Prescription PDF

The prescription Prescription: is an order for a medicine (s) written by physician, dentist, veterinarian or other licensed health science practitioner legally entitled prescriber. Prescription Parts: 1- Name 2- Date 3- Superscription...

The prescription Prescription: is an order for a medicine (s) written by physician, dentist, veterinarian or other licensed health science practitioner legally entitled prescriber. Prescription Parts: 1- Name 2- Date 3- Superscription 4- Inscription 5- Subscription 6- Transcription 7- Signature Prescription Type: 1- Simple 2- Compound 3- Narcotic Prescription Handling: 1- Receiving 2- Check safety 3- Compounding Prescription Parts 1 Patient's name: age: address: 2 Date: 3 R/: 4 Salicylamide 0.3gm 5 Paracetamol 0.25gm 6 Fiat capsule , mitte X 7 Sign: one capsule to be taken three times daily Prescriber's Signature Dr….. 1  1. The name address and age of the patient 2. The date 3. The superscription: means direction to pharmacist, R/ is a symbol for the Latin word recipe = you take i.e. it directs the pharmacist to prepare the medicine. 4. The inscription, contains a list of ingredients and their quantities to be used in compounding the prescription 5. The subscription: means direction to pharmacist  Fiat: let them to be made (dosage from)  Mitte: send (number of doses to be prepared) 6. The transcription: means direction to patient  sign= write directions to the patient for the use of the prescription 7. The name of the prescriber, may be given as an official signature Prescription types 1- Simple prescription: It is the prescription consisting only of the active ingredients (as the prescription mentioned before) 2- Compound prescription: The prescription contains four portions: 1- Base 2- Adjuvant 3- Corrective 4- Vehicle Example for compound prescription 1. Patient: name……..age……..address……….. 2. Date: 3. R/ 4. Chloral hydrate 8 gm base Sodium bromide 10gm adjuvant Syrup of raspberry 22.5ml corrective Water to 60ml Vehicle 5. Fiat: mixture 6. Sign: 4 ml every 4 hours 7. Signature of prescriber 2 - Base: is the main active ingredient with the main therapeutic effect. (Chloral hydrate is hypnotic) - Adjuvant: it aids the base in its action (sodium bromide has a sedative action) - Corrective: serve as flavouring agent - Vehicle: water is added to dilute the active ingredient and to adjust the volume. 3-Narcotic Prescription - It must be written in ink or typewriter. - The quantities must be written in words and numbers. - In pharmacy, it must include date on which it was filled, name, address and registry number of the pharmacy. - It should be kept in separate file and not be refilled. - Narcotics are drugs with narcotic activity e.g. morphine - It must include: Name of prescriber Address of prescriber Registry number of prescriber Signature of prescriber Example for Narcotic prescription 1. Patient's name…………..age………….address………… 2. Date………. 3. R/ 4. Codeine phosphate 20(twenty) mg 5. Fiat: Capsule, Mitte 16 (sixteen) Caps. 6. Signa: One Capsule, Four times a day 7. Prescriber's name: Address: Registry no.: Signature: Dr………….. 3  Handling the prescription Handling the prescription Receiving Check safety Compounding i. Receiving the prescription: The pharmacist estimates the length of time to dispense the prescription. Pharmacist prices it before dispensing especially when expensive. In order to identify the finished product, some pharmacies employ (prescription claim check). This check is divided into 3 parts, each part has the same number, one part is given to the patient, and the second is attached to the prescription order and the third is attached to the final container. The identification is made more frequently by patient's name and address. ii. Checking the prescription for safety: The pharmacist should understand the prescription very well. The pharmacist must be sure that there is no dangerous overdose or 4  incompatibilities, otherwise he should consult the physician who wrote it. Methods for calculating the dose for child or infant can be based on: 1. Age 2. Weight 3. Body surface area 1-Based on age: for infants younger than 2 years use Fried's rule:  Infant dose = (Age in month/150) x adult dose For children 2 years and older use Young's rule:  Child dose= (age in years/ (age in years + 12)) x adult dose 2-Based on weight: Generally, heavy individuals can withstand larger dose, than a person with less weight. The usual doses in considered for persons with 70 Kg. For weight in pounds:  Child's dose= (weight in pounds/150) X adult dose For weight in Kg:  Child's dose= (weight in Kg/70) X adult dose 3-Based on body surface area ''B.S.A.": The average body surface area for adult is 1.7 m²  Child's dose= (B.S.A. in m² for child/ B.S.A. in m² of adult) X adult dose Or:  Child's dose= (B.S.A. in m² for child/ 1.7) X adult dose B. Route of Administration 1- Oral: e.g tablet and capsules 2- Rectal: e.g. suppositories 3- Parenteral: IM, IV, SC 4- Ophthalmic drops: eye drops and ointments 5- Nazal: drops or cream 6- Topical: ointment, gel and cream 5  No valid rule can be established for predicting the parental or the rectal dose of drug from the oral dose. Drugs which are absorbed completely from G.I.T will have equal parental and oral dose. Drugs which are poorly absorbed by the oral route will have smaller doses parentrally than orally. C. Pharmaceutical Dosage form 1. The vehicle of prescription affects the safety and the therapeutic effect of the prescription. e.g. polyethylene glycol ointment should contain ½ the concentration of benzoic acid and salicylic acid used in hydrocarbon base (vaslin) because they are more active in polyethylene glycol base. 1. The degree of subdivision of an active drug may affect therapeutic activity e.g. if polysorbate 80 is mixed with coal tar prior to incorporation of coal tar into the ointment base, a lower concentration of coal tar must be prescribed. As the subdivision of the coal tar results in more pronounced action on the skin. D. Frequency of Administration 1. Many potent drugs have cumulative action. If the frequency is too high, toxicity may occur even if the individual dose is safe e.g. digoxin. 2. In case of overdose the pharmacist should consult the physician. 3. In certain cases only the physician can know about the safety of the dose e.g.:  A nervous person needs higher dose of sedatives  In sever pain, large doses of narcotics are used. III Compounding of the prescription: 1. Calculation 2. Storage Requirements 3. Container selection 4. Labeling 6 1) Calculation: Check any calculation for the quantity of medicine Example: R/ chloral hydrate 9 gm Sod. Bromide 12 gm Syrup of raspberry 22.5 ml Water to 60 ml Fiat: mixture Mitte: 100 ml Signa: 5 ml every 4 hours X (100/60) R/ chloral hydrate 9 gm 15 gm Sod. Bromide 12 gm 20 gm Syrup of raspberry 22.5 ml 37.5 gm Water to 60 ml to 100 ml Fiat: mixture Mitte: 100 ml Signa: 5 ml every 4 hours 2- Checking the storage conditions or Requirements: Many drugs are photosensitive (degraded in presence of light) - therefore they need to be stored in amber containers. Some drugs should be protected from atmospheric gases as oxygen which support microorganisms growth and CO2 which shifts pH. -Therefore, they need to be protected from air and humidity by using tightly dosed containers 7 3- Selecting the container: Any pharmaceutical formulation must have suitable container such as:  Amber glass bottles: all oral medicines  Eye dropper bottles: ear, nasal and eye drops. Pots or collapsible tubes: ointment and creams. 4- Writing the label: Direction for the use of medicine should be clear and written before dispensary on a suitable size label. On the label the following should be written: 1. The prescription number, 2. date of dispensing, 3. patient name, 4. the prescriber's name 5. direction for use 1. Quantity to be taken 2. Amount to be used 3. Frequency of administration 4. Route of administration Auxiliary labels: 1. Shake the bottle (suspension and emulsions) 2. For external use only 3. Keep it away from reach of children 4. Not be swallowed in large amount (gargle and mouth wash) 5. For rectal use only 6. For the eye 7. For the ear 8. Keep in a cool place 9. Use as a gargle N.B. White labels for oral rout and Red labels for external use preparations. 8