1.

A 35 year old male who is a habitual drinker came with symptoms of chronic intestinal
amoebiasis .He was given
T .Metronidazole 15
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written.
2. Diagnosis & ℞ symbol are not written.
3. There is no advice given to the patient.
4. There is no signature of the doctor with date.
5.Dose and duration of metronidazole are not given.
6.Metronidazole produces disulfiram like reaction with alcohol. Patient must be instructed not to
take alcohol or an alternate drug like Satranidazole which does not produce disulfiram like
reaction with alcohol may be prescribed .
7. Diloxanide furoate which eliminate luminal cysts may be prescribed as the patient is
suffering from chronic intestinal amoebiasis .

B. Correct prescription
Dr .KUMAR M.D. . Mr.SARAVANAN
Reg No.32007. 35 years /Male,
Golden Hospital, Occupation : cooly
Thanjavur. K.K.Nagar ,Thanjavur.

Diagnosis : Chronic intestinal amoebiasis .

℞
Tablet. Satranidazole 300mg orally twice daily x 5 days.
Tablet. Diloxanide furoate 500mg orally thrice daily x 10 days.

Advice;
Avoid raw & uncooked vegetables
Ensure Safety of drinking water.
Signature: KUMAR
Date:dd/mm/yyyy
2. 40 years old male , a known peptic ulcer patient came with upper respiratory tract infection
and was prescribed with
Cap.Omeprazole 20 mg tds after food
Tab.Erythromycin 500 mg thrice daily 1 week

Criticize, Correct & Rewrite the Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Omeprazole bioavailability is reduced by food. So it should be given as 20 mg once daily
before food
6. Erythromycin produces mild to severe epigastric pain. Instead Amoxycillin can be used.

B. Correct Prescription
Dr. Suresh.M.D Mr. Ramu
Regn. No. 40553 40 years / Male
Sivakami Hospital, Occupation: Lorry Driver
Madurai. 26, Gandhinagar, Madurai

Diagnosis: Peptic Ulcer with Upper Respiratory Tract Infection

℞x

Capsule. Omeprazole 20 mg Once Daily Before Food

Capsule. Amoxycillin 500 mg Thrice Daily 1 Week

Advice;
Avoid Spicy Food. Signature: Suresh.
Review after one week Date: dd/mm/yyyy
3. A 24 year old lady with 4months of pregnancy attended OPD with complaints of fever with
rigor. She was diagnosed to have urinary tract infection. Urine was sent for culture & sensitivity
and she was started on

T.Norfloxacin 200 mg bd for 3 days

T.Paracetamol 250 mg bd for 3 days

To come for review after 3 days with culture report

Criticize, Correct & Rewrite the Prescription

A. Criticism;

1. Details of the doctor & patient are not written

2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Norfloxacin is contraindicated in pregnancy. Safe antibiotics like Pencillins and
Cephalosporins can be used.
6. Paracetamol dose is low.

B. Correct prescription

Dr.Surya M.D. Mrs.Alagi,.

Reg No.32007. 24 years / female,

Golden Hospital, Occupation: House wife

Thanjavur. Alagammal nagar,Thanjavur .

Diagnosis: Urinary Tract Infection in Pregnancy

T.Amoxycillin + Clavulinic acid (500 +125mg) 8th hourly for 3 days

T.Paracetamol 500 mg 6th hourly for 3 days

Advice;

To take plenty of oral fluids Signature: Surya

Review after 3days with culture report Date: dd/mm/yyyy

4.26yr old male with 10 days fever was admitted in hospital & was diagnosed to have typhoid
fever. He was given
Tab.Erythromycin 500mg twice daily
T. Paracetamol 500mg bd
Criticize, Correct & Rewrite the Prescription
A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Erythromycin is not the drug of choice for typhoid fever.
6. Injection. Ceftriaxone is the most reliable and fastest acting bactericidal drug for
enteric fever.
7. Paracetamol should be given in the dose of 500mg 6th hourly till fever subsides

B. Correct prescription
Dr.SARAVANAN M.D. Mr.Naveen
Reg No.32007. 26 years / Male,
Kiruthiga Hospital, Occupation: student
Thanjavur. Manojipatty,Thanjavur.
Diagnosis: Typhoid Fever
℞
1. Injection. Ceftriaxone 1 g twice daily for 7 days
2. T. Paracetamol 500mg 6th hourly till fever subsides

Advice;
To take Bland diet
Bed rest Signature: SARAVANAN
Date:dd/mm/yyyy
5. A 25 year old man with anaphylactic shock after Inj. Procaine penicillin was treated with the
following

Inj. Adrenaline 0.5cc (1/100 solution) iv

Tab. Pheniramine 250mg orally.

Criticize, Correct & Rewrite the Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Injection.Adrenaline is given 0.5cc intramuscularly (1/1000 sol) in anaphylactic
shock and iv route is not indicated unless shock is immediately life threatening.
6. The dose of Pheniramine is very high. It should be administered intramuscularly
in the dose 22.5mg in anaphylactic shock.

B. Correct prescription
Dr.KUMAR M.D. . Mr.SARAVANAN
Reg No.32007. 25 years /Male,
DKM Hospital, Occupation: cooly
Thanjavur. Yagappa Nagar,Thanjavur.
Diagnosis: Anaphylactic shock
℞
Injection. Adrenaline 0.5cc (1/1000 solution) im. statum
Injection. Hydrocortisone 100mg iv. statum
Injection. Pheniramine 1cc (22.5mg) im. statum.

Advice;
To avoid Penicillins
Signature: KUMAR
Date: dd/mm/yyyy.
6. A primi gravida, has taken with T.Aceclofenac 100mg as self medication for body pain . She
developed gastritis for which she was prescribed
Cap. Misoprostol 200 µg qid
Antacid gel 2 tsp tid
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written.
3. There is no advice given to the patient.
4. There is no signature of the doctor with date.
5. Misoprostol should not be given to pregnant mother as Prostaglandin will increase uterine
contraction and induce abortion. Safe alternative drugs like can be given.
6. Antacids reduce absorption of H2 blockers if taken concurrently .So antacids should be taken 2
hours after taking H2 blockers.

B. Correct prescription
Dr. Natraj. M.D. Name : Mrs. Lakshmi
Regn. No. 46433 28 years / Female
Sivakami Hospital, Occupation : House wife
Madurai. 26, Gandhinagar, Madurai

Diagnosis : Drug induced gastritis .

℞
Tablet. Ranitidine 150mg orally twice daily x 7 days.
Antacid gel 2 tsp thrice daily 2 hours after Ranitidine x 7 days.

Advice;
To avoid spicy food .
Avoid taking drugs inducing gastritis.
To review after 7 days.
Signature: Natraj
Date:dd/mm/yy
7. A 14 years old girl suffers from motion sickness. She was prescribed with
T. Metoclopramide 10 mg tid
T. BCT 1 tds
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Metaclopramide is not indicated in motion sickness. Anticholinergics or antihistamines should
be given.
6. Drugs for motion sickness should be given one hour before journey.
7.B complex vitamins are not indicated.

B. Correct prescription
Dr. Sumathy. M.D. Name : Miss. Latha
Regn. No. 46973, 14 / Female
Pioneer Hospital, 26, Gandhinagar,
Thanjavur. Thanjavur.
Diagnosis: Motion sickness.

℞
Hyoscine transdermal patch (1.5 mg)

Advice;
Patch should be applied behind Pinna one hour before journey

Signature: Sumathy.
Date:dd/mm/yy
8. A 60 year old postmenopausal woman with osteoporosis with h / o ischemic
heart disease was prescribed
T.Raloxifene 60mg od for 15 days
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Though Raloxifene is a first line drug for prevention &treatment of osteoporosis
it may produce deep vein thrombosis and embolism. As the patient is already
suffering from ischemic heart disease raloxifene is not preferred
6. Bisphosphonates are the other first line drugs and it may be prescribed.
7. Calcium & vitamin D supplements can enhance the benefit.

B. Correct prescription
Dr. Sumathy. M.D Name : Mrs. Latha
Regn. No. 46973, 60years / Female
Pioneer Hospital, 26, Gandhinagar,
Thanjavur. Thanjavur.
Diagnosis: Osteoporosis .

℞
T. Risedronate 35mg / week /morning (empty stomach)
T. Calcium gluconate 500mg once daily
T. Alfa Calcidol 1µg once daily x 15days

Advice;
To take Risedronate with 1 full glass of water
Not to lie down after taking Risedronate
Review after 15 days
Signature: Sumathy.
Date:dd/mm/yy

9. A 38 year old man with diagnosis of hyperlipidaemia and was treated with the following
drug.

T. Atorvastatin 10mg bd X 30days

The patient’s fasting lipid profile before treatment was

Patient values Normal values

TGL – 320 TGL < 150

TC - 280 TC < 200

LDL – 180 LDL < 130

VLDL – 120 VLDL < 30

HDL – 40 HDL > 35

Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Patient presents with striking hypertriglyceridemia. Primary triglyceride lowering drugs are fibric
acid derivatives & nicotinic acid .
6. Statins are first choice drugs in hyperlipidaemias with or without raised triglycerides.
Atorvastatin is more potent and has long half life &can be given once daily
B. Correct prescription:
Dr. Naveen. M.D Name: Deepan
Regn. No. 54633 38 years / Male
Golden Hospital, 42, KK Nagar.
Thanjavur. Thanjavur.
Diagnosis: Hyperlipidemia with hypertriglyceridemia

℞
T. Atorvastatin 20mg once daily

T. Gemfibrozil 600 mg twice daily before meal. x 30days

Advice:
Low fat diet
Regular exercise
Review after 1 month
Signature: Naveen.
Date:dd/mm/yy

10. A pregnant woman was diagnosed to have hyperthyroidism & was prescribed
T. Carbimazole 10 mg tid followed by Lugols iodine 10 drops a day for 15 days
Criticize, Correct & Rewrite the Prescription

A. Criticism;

1. Details of the doctor & patient are not written

2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Antithyroid drugs like carbimazole may produce foetal hypothyroidism & goiter.
6. Low dose of propylthiouracil is preferred as its greater protein binding allows
less transfer to the foetus.
7. Iodides also produce foetal hypothyroidism & goiter.Lugol’s iodine is used to reduce
the size of the gland preoperatively. But thyroidectomy is contraindicated in pregnancy
B. Correct prescription

Dr.Surya M.D. Mrs.Alagi,.

Reg No.32007. 24 years / female,
Golden Hospital, Occupation: House wife
Thanjavur. K.K.nagar, Thanjavur.

Diagnosis: Hyperthyroidism in Pregnancy

T.Propylthiouracil 25 mg thrice daily for 15 days

Advice;

Review after15 days

Signature: Surya
 Date:dd/mm/yy

11. A boy of 18years suffering from Grand mal Epilepsy was treated with T.Phenytoin. He developed
rashes , seizures were not controlled and he was prescribed
T. Carbamazepine 20 mg tds .
T.Valproate 200 mg od.
T.Clonazepam 5mg tds
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5.Carbamazepine also has tendency to produce allergic rashes.As the patient has already developed
rashes carbamazepine is not preferred.
6. The dose of valproate is low.It should be given as 200 mg tds. As the rashes are infrequent with
valproate it is preferred.
7. Clonazepam has no value in grandmal epilepsy.

B. Correct prescription:

Dr. Naveen. M.D. Name: Deepan

Regn. No. 54633 18 years / Male
Golden Hospital, 42, KK Nagar,
Thanjavur. Thanjavur.
Diagnosis: Grandmal Epilepsy with Phenytoin hypersensitivity reaction

℞
T.Valproate 200 mg three times daily for 1 Month

Advice:
Maintain seizure diary
Review after 1 month
 Signature: Naveen.
Date:dd/mm/yy

12. A female of 25 years known case of type I Diabetes Mellitus developed diabetic ketoacidosis and
she was prescribed,
Tab.Metformin 2gm
Sodium Bicarbonate 50mg orally
Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5.Tab Metformin produces lactic acidosis, moreover Insulin is the drug of choice for diabetic
ketoacidosis,So Metformin is not indicated.
6.Sodium Bicarbonate is indicated to correct acidosis but route of administration is through i.v. route.

7.I.V. fluids are indicated. ½ N saline, Normal saline, 5% Glucose solution are given i.v.

B. Correct prescription:
Dr. Naveen. M.D. Name: Deepika
Regn. No. 54633 25 years / female
Golden Hospital, 42, KK Nagar,
Thanjavur. Thanjavur.
Diagnosis: Diabetic Ketoacidosis

℞
Regular Insulin bolus 0.1 to 0.2 units/kg i.v. followed by 0.1 units/kg/hr till blood sugar is brought
to 300 mg /dl

2 to 3 units of insulin infused/hr according to blood sugar levels.

IV fluids- NS 1 litre/hr till dehydration is corrected and then 0.5 litre/4 hrs.
 Once BP &HR is stabillised ½ NS in 5% glucose to be given i.v. to restore the hepatic glycogen

KCL upto 50 meq/hr after 4 hours of initiation of therapy,with insulin to be added in I.v. fluids.

Sodium Bicarbonate 50 meq added to i.v.fluids till blood pH raises to 7.2

Suitable antibiotics.

Signature: Naveen.
Date:dd/mm/yy
13. 50 years old female was taking tab chlorpromazine and she developed drug induced parkinsonism.
She was prescribed

Tab.Levodopa 100mg BD

Tab.Carbidopa 10mg BD

Tab.Thioridazine 1 gram

Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5.Levodopa is not useful in drug induced parkinsonism as D2 receptors are already blocked by
chlorpromazine
6.Carbidopa is the peripheral decarboxylase inhibitor and is used along with levodopa so not
used here
7. A phenothiazine derivative thioridazine itself produces extrapyramidal side effects so it is
contraindicated.

B. Correct prescription:

Dr. Naveen. M.D. Name:Kasturi

Regn. No. 54633 50 years / female
Golden Hospital, 42, KK Nagar,
Thanjavur. Thanjavur.
Diagnosis: Drug Induced Parkinsonism
℞
Tab. Trihexyphenidyl 2 mg tds for 5 days

Advice: review after 5 days.

Signature: Naveen.
Date:dd/mm/yy

14.50 year old male with acute anginal pain was prescribed

Inj. Pentazocine 50mg

Glyceryl Trinitrate 2 mg

Propranolol 200mg

Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5. Pentazocine through analgesic causes cardiac workload and raises BP.
6. Propranolol is not the preferred ß-blocker since it further aggravate coronary spasm. So
better avoided. A cardioselective ß-blocker should be used.
7.Glyceryl trinitrate is the drug of choice as it reduces preload and afterload. It is to be
combined with a cardioselective ß-blocker to counteract reflex tachycardia.

B. Correct prescription:

Dr. Naveen. M.D. Name:Karuppaiya

Regn. No. 54633 50 years / male
Golden Hospital, 42, KK Nagar,
Thanjavur. Thanjavur.
Diagnosis: Acute Anginal pain

℞
 Tab. Glyceryl trinitrate 0.5 mg sublingual
Tab. Atenolol 50 mg od
Advice:
Restricted Physical activity.
Avoid stress, emotion and exitement.
Aviod smoking and alcohol.
Signature: Naveen.
Date:dd/mm/yy

15. A 45 years obese male with hypertension (BP: 150/100 ) and mild type II diabetes mellitus
was prescribed
Propranolol 1gm BD
Lisinopril 1mg
Syp.potassium chloride 5ml BD
Tab.Glibenclamide 5mg BD

Criticise , Correct & Rewrite The Prescription

A. Criticism;
1. Details of the doctor & patient are not written
2. Diagnosis & ℞ symbol are not written
3. There is no advice given to the patient
4. There is no signature of the doctor with date
5.Propranolol reduces carbohydrate tolerance by reducing insulin release, so it is to be avoided.
6.Lisinopril :ACE inhibitor is the drug of choice as it retards diabetic nephropathy. Dose is 5 to
40 mg.
7.Potassium Chloride syrup causes hyperkalemia when it is combined with lisinopril so it is not
indicated.

B. Correct prescription:

Dr. Naveen. M.D. Name: Karuppaiya

Regn. No. 54633 45 years / male
Golden Hospital, 42, KK Nagar,
Thanjavur. Thanjavur.
 Diagnosis: Hypertensin with Diabetes Mellitus

℞
for 15 days
Tab.Lisinopril 5mg OD
Tab.Metformin 500 mg BD

Advice:
Salt restricted diet.
Regular exercise.
Regular antidiabetic drug of diet. Signature: Naveen.
Date:dd/mm/yy