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The Tooth
A tooth is a hard structure, set in the upper or lower jaw, that is used for chewing food. Teeth also give shape to the face and aid in the process of speaking clearly. The enamel that covers the crown (the part above the gum) in each tooth can be broken down by acids produced by the mouth for digestive purposes. This process is called "decay". To prevent decay, good oral hygiene, consisting of daily brushing and flossing, is necessary. The hardest substance in the human body is one of the four kinds of tissue which make up the tooth. It is enamel and covers the crown (area above the gum line) of the tooth. A bony material called "cementum" covers the root, which fits into the jaw socket and is joined to it with membranes. "Dentin" is found under the enamel and the cementum, and this material forms the largest part of the tooth. At the heart of each tooth is living "pulp," which contains nerves, connective tissues, blood vessels and lymphatics. When a person gets a toothache, the pulp is what hurts. Salivary Glands The mouth also contains the salivary glands which are accessory digestive glands that produce a fluid secretion called saliva. Saliva functions as a solvent in cleansing the teeth and dissolving food particles so that they may be tasted. Saliva also contains starch-digesting enzymes and mucus, which lubricates the pharynx to facilitate swallowing. There are three major pairs of salivary glands. The largest of which is the parotid gland and is located anteriorly and inferiorly to the ear between the skin and the muscle of chewing, the masseter. The parotid duct carries its contents and drains into the mouth. It is the parotid gland that becomes swollen and infected with the mumps or parotitis. The submandibular gland is located inferiorly to the mandible or jawbone midway along the inner side of the jaw. It has a muscular covering and empties its contents by way of the submandibular duct into the floor of the mouth on both sides. The sublingual gland, as its name implies, lies under the floor of the mouth and on the side of the tongue. Each sublingual gland possesses several small sublingual ducts that empty into the floor of the mouth in an area posterior to the submandibular duct. Mouth (An Overview) The function of the mouth and its associated structures is to form a receptacle for food, to begin mechanical digestion through chewing (mastication), to swallow food, and to form words in speech. It can also assist the respiratory system in the passage of air. Epiglottis The epiglottis is the flap of cartilage lying behind the tongue and in front of the entrance to the larynx (voice box). At rest, the epiglottis is upright and allows air to pass through the larynx and into the rest of the respiratory system. During swallowing, it folds back to cover the entrance to the larynx, preventing food and drink from entering the windpipe. The throat contains both an air passage (the wind pipe) and a food passage (the esophagus). If these passages were both open when a person swallowed, air could enter the stomach and food could enter the lungs. Part of the safety hatch that seals off the windpipe is the "epiglottis," a little valvelike cartilage, which works with the larynx to act as a lid every time we swallow. The larynx draws upward and forward to close the windpipe. This keeps solid food and liquid out of the respiratory tract. At the end of each swallow, the epiglottis moves up again, the larynx returns to rest, and the flow of air

into the windpipe continues. The uvula (Latin for "little grape") is a fleshy piece of muscle, tissue and mucous membrane that hangs down from the palate. It is the part that moves upward when we say, "Ah!" It flips up and helps close off the nasal passages when we swallow. Contrary to the depictions seen in cartoons, the uvula does not vibrate during singing and shouting and, in fact, has nothing to do with the voice. Trachea The trachea begins immediately below the larynx (voicebox) and runs down the center of the front part of the neck ends behind the upper part of the sternum. Here it divides to form two branches which enter the lung cavities. The trachea (windpipe) forms the trunk of an upsidedown tree and is flexible, like a vacuum tube, so that the head and neck may twist and bend during the process of breathing. The trachea, or windpipe, is made up of fibrous and elastic tissues and smooth muscle with about twenty rings of cartilage, which help keep the trachea open during extreme movement of the neck. The lining includes cells that secrete mucus along with other cells that bear very small hairlike fringes. This mucus traps tiny particles of debris, and the beating of the fringes moves the mucus up and out of the respiratory tract, keeping the lungs and air passages free. In Russian folk medicine, there is the thought that rubbing the chest with pork fat will cure a cold. Mustard plasters and boiled snails in barley water were thought to be effective by others, and nobody knows what the ingredients were for early "cure-all tonics" and "snake oil" kits. It is now believed that the best medicine is to rest, keep warm, drink plenty of fluids, and eat good, digestible meals. Sounds good to me...and certainly better smelling. Esophagus The esophagus is a muscular tube which carries food and liquids from the throat to the stomach for digestion after it has been chewed and chemically softened in the mouth. Food is forced downward to the stomach (or upwards, if one is standing on his head) by powerful waves of muscle contractions passing through the walls of the esophagus. Because these contractions are so strong in the throat and the esophagus, we can swallow in any position -- even upside-down! If the food is bad, poison, or more than we can "stomach," it may travel back by the same force to be thrown out through the mouth, which is called vomiting. The esophagus has a ring of muscle at the top and at the bottom. These rings close or contract after the food passes through and enters the stomach, where there is an abundance of churning acid waiting to digest the food. If the bottom muscle weakens, stomach contents, along with the stomach acid, may return to the esophagus and cause an uncomfortable, burning sensation known as "heartburn", although it is not connected with the heart at all, but be careful next time you are forced to swallow your pride. Liver Thirty per cent of the blood pumped through the heart in one minute passes through the body's chemical factory, which is called the liver. The liver cleanses the blood and processes nutritional molecules, which are distributed to the tissues. The liver also receives bright red blood from the lungs, filled with vital oxygen to be delivered to the heart. The only part of the body which receives more blood than the liver is the brain. The liver is located at the top of the abdomen, just below the diaphragm and has two main lobes. It is the largest gland in the body, weighing 2.5 to 3.3 pounds. When we eat, more blood is diverted to the intestines to deal with digestive processes; when not eating, three-fourths of the blood supply to the liver comes from the intestines. It also produces about two and one-half pints of bile in its ducts, which is delivered to

It has a capacity of around one and one-half fluid ounces. If this weren't possible. When food leaves the stomach. such as the alteration of ammonia to urea. believed that life is based on the four elements of earth. The liver also synthesizes triglycerides and cholesterol. which enables us to eat only two or three meals a day. which makes the important decision as to whether incoming substances are useful to the body or whether they are waste. Many chemical compounds are inactivated by the liver through modification of chemical structures. defeat was predicted Stomach A hollow. phlegm (cold and moist). so that the stomach is prepared when the food arrives. breaks down fatty acids. a secretion causes the gallbladder to contract and expel its contents into the duodenum. The process of digestion is triggered by the sight. Pythagoras. The liver is an extremely important organ and has multiple functions. IX and XI. mucus substance called "bile. and produces plasma proteins necessary for the clotting of blood. the strong muscles contract and mash the food into a sticky. Every time you pass a bakery shop or smell your mother's good cooking. The perfect or imperfect balance of these humors supposedly determined one's health and intelligence. The average adult stomach stretches to hold from two to three pints and produces approximately the same amount of gastric juices every twenty-four hours. We still speak in terms of "melancholia" (excess black bile. the 6th Century BC Greek mathematician. The gallbladder is a small. A "lily-livered coward" was someone whose liver contained no blood. pear-shaped sac which is situated just below the liver and is attached to it by tissues. (3) as a sterilizing system. sac-like organ connected to the esophagus and the duodenum (the first part of the small intestine). (2) as a food mixer. It stores bile and then releases it when food passes from the stomach to the duodenum (the first part of the small intestine) to help in the process of digestion. VII. It is also a storage compartment. where the cells in the stomach produce an acid which kills germs in "bad" food. The Greeks and Romans sacrificed animals to the gods before going into battle. holding a meal in the upper portion and releasing it a little at a time into the lower portion for processing. and proteins. The stomach has several functions: (1) as a storage bin. The liver also produces bile salts and excretes bilirubin. V. we would have to eat about every twenty minutes. the stomach consists of layers of muscle and nerves that continue the breakdown of food which begins in the mouth. air. leading to depression) and "phlegmatic" (sluggish or impassive) and scientists . where the bile disperses the fats in the food into liquid. smell or taste of food. starches. and can also produce glucose from sugars. fire and water which correspond to the body's "humors": blood (hot and moist). The liver converts glucose to a storage form of energy called glycogen. slushy mass. these gastric juices begin eroding the stomach lining itself. a victory was promised. such as clotting factors I. III. The liver detoxifies blood cells by mixing them with bile and by chemical alteration to less toxic substances. (4) as a digestive tub. the body begins a digestive process. the stomach produces digestive fluid which splits and cracks the chemicals in food to be distributed as fuel for the body. yellow bile (hot and dry) and black bile (cold and dry). if it was healthy and the blood was bright red. so fill 'er up! Gallbladder The gallbladder is an active storage shed. When the liver was examined. If the stomach is not filled." to be released when food is present in the stomach. "Liver" is probably an appropriate name for this gland. if it was diseased or the blood was pale. which absorbs mineral salts and water received from the liver and converts it into a thick.the gallbladder through a small tube called the "cystic duct" for storage.

so it is removed to stop the loss of blood. . lymph vessels and lymph nodes. only about twelve ounces of waste enters the large intestine. The spleen is a valuable organ which produces some of the white blood cells. The chief danger of appendicitis is that is may rupture and empty its contents of fecal matter and waste into the abdominal cavity producing an extremely serious condition called peritonitis. and lubricates it to protect the colon and ease its passage. It is just about the size of the heart and is a spongy material which will hold up to . It acts as a storage for fat and also may limit the spread of infection in the abdominal cavity. consists of ascending. because the materials that reach it are of very small use to the body and are sent on to be disposed of. come on. The last few inches of the colon is the rectum which is a storage site for solid waste which leaves the body by way of an external opening called the anus. and vomiting. Oh. Waste that accumulates in the appendix cannot be moved easily by peristalsis since the appendix has only one opening. when oxygen in the circulatory system is short. transverse. It is located on the left side of the body. Of the two to two and one-half gallons of food and liquids taken in by the average adult. cells shed by the intestine. The first half of the colon absorbs fluids and recycles them into the blood stream. We often hear that the victim of an auto accident has had a ruptured spleen which has been removed surgically. worn-out red blood cells and returns needed iron to the blood. and sigmoid portions. where's your sense of "humor"? Spleen The spleen is the largest of the lymphoid tissues. it cannot be repaired by surgery. From there. Feces are comprised of about three quarters water. fat. The remainder is protein. and dead bacteria. The ascending portion extends from the cecum superiorly along the right abdominal wall to the inferior surface of the liver and bends sharply at a right angle to the left at a curve called the hepatic flexure. nerves. filters the blood. The symptoms of appendicitis include muscular rigidity. A common disorder of the large intestine is inflammation of the appendix. The spleen also stores excess blood for emergencies. The large intestine or "bowel" is sometimes called the "garbage dump" of the body. just behind the stomach. undigested food roughage. Substances which have not been absorbed in the small intestine enter the large intestine in the form of liquid and fiber. it crosses the abdominal cavity as the transverse colon to the left abdominal wall at the splenic flexure and begins the descending colon which traverses inferiorly along the left abdominal wall to the pelvic region. It contains blood vessels. destroys old. for example. descending. Because the spleen is so soft and spongy. dried digestive juices. The second half compacts the wastes into feces.3 gallons of blood. Omentum The omentum is an apronlike double fold of fatty membrane that hangs down in front of the intestines. Pythagoras was kind of a "square". or appendicitis. disposing of the rest as waste. localized pain in the right lower quarter of the abdomen.have named the heavy mucus secreted in the respiratory passages . or colon.phlegm. The colon then forms an angle medially from the pelvis to form an s-shaped curve called the sigmoid colon. Large Intestine The large intestine. secretes mucus which binds the substances. controlled by muscles called sphincters.

liquids and bodily waste every day. knead it.5 gallons of food. Attached to the first portion of the large intestine is a troublesome pouch called the (veriform) appendix. (2) the jejunum. where most of the nutrients are absorbed into the blood and (3) the ileum. and glucose and amino acids go to the blood and on to the liver. Each of these cells contain thousands of tiny finger-like projections called "villi. oxygenated blood and sends out nutrient-enriched blood. Feces collects here until pressure on the rectal walls cause nerve impulses to pass to the brain. and to mix it with gastric juices. which makes it about four times longer than the person is tall. The intestines process about 2. The fatty nutrients go to the lymph vessels. It is a three-part tube of about one and one-half to two inches in diameter and is divided into three sections: (1) the duodenum. The appendix has no function in modern humans. Each villus brings in fresh. Rectum The rectum is a short. which then sends messages to the voluntary muscles in the anus to relax. to churn it. In order for enough nutrients to be absorbed into the body. these movements may be strong and rapid to expel the poisons quickly. where the remaining nutrients are absorbed before moving into the large intestine. muscular tube that forms the lowest portion of the large intestine and connects it to the anus.Small Intestine If the small intestine were not looped back and forth upon itself. permitting expulsion. The villi sway constantly to stir up liquefied food and remove the nutrients which can be absorbed and then passed through the membranes of the villi into the blood and lymph vessels. however it is believed to have been part of the digestive system in our primitive ancestors. slushy environment. Appendix Digestion takes place almost continuously in a watery. it must come in contact with large numbers of intestinal cells which are folded like gathered skirts. In one square inch of small intestine. it could not fit into the abdominal space it occupies. a receiving area for chemicals and partially digested food from the stomach. there are about 20.000 villi and ten billion microvilli. If a toxic substance enters the small intestine. . It is held in place by tissues which are attached to the abdominal wall and measures eighteen to twenty-three feet in the average adult. The muscles which encircle this tube constrict about seven to twelve times a minute to move the food back and forth. but these are usually weak and infrequent to allow the food to stay in one place until the nutrients can be absorbed." and each villus contains microscopic "microvilli". The small intestine also makes waves which move the food forward. The large intestine absorbs water from its inner contents and stores the rest until it is convenient to dispose of it.

This size is firstly determined by genes and secondly by diet. digestive system. primarily the sweat and sebaceous glands. Integumentary system Integumentary system The integumentary system is the largest organ system in the human body. torso. is the skin. . veins. which vary in thickness and function Digestive system Digestive system and Human gastrointestinal tract The digestive system provides the body's means of processing food and transforming nutrients into energy. cardiovascular system. nails and erectores pili (tiny muscles at the root of each hair that cause goosebumps). while the right side (right ventricle and right atrium pumps only to the lungs. and consists of a head. myocardium and epicardium. integumentary system.7–1. Systems Organ systems The organ systems of the body include the musculoskeletal system. immune system. These cells are organised biologically to eventually form the whole body. Body type and body composition are influenced by postnatal factors such as diet and exercise. By the time the human reaches adulthood. The primary function of the heart is to circulate the blood. nervous system and reproductive system. the body consists of close to 10 trillion cells.6–1.[2][3] The heart itself is divided into three layers called the endocardium. lymphatic system. Size. neck. The largest organ in the body. hair. and is responsible for protecting the body from most physical and environmental factors. endocrine system. respiratory system. Cardiovascular system Cardiovascular system and Human heart The cardiovascular system comprises the heart. arteries and capillaries. two arms and two legs.HUMAN BODY The human body is the entire structure of a human organism. urinary system.7 m (5'3" to 5'7") tall. The integument also includes appendages. the basic unit of life. type and proportion Body proportion The average height of an adult male human (in developed countries) is about 1. and through the blood. oxygen and vital minerals to the tissues and organs that comprise the body. The left side of the main organ (left ventricle and left atrium) is responsible for pumping blood to all parts of the body.8 m (5'7" to 5'11") tall and the adult female about 1.

the fluid found in between cells. transport and metabolise lymph. which acts as the . The final category are those used for copulation. these include the penis. The primary direct function of the male reproductive system is to provide the male gamete or spermatozoa for fertilization of the ovum. The human female reproductive system is a series of organs primarily located inside of the body and around the pelvic region of a female that contribute towards the reproductive process. The sperm then travels through the vagina and cervix into the uterus or fallopian tubes for fertilization of the ovum. urethra. The human female reproductive system contains three main parts: the vagina. which contains sperm. into the female's vagina. The lymphatic system is very similar to the circulatory system in terms of both its structure its most basic function (to carry a body fluid). Reproductive system Reproductive system Human reproduction takes place as internal fertilization by sexual intercourse.Lymphatic system Lymphatic system and Immune system The main function of the lymphatic system is to extract. During this process. Production takes place in the testes which are housed in the temperature regulating scrotum. and skeletal muscle attached to the skeleton by tendons. made by bones attached to other bones with joints. prostate. The major reproductive organs of the male can be grouped into three categories. Musculoskeletal system Musculoskeletal system The human musculoskeletal system consists of the human skeleton. vas deferens and Cowper's gland. Bones Human skeleton and List of bones of the human skeleton An adult human has approximately 206 distinct bones: Spine and vertebral column (26) Cranium (8) Face (14) Hyoid bone. The first category is sperm production and storage. sternum and ribs (26) Upper extremities (64) Lower extremities (62) Nervous System Nervous system and Human brain The nervous system is a network of specialized cells that communicate information about an organism's surroundings and itself. The human male reproductive system is a series of organs located outside the body and around the pelvic region of a male that contribute towards the reproductive process. The second category are the ejaculatory fluid producing glands which include the seminal vesicles. and the vas deferens. immature sperm then travel to the epididymis for development and storage. and deposition of the spermatozoa (sperm) within the female. the erect penis of the male is inserted into the female's vagina until the male ejaculates semen.

The vagina is attached to the uterus through the cervix. and unfertilized ova are shed each cycle through a process known as menstruation. The vagina meets the outside at the vulva. which also includes the labia. clitoris and urethra. the ovaries release an ovum. At certain intervals. and the ovaries. . called the endometrium. which holds the developing fetus. the uterus. which produce the female's ova. The lining of the uterus. The breasts are also an important reproductive organ during the parenting stage of reproduction. typically approximately every 28 days.receptacle for the male's sperm. while the uterus is attached to the ovaries via the fallopian tubes. which passes through the fallopian tube into the uterus. during intercourse this area is lubricated by mucus secreted by the Bartholin's glands.

reflux suppressants. mode or route of administration.. The World Health Organization keeps a list of essential medicines. prostaglandin analogues Lower digestive tract: laxatives. anticholinergics. can be loosely defined as any chemical substance intended for use in the medical diagnosis. cardiac glycosides.Antimalarial drugs: treating malaria . Parkinson's disease) drugs. An elaborate and widely used classification system is the Anatomical Therapeutic Chemical Classification System (ATC system). A sampling of classes of medicine includes: . antihistamines. stimulants (including amphetamines). α blockers Coagulation: anticoagulants. antidiarrhoeals. calcium channel blockers. antiplatelet drugs. statins. monoamine oxidase inhibitors.A pharmaceutical drug. cyclopyrrolones. or therapeutic effects. such as by chemical properties. H2-receptor antagonistss. For the central nervous system See also: Psychiatric medication and Psychoactive drug Drugs affecting the central nervous system include: hypnotics.g. cholinergics. antiflatulents. lithium salts. opioid For the cardiovascular system General: β-receptor blockers ("beta blockers"). vasodilators. anxiolytics. antiemetics. or prevention of disease Classification Medications can be classified in various ways. diuretics. anaesthetics. and 5-HT (serotonin) antagonists.Antibiotics: inhibiting germ growth . angiotensin receptor blockers. antianginals. For musculo-skeletal disorders . cuts and wounds Types of medications (type of pharmacotherapy) For the gastrointestinal tract (digestive system) Upper digestive tract: antacids. antidepressants (including tricyclic antidepressants. movement disorder (e. nitrate. antiarrhythmics. vasoconstrictors. cure. dopamine antagonists. tricyclic antidepressants and anticonvulsants.Antipyretics: reducing fever (pyrexia/pyresis) .Antiseptics: prevention of germ growth near burns. fibrinolytics. anticonvulsants/antiepileptics.Analgesics: reducing pain (painkillers) . and selective serotonin reuptake inhibitors (SSRIs)). cannabinoids. medication or medicament. cytoprotectants. For pain & consciousness (analgesic drugs) Analgesic The main classes of painkillers are NSAIDs. bile acid sequestrants. opioids and various orphans such as paracetamol. peripheral activators Affecting blood pressure (antihypertensive drugs): ACE inhibitors. antidopaminergics. benzodiazepines. proton pump inhibitors (PPIs). treatment. antispasmodics. also referred to as medicine. antipsychotics. emetics. haemostatic drugs Atherosclerosis/cholesterol inhibitors: hypolipidaemic agents. biological system affected. barbiturates. heparin. anti-hemophilic factors.

Diethylstilbestrol For the skin emollients. antispasmodics. selective alpha-1 blockers. diphosponate. anti-allergics. clomiphene. and anticholinesterases. follicle stimulating hormone. steroids For endocrine problems androgens. nitroglycerin For the ear. gonadorelin. bone regulators. gonadotropin. NSAIDs. disinfectants. mucolytics. antithyroid drugs. thyroid hormones. polyenes Anti-inflammatory: NSAIDs. mydriatics. keratolytics. thiazolidinediones. sympathomimetics. prostaglandins. antibiotics. cerumenolyti For the respiratory system bronchodilators. ocular lubricant Diagnostic: topical anesthetics. beta-blockers. sulfa drugs. corticosteroids Anti-allergy: mast cell inhibitors Anti-glaucoma: adrenergic agonists. anticholinergics. parasympathomimetics. haemostatic drugs. antifibrinolytics. parasympatholytics. antiseptics. calcitonin.The main categories of drugs for musculoskeletal disorders are: NSAIDs (including COX-2 selective inhibitors). tar products. corticosteroids. dopamine agonists. antifungals. steroids. LHRH gamolenic acid. nose and oropharynx sympathomimetics. For the eye General: adrenergic neurone blocker. cholinergics. alkalising agents. astringent. abrasives. pediculicides. 5-alpha reductase inhibitor. decongestants corticosteroids. carbonic anhydrase inhibitors/hyperosmotics. human growth hormone. local anesthetics. cholinergics. Hormone Replacement Therapy (HRT). muscle relaxants. luteinising hormone. topical . beta-receptor antagonists. prostaglandin agonists/prostaglandin inhibitors. sildenafils. cycloplegics Anti-bacterial: antibiotics. antidiabetics (sulfonylureas. scabicides. biguanides/metformin. quinolones. antifungals. neuromuscular drugs. anticholinesterases. vasopressin analogues For the reproductive system or urinary system antifungal. vitamin D analogues. systemic antibiotics. antihistamines. anti-pruritics. topical antibiotics. vitamin A derivatives. antitussives. oestrogen. aminoglycosides. NSAIDs. tamoxifen. anticholinergics. progestogen. beta-receptor agonists. fluoroquinolones Antiviral drug: Anti-fungal: imidazoles. gonadotropin release inhibitor. insulin). anticholinergics. antiandrogens. insulin. anticholinergics. miotics. fertility medications For contraception Hormonal contraception Ormeloxifene Spermicide For obstetrics and gynecology NSAIDs.

recombinant interleukins. aromatase inhibitors. antivirals. proteolytics. and prescription only medicine (POM). government-regulated cannabis is available by prescription. are available to countries which cannot afford the drug owner's price. behind-the-counter medications (BTMs). OTC medications are sold without restriction as they are considered safe enough that most people will not hurt themselves accidentally by taking it as instructed. desloughing agents. in certain situations. Legal considerations Medications may be divided into over-the-counter drugs (OTC) which may be available without special restrictions. sex hormones. therapeutic antibodies. antileprotics. which must be prescribed by a licensed medical practitioner. antimalarials. such as the United Kingdom have a third category of pharmacy medicines which can only be sold in registered pharmacies. They publish a lengthy list of chemicals and plants whose trade and consumption (where applicable) is forbidden. BTMs do not require a prescription. Blockbuster drug A blockbuster drug is a drug generating more than $1 billion of revenue for its owner each year. countries may have certain mandatory licensing programs which compel. not visible to the public. amoebicides. sunscreens. NSAIDs For nutrition tonics. antifungals. In some countries. and consequently medicines will not be licensed for this use in those countries. immunosuppressants. anthelmintics. anti-obesity drugs. exudate absorbents. but must be kept in the dispensary. haematopoietic drugs. vitamins. Euthanasia is not permitted by law in many countries. monoclonal antibodies For allergic disorders anti-allergics. antituberculous drugs. such as AIDS drugs. For patented medications.[4] The search for blockbusters has been the foundation of the R&D strategy adopted by big . antihistamines. by or under the supervision of a pharmacist.antibiotics. and only be sold by a pharmacist or pharmacy technician. Many countries. immunoglobulins. erythropoietin For diagnostics contrast media For euthanasia See also: Barbiturate#Other non-therapeutical uses and barbituates An euthanaticum is used for euthanasia and physician-assisted suicide. parenteral nutritional supplements. anabolic drugs. G-CSF. is implemented in some jurisdictions. hormones. or may be part of efforts to ensure that disease treating drugs. antiperspirants. somatostatin inhibitors. electrolytes. corticosteroids For infections and infestations antibiotics. a medication's owner to contract with other agents to manufacture the drug. The precise distinction between OTC and prescription depends on the legal jurisdiction. Such programs may deal with the contingency of a lack of medication in the event of a serious epidemic of disease. fibrinolytics. antiprotozoals For the immune system vaccines. iron preparations. The International Narcotics Control Board of the United Nations imposes a world law of prohibition of certain medications. [[food product drug]s For neoplastic disorders cytotoxic drugs. interferons. A third category.

About 100 products are blockbusters. manufacturers had legally released 271 million pounds of drugs into the environment. compounding of metals. pharmacy. Environmental impact Since the 1990s water contamination by pharmaceuticals has been an environmental issue of concern. and the promise of personalized medicine. Most pharmaceuticals are deposited in the environment through human consumption and excretion. a cholesterol-lowering medication marketed by Pfizer with sales of $12. subtle effects on organisms. In 2009 an investigative report by Associated Press concluded that U. History Ancient pharmacology Using plants and plant substances to treat all kinds of diseases and medical conditions is believed to date back to prehistoric medicine. operative skills. new nosologies and new therapies dating from about 400 BCE onwards. dates to about 1800 BCE and represents the first documented use of any kind of medication It and other medical papyri describe Ancient Egyptian medical practices. horticulture. The top seller was Lipitor. It also found that an estimated 250 million pounds of pharmaceuticals and contaminated packaging were discarded by hospitals and long-term care facilities. the Atharvaveda. and preparation of alkalis. New advances in genomics. a sacred text of Hinduism whose core dates from sometime during the 2nd millenium BCE. It describes plant-based medications to counter diseases. metallurgy.. attributed to 5th century BCE Greece. sugar manufacture. 92% of which was the antiseptics phenol and hydrogen peroxide. A recent report from Urch Publishing estimated that about one third of the pharma market by value is accounted for by blockbusters. runoff from sludge fertilizer and reclaimed wastewater irrigation. The Hippocratic Oath for physicians. Medicinal creams and pills were employed as treatments. analysis and separation of minerals. developed a mathematical scale to quantify the strength of drugs. and are often filtered ineffectively by wastewater treatment plants which are not designed to manage them. The earliest foundations of ayurveda were built on a synthesis of selected ancient herbal practices. but this looks set to change. The first drugstores were created in Baghdad in the 8th century CE. It could not distinguish between drugs released by manufacturers as opposed to the pharmaceutical industry.. such as using honey to treat infections. . and leaky sewage. De Gradibus. cooking. is the first Indic text dealing with medicine. Ancient Babylonian medicine demonstrate the use of prescriptions in the first half of the 2nd millennium BC. Once in the water they can have diverse. The student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation.pharmaceutical companies. On the Indian subcontinent.2 billion. refers to the existence of "deadly drugs". The Kahun Gynaecological Papyrus.S. and ancient Greek physicians imported medications from Egypt and elsewhere. Pharmaceuticals may also be deposited in the environment through improper disposal. although research is limited. the oldest known medical text of any kind. although the hymns recorded in it are believed to be older. are likely to fragment the pharmaceutical market[citation needed]. together with a massive addition of theoretical conceptualizations. The injection syringe was invented by Ammar ibn Ali al-Mawsili in 9th century Iraq. Al-Kindi's 9th century CE book.

During the First World War. Governments have been heavily involved in the development and sale of drugs. one of the most significant surgeons of the medieval period. and a few synthetic drugs. The Second World War saw the introduction of widespread and effective antimicrobial therapy with the development and mass production of penicillin antibiotics. the Elixir Sulfanilamide disaster led to the establishment of the Food and Drug Administration. Other drugs included antitoxins. codeine. and insulin for diabetes. to famously comment in 1842 that "if all medicines in the world were thrown into the sea. and typical antipsychotics for psychosis. In the inter-war period. and Cosmetic Act required manufacturers to file new drugs with the FDA. reported 800 tested drugs at the time of its completion in 1025 CE. which was important to the development of the pharmaceutical sciences. Although often accepted as an advance in some ways. Modern pharmacology For most of the nineteenth century. due to serious adverse effects such as tardive dyskinesia. there was some opposition. (1205-1296). responsible for introducing and promoting important surgical advances including basic antiseptic practice and the use of anaesthetics. antihistamines for nasal allergies. leading Oliver Wendell Holmes. and the 1938 Federal Food. drugs were not highly effective.The Canon of Medicine by Ibn Sina (Avicenna). a germicide which helped prevent gangrene. nitroglycerin. and quinine for heart disorders. Drug. Alexis Carrel and Henry Dakin developed the Carrel-Dakin method of treating wounds with an irrigation.000 medicinal and chemical substances. The Canon is considered the first pharmacopoeia. Folklore cures and potentially poisonous metal-based compounds were popular treatments. and morphine for pain. xanthines for asthma. beyond opium and quinine. who is considered the father of modern medicine. In the 1950s new psychiatric drugs. notably the antipsychotic chlorpromazine. then penicillin and other antibiotics. The 1951 Humphrey-Durham Amendment required certain drugs to be sold by .S. Garcia de Orta described some herbal treatments. biotechnology is used to discover biopharmaceuticals. rauwolfia alkloids as tranqulizers and antihypertensives.Islamic medicine knew of at least 2. or organized list of medications and their preparation Ibn Sina's contributions include the separation of medicine from pharmacology. Dakin's solution. In the 1930s antibiotics emerged: first sulfa drugs. a few biological vaccines. digitalis. were designed in laboratories and slowly came into preferred use..As of 2008. In the 1950s other drugs emerged including corticosteroids for inflammation. the first anti-bacterial agents such as the sulpha antibiotics were developed. Increasingly. Theodoric Borgognoni. but few truly effective drugs existed. In the U. made possible by the pressures of the war and the collaboration of British scientists with the American pharmaceutical industry. Sr. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. it would be all the better for mankind and all the worse for the fishes". Medicines commonly used by the late 1920s included aspirin. Drugs increasingly became "the center of medical practice". Medieval pharmacology Medieval medicine saw advances in surgery. thousands of approved drugs have been developed.

. Medicare Part D.S. drug prices were not a major concern for doctors and patients. In 2000 U. the United States is the leader in medical research. developed eight. law.S. including pharmaceutical development. developed three. U. As of 2008. Throughout the 1990s outcomes were similar. and by the 1970s nearly every U. France. based firms developed 29 of the 75 top-selling drugs.S. and drug innovation is correspondingly high. In 1962 a subsequent amendment required new drugs to be tested for efficacy and safety in clinical trials. which offers Medicare coverage for drugs. Until the 1970s. As more drugs became prescribed for chronic illnesses. and the United Kingdom contributed 10.S. This also led to the 2006 U.prescription. Japan. drug prices are among the highest in the world. costs became burdensome. state required or encouraged the substitution of generic drugs for higher-priced brand names. firms from the second-largest market. however. which imposes price controls.

The word "prescription" can be decomposed into "pre" and "script" and literally means. the name and address of the prescribing provider and any other legal requirement such as a registration number (e. and the "x" is short for "script". Literally. "to take or take thus"[6]. Alternatively. and it is quite possible that more than one of these factors influenced its form. laboratory tests. caretaker. Prescriptions have legal implications.[1] Prescriptions may include orders to be performed by a patient. where the "P" is short for "pre". DEA Number in the United States). and imaging studies relevant to optimizing the safety or efficacy.some note its similarity to the Eye of Horus[3] [4]. the scope of meaning of the term "prescription" has broadened to also include clinical assessments. Exhibit A below illustrates the legal definition of a prescription. Preprinted on the form is text that identifies the document as a prescription." and when a medical practitioner writes a prescription beginning with "℞".see Exhibit C paragraph 10) and how prescriptions are handled and stored by the pharmacist. "to write before" a drug can be prepared...g. However. There are various theories about the origin of this symbol . the imperative form of "recipere". Contents Both pharmacists and prescribers are regulated professions in most jurisdictions. Unique for each prescription is the name of the patient. he or she is completing the command. the contents and format of the prescription (including the size of the piece of paper . as medications have increasingly become pre–packaged manufactured products and medical practice has become more complex. others to the ancient symbol for Jupiter. Many jurisdictions will now allow faxed or phone prescriptions containing the same information. Another theory exists that the "℞" may have originally been a "Px". Each prescription is dated and some jurisdictions may place a time limit on the prescription [2].Medical prescription A prescription (℞) is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. nurse. In the United Kingdom the patient's name and address must also be recorded. It is sometimes transliterated as "Rx" or just "Rx".. Commonly. rather than at the patient who must "take" the medicine. Format and definition Prescription symbol Prescriptions are handwritten on preprinted prescription forms that are assembled into pads. . in the sense of consuming it. pharmacist or other therapist. it may be intended as an abbreviation of the Latin "recipe" [5]. the term prescription is used to mean an order to take certain medications. This was probably originally directed at the pharmacist who needed to take a certain amount of each ingredient to compound the medicine. There is the specific "recipe" of the medication and the directions for taking it. as they may indicate that the prescriber takes responsibility for the clinical care of the patient and in particular for monitoring efficacy and safety. both gods whose protection may have been sought in medical contexts. Those within the industry will often call prescriptions simply "scripts". ℞ is a symbol meaning "prescription". Regulations may define what constitutes a prescription. A prescription as a communications mechanism between them is also regulated and is a legal document. "Recipe" means simply "Take. or alternatively printed onto similar forms using a computer printer.

pharmacist is instructed to label the medication. [edit] Handling When filled by a pharmacist. Prescriptions will also contain instructions on whether the prescriber will allow the pharmacist to substitute a generic version of the drug. Sometimes such information is printed onto labels and the labels affixed right onto the prescription. Legislation may require the pharmacist sign the prescription. Some have a preprinted box "dispense as written" for the prescriber to check off (but this is easily checked off by anyone with access to the prescription). never mind a different formula of words. "brand necessary". Information such as the actual manufacturer of the drug and the date the medication was dispensed may be written right onto the prescription. When filled by the pharmacist. This assists the pharmacist in checking for errors as many common medications can be used for multiple medical conditions. The patient may be required to reference the prescription number for refills and drug .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. For pediatric prescriptions some advise the inclusion of the age of the child if the patient is less than twelve and the age and months if less than five. (In general. what is being treated. "do not interchange"[7]. as a matter of business practice. The prescription number is also put on the label on the dispensed medication. When checked. Prescribers typically circle themselves to indicate who is prescribing or there may be a checkbox next to their name. Many brand name drugs have less expensive generic drug substitutes that are therapeutically equivalent. The prescription number is written right on the prescription by the pharmacist. "medically necessary". "no substitution". all such information is printed and stapled to the prescription. the pharmacist may write certain information right on the prescription.e. In computerized pharmacies. i. In some jurisdictions. Some prescribers further inform the patient and pharmacist by providing the indicator for the medication. Regulations may restrict some types of drugs from being refilled. the patient only receives instructions for taking the medication and no information about the prescription itself. it may be a legal requirement to include the age of child on the prescription [8]. including the age on the prescription is helpful. that is whether the patient may obtain more of the same medication without getting a new prescription from the medical practitioner. In group practices. In other jurisdictions may they use completely different languages. In some jurisdictions. the preprinted prescription contains two signature lines: one line has "dispense as written" printed underneath. The prescription number has the practical purpose of uniquely identifying the prescription later on while filed (both manual and electronic). Other jurisdictions the protocol is for the prescriber to handwrite one of the following phrases: "dispense as written". "do not substitute". "DAW". the preprinted portion of the prescription may contain multiple prescribers' names. prescriptions are typically assigned a "prescription number" (often abbreviated "Rx#" in the US) that is unique to the pharmacy that filled the prescription. When not checked. Prescriptions often have a "label" box [9].) Adding the weight of the child is also helpful. the other line has "substitution permitted" underneath. This instruction is communicated in a number of ways. This may also be mandated by legislation (see Exhibit D). Some prescriptions will specify whether and how many "repeats" or "refills" are allowed.

Prescriptions for non-narcotic drugs may also be "transferred" from one pharmacy to another for subsequent repeats to be dispensed from another pharmacy. Some jurisdictions help control stolen prescriptions by requiring special "triplicate prescriptions" for certain classes of drugs [15][dead link]. this may be mandated by law[14][dead link]. Often the patient cannot take the original prescription with them. but all the information on it is transferred from one pharmacy to another. This number has grown from 1. claims.5 billion in 1989 and is expected to continue to grow. The physical piece of paper that is the prescription is not transferred. The regulating agency can issue lists of forged prescriptions that pharmacists can check. States have various laws making theft of prescription blanks or forgery of prescriptions criminal offenses and/or providing special treatment for these offenses (for Example N. The retention period varies but can be as long as six years. As a legal document. Legislation may dictate the protocol by which the transfer occurs and whether the transfer needs to be noted on the original paper prescription. Once the retention period has passed. pharmacists will call the medical practitioner to verify the prescription. For example. requires that only state approved printers may be used to print official "New Jersey Prescription Blanks. There may also be a legal requirement for prescription numbers for subsequent identification purposes. Again. call back numbers may be falsified and phoned or faxed prescriptions faked [11]. Some medical practitioners will use prescription pads that contain similar security measures as checks to make photocopying prescriptions harder. The medical practitioner retains a copy. [edit] Forgeries and prevention Prescriptions are sometimes forged because many narcotics are cheaper and safer as prescription drugs than as street drugs. New Jersey. Some jurisdictions may entitle patients to a copy. Legislation may also dictate what happens to the prescriptions if the pharmacy closes or is sold. Forged prescriptions are no longer considered medical documents and doctorpatient confidentiality rules no longer apply. Blank triplicates are only available from the regulating agency and are individually numbered. California has recently replaced triplicate forms with new forms that are impossible to photocopy or fax: the background is printed with repetitions of the word void in a color that shows up as black on a photocopy. . The pharmacist retains the second copy and the third copy is submitted to the regulating agency. some jurisdictions will mandate the archiving of the original paper prescription in the pharmacy. In this example. if the pharmacy goes out of business. amounts may be altered on legitimate prescriptions.[16] When forgery is suspected.J. Forgery takes many forms: Prescription pads are sometimes stolen. the pharmacist may be required to return the prescription to the patient. the prescription's validity is further limited to 72 hours from issuance. Stat."[13][dead link] (See Exhibit E. These security measures may be mandated by law—see Exhibit C for sample legal specifications. It is estimated that 3 billion (3 thousand million) prescriptions were written in the United States in 2002[10]. privacy legislation may dictate what can be done with the original paper prescription. See Exhibit B for sample legislation governing the archiving of prescriptions. making forgery of a prescription blank a third degree rather than fourth degree offense). to the next closest pharmacy or to the governing body for pharmacists.) Prescribers can make it harder for amount forgeries by writing out the amounts in words. Legislation may mandate that only certain printers may print prescriptions [12][dead link]. for example. the second and third copies are given to the patient to give to the pharmacist.

c.5 instead of .50 to avoid misinterpretation of . Avoiding decimals altogether by changing the units: 0. clinical pharmacists are allowed to prescribe in some states through the use of a drug formulary or collaboration agreements. [edit] Conventions for avoiding ambiguity Over the years. Always using zero prefix decimals: e. and also issue spectacle and contact lens prescriptions for corrective eyewear.[18] Historically. veterinarians. Quantities given directly or implied by the frequency and duration of the directions. even though some of the individual letters are illegible. "mL" is used instead of "cc" or "cm³" even though they are technically equivalent to avoid misinterpretation of 'c' as '0' or the common medical abbreviation for "with" (the Latin "cum").000 people annually. Further. 0. In addition.g. allowing clinical psychologists (PhD's or PsyD's) who are registered as medical psychologists and have also undergone specialized training in script-writing to prescribe a limited number of drugs to treat emotional and mental disorders. when handwritten. are notorious for being often illegible. the position of the legible letters and length of the word is sufficient to distinguish the medication based on the knowledge of the pharmacist. pharmacists call the medical practitioner. which is written as a 'c' with a bar above the letter. optometrists prescribe medications to treat certain eye diseases. Avoiding trailing zeros on decimals: e.g. Directions written out in full in English (although some common Latin abbreviations are listed below). . according to a July 2006 report from the National Academies of Science's Institute of Medicine (IOM). the quantity should always be specified. which is an uncommonly used abbreviation for "take with meals" (the Latin "cum cibum").g.[edit] Writing prescriptions [edit] Who can write prescriptions Who can issue prescriptions is governed by local legislation. In all states. many of the abbreviations are still widely used and must be understood to interpret prescriptions.50 as 50. Today.0 mL to avoid possible misinterpretation of 5.5 g is less easily confused when written as 500 mg. physicians used Latin words and abbreviations to convey the entire prescription to the pharmacist. Some jurisdictions have legislated legible prescriptions (e. When in doubt. medical practitioners' sloppy handwriting kills more than 7. In the US.0 as 50. dentists. cc could be misinterpreted as "c. In the United States medical practitioners. prescribers have developed many conventions for prescription-writing. At other times. and podiatrists have prescribing power.5 to avoid misinterpretation of .[21] [22] [23] These include: Careful use of decimal points to avoid ambiguity: Avoiding unnecessary decimal points: a prescription will be written as 5 mL instead of 5.5 instead of . Where the directions are "as needed". with the goal of avoiding ambiguities or misinterpretation.". Several states have passed RxP legislation. Florida [19]). Some have advocated the elimination of handwritten prescriptions altogether [20] and computer printed prescriptions are becoming increasingly common in some places. 0.[17] States allow registered certified physician assistants (also known as physician associates or PAs) prescription powers in all 50 states. [edit] Legibility Prescriptions.5 as 5.

[edit] Non-prescription drug prescriptions Prescriptions are also used for things that are not strictly regulated as a prescription drug. These are included in a separate list in Appendix 1. which looks almost identical to an 'm'. respectively).. Providing the indication for all prescriptions even when obvious to the prescriber. the minimum duration between repeats and number of repeats should be specified. If the patient wants the medication not under prescription. secondary." Writing out numbers as words and numerals ("dispense #30 (thirty)") as in a bank draft or cheque. The use of permanent ink. so that the pharmacist may identify possible errors. Many abbreviations are derived from Latin phrases. all abbreviations carry an increased risk for confusion and misinterpretation and should be used cautiously. prescribers may ask patients if they want it as a prescription or purchase it themselves. drams (ℨ).g. "q 2-4°" for every 2 . 20 and 30. and tertiary (1°. This is applied to non-medications as well. should not be used. and the symbol for pint (O) can be easily read as a '0'. and registered massage therapy may be reimbursed under some health discouraged given the potential for confusion. and minims (♏) -. Hospital pharmacies have more abbreviations. if a medication is available over-the-counter. . grains (gr). specific limits and indicators are provided e. usage directions should specify times (7 am. which is commonly used as an abbreviation for hours (e.e. abbreviated g. The use of apothecary/avoirdupois units and symbols of measure -. but only if given out by a prescriber as a prescription. Prescriptions that don't follow area conventions may be flagged as possible forgeries. 10. Avoiding unspecified prn or "as needed" instructions—instead. the symbols for ounce (℥) and dram (ℨ) can easily be confused with the numeral '3'. since the former could be confused with quantities (i. Different jurisdictions follow different conventions on what is abbreviated or not. Some abbreviations which are ambiguous." For refills. 3 pm. and the symbol for minims (♏). some specific to the hospital.pints (O). Further. The use of the degree symbol (°). "every 3 hours prn pain. scruples (℈). are not recommended and should be avoided. the use of the degree symbol for primary. metric equivalents should always be used.g. [edit] Abbreviations See list of abbreviations used in medical prescriptions. Avoiding units such as "teaspoons" or "tablespoons. Prescribers will often give non-prescription drugs out as prescriptions because drug benefit plans may reimburse the patient only if the over-the-counter medication is taken under the direction of a medical practitioner. and 3°) is discouraged.Where possible.4 hours). For example. ounces (℥). For example. Also. Conversely. Given the potential for errors. or which in their written form might be confused with something else. Pharmacists may or may not be able to price the medication competively with over-the-counter equivalents. since it can be confused with a '0'. can be confused with micrograms or meters. crutches. 2°. the prescriber is usually careful to give the medication name to the patient on a blank piece of paper to avoid any confusion with a prescription. 11 pm) rather than simply frequency (3 times a day) and especially relationship to meals for orally consumed medication. the abbreviation for a grain ("gr") can be confused with the gram. However.

A "green prescription" is direction from a medical practitioner to a patient for exercise and healthy diet. Such prescription devices can only be used under the supervision of authorized personnel and such authorization is typically documented using a prescription. "I want the patient to have the following medication" [30] .in other words. gut sutures. Such legislation will often specify a prescription as the means by which one may legally possess syringes. "prescription" is often used as a metaphor for healthy directions from a prescribing medical practitioner.Prescribers will often use blank prescriptions as general letterhead. This may be compounding instructions or quantities. The inscription section is further composed of one or more of[31]: a "basis" or chief ingredient indended to cure (curare) an "adjuvant" to assist its action and make it cure quickly (cito) a "corrective" to prevent or lessen any undesirable effect (tuto) a "vehicle" or "excipient" to make it suitable for administration and pleasant to the patient (jucunde) The "subscription" section contains dispensing directions to the pharmacist. Modern prescriptions are actually "extemporaneous prescriptions" from the Latin (ex tempore) for "at/from time" [27]. hypodermic syringes are in a special class of their own. Modern prescriptions evolved with the separation of the role of the pharmacists from that of the physician [28]. cervical cap and ultrasound monitor. the "℞" is a symbol for recipe or literally the imperative "take. . Legislation may define certain equipment as "prescription devices"[24]. regulated as illicit drug use accessories [25] separate from regular medical legislation. Predating modern legal definitions of a prescription. Examples of prescription devices include dental cement (for affixing braces to tooth surfaces)." This is an exhortation to the pharmacist by the medical practitioner. This is distinguished from a non-extemporaneous prescription which is a generic recipe for a general ailment. In this arrangement of the prescription. "Extemporaneous" means the prescription is written on the spot for a specific patient with a specific ailment. [edit] Related usage of the term prescription Prescription may also be used as a short form for prescription drugs to distinguish from overthe-counter drugs. In reference to the entire system of controlling drug distribution (as opposed to illicit drugs). address. [edit] History The concept of prescriptions dates back to the beginning of history. So long as there were medications and a writing system to capture directions for preparation and usage. there were prescriptions [26]. sickle cell tests. a prescription traditionally is composed of four parts: a "superscription". etc). The symbol "℞" separates the superscription from the inscriptions sections. Today the term "extemporaneous prescriptions" is reserved for "compound prescriptions" which requires the pharmacist to mix or "compound" the medication in the pharmacy for the specific needs of the patient. "subscription" and "signature" [29]. In some jurisdictions. "take the following components and compound this medication for the patient." The inscription section defines what is the medication. age. various prostheses. The superscription section contains the date of the prescription and patient information (name. "inscription".

" It also obviously contains the signature of the prescribing medical practitioner though the word "signature" has two distinct meanings here and the abbreviations are sometimes used to avoid confusion. Joint Commission Journal of Quality and Safety 2004.[34] In the United Kingdom a project called the Electronic Transfer of Prescriptions (ETP) within the National Programme for IT (NPfIT) is currently piloting such a scheme between prescribers and pharmacies. for example. Many pharmacies now offer services to ship prescription refills right to the patient's home. Littenberg B. and they will ship the filled prescription back to you. will ship refills free of charge.[35] Many prescribers lack the digitized information systems that reduce prescribing errors. for example. Such forms are thought to reduce errors. specialized field. original prescription and a signed document. Some online pharmacies also offer services to customers over the internet. the information on paper prescriptions is recorded into a database. and to print it out.: patient instructions [edit] Use of Technology As a prescription is nothing more than information among a prescriber. pharmacist and patient. Thus sample prescriptions in modern textbooks are often presented as: ℞: medication Disp. Walgreens' web site.The "signature" section contains directions to the patient [32] and is often abbreviated "Sig. CVS. units and frequencies that the prescriber may circle rather than write out. Existing information technology is adequate to print out prescriptions. Afterward. allows customers to order refills for medicine over the internet.) [edit] Exhibit A: sample legal definition of a prescription Taken from California's Business and Professions Code Section 4040 [37]: . for example. as well as have their information available for new prescriptions at any Walgreens. and allows them to specify the store that they will pick up the medicine from. Walgreens. Within computerized pharmacies. The modified forms also contain pre-defined choices such as common quantities. information technology can be applied to it.[36] To reduce these errors. 30:480-487. A pharmacy chain is often linked together through corporate headquarters with computer networking. Prescription data mining of such data is a developing. (See: Kennedy AG. Pharmacy information systems are a potential source of valuable information for pharmaceutical companies as it contains information about the prescriber's prescribing habits. uses satellite technology to share patient information. A Modified Outpatient Prescription Form to Reduce Prescription Errors. A person who has a prescription filled at one Walgreens can get a refill of that prescription at any other store in the chain. Their web site also allows consumers to lookup their prescription history. the paper prescription is archived for storage and legal reasons. especially omission and handwriting errors and are actively under evaluation.: dispensing instructions Sig. There are proposals to securely transmit the prescription from the prescriber to the pharmacist using smartcard or the internet. some investigators have developed modified prescription forms that prompt the prescriber to provide all the desired elements of a good prescription. They also offer mail service where you can mail in a new. Medical information systems in some hospitals do away with prescriptions within the hospital." [33] or "Signa.

directions for use. if a controlled substance is prescribed. including those in Schedule III. Section 11164 of the Health and Safety Code shall prevail. the name and quantity of the drug prescribed. IV and V. All prescriptions shall be filed in one of the following ways: A. and the date of issue may be treated as a prescription by the dispensing pharmacist as long as any additional information required by subdivision (a) is readily retrievable in the pharmacy. his or her license classification.1. (e) Nothing in the amendments made to this section (formerly Section 4036) at the 1969 Regular Session of the Legislature shall be construed as expanding or limiting the right that a chiropractor. or electronic transmission order that is both of the following: (1) Given individually for the person or persons for whom ordered that includes all of the following: (A) The name or names and address of the patient or patients. (d) The use of commonly used abbreviations shall not invalidate an otherwise valid prescription. (F) If in writing. [edit] Exhibit B: sample legal requirement for storage of prescriptions From the Mississippi Board of Pharmacy [38]: ARTICLE XIII PRESCRIPTIONS TO BE FILED 1. "Electronic image transmission prescription" means any prescription order for which a facsimile of the order is received by a pharmacy from a licensed prescriber. a written order of the prescriber for a dangerous drug. while acting within the scope of his or her license. In the event of a conflict between this subdivision and Section 11164 of the Health and Safety Code. that is electronically transmitted from a licensed prescriber to a pharmacy. IV and V prescriptions dispensed. address. not less than one inch high. (b) Notwithstanding subdivision (a). (c) "Electronic transmission prescription" includes both image and data prescriptions. a file for Schedule III. and telephone number of the prescriber. nurse practitioner. that contains at least the name and signature of the prescriber.2836. in the lower right-hand corner. the prescriptions for Schedule III. or physician assistant who issues a drug order pursuant to Section 2746. (E) A legible. (2) Issued by a precribing medical practitioner if a drug order is issued pursuant to Section 2746. or 3502. Two files may be maintained.51.1. This distinctive . clear notice of the condition for which the drug is being prescribed.4040. and his or her federal registry number.1. 2836. or printed by hand or typeset. the name and address of the patient in a manner consistent with paragraph (3) of subdivision (b) of Section 11164 of the Health and Safety Code. or 3502.51. signed by the prescriber issuing the order. and a file for all other prescriptions dispensed. written. "Electronic data transmission prescription" means any prescription order. (D) Either rubber stamped. IV and V substances must be stamped with the letter "C" in red ink. If this method is used. a file for all Schedule II prescriptions dispensed and another file for all other prescriptions dispensed. may have to prescribe a device. or the certified nurse-midwife. (a) "Prescription" means an oral. typed. except for any Schedule II controlled substance. a file for Schedule II prescriptions dispensed.1. if requested by the patient or patients. Three separate files may be maintained. other than an electronic image transmission prescription. the name. (B) The name and quantity of the drug or device prescribed and the directions for use. B. (C) The date of issue.

(7) Only one (1) prescription may be written per prescription blank. professional association. 2. as defined by IC 16-42-19-5. may appear on the prescription blank. (2) There shall be a custom artificial watermark printed on the back side of the base paper so that it may only be seen at a forty-five (45) degree angle. . (a) All controlled substance prescriptions written by licensed Indiana practitioners. A hard copy of original prescriptions. Pharmacies with automatic data processing systems are exempted from marking Schedule III. The watermark shall consist of the words "Indiana Security Prescription". IV and V controlled substance prescriptions with the red "C". as defined by this subdivision. or hospital. all computer generated labels should be affixed to the prescription document in such a manner as not to obscure information on the face of the document. If a pharmacy utilizes a data processing system for record keeping. (8) Refill options that can be circled by the prescriber must appear below any logos and above the signature lines on the left side of the prescription blank in the following order: Refill NR 1 2 3 4 5 Void after_____. may appear on the prescription blank. Only logos. The following statement must be printed on the bottom of the pad: "Prescription is void if more than one (1) prescription is written per blank. (5) No advertisements may appear on the front or back of the prescription blank. All prescriptions shall be maintained for at least five years from the date of original dispensing. professional practice.". defined as a symbol utilized by an individual. appearing horizontally in a step-and-repeated format in five lines on the back of the document using 12-point Helvetica bold type style. shall be assigned a serial number and maintained by the pharmacy in numerical and chronological order. whether records are maintained manually or in a data processing system. The symbol must be three-fourths (3/4) inch in size and must disappear if the prescription copy is lightened. (4) Six (6) quantity check-off boxes must be printed on the form and the following quantities must appear and the appropriate box be checked off for the prescription to be valid: (A) 1-24 (B) 25-49 (C) 50-74 (D) 75-100 (E) 101-150 (F) 151 and over. repetitive "void" pattern screened at five percent (5%) in reflex blue must appear across the entire face of the document when the prescription is photocopied. 2. 3. one-eighth (1/8) of an inch from the top of the pad and five-sixteenths (5/16) of an inch from the right side of the pad. [edit] Exhibit C: sample legal requirements for security and format From Indiana Board of Pharmacy [39]: 856 IAC 1-34-2 Security feature requirements Authority: IC 35-48-7-8 Affected: IC 16-42-19-5 Sec. The upper left one (1) inch square of the prescription blank is reserved for the purpose of logos.marking makes the records readily retrievable for inspection. (6) Logos. must contain the following security features: (1) A latent. (3) An opaque RX symbol must appear in the upper right-hand corner.

(g) the signature of the person dispensing the drug and. R. 1995. (d) the name and address of the prescriber. (Indiana Board of Pharmacy. (c) the directions for use. The New Jersey Prescription Blanks shall bear the unique provider number assigned to that health care facility for the issuing of prescriptions for controlled dangerous substances. [edit] Exhibit E: New Jersey requirements for prescription blanks From New Jersey official statutes:[41] 45:14-55 Use of New Jersey Prescription Blanks. 17. The health care facility shall notify the Office of Drug Control in the Division of Consumer Affairs as soon as possible but no later than 72 hours of being made aware that any New Jersey . The prescription blanks shall be secured from a vendor approved by the Division of Consumer Affairs in the Department of Law and Public Safety.S. eff Jan 1. (10) All prescription blanks printed under this rule shall be four and one-fourth (4-1/4) inches high and five and one-half (5-1/2) inches wide.O. 1996) [edit] Exhibit D: sample requirements on information added by the pharmacist Taken from the Ontario's Drug and Pharmacies Regulation Act [40]. 856 IAC 1-342. non-erasable safety paper New Jersey Prescription Blanks. 156 (1).4. H. a. Prescriptions issued by a health care facility licensed pursuant to P. also the signature of the person receiving a verbal prescription. a. b. s. 1990. prescription legend drugs or other prescription items. (i) the price charged. paragraph 156. Upon receipt of notification. The prescription blanks shall be secured from a vendor approved by the Division of Consumer Affairs in the Department of Law and Public Safety.) shall be written on non-reproducible. strength (where applicable) and quantity of the prescribed drug. stamped. where different. b. (b) the name. 16. the Office of Drug Control shall take appropriate action. as prescribed. c. 45:14-56 Health care facility prescriptions.136 (C. c. including notification to the Department of Human Services and the Attorney General. A health care facility shall maintain a record of the receipt of New Jersey Prescription Blanks. prescription legend drugs or other prescription items. non-erasable safety paper New Jersey Prescription Blanks bearing that practitioner's license number whenever the practitioner issues prescriptions for controlled dangerous substances.26:2H-1 et seq. The practitioner shall notify the Office of Drug Control in the Division of Consumer Affairs as soon as possible but no later than 72 hours of being made aware that any New Jersey Prescription Blank in the practitioner's possession has been stolen.1971. (h) the date on which the drug is dispensed. filed Jul 5. (f) an identification number or other designation.L. (1) Every person who dispenses a drug pursuant to a prescription shall ensure that the following information is recorded on the prescription. (b) Nothing in this rule shall prevent licensed Indiana practitioners from utilizing security paper prescriptions for the prescribing of any legend drug. 9:45 a.: 18 IR 2782. (a) the name and address of the person for whom the drug is prescribed. (e) the identity of the manufacturer of the drug dispensed. A practitioner practicing in this State shall use non-reproducible. A licensed practitioner practicing in this State shall maintain a record of the receipt of New Jersey Prescription Blanks.m. or manually printed on the prescription.(9) Practitioner name and state issued professional license number must be preprinted.

.A prescription issued by a practitioner or health care facility licensed in New Jersey shall not be filled by a pharmacist unless the prescription is issued on a New Jersey Prescription Blank bearing the practitioner's license number or the unique provider number assigned to a health care facility. non-reproducible. 20. which format shall include an identifiable logo or symbol that will appear on all prescription blanks. non-erasable safety paper prescription blanks. the Office of Drug Control shall take appropriate action including notification to the Department of Human Services and the Attorney General. 45:14-59 Format for New Jersey Prescription Blanks. 45:14-57 Requirements for prescription to be filled. to be known as New Jersey Prescription Blanks.Prescription Blank in the facility's possession has been stolen. The division shall approve a sufficient number of vendors to ensure production of an adequate supply of New Jersey Prescription Blanks for practitioners and health care facilities statewide.The Division of Consumer Affairs in the Department of Law and Public Safety shall establish the format for uniform. Upon receipt of notification. 18.