dispensed, whichever date is earlier. The
expiration date for certain products such as
insulin is different. For example, the
expiration date on insulin products is
24 months from the date of manufacture.
However, the stability of the insulin is
altered once the product is opened and it
therefore bears a new expiration date.
The expiration information can be found
in the products package insert. For example,
insulin glargine (Lantus) and other
insulin vials should discarded 28 days after
the product is opened. Other drug
products may also have new expiration
dates when opened. For example,
Latanoprost (Xalatan) needs to be stored
in the refrigerator until first use, then
may be stored at room temperature for
6 weeks.
c. Handling
1. Certain medications need careful handling to
prevent degradation of the product.
2. The pharmacist should take precaution
when preparing medications for patients.
An example of this would be not shaking a
vial of colistimethate for reconstitution, but
rather gentle swirling.
3. Overall handling of sterile products is
briefly reviewed in Chapter 3 on
compounding.
d. Administration
1. When a medication is dispensed to the
patient, the prescription label must have
specific information*:
 Pharmacy name, address, and telephone
number
 Assigned prescription number

*Specific state laws may require additional information.

Dispensing

41

 Date of the prescription or the date of its

filling or refilling (state law often

determines which date is to be used)
 Name of patient
 Name of prescriber
 Directions for use and any cautionary
statements
 Controlled substance schedules II, III, or IV
must contain the following warning:
CAUTION: Federal law prohibits the
transfer of this drug to any person other
than the patient for whom it was
prescribed.
2. Most medications are to be discarded in
the trash, not flushed down the toilet.
This should be done by taking the
medications out of their original container
and mixing with an undesirable substance
such as coffee grounds or cat litter.
However, the Office of National Drug
Control Policy states that certain
medications (e.g., fentanyl) can be disposed
of in the toilet.
3. Patients should be aware of safe and legal
disposal of drug devices. (e.g., needles
disposed in appropriate sharps containers).
4. Disposal instruction is not limited to patient
knowledge but this knowledge is also
important for the pharmacist, who may have
to dispose of hazardous materials such as
chemotherapeutic drugs.
H. Identify and describe the use of equipment and
apparatus required to administer medications.
a. The pharmacist should be able to describe in
patient-appropriate language, how each
medication should be used. This is particularly
important for describing proper use of inhalers,
nebulizers, insulin administration, auto
injectors (e.g., EpiPen), and ophthalmic and
otic preparations.
b. In addition to education regarding how to use a
device, the pharmacist should be able to
describe other elements of medication use
(described in greater detail in Chapter 6, Patient
Education).
1. Possible adverse effects and their
management
2. Therapeutic drug monitoring including
needed laboratory tests
3. What to do in the event of a missed dose
4. Helpful nondrug activities

References
Kiliany BJ, Kremzner M, Nelson T: The evolution of
imprint identification, Pharm Times. Available at http://
www.pharmacytimes.com/issue/pharmacy/2006/200603/2006-03-5374. Accessed June 2009.
FDA: Electronic orange book. Available at http://www.fda.
gov/cder/ob/default.htm. Accessed September 2008.
FDA: Dietary Supplement Health and Education Act of 1994.
Available at http://www.cfsan.fda.gov/dms/dietsupp.
html. Accessed September 2008.