DEFINE: PRESCRIPTION

PRESCRIPTION

• A written order by the doctor to a pharmacist specifying the medications to be dispensed to a specific
patient and usually accompanied by directions for use and administration.

"pre"- before

"script" – written

Enumerate the parts of a prescription:

Parts of a prescription

• prescriber's information

• patient's information

• date

• superscription

• inscription

• subscription

• transcription

• special labeling/other instruction such as refill number

Describe Violative Rx.

types of unethical prescription

violative prescription

» where generic name is not written

» where the generic name is not legible while the brand name is legibly written

» when the brand name is indicated with instruction such as "no substitution" is written which hinder
proper generic dispensing

Describe Erroneous Rx.

erroneous prescription

» where the brand name precedes the,generic name

» where the generic name is the one in the parenthesis

» where the brand name is not in parenthesis

» where more than one product is prescribed on one prescription form

impossible prescription

» where only the generic name is written but is not legible

» where the generic name does not correspond to the brand name

» where both the generic name and the brand name are not legibly written

» when the drug product prescribed is not registered with FDA

what to do if you receive such type of prescription

• erroneous prescription

» shall be filled

» such prescription shall be kept and reported to the nearest FDA office for appropriate action

• violative and impossible prescriptions

» shall not be filled

» pharmacist shall advise the prescriber of the problem and instruct the customer to

get to proper prescription

» such prescription must be kept and reported to the nearest FDA office for appropriate action

What to do upon receipt of Rx?

Proper handling of Prescription

1. Receiving the prescription

2. Reading & checking the prescription

3. Numbering & dating

4. Labeling

5. Preparing the prescription

6. Packaging

7. Rechecking

8. Delivery & counseling

9.Recording & filing

10.Pricing the prescription

Prescription then what?

What to check out for?

Read and Check Rx for:

I - Interaction

D- Dose

E- Evidence of harm/ benefit

A- Appropriate

L- Legal and complete

C- Cost effective

A- Acceptable to the px

S-

E-

Prescription vs non-rx?

Broad classification of medication

• OTC / Non-prescription Drug

» drugs that do not require a doctor's prescription

» can be bought off-the-shelf in stores

» regulated by FDA through the OTC drug monograph

Broad classification of medication

• Prescription / Legend Drug

» prescribed by a doctor

» can only be bough at a pharmacy

» prescribed for and intended to be used by one patient

» regulated by FDA through the New Drug Application process

What is a narcotic drug?

NARCOTIC

• a drug that produce analgesia, narcosis, and addiction

• narcotic prescription

(should be in triplicate)

» one copy for the medical practitioner

» one copy for the pharmacy/pharmacist

» one copy for the patient

Controlled (Regulated) drug substance

• Any drug or therapeutic agent– commonly understood to include narcotics, with a potential for abuse
or addiction, which is held under strict governmental control and are placed in specific schedules.

• Require specialized prescription blanks.

FDA Controlled Substances

• Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct
categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or
dependency potential.

FDA Controlled Substances

Schedule I

• drugs with no currently accepted medical use

• high potential for abuse

• most dangerous drugs of all the drug schedules with potentially severe psychological or physical
dependence.

No prescriptions may be written for Schedule I substances, and they are not readily available for clinical
use.

Give an example of drugs under Schedule I.

Schedule I

• Gamma-Hydroxybutyric Acid (GHB)

• 12-Methoxyibogamine (Ibogaine)

• Marijuana (cannabis)

• Methaqualone
• Diacetylmorphine (Heroin)

• Pholcodine

• methylenedioxymethamphetamine (MDMA) or (ecstasy)

• Mescaline (Peyote)

• alpha-methyltryptamine (AMT)

• Bufotenin

• dextorphan (DXO)

• Benzylpiperazine (BZP)

• lysergic acid diethylamide (LSD)

FDA Controlled Substances

Schedule II

• drugs with a high potential for abuse but less abuse potential than S- I drugs

• with use potentially leading to severe psychological or physical dependence

Substance II drugs may not be dispensed without written prescription from a doctor.

Prescriptions of substance II drugs are in a "closed system". This means, the prescription may not be
refilled, unless medically required.

Give an example of drugs under Schedule II.

Schedule II

• Methylphenidate (Ritalin)

• Meperidine (Demerol)

• Cocaine

• Opium

• Methadone (Dolophine)

• Oxycodone (OxyContin)

• Fentanyl (Sublimate)

• Morphine

• Mixed Amphetamine Salts (Adderall)

• Lisdexamfetamine (Vyvanse)

• Dextroamphetamine (Dexedrine)
• Methamphetamine (Desoxyn)

• Hydrocodone (Vicodin)

• Hydromorphone (Dilaudid)

• Secobarbital (Seconal)

• Pethidine

• Nabilone (Cesamet)

• Tapentadol

FDA Controlled Substances

Schedule III

• drugs with a moderate to low potential for physical and psychological dependence.

• with a currently accepted medical use in treatment

Schedule III drugs may not be used without prescription from a doctor. Prescriptions may not be refilled
after six months of the date they were issued for use.

Give an example of drugs under Schedule III.

Schedule III

• Anabolic Steroids

• Buprenorphine

• Amphetamine

• Dihydrocodeine

• Ketamine

• Xyrem

• Hydrocodone/Codeine

• Marinol

• Lysergic Acid Amide (LSA)

• Paregoric

• Barbiturates (Short acting)

FDA controlled substances

Schedule IV

• drugs with a low potential for abuse and low risk of physical or psychological dependence.

• with a currently accepted medical use in treatment.

Prescriptions for Schedule IV drugs may be refilled up to five times within six months.

Give an example of drugs under Schedule IV.

Schedule IV

• Alprazolam (Xanax)

• Diazepam (Valium)

• Lorazepam (Ativan)

• Temazepam (Restoril)

• Barbiturates (Long acting)

• Modafinil (Provigil)

• Dextropropoxyphene (Darvon)

• Carisoprodol (Soma)

• Propoxyphene (Darvon)

• Zolpidem (Ambien)

• Tramadol

• Difenoxin

FDA Controlled Substances

Schedule V

• drugs with lower potential for abuse than S- IV and consist of preparations containing limited
quantities of certain narcotics.

• Abuse of the drug may lead to limited physical dependence or psychological dependence.

• generally used for antidiarrheal, antitussive, and analgesic purposes.

No drug found in schedule V may be dispensed or distributed for anything other than medicinal use.
Give an example of drugs under Schedule V.

Schedule V

• cough preparations with less than 200 mg of codeine (Robitussin AC)

• Lomotil

• Motofen

• Lyrica

• Parepectolin

Give one tip to avoid ambiguity in prescription.

Conventions in avoiding ambiguity

1. Careful use of decimal point

2. Directions in full english

3. Direction should be specific

4. Use of permanent ink

5. Avoid units such as tsp/ tbsp

6. Writing out numbers as words

7. Use of apothecary units

8. Use of degree symbol

How can we classify if a drug is considered safe for Pregnant women?

FDA Pregnancy Categories

• The FDA has established five categories to indicate the potential of a drug to cause birth defects if
used during pregnancy. The categories are determined by the reliability of documentation and the risk
to benefit ratio.

FDA Pregnancy Categories

• Category A

• Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first
trimester of pregnancy (and there is no evidence of risk in later trimesters).

• levothyroxine

• folic acid
 • magnesium sulfate

• liothyronine

FDA Pregnancy Categories

• Category B

• Animal reproduction studies have failed to

demonstrate a risk to the fetus and there are no

adequate and well-controlled studies in

pregnant women.

• metformin

• hydrochlorothiazide

• cyclobenzaprine

• amoxicillin

• pantoprazole

FDA Pregnancy Categories

• Category C

• Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate
and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant
women despite potential risks.

• tramadol

• gabapentin

• amlodipine

• trazodone

• prednisone
FDA Pregnancy Categories

• Category D

• There is positive evidence of human fetal risk based on adverse reaction data from investigational or
marketing experience or studies in humans, but potential benefits may warrant use of the drug in
pregnant women despite potential risks.

• lisinopril

• alprazolam

• losartan

• clonazepam

• lorazepam

FDA Pregnancy Categories

• Category X

• Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence
of human fetal risk based on adverse reaction data from investigational or marketing experience, and
the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

• atorvastatin

• simvastatin

• warfarin

• methotrexate

• finasteride

Pharmacy (Phármakon) – Art and Science of preparing, dispensing and proper utilization of medications
and the provision of drug -related information to the public.

- The art and science of preparing from natural and synthetic sources suitable and convenient
material for distribution and use in the treatment and prevention of disease
- It embraces knowledge of identification, selection, pharmacological action, preservation, and
analysis and standardization of drugs and medicines.
MEDICINE – Medicines are chemicals or compounds used to cure, halt, or prevent disease; ease
symptoms; or help in the diagnosis of illnesses. Liquid, tablet, capsules.

DRUG - A chemical substance, especially one prescribed by a medical provider, that is used in the
diagnosis, treatment, or prevention of a condition or disease.

SCOPE OF PHARMACY

It involves : Interpretation of prescription order

 Compounding

Labeling

Dispensing of drugs and devices

Drug product selection and drug utilization reviews

Patient monitoring and interventions

Provision of information of medications and devices

"Pharmacy should be conceived basically as a knowledge system that renders a health service by
concerning itself with understanding drugs and their effects." -The report of Commission of Pharmacy,
Pharmacists for the Future (Millis Report)

PHARMACEUTICAL CARE:

This is the current philosophy or approach to professional practice in pharmacy'

"The responsible provision of drug therapy for the purpose of achieving definite outcomes that
improve a patient's quality of life."
PHARMACIST

 Those who are educated and licensed to dispense drugs and to provide drug information
 They are known to be as drug experts.
 They are the most accessible member of today's healthcare team
 The first source of assistance and advice on many common ailments and healthcare matters.
DRUG

1. Articles recognized in the:

 Official United States Pharmacopoeia-National Formulary (USP-NF) and other Pharmacopoeia of
the United States
 British Pharmacopoeia
 Philippine Pharmacopoeia
 Philippine National Drug Formulary
 European Pharmacopoeia
 Japanese Pharmacopoeia
 Indian Pharmacopoeia
 any national compendium or any supplement to any of them

2. Articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of diseases
3. Articles, other than food, intended to affect the structure or any function of the human body or
animals
4. Articles intended for use as a component of any article specified but does not include devices or
their components, parts or accessories
5. Herbal and/or traditional drugs which are articles of plant or animal origin used in folk medicine
which are:
 I. Recognized in the PNDF
II. Intended for use in the tx or cure or mitigation of disease symptoms, injury or body
defects in humans
III. Other than food, intended to affect the structure or function of the human body any
IV. In finished or ready-to-use dosage forms
V. Intended for use as a component of any of the articles specified
UNITS OF MEASUREMENTS