Prescription

Dr. Dinesh Kumar

Department of Pharmaceutical Engineering & Technology,
IIT (BHU), Varanasi
CONTENTS

• Introduction
• Prescription‐form of the prescription order,
• Components of prescription,
• Handling of prescription,
• Legal considerations
Introduction
• It is an order written by a physician, dentist, veterinarian or a registered medical
practitioner (RMP) to a pharmacist to compound and dispense a specific drug for
the patient.

• The word "prescription" is derived from the Latin

term praescriptus.
(Prae - 'before' and scribere- meaning 'to write’).
• Prescription means 'to write before' which means prescription had to be written
before a drug could be compounded and administered to a patient.
 PARTS OF A PRESCRIPTION
A typical prescription consists of the following parts:
Prescriber office information (Head)
1. Date
2. Patient information (Name, Age, Sex And Address Of
The Patient)
3. Superscription (symbol Rx)
4. Inscription (Medication prescribed)- Main part of
prescription
5. Subscription(Direction to Pharmacist/Dispenser )
6. Signatura or Transcription (Direction for Patient)
7. Renewal instructions if required
8. Prescriber’s signature and registration number
Physician (Prescriber) office Information-
Heading
• Information about physician is essential so that the patient could be
contact in emergency.
• Following information is mentioned on the prescription
i. Doctor's or office name.
ii. Address with phone number and e-mail.
iii. Prescription number, (required when calling the pharmacy for a
refill)
1. Date
• It helps a pharmacist to find out the date of prescribing.
• It also helps in know when the medicines were last dispensed if the
prescription is brought for re-dispensing.
• In case of habit forming drug the date prevents the misuse of the drug
by the patient
2. Patient information
• PATIENT INFORMATION (Name, Age, Sex and Address of the Patient)
• Name and address of the patient for identification purpose.
• Age and sex of the patient is required for child patient to check the
prescribed dose.
3. SUPERSCRIPTION (symbol ℞)
• It is represented by ℞ (Latin term) „recipe‟ which means „take thou‟
or „you take‟.
• In olden days, the symbol was considered to be originated from the
sign of Jupiter.
• Jupiter is the Greek God of healing.
• This symbol was use for requesting God for the quick recovery of the
patient.
4. INSCRIPTION (Medication prescribed)
• It is the main part of the prescription.
• It contains the names and quantities of the prescribed medicaments.
• The medicament may be official preparation or nonofficial
preparation.
a.) Official preparation (i.e. from pharmacopoeia) – Only name of the
preparation is written E.g. Piperazine Citrate Elixir IP
b.) Nonofficial preparation- Quantity of each ingredient will be given
and type of preparation will also be given
5. SUBSCRIPTION (Direction to
Pharmacist)
• In this part the prescriber gives direction to the pharmacist
a) Regarding the dosage form to be prepared.
b) Number of doses to be dispensed.
6. SIGNATURA (Direction for Patient)-
Transcription
• To be placed on the label.
• It is usually written as „Sig.‟.
• The signatura written in English and use some Latin abbreviations like
t.i.d (thrice a day), b.i.d (twice a day) and o.d (once a day).
• Instructions should be written on the label of container so that the
patient can follow them which may include;
a) Quantity to be taken(dose of drug)
b) Frequency and timing of administration of the preparation (dose interval)
c) Route of administration
d) Special instruction (if any)
7. RENEWAL INSTRUCTIONS
• The number of times a prescription is to be repeated is written by the
physician.
• It is very important for the case of habit forming drugs to prevent its
misuse.
8. PRESCRIBER’S SIGNATURE AND
REGISTRATION NUMBER
• The prescription must be signed by the prescriber by his / her own
hand.
• Registration number should be written in the case of dangerous and
habit forming drugs.
TYPES OF PRESCRIPTION
a) Compounded prescription
b) Non-compounded prescription

a). Compounded prescription-Also known as extemporaneous prescription.

It is an order that requires mixing of one or more ingredients (active medicaments).
(a) Base: The active medicaments (Produce the therapeutic effect).
(b) Additives-
1) It enhances the action of the drug.
2) It makes the preparation more elegant (attractive) and palatable.
(c) Vehicle: It is the main carrier of the drug. E.g. –In liquid preparations solvent (water) used as vehicle.
Now a day’s compounding is omitted from prescription.
E.g. Sodium bicarbonate -3g
Simple Syrup -6ml
Purified Water (q.s.)- 100ml
Cont…
b).Non-compounded prescription
• Does not require compounding of pharmaceutical product.
• Pre-compounded drugs supplied by a pharmaceutical company by its
official or proprietary name.
• Next class
HANDLING OF PRESCRIPTION
• The following procedures should be adopted by the pharmacist while
handling the prescription for compounding and dispensing:
• I. Receiving
• II. Reading and checking
• III. Collecting and weighing the materials
• IV. Compounding, packaging and labelling
I. Receiving

• The prescription should be received by the pharmacist.

• While receiving a prescription, a pharmacist should not change
his/her facial expression.
• It gives an impression that he/she is confused or surprised after
seeing the prescription.
II. Reading and checking

• After receiving the prescription it should be screened behind the

counter.
• Prescription authenticity should be checked.
• The signature of the prescriber and the date of prescription should be
checked.
• The pharmacist should read all the lines and words of the prescription.
• He/she must not guess any word.
• If there is any doubt, the pharmacist should consult with the other
pharmacist or the prescriber over telephone.
(III). Collecting and weighing the material

• Before compounding a prescription all the materials should be collected

from the shelves or drawers.
• All the materials kept in the left hand side of the balance. After measuring
each material should be kept on the right hand side of the balance.
• After compounding of the prescription materials are replaced back to the
shelves / drawers.
• While compounding every container of material should be checked thrice in
the following manner:
(i) When collected from the shelves/drawers.
(ii) When the materials are measured.
(iii) When the containers are replaced back to the shelves/drawers.
IV. Compounding, packaging and labelling
• Only one prescription should be compounded at a time.
• Compounding should be done on a clean table.
• All equipment required should be cleaned and dried.
• The preparation should be prepared according to the direction of the
prescriber or as per methods given in pharmacopoeia or formulary.
• The compounded preparations should be filled in suitable containers.
• Label the container.
CARE REQUIRED IN DISPENSING
PRESCRIPTION
Mistake to avoid
1. Abbreviation
• In most of the prescriptions abbreviated terms are used by the
prescriber that leads to major errors during interpretation by the
pharmacists. E.g. „SSKI‟ is the abbreviated term of „Saturated Solution
of Potassium Iodide‟.
• It is preferable to avoid these types of misleading abbreviations.
2. Name of the drugs
Names of some drugs (especially the brand names) either look or sound
alike. So any error in the name of a drug will lead to major danger to the
patient. e.g. Althrocin – Eltroxin, Acidin – Apidin , Digoxin- Digitoxin etc.
3. Strength of the preparation
• Drugs are available in the market in various strengths.
• So a drug must not be dispensed if the strength is not written in the
prescription. E.g. Paracetamol tablet 500mg should not be dispensed when no
strength is mentioned
4. Communication failure
• Failures during the process of patient management -Includes illegible
handwriting, incomplete prescribing order. Common errors include: „g‟
mistaken for „mg‟
5.Dosage form of the drug prescribed
• Many drugs are available in more than one dosage forms. E.g. liquid,
tablets, injections or suppositories.
• The dosage form intended for the patient must be mentioned in the
prescription to reduce ambiguity.
6.Dose
• If unusually high or low dose is mentioned in the prescription then it
must be consulted with the prescriber. Some time a sustained release
(SR) dosage form is prescribed thrice or more times daily. Actually SR
dosage forms should be given once or twice a day.
7. Instructions to the patient
• Some times the instruction for a certain preparation is either omitted of
mentioned partially. The route of administration should be mentioned clearly.
8. Incompatibilities
• It is essential to check that there are no pharmaceutical or therapeutic
incompatibilities in the prescription.
• If more than two medicines are prescribed then it is the duty of the pharmacist
to see whether their interactions will produce any harm to the patient or not.
• Certain drugs have interactions with food. E..g, Tetracycline should not be taken
with milk or antacid.
Legal Requirements for a Valid Prescription
1. Prescription should be written in indelible (can not erased) ink (may be handwritten
or computer generated)
2. Prescription must be signed in indelible ink by the practitioner using his own name.
3. Prescription must be dated by the prescriber.
4. Prescription should state address of the practitioner
5. if issued by a dentist the words „for dental use only
6. Prescription always writes legibly.
7. Prescription always space out words and numbers to avoid confusion.
8. Prescription always contains complete medication orders.
9. Avoid abbreviations.
Cont…
• Now a day’s electronic prescriptions
use, to minimize medication errors.
• The use of Latin word in prescription
writing is traditional.
• Now a day’s Latin has slowly gone.
Latin Terms Latin term / phrases abbreviation