02 writing prescriptions

8/6/2019 02 Writing Prescriptions

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�Topic 2:

Writing prescription



� A prescription () is a health-care programimplemented by a physician or other qualifiedhealthcare practitioner in the form of instructionsthat govern the plan of care for an individualpatient.

� Prescriptions may include orders to be performedby a patient, caretaker, nurse, pharmacist or othertherapist.

� Prescriptions are often written, though they may betyped into a computerized physician order entrysystem or issued verbally to the patient, a nurse, a

pharmacist or other therapist.

� Prescriptions have legal implications, as they mayindicate that the prescriber takes responsibility forthe clinical care of the patient and in particular formonitoring efficacy and safety.



� Prescriptions are either entered into a Computerized Physician

Order Entry system, handwritten on preprinted prescription forms

that are assembled into pads, or alternatively printed onto similar

forms using a computer printer

� The symbol "Rx" meaning "prescription" is a transliteration of a

symbol resembling a capital R with a cross on the diagonal ().

� The word "prescription" can be decomposed into "pre" and

"script" and literally means, "to write before" a drug can be

prepared. Those within the industry will often call prescriptions

simply "scripts".



�

Both pharmacists and prescribers are regulated professions inmost jurisdictions. A prescription as a communications mechanism

between them is also regulated and is a legal document. of the

prescription (including the Regulations may define what

constitutes a prescription, the contents and format he size of the

piece of paper - Many jurisdictions will now allow faxed or phone

prescriptions containing the same information.

� Drug companies use direct-to-prescriber advertising in an effort

to convince prescribers to dispense as written with brand-name

products rather than generic drugs.

� Many brand name drugs have less expensive generic drug

substitutes that are therapeutically equivalent.Prescriptions will

also contain instructions on whether the prescriber will allow the

pharmacist to substitute a generic version of the drug.



� This instruction is communicated in a number of ways. In some

jurisdictions, the preprinted prescription contains two signature

lines: one line has "dispense as written" printed underneath; the

other line has "substitution permitted" underneath. Some have apreprinted box "dispense as written" for the prescriber to check

off (but this is easily checked off by anyone with access to the

prescription). Other jurisdictions the protocol is for the prescriber

to handwrite one of the following phrases: "dispense as written",

"DAW", "brand necessary", "do not substitute", "no substitution",

"medically necessary", "do not interchange´

� As a guideline, pediatric prescriptions should include the age of

the child if the patient is less than twelve and the age and months

if less than five. (In general, including the age on the prescription

is helpful.) In some jurisdictions, it may be a legal requirement toinclude the age of child on the prescription Adding the weight of

the child is also helpful.



� Prescriptions often have a "label" box. When checked, pharmacistis instructed to label the medication. When not checked, thepatient only receives instructions for taking the medication and no

information about the prescription itself.

� Some prescribers further inform the patient and pharmacist byproviding the indicator for the medication; i.e. what is beingtreated. This assists the pharmacist in checking for errors as manycommon medications can be used for multiple medicalconditions.

� Some prescriptions will specify whether and how many "repeats"or "refills" are allowed; that is whether the patient may obtainmore of the same medication without getting a new prescriptionfrom the doctor. Regulations may restrict some types of drugs frombeing refilled.

� In group practices, the preprinted portion of the prescription maycontain multiple prescribers' names.Prescribers typically circlethemselves to indicate who is prescribing or there may be acheckbox next to their name.



� A prescription, stripped to its barest form, consists of the superscription,the inscription, the subscription, the signa, and the name of the prescriber- written within the confines of a form.

� Superscription

The date when the prescription order is written; the name, address andage of the patient; and the symbol Rx (an abbreviation for "recipe," theLatin for "take thou."

� InscriptionThe body of the prescription, containing the name and amount or strengthof each ingredient.

� SubscriptionThe directions to the pharmacist, usually consisting of a short sentencesuch as: "make a solution," "mix and place into 10 capsules," or "dispense10 tablets."



� SignaturaFrom the Latin "signa," meaning "write," "make," or "label," this sectionscontains the directions to the patient. These should always be written inEnglish; however, physicians continue to insert Latin abbreviations, e.g. "1cap t.i.d. pc," which the pharmacist translates into English, "take onecapsule three times daily after meals." Since the pharmacist always writesthe label in English, the use of such abbreviations or symbols should bediscouraged.

� The instruction, "take as directed," is not satisfactory and should beavoided. The directions to the patient should include a reminder of theintended purpose of the medication by including such phrases as "forpain," "for relief of headache," or "to relieve itching´ .

� LabelingWhen the physician wants his patient to know the name of the drug, the

box on the prescription form marked "label" should be checked.

� RefillsThe physician should designate the number of refills he wishes thepatient to have.



� i) Prescribers or Physician details� ii) Patient details� iii) The superscription� iv) The inscription� v) The subscription� vi) The signa� vii) Instruction for Renewal� viii) Name and signature of Physician

� Prescribers or Physician detail (Date on which prescribed and nameand address of the prescriber)

� Date of prescribing and the date of presentation for filling are necessaryfor keeping accurate records and ascertaining the needs of the patient.

� Patient details (Name, address and age of the patient)� Age and sex of the patient if mentioned, help the pharmacist to check the

prescribed dose of medication.



� The superscription

The superscription consists of the symbol Rx which is the abbreviation of

the Latin word Recipe meaning you take.� The inscription

Inscription contains the names and quantities of the ingredients to be

compounded or dispensed by the pharmacist.

� The subscription

It embodies the directions to the pharmacist for preparing the

prescription.� The signa

Signa or Signatura contains the directions for the patient regarding

administration of drugs.

� Instruction for Renewal

The number of times a prescription prescribed by the Physician be

repeated is prescribed by the physician under refill information.

� Name and signature of Physician

The prescription must bear the signature of the prescriber with the seal

contain name and registration number. With out the signature and seal the

prescription is invalid.



�

Inscription :� Contains : dosage form, name of medication, strength,

dose, frequency of dose, duration.

� Name of medication:

� Most drug have 3 different name:� 1. chemical name : ( refer to chemical structure name)

� 2. generic (non-proprietary) name : simplified chemical name

� 3. trade (proprietary )name : trademark name from manufacturer.

Exp:T.Paracetamol 1gram tds PRN 3/7

T.Panadol 500mg ii tds PRN 3/7

Sy.Panadol 250mg 5ml 4H PRN 3/7



atovarstatin calcium Lipitor 10mg Atorlip-10

[R-(R*, R*)]-2-(4-fluorophenyl)-b, d -dihydroxy-5- (1-

methylethyl)-3- phenyl-4-[(phenylamino)carbonyl]- 1H-

pyrrole-1-heptanoic acid, calcium salt (2:1) trihydrate.



� When filled by a pharmacist, as a matter of

business practice, the pharmacist may writecertain information right on the prescription.

� This may also be mandated by legislation .

� Information such as the actual manufacturer of the drug and the date the medication wasdispensed may be written right onto the

prescription.

� Legislation may require the pharmacist sign theprescription.

� In computerized pharmacies, all suchinformation is printed and stapled to theprescription.

� Sometimes such information is printed ontolabels and the labels affixed right onto theprescription.



� When filled by the pharmacist, prescriptions aretypically assigned a "prescription number ́ that isunique to the pharmacy that filled the prescription.

� The prescription number is written right on theprescription by the pharmacist.

� The prescription number has the practical purpose of uniquely identifying the prescription later on while

filed (both manual and electronic).

� The prescription number is also put on the label on thedispensed medication.



� As a legal document, some jurisdictions will mandate thearchiving of the original paper prescription in the pharmacy.

� Often the patient cannot take the original prescription withthem. Some jurisdictions may entitle patients to a copy.

� The retention period varies but can be as long as six years.

� Once the retention period has passed, privacy legislationmay dictate what can be done with the original paperprescription.

� Legislation may also dictate what happens to the

prescriptions if the pharmacy closes or is sold. For example,if the pharmacy goes out of business, the pharmacist may berequired to return the prescription to the patient, to the nextclosest pharmacy or to the governing body for pharmacists.



� Prescriptions for non-narcotic drugsmay also be "transferred" from onepharmacy to another for subsequentrepeats to be dispensed from anotherpharmacy.

� The physical piece of paper that is theprescription is not transferred, but allthe information on it is transferred fromone pharmacy to another.

� Legislation may dictate the protocol by which the transfer occurs and whetherthe transfer needs to be noted on theoriginal paper prescription.

02 writing prescriptions

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