Prescription Information PDF

PRESCRIPTION Presented By: Dr.R Venu Priya Introduction Prescription is a written order from a registered medical practitioner, or other properly licensed practioners, such as dentist, veterinarian etc. to a pharmacist to compound and dispense a specific medication...

PRESCRIPTION Presented By: Dr.R Venu Priya Introduction Prescription is a written order from a registered medical practitioner, or other properly licensed practioners, such as dentist, veterinarian etc. to a pharmacist to compound and dispense a specific medication for the patient. The order is accompanied by directions for the pharmacist to prepare a specific type and quantity of preparation for a patient.  The prescription also include the directions for the patient regarding the mode of administration of drugs, which is dispensed for him. Thus prescription is a media through which treatment is provided for a patient by the combined skill and services of both the physician and the pharmacist. The prescriptions are generally written in the English language but latin word or abbreviations are frequently used in order to save time. So it becomes necessary for a pharmacist to become familiar with the common latin terms and abbreviations used by the prescriber with writing the prescription  Parts of Prescription 1. Date 2. Name, age, sex and address of the patient 3. Superscription 4. Inscription 5. Subscription 6. Signa. Or signatura 7. Renewal instruction 8. Signature, address and registration number of the prescriber. DATE It helps a pharmacist to find out the date of prescribing and date of prescription for filling the prescription. The prescription which prescribe narcotic or other habit forming drug, must bear the date, so as to avoid the misuse of prescription if it is presented by the patient, a number of times for dispensing  Name, age, sex and address of the patient Name, age, sex and address of the patient: - must be written in the prescription because it serves to identify the prescription. In case, if any of this information is missing in the prescription, the same may be included by the pharmacist after proper enquiry from the patient. Also used in dose calculation of children. Superscription Superscription: - it is represented by Rx symbol, which is written before writing the prescription. Rx is an abbreviation of the Latin word recipe, It means you take. In older days, the symbol was considered to be originated from the sign of Jupiter, god of healing. This symbol was employed by the ancient in requesting god for the quick recovery of the patient.  Inscription Inscription: - this is the main part of the prescription order, contains the names and quantities of the prescribed ingredients. The names of ingredients written in English language, but common abbreviation used can be written both in English and Latin languages. The name of each ingredient is written on a separate line along with its quantity. In complex prescription in divided into following parts i. Base: - the active medicaments which are intended to produced the therapeutic effect. ii. Adjuvant: - it is included either to enhance the action of medicament or to improve the palatability of the preparation. iii. Vehicle: - it is included in the prescription either to dissolve the solid ingredients or to increase the volume of the preparation.  Nowadays, the majority of the drugs are prescribed which are already in a suitable formulation. The pharmacist is required to dispense the readymade from of drugs. So, compounding of prescription is almost eliminated. Subscription: Subscription: - this comprises direction to the pharmacist for preparing the prescription and number of doses to be dispensed. These days the prescribers are omitting the specific instructions to the pharmacist because the majority of the prescriptions are not compounded and dispensed. Signatura or Signa Signatura or Signa :-this consists of the direction to be given to the patient regarding the administration of drug. It is usually written as ‘Sig’ on the prescription. The instructions given in the prescription are required to be transferred to the container in which the medicament is to be dispensed, so that the patient can follow it. The instruction may include: i. The quantity to be taken or amount to be used ii. The frequency and timing of administration or application. iii. The route of administration. iv. The special instruction such as dilution direction  Renewal instruction: - the prescriber indicate on every prescription order, whether it may be renewed and if so, how many times. It is very important particularly in the prescription containing the narcotic and habit forming drugs to prevent its misuse. Signature, address and registration number of the prescriber Signature, address and registration number of the prescriber: - the prescription must bear the signature of the prescriber along with its registration number and address. It is very important particularly in the prescription containing the narcotic and habit forming drugs to prevent its misuse. HANDLING OF PRESCRIPTION The following procedure should be adopted by the pharmacist while handling the prescription for compounding and dispensing 1. Receiving 2. Reading and checking 3. Collecting and weighting the materials 4. Compounding, labeling and packaging Receiving: - the prescription should be received from the patient by the pharmacist himself. While receiving a prescription, a pharmacist should not change his facial expression which gives an impression to the patient that he is surprised or confused after seeing the prescription Reading and checking: on receiving a prescription, always check it that it is written in proper format. A prescription should always be screened behind the counter. In case of any doubt regarding the prescription ingredients or directions, the pharmacist should consult the other pharmacist or prescriber Collecting and weighing the material: Before compounding the prescription, all the materials required for it, should be collected on the left hand side of the balance. After weighing the material it should be shifted to right hand side of the balance. This gives a check of ingredients which have been weighed. While compounding the label of every stock bottle should be read at least 3times in order avoid any error. i. When taken from the shelf or drawer. ii. When the contents removed for weighing and measuring. iii. When the containers are returned back to its proper place  Compounding, labeling and packaging: Compounding should be carried out in a neat place. All the equipment etc... required should be thoroughly cleaned and dried. Only one prescription should be compounded at one time. The compounded medicament should be filled in suitable containers depending on its quantity and use. The filled containers are suitable labeled. White plain paper of good quality should be used for labeling the container.  White plain paper of good quality should be used for labeling the containers. The size of the label should be proportional to the size of the container which is written or typed, giving all the desired information. The label should be fixed with a good quality of adhesive almost in the centre leaving equal space from the bottom and top of the container. The container is polished so as to remove the figure prints. While delivering the prescription to the patient, the pharmacist should explain the mode of administration, direction for use, and storage  MODERN METHODS OF PRESCRIBING Nowadays, the majority of the drugs are available in the market as readymade formulation manufacturing by different pharmaceutical companies. The drugs should be prescribed by its official name and not by its proprietary or trade name.  ADVANTAGES 1. It’s easy to remember proprietary because they are very catchy. Eg: Crocin(Paracetamol) 2. It is easy to communicate with the patient 3. The continuity can be maintained by prescribing the same proprietary name every time. 4. The bioavailability of drugs change with the change of adjutants used in drugs formulation manufacture by different manufactures. So only those proprietary drugs can be prescribed which have a better bioavailability.  DISADVANTAGES It is cheaper to prescribe the drugs by its official name. It becomes difficult for a pharmacist to dispense the substitute of the drug which is available in the stock.  There are 4 types of prescriptions which are generally received by the retail drug store… I. Prescription in general practice. II. Private prescription. III. Hospital prescription meant for ‘out patients’. IV. Hospital prescription meant for ‘in patient’  CARE REQUIRED IN DISPENSING PRESCRIPTION Following precaution should be taken while dispensing a prescription. 1) Always keep the prescription before you. Take the prescription with you while taking out the medicine from the shelf. It will serve as a constant reminder of the name and strength of the preparation required and helps to avoid mistakes. 2) Always check the dispensing balance before weighing the ingredients which are required and help to avoid mistakes.  3) Replace containers of stock preparation or drugs in their proper position after use. 4) Care should be taken to keep the dispensing balance clean. The powder should be transferred from the stock container by using a clean spatula. The scale pan should be cleaned immediately after use.  7) Medicines which are uses externally such as lotions, liniments, paints, etc...Should be supplied in vertically fluted or fibbed bottles in order to distinguish it by touch. They must be labeled in red or against a red background. 8) Before handing over the medicine to the patients, again check that the correct preparation, in the correct strength, has been supplied and correct direction has been stated on the label.  SOURCES OF ERRORS IN PRESCRIPTION 1. Abbreviation Abbreviation presents a problem in understanding parts of the prescription order. Extreme care should be taken by a pharmacist in interpreting the Abbreviation. Pharmacists should not guess at the meaning of an ambiguous Abbreviation Eg: to dispense Achromycin for “ACHRO” may cause difficulty when the intention of the prescriber is to dispense Achrostatin. 2. Name of the drug:- There are certain drugs whose name look or sound like those of other drugs. Some of the example of such drugs is as under: - Digitoxin and Digoxin Prednisone Prednisolone Indocin Linocin 3. Strength of preparation: The strength of the preparation should be stated by the prescriber. It is essential when various strengths of a product are available in market. 4. Dosage form of the drug prescribed. Many medicines are available in more than one dosage form like as liquid, tablet, capsule, etc... 5. Dose Unusually high or low doses should be discussed with the prescriber. Pediatric dosage may present. So pharmacist should consult pediatric posology to avoid an error. Sometime a reasonable dose is administered too frequently. 6. Instructions for the patient The instructions for the patient which are given in the prescription are incomplete or omitted. The quantity of the drug to be taken, the frequent and timing of administration and route of administration should be clearly given in the prescription so as to avoid any confusion. 7. Incompatibilities: It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in a prescribed preparation and that different medicines prescribed for the same patient do not interact with each other to produce any harm to patient. Certain antibiotics should not be given with meals since it significantly decrease the absorption of the drug.  Latin terms Auristille Eardrops Capsula Capsule Cataplasmapoultice Charta powder Collutorium mouthwash Collyrium eyewash  Cremor cream Emulsio emulsion Haustous drought Injectis injection Insufflatio insufflation Linctus linctus Linimentum liniment