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Sample Prescriptions

The document contains 4 prescriptions written by Dr. Gerald Understand for various patients: 1) A prescription for a 10-year old boy with fever, prescribing paracetamol syrup at a dose of 10mg/kg every 4 hours for fever over 38°C, dispensed as a 120mL bottle. 2) A prescription for an 11-year old girl diagnosed with a UTI, prescribing ampicillin at a dose of 50mg/kg/day divided into 4 doses for 7 days, dispensed as 28 vials of 500mg ampicillin. 3) A prescription for a 30-year old woman diagnosed with atypical pneumonia, prescribing azithromycin 500mg tablets once

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Clare Espiritu Ducut
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3K views5 pages

Sample Prescriptions

The document contains 4 prescriptions written by Dr. Gerald Understand for various patients: 1) A prescription for a 10-year old boy with fever, prescribing paracetamol syrup at a dose of 10mg/kg every 4 hours for fever over 38°C, dispensed as a 120mL bottle. 2) A prescription for an 11-year old girl diagnosed with a UTI, prescribing ampicillin at a dose of 50mg/kg/day divided into 4 doses for 7 days, dispensed as 28 vials of 500mg ampicillin. 3) A prescription for a 30-year old woman diagnosed with atypical pneumonia, prescribing azithromycin 500mg tablets once

Uploaded by

Clare Espiritu Ducut
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Prescription for 10-Year-Old Boy: Guides on writing a prescription for a child with fever using Paracetamol.
  • Prescription for 11-Year-Old Girl: Details prescription for a girl diagnosed with UTI requiring Ampicillin.
  • Prescription for 30-Year-Old Female: Instructs on prescribing Azithromycin for atypical pneumonia in a female patient.
  • Prescription for 56-Year-Old Male: Provides guidance on opioid prescription for pain management post-hospital discharge.
  • Sample Prescription Form: Displays a sample prescription form for reference purposes.

Write a prescription for a 10 y/o boy who consulted your clinic because of high grade fever using

Paracetamol of a dose of 10mg/kg/dose.


Available preparation:
Tempra syrup 250mg/5ml 60ml bottle and 120ml bottle
Tempra syrup 125mg/5ml 60ml bottle and 120ml bottle

Gerald Understand, M.D.


Family Medicine Specialist
Metropolitan Medical Center
1357 Masangkay St. Santa Cruz, Manila
3/F Rm. 3012, (501) 213-5820/09154823859

Patient’s Name: Juswa Garcia Age: 10 Sex: M


Address: Tondo, Manila Date: September 15, 2019

Paracetamol syrup 250mg/5ml


(Tempra)

Dispense: 1 bottle (120 mL)

Label: take 5.6ml of Paracetamol syrup every four hours


as needed for temperature more than 38O C

(10x2)+8 = 28kg = wei ght of Juswa


10mg/kg/dose = 280mg/dose

(250mg/5ml )(280mg/x)
 (250x)(1400)
 x = 1400/250
 x = 5.6 Gerald Understand, M.D.
*bakit 120 mL bottle at hindi 60mL lang? Lic No. 12345
 If every 4 hrs ang pag inom, 6x a day
syang umiinom
PTR No. 1234567
 5.6 ml x 6 = 33.6mL/day
o So yung 60 ml, kulang na sya
for a 2 days usage
Write a prescription for an 11 year old girl who was diagnosed with UTI using Ampicillin at a dose of
50mg/kg/day in 4 equally divided dose for 7 days.
Available preparation:
Ampicin 250mg vial and 500mg vial

Gerald Understand, M.D.


Family Medicine Specialist
Metropolitan Medical Center
1357 Masangkay St. Santa Cruz, Manila
3/F Rm. 3012, (501) 213-5820/09154823859

Patient’s Name: Bea Alanzo Age: 11 Sex: F


Address: Tondo, Manila Date: September 15, 2019

Ampicillin 500mg vial


(Ampicin)

Dispense: 28 vials

Label: administer 375mg of Ampicillin every six hours for


seven days for UTI

(11x2)+8 = 30kg = weight of Bea


50mg/kg/day = 1500mg/day
1500mg/4=375mg per injection
*Mabilis masira yung gamot kaya every Gerald Understand, M.D.
vial need agad gamitin. We’ll use the Lic No. 12345
500mg vials. Kukuha ng 375mg then PTR No. 1234567
dispose.
four 500mg vials x 7= 28 500mg vials
Write a prescription for a 30 year old female who was diagnosed to have atypical pneumonia using
Arithromycin 500 mg tablet once a day for 3 days.
Available preparation: Azithromax 500mg/tablet

Gerald Understand, M.D.


Family Medicine Specialist
Metropolitan Medical Center
1357 Masangkay St. Santa Cruz, Manila
3/F Rm. 3012, (501) 213-5820/09154823859

Patient’s Name: Julia Bareta Age: 30 Sex: F


Address: Tondo, Manila Date: September 15, 2019

Arithromycin 500mg tablet


(Azithromax)

Dispense: three tablets

Label: Take one tablet of Azithromycin 500mg per day for three days
for atypical pneumonia

Gerald Understand, M.D.


Lic No. 12345
PTR No. 1234567
Write a prescription for a 56 year old, male who is being discharged from the hospital. He was under
PCA (Patient Controlled Anesthesia) Fentanyl IV 150 mcg/hour while admitted. As an out-patient, he will
be using Fentanyl matrix patch for pain control due to Pancreatic CA.
Available in the pharmacy:
12 mcg/hour Fentanyl patch
25 mcg/hour Fentanyl patch
50 mcg/hour Fentanyl patch

FORM NO. 1-72


REPUBLIC OF THE PHILIPPINES
OFFICE OF THE PRESIDENT NO. 18-270537903
DEPARTMENT OF HEALTH
MANILA
Janella Salmo, MD Dennis Patilya
Name of Doctor Name of Patient
1357 Masangkay St. Santa Cruz, Manila Tondo, Manila
Address Address
License No.: 123456
Dangerous Drug License No.: 18-270537903
Date of Issue: September 15, 2019
Date: September 15, 2019

Fentanyl 50 mcg/hour patch


(Durogesic)

Dispense: thirty patches

Label: Apply three patches (to be changed every three days) for pain

150 mcg/hour (ito na po yung maintenance/stable dose ni patient for


anesthesia) Doctor’s Signature
PTR No.: 1234567
150 mcg / 50 mcg per patch = 3 patches (per cycle)

 Patches are sustainable for exactly 72 hours (3 days)


 A yellow prescription expires 2 mos after the prescription
date
 A regulated drug written in the S2 prescrition pad is good
for 1 month

30 days / 3 days = 10 cycle (to change the patch)

 10 cycle x 3 patch = 30 patches to be dispensed that is


good for 1 month

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