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Introduction

This SOP enables the clinical pharmacists to adopt uniform approach during dose division, at your practicing hospital to pediatric patients and is usually performed by the postgraduate students of Pharmacy Practice and Pharm.D students.

Objectives

• To make the students to learn the importance of dose division.
• To make the students to learn the procedure involved in dose division method.

Procedure

After prescription is received, note the dose that is required and number of doses to be dispensed. Ensure that the labeled strength of commercial preparation brought for dose division is sufficient to carry out the procedure. Else, inform the requester to bring the appropriate preparation.

Clean the weighing balance and area. Cut out the required number of butter paper squares.
Weigh the required quantity of tablets.

Clean the mortar and pestle with some sterile water for injection. Sterilize your hands using sanitizer. Wear the mask and gloves.

Powder the tablets and remove any film coating that cannot be triturated into powder form.

Calculate the amount to be dispensed for tablets as follows:

Required dose of drug = x
Weight of n number of tablets = a (in gms) Weight of powdered tablets = b (gms)
Labelled amount of drug on formulation X n (number of tablets) = c Amount of drug present in powdered tablet = b X c/a = d (gms) Amount of powder to be weighed = x X b/d = ygms

Place the butter paper square on the weighing machine and tare it. Weigh out the calculated quantity of powder. Remove butter paper and pack it in a manner such that the contents will not spill out. Weigh out the required number of doses in a similar manner.

Place all the doses in an envelope and label as follows:

Name of the patient:
Name of the drug:
Number of doses dispensed:
Each sachet contains ………… gms of drug. No of Doses to be taken per day:
Date Dispensed:

GENERAL INSTRUCTIONS

  • Receive the prescription at OPD and note the details of the dose division request. Note the date on the prescription and send back prescriptions that are more than a month old to the prescriber for a fresh prescription.
  • Check whether the drug is mentioned in the list of drugs that are NOT to be crushed or split. Suggest alternate dosage form if drug name is mentioned in the list.
  • Check whether the drug is in a sustained release/extended release/slow release or enteric-coated form. If so, send back the prescription to the prescriber for prescribing a conventional dosage form.
  • Check whether the drug for division is available in alternate dosage form meant for pediatric use. If so, suggest the same to the prescriber.
  • Inform the requester a probable time estimate that the divided doses may be dispensed.
  • Calculate the required dose to be dispensed and get approval from the OPD staff in-charge for the same.
  • Perform the dose division as per the procedure.
  • Ensure that the envelope containing the divided doses is properly labeled before dispensing.
  • Document the activity in the Dose Division Request Form as well as on the online database of Clinical Pharmacy activities
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