Pharmacy Orientation Lecture (6) - PDF

Pharmacy Orientation Lecture (6) Dr. Ahmed Y. Kira Lecturer of Pharmaceutics and Pharmaceutical Technology Lecture (6)  The prescription Prescription: is an order for a medication written by a licensed medical practitioner such as, ph...

Pharmacy Orientation Lecture (6) Dr. Ahmed Y. Kira Lecturer of Pharmaceutics and Pharmaceutical Technology Lecture (6)  The prescription Prescription: is an order for a medication written by a licensed medical practitioner such as, physician. Prescriptions provide a specific medication and dosage to be administrated to a particular patient at a specific time.  Prescription Parts Prescriber’s information Patient information The Date The Superscription (Rx) The Inscription The Subscription The Transcription Prescriber's Signature  1. Prescriber’s information ▪ The Name ▪ Address ▪ Telephone Number ▪ Practice site: Hospital or clinic  2. Patient information It includes the name, age, and gender of the patient. Pediatric prescriptions should contain more information such as, weight and body surface area. These information help the pharmacist to calculate the accurate dose for the child. Methods for calculating the dose for infant or child 1- Based on (Age) ✓For infants younger than 2 years use Fried’s rule: Infant’s dose = (Age in month/150) x adult dose ✓For children 2 years and older use Young’s rule: Child’s dose = (Age in years/ (age in years + 12)) x adult dose 2- Based on (Weight) ✓The usual doses in considered for persons with 70 Kg. Therefore, Crack’s rule can be used: Child’s dose = (weight in Kg/70) X adult dose 3- Based on (Body surface area) ✓The average body surface area (B.S.A) for adult is 1.7 m²: Child’s dose = (B.S.A. in m² for child/ 1.7) X adult dose B.S.A. in m² = (Weigh (Kg) × height (Cm) ) / 3600 Try Your Self (Assignment) 1) A physician orders drug X (adult dose = 50 mg) oral administration every six hours for pediatric patient who admitted to the hospital. Calculate the dose for a 1.5 years old baby and for a 3 years old child? 2) Calculate the dose of drug solution in mL for a child weighing 35 Kg. The adult dose is 100 mg. The solution comes in a concentration of 20 mg/mL? 3) If the adult dose of a drug is 70 mg, what would be the dose for a child weighing 20 Kg. and measuring 65 Cm in height using the B.S.A method?  3. The Date Prescriptions are dated at the time they are written and when they are received and filled in the pharmacy. The date is important in establishing the medication record of the patient. The date prescribed is also important to a pharmacist in filling prescriptions for controlled substances (narcotics).  4. The Superscription The superscription is written Rx and is the symbol for the Latin word “recipe”, meaning (you take). It directs the pharmacist to take the drug listed in the prescription with quantities given to prepare the medication.  5. The Inscription (Medications prescribed) This is the body or the principal part of the prescription order. It contains a list of the ingredients and their quantities to be used in compounding the prescription. (Compound prescription) Today, the majority of the prescriptions are Paracetamol 120 mg/ 5 mL written for medications already prepared by Fiat: liq industrial manufacturers. Mitte: 100 mL The medications may be prescribed under their brand names or generic names. (Simple prescription)  6. The Subscription Dispensing directions to the pharmacist The class of the preparation (solutions, capsules, ointment.... etc.) is noted and the number of doses to be prepared is indicated. Fiat is a Latin word which means make. Mitte is a Latin word which means send. Paracetamol 120 mg/ 5 mL Examples of prescription directions to the Fiat: liq Mitte: 100 mL pharmacist: Fiat: liq. Mitte: 100 mL (Make solution with a final volume of 100 mL).  7. The Transcription Directions for patients (Signa or Sig) Sig is a Latin word which means write or let be written. The directions are transcribed by the pharmacist onto the label of the container. The directions are written using abbreviated Paracetamol forms of English or Latin terms or a Fiat: liq Mitte: 100 mL combination of each. 5 mL p.r.n Example: Sig: 5 mL p.r.n (Take one teaspoonful when required) Sig: tabs ii t.i.d (Take two tablets three times daily).  8. Prescriber's Signature This is a necessary part of the prescription and is required to validate the prescription order. Paracetamol Fiat: liq Mitte: 100 mL 5 mL p.r.n John, M.D.  Prescription Types 1- Simple prescription In which the inscription consists only of the active ingredient (as the prescription mentioned before) 2- Compound prescription It contains a list of the ingredients and their quantities to be used in compounding the prescription 3- Narcotic prescription It Is a prescription containing controlled substances such as morphine  Compound prescription Compound prescription contains four portions: 1- Base: The main active 2- Adjuvant: enhance the ingredient with the main activity of the base. therapeutic effect. 3- Corrective: to address issues 4- Vehicle: for liquid dosage (bitter taste, faint odor) with forms, to dilute the active the drug. constituents to a suitable dose.  Compound prescription Base: (Chloral hydrate is hypnotic, the main active ingredient ) Adjuvant: (sodium bromide has a Rx sedative action, it aids the base in its Chloral hydrate 8 mg action) Sodium Bromide 10 mg Syrup of raspberry 22.5 mL Corrective: (Syrup of raspberry serves Water to 60 mL as flavoring agent) 5 mLMist Fiat: o.n Mitte: 30 mL Vehicle: water is added to dilute the active ingredient to the required Sig: 5 mL O.n. concentration. John, M.D.  Narcotic prescription In the pharmacy, the narcotic prescription must include the date on which the prescription was filled and the name, address and the registration number (Reg. No) of the prescriber and the pharmacy. By the law in Egypt, no prescription order for controlled substances may be dispensed more than 5 days after the date prescribed. Narcotic prescriptions must be kept in a separate file and cannot be refilled. Narcotic prescription Signature John, M.D. Name of pharmacy to dispense: License#:  Thank You Any questions ? Pharmaceutics Department Faculty of Pharmacy Delta University for Science and Technology