Introduction To Pharmaceutical Dosage Forms

Drugs

-Article intended for use in the diagnosis, cure, mitigation, prevention, or treatment of
diseases in man or other animals
Methods of Drug Administration

- Oral dosage forms

 To be taken orally
- Parenteral dosage forms
 Preparations introduced into the body by injection through the skin, mucous,
serous membrane
- Rectal dosage forms
 Employed for systemic effect or a local action through the rectum
- Inhalation
 Intended to finally dispensed or vaporized to the mucus membrane of the lower
part of respiratory tract
- Topical applications
- Intended to be applied into the skin, or instilled in the eyes, nose or ears
Conditions or situations when parenteral route is undertaken:

- When rapid drug action is desired as in emergency cases.

- When the patient:
 uncooperative, unconscious, or unable to accept or tolerate medication by the oral
route.
- When the drug itself is ineffective by other routes.

Classifications of Pharmaceutical Preparations:

Based on physical preparation

I. Liquids
 Aqueous Solution , viscid or sweet preparations, Non-aqueous solution
 Emulsions & Suspensions
 Extractives
- Solids
 Tablets, capsules & pills
- Semisolids
 Ointments, creams, powder, gel and cataplasm
- Gases
 Aerosols and inhalants
A. Solution
 A homogenous mixture that is prepared by dissolving a solid or liquid or gas in
another liquid
 Represents a group of preparations in which the molecules of slutes or dissolved
substances are dispersed among those solvents
1. Aqueous Solution- water is used as the vehicle or the solvent
- Waters
 Commonly used vehicle and a solvent for desired flavoring or medicinal ingredients
- Aromatic water
 Known as medicated water
 Clear saturated aqueous solutions of volatile oils or aromatic substances
 Used as flavored or perfume vehicle
- Aqueous acids
 Official inroganic acids and certain although of minor significance
 Available as in the form of concentrated aqueous solution and expressed in % by
weight
- Diluted acids
 Aqueous acids with a strength of 10% w/v
 Except HAC with 6% strength w/v
 They are used for internal administration
 For manufacture of other preparations.
- Solutions
 Contains one or more soluble chemical substances dissolved in water.
 They are used for the specific therapeutic effect of the solute either internally or
externally.
- Douches
 Aqueous solutions directed against a part or into a cavity of the body.
 Used as a cleaning agent or antiseptic agent.
- Enemas
 Known as evacuation enemas.
 They are rectal injections employed to evacuate the bowel retention enemas to
influence the general system by absorption, or to affect locally the seat of disease.
- Gargles
 Aqueous solutions used for treating the pharynx and nasopharynx by forcing air
from the lung through the gargle which is held on throat.
- Washes
 Aqueous solutions which are most often used for their deodorant, refreshing or
antiseptic effect.
- Juices
 prepared from fresh ripe fruits, aqueous in character and used in making syrups
which are employed as vehicles.
- Nasal solutions
 Aqueous solutin designed to be administered to the nasal passages in the drops
or spray form
- Otic solutions
 Dispensed in a container which permits administration of drops to the ear
2. Sweet or Other Viscid Aqueous Solutions
- Syrups:
 Concentrated solutions of sugar such as sucrose in water or other aqueous liquids.
 They are used as flavored syrup or medicated syrup.
- Honeys:
 Thick liquid preparation somewhat allied to the syrup
 Used as a base instead of syrup.
- Mucilage’s
  Thick, viscid, adhesive liquids produced by dispensing gum in water
 Extracted with water the mucilaginous principles from vegetable substances.
 They are used as an aid in dispensing insoluble substances in liquids,
 Their colloidal character and viscosity help them prevent immediate sedimentation.
- Jellies
Class of gels in which the structural matrix contains a high proportion of liquid,
usually water.
 They are used as lubricants for surgical gloves, catheters and rectal thermometer.
3. Non-aqueous Solutions
- Colloidions
 Liquid preparation containing pyroxillin in a mixture of ethyl ether and ethanol.
 They are applied to the skin by means of a soft brush or other suitable applicator
 When the ether and ethanol have evaporated, they leave a film of pyroxillin on the
surface.
- Elixirs
 Clear, pleasantly flavored sweetened hydro-alcoholic liquids intended for oral use.
 They are used as flavors and vehicles.
- Glycerites
 Solutions or mixtures of medicinal substances in not less than 50% by weight of
glycerin.
- Inhalations and Inhalants
 These are solutions of drugs administered by the nasal or oral respiratory route
for local or systemic effect.
 Nebulizers are used for the administration of inhalations.
 They are consists of drugs or combinations of drugs that carried by air thru high
pressure into the nasal passage where they extend their effect.
 The container used for its administration is an inhaler.
- Liniments
 Solutions or mixtures of various substances in oil, alcoholic solutions of soap or
emulsions.
 They are intended for external application.
 They are applied by being rubbed on the affected areas.
- Liniments
 Solutions or mixtures of various substances in oil, alcoholic solutions of soap or
emulsions.
 They are intended for external application.
 They are applied by being rubbed on the affected areas.
- Spirits
 Known as essences are hydro-alcohol solutions of volatile substances.
 Used medicinally by inhalation
 Large volume are used as flavoring agent.
- Toothache drops
 Used for temporary relief of toothache by application of cotton saturated with the
product into the tooth decay.
B. Emulsion
- A two-phase system prepared by combining two immiscible liquids one which is uniformly
dispersed through the other and consists of globules.
 - Third substance the emulsifying agent, is incorporated to prevent separation of the two-
phases
C. Suspensions
- A two phase system consisting of finely divided solid dispersed in a solid, liquid, or gas.
- Suspending agent is added to ensure the homogeneity of the solids in the vehicle.
- Gels
 Semisolid system of either suspension made up of small inorganic particles or large
organic molecules interpenetrated by a liquid.
- Lotions
 Usually liquid suspensions or dispersions intended for external application to the
body.
- Magmas and milk
 Aqueous of insoluble inorganic drugs and differ from gels mainly in that the
suspended particles are layers.
- Mixtures
 Aqueous liquid preparations which contain suspended insoluble, solid substances
intended for internal use.
I. Extracts
- Are solutions of the active constituents of a crude drug obtained by maceration/
percolation ready for use as a medicinal agent or may be further processed to produce
solid or semisolid extracts.
- Tincture
 Alcoholic or hydroalcoholic solutions prepared from vegetable materials or from
chemical substances
- Fluidextracts
 Liquid reparations of vegetable drug containing alcohol as a solvent or as a
preservative or both so made each ml containstherapeutic constituent of 1g of the
standard drug that ot represents
- Extracts
 Concentrated preparations of vegetable or animal drugs obtained by removal of
the active constituent of respective drug with suitable menstruum, evaporating of
all or nearly the solvent and adjustment of the residual masses or powders to the
prescribed standard
II. Parenteral preparations
- Sterile preparations intended to be administerd by injection under or through one or more
layers of skin or mucus membrane
- Packed in ampules or vials
- Solutions ready for injection
- Dry soluble products ready to be combined with a solvent just prior to use
- Suspensions ready for injection
- Dry, insoluble products ready to be combined with a vehicle just prior to use
- Emulsions
III. Intravenous admisture
- Mixture of intravenous fluids and drugs to be adminstered via injection
- Intravenous fluids
 Sterile, large volume solutions intended to be administered by inFUSIONS
 They contain sugar, amino acids, electrolytes
- Intravenous admixture
  Combination of one or more sterile products added to an IV fluid for administration
 The products are mixed in a suitable environment using aseptic technique
- Total parenteral nutrition
 Preparation containing calories, nitrogen, and other nutrients in sufficient
quantities
 The preferred source of calories is dextrose, protein hydroxylase fro nitrogen, and
electrolyte and vitamins for the nutrients
IV. Opthalmic preparation
- Sterile preparation to be used in the eyes
- Solutions
 Intended for the eye
 Clear, sterile solutions to be instilled into the yes by the use of a dropper
- Suspensions
 Dispersion of finely divided relatively insoluble drug substances in an aqueous
vehicle containing suitable suspending agent and dispersing agent
- Ointments
 Intended for the eyes
 They contain medicinal agents added to the ointment base of white petrolatum
and mineral either as a solution or as a micronized powder
 They are limited to bedtime installation
- Lens care products
 Sterile preparations intended to protect the lens
 Wetting solutions
 Preparations designed to furnish hydrophilic coating over the
characteristically hydrophilic surface of hard contact lens surfaces
 Cleaning solutions
 Used to remove surface contaminants, lipids, proteins and the like
 Disinfection soluitons
 Isotonic and sterile solution ehich exhibits disinfecting activity
 Artificial tears
 Solution intended to rewet hard lenses in situ ads referred to as rewetting
solutions
V. Medicated applications
- Applied to the skin or inserted into the bosy orifices in liwuid, semi solid or solid forms
- Ointments
 Semi solid preparation intended for externally application to the skin or mucus
membrane usually but not always they contain medicinal substances
- Cataplasm (poultices)
 A soft moist mass of meals, herbs, seeds usually applied hot in clothes
 They are intended to localize infectious materials in the body or to act as counter
irritants
- Pastes
 Concentrate of absorptive powder dispesed in petroleum or hydrophilic petrolatum
 They are stiff to the point of dryness and are often used in the treatment of oozing
lesions where they act to absorb serous secretions
- Powders for externlal use
 Usually described as dusting powders
 They usually contain starch, tals, zinc stearate
 - Dressings
 External applications resembling ointment usually usdd as a covering or prtection
- Creams
 Viscous liquid or semi solid emulsions of either the oil or water or water in oil type
 Cream of oil in water type include shaving creams, hand creams, foundation cream
 Water in oil type include cold cream and emollient cream
- Plasters
 Substance intended for ecternal application
 They are made of soft materials and of such consistency as to adhere to the skin
and attach to a dressing
 They are intnded to afford protection and support to furnish an occlusive and
macerating action and to bring medication into close contact with the skin
- Suppositories
 Solid dosage forms of various weights and shapes usually medicated for insertion
into the rectum, vagina or urethra
VI. Powders
- Oral powders
 Supplied as finely divided powders or as effervescent granule
 The finely divided powders are intended to be suspended or dissolved in water or
mixed with soft food prior to administration
 Effervescent powders in solution in water releases carbon dioxide which mask the
taste of bitter medication
- Dentrifices
 May be prepared in the form of a bulk powder generally containing soap or
detergent, mild abrasive, and an anticariogenic agent
- Douche powders
 Soluble powder intended to be dissolved in water prior to use as antiseptic or
cleaning agents for a body cavity
 They are applied to various parts of the body as lubricants, protectives,
absorbents, antiseptics, antipruritics, astringents and antiperpirant
- Insufflations
 Finely divided powders introduced into the body cavitie such as the ears, nose,
throat, tooth sockets, and vagina with the use of an insufflatoe (powder blower)
- Triturations
 Dilutions of potent powdered drugs prepared by intimately mixing them with a
suitable diluent in 1:10 dilutions
VII. Oral dosage forms
A. Tablets
- Solid dosage forms containing drug substances with or without suitable diluents and
prepared either by compressiom or molding metho
- Compressed tablet
 Sugar coated tablet
 Fil coated tablet
 Enteric coated
 Multiple compressed
 Controlled release tablet
 Effervescent tablet
 Compressed suppositories or inserts
  Buccal and sublingual tablets
- Molded tablets or tablet triturates
 Dispensing tablet
 Hypodemic tablets
B. Capsules
- Solid dosage forms in which the drug substance is enclosed in either a hard or soft soluble
container or a suitable form of gelatin
C. Pills
- Small round solid dosage form containing agents and intended for oral administration
D. Troches
- Lozenges or pastilles
- They are discoid shape containing the medicinal agent in a suitably flavored base
- They are placed in the mouth where they slowly dissolve, liberating the active ingredient
E. Cachets
- Related to capsu;es in as much as they provide an edible container for the oral
administration of solid drugs
- They may vary in size ¾ to 1/8 inches in diameter and they consist of 2 cocave pieces of
wafer made of flour and water
F. Pellets
- Small sterile cylinders about 3.2 mm in diameter by 8mm in lenth
- Formed by compression form medicated masses
VIII. Aerosols
- Both orally or topically
- They contain therapeutically active ingredient dissolved, suspended, or emulsified in a
propellant
- Oral aerosols
 For treatment of asthma
- Topical
 For treatment of multitude of dermatological manifestation
IX. Radiopharmaceuticals
- Radioisotopes used in medicine fro therapeutic and diagnostic purposes
X. Biological Products
A. Biologics for active immunity
- Vaccine
 A suspension of attenuated (live) and inactivated (killed)microorganisms or
fraction thereof administered to induce immunity and thus prevent infectious
disease
- Toxoid
 A modified antigen from an infectious organism used as a vaccine
B. Biologics for passive immunity
- Human sera
 Immune globulin
 A solution containing antibodies from the pooled plasma of not less than
1,000 normal individual
 Hyperimmunr sera
 A special preparation obtained from human donor pools selected fro high
antibody titer against a specific disease
- Animal immune serum
  Antitoxin
 A solution of antibodies derived from the serum of animals immunized with
specific toxins (toxoids) used to achieve passive immunity or to effect a
treatment
 Antiviral serum
 A solution antibodies derived from the serum of animals immunized with
specific viral vaccines
 Antivenin
A preparation of antibodies derived from the serum of animals immunized with specific venon
used to neutralized the venoms produced by the specific organisms

Medical Terms and Common Abbreviations Used In Prescription and Medication

Orders and By Medical Practitioners (

Prescription
- Defined as a written order from a licensed physician, dentist, and veterinarian to a licensed
pharmacist to prepare and dispense specific medication for a particular outpatient.
- Usually written on preprinted forms containing the traditional symbol Rx, name, address,
telephone number, and other pertinent information regarding the physician or other
prescriber.
- In addition, blank spaces are used by the prescriber to provide information about the
patient, the medication desired and the directions for use.
- A written prescription may be presented at the pharmacy by the patient or caregiver, or
it may be transmitted from the prescriber by telephone or by other electronic means
▪ The pharmacist immediately reduces the order to a properly written form or
computer entry
- In hospitals and other institutions, the forms are different and are referred to as
medication orders
▪ The orders are typed; typically, the instructions are written by the physician in ink
▪ A prescription or medication order for an infant, child, or an elderly person may
also include the age, weight, and/or body surface area of the patient. This
information is sometimes necessary in calculating the appropriate medication
dosage
- Two broad categories:
▪ Those written for a single component or prefabricated product and not requiring
compounding or admixture by the pharmacist
▪ Those written for more than a single component and requiring compounding
Pharmacy Compounding
- Involves the mixing, assembling, packaging, and labeling of a medication on receipt of a
prescription order for a specific patient
- May include the chemical or nonproprietary (generic) name of the substance or the
manufacturer’s brand or trademark name
- Prescriptions requiring compounding, contain the quantities of each ingredient required
- Medications are prepared into the various types of dosage forms and drug delivery
systems to ensure that the medication is administered accurately and appropriately.
Parts of Prescription

- Prescriber information
✓ Name of prescriber
✓ Signature of prescriber
✓ PTR number and date issued
✓ PRC license number and date issued
✓ S2 license number and date issued (for dangerous drugs)
- Patient Information
✓ Name
✓ Age
✓ Sex
✓ Weight and height
- Date Prescription was written
- Superscription meaning to “take thou,” “you take,” or “recipe”
- Medication prescribed (Inscription)
▪ For prepared drug
Generic name of the drug
Brand name of the drug
Dosage form
 Potency/strength
Quantity
▪ For compounding drug
Name of the ingredient (base, adjuvant, corrective, vehicle)
Quantity
- Dispensing instructions to the Pharmacist (Subscription)
- Directions to the Patient (Signa)
▪ Size of the dose
▪ Number of doses
▪ Number of days the drug must be taken
▪ Use of the drug
▪ Mode of administration
- Special Instructions
▪ Shake well, Refrigerate, etc.

Classification of Drugs based on Prescription Requirement

1. OTC drug or Non-prescription drug

¤ Can be dispensed even without the written order of a validly-registered
physician, dentist or veterinarian in duly licensed drug outlets
¤ RPh should give the necessary information and direction for the use of the drug
2. Prescription drug (Ethical drug or Legend drug)
 ¤Can only be dispensed upon a written order of a validly-registered physician,
dentist or veterinarian
3. Dangerous drug
¤ Prohibited drugs
¤ Regulated drugs
Dispensing

➢ Is the act by a validly-registered pharmacist of filling a prescription or doctor’s order on

the patient’s chart
Generic Dispensing

➢ Dispensing the patient’s/buyer’s choice from among generic equivalents

✓ finished pharmaceutical products having the same active ingredient/s, same
dosage form and same strength as the prescribed drug
Partial filling of prescription

- Dispensing less than the total number of units prescribed

Dispensing: Label

1. Name of the patient

2. Generic name of the drug
3. Brand name, if any
4. Manufacture
5. Dosage strength
6. Expiry date
7. Directions for use
8. Name of the pharmacist

Partial filling of the prescription

- The following shall be written on the face of the prescription:

1. The date of partial filling
2. The quantity served and balance of the prescription unserved
3. Name and address of the drugstore
Note: The partially-filled prescription shall be returned to the buyer after recording the partial
filling in the prescription book. The drugstore which completes the filling of the prescription
shall keep the prescription in file.

Dispensing drugs in List A and List B

- In the dispensing drugs included in List A (Prohibited and Regulated Drugs) and List B
(Drugs requiring strict precautions in their use), the following shall be observed:
1. Dispensing must be done by the pharmacist who shall affix his/her signature on the
prescription filled
2. The order and instructions of the doctor as written on the prescription, must be precisely
followed
3. Partial filling of prescription for drugs belonging to List A shall not be allowed
Number of Years required to keep prescriptions and record book

1. Dangerous drug prescriptions

➢ 1 year
2. Ordinary prescriptions
➢ 2 years
3. Poison
➢ 5 years
Types of Unlawful Prescription

1. Erroneous prescription
2. Violative prescription
3. Impossible prescription

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 the parenthesis
❖ What to do: Shall be filled but prescription shall be kept and reported by the RPh of the
drug outlet or any other interested party to the nearest DOH office foor appropriate
action.
Violative prescription

✓ Where the generic name is not written

✓ Where the generic name is not legible and a brand name which is legible is written
✓ Where the brand name is indicated and instructions added (such as the phrase “no
substitution”)
❖ What to do: Shall NOT be filled and prescription shall be kept and reported by the RPh
of the drug outlet or any other interested party to the nearest DOH office for
appropriate action. RPh shall advise the prescriber of the problem and/or instruct the
customer to get the proper prescription.
Impossible prescription

✓ When only the generic name is written but is not legible

✓ When the generic name does not correspond to the brand name
✓ When both the generic name and brand name are not legible
✓ When the drug product prescribed is not registered with the FDA
❖ What to do: Shall NOT be filled and prescription shall be kept and reported by the RPh
of the drug outlet or any other interested party to the nearest DOH office foor
appropriate action. RPh shall advise the prescriber of the problem and/or instruct the
customer to get the proper prescription.
Delivering and patient counselling

- The following information should be provided to the patient

• Dosage form and its identity
• Indications or expected actions
• Contraindication
• Dosage or amount to be used
• Frequency of administration (correct/exact time of administration)
• Duration of treatment
• Expected side effects
• ADR’s
 • Drug interactions (drug-drug, drug-food)
• Consequences of compliance and non-compliance
• Proper storage of medications

Suggested questions to ask the patient when dispensing a new prescription

• What did the doctor tell you the medication is for?

• How did the doctor tell you to take this medication?
• What did the doctor tell you to expect from the medication?

Information in the Medication Order

1. Patient information
2. Room number
3. Date and time the order was written
4. Name of the drug, dosage form, potency, quantity and route of administration
5. Prescriber’s signature
6. Directions for the pharmacist
7. Instruction for administration, including quantity, schedule and duration of use
 8. Name or initials of person/s who transcribed the order (nurse or pharmacist)

Check for incompatibility in the Prescription

Contents of the Prescription

• Name of the drug

AVOID THE USE OF:
 • Abbreviations
• Many drugs identified with abbreviations
• EX: HCT for hydrochlorothiazide, MSO4 for morphine sulfate
• Attempts to standardize abbreviations have been unsuccessful
▪ Dosing
Weight – based dosing
- Always convert patient weight to correct units (kg)
Liquid medications
- One product may be available in a number of concentrations
- Be familiar with various product concentrations
- Indicate BOTH concentration and dose of medication
- Example: Cephalexin suspension 125 mg/ 5 ml
- 1 teaspoon/ every 8 h
▪ Strength of the drug
Decimal points
Avoid trailing zeros.
EX. 5 mg vs. 5.0 mg; can be mistaken for 50 mg
Always use leading zeros.
EX. 0.8 ml vs. .8 ml; can be mistaken for 8 ml
▪ Quantity of the drug
▪ Prescribe only necessary quantity
▪ Write for specific quantities rather than time period (for example: dispense
#30 vs. dispense for 1 month)
▪ Calculate: quantity = frequency per day x treatment days
▪ Writing out “Dispense # X” is helpful

Tamper-Resistant Prescription Pads

• To prevent the unauthorized copying, modification, or counterfeiting of prescriptions,

tamper-resistant prescription pads have been developed.
• Their use is mandated for hand-written prescriptions for outpatient drugs
covered by Medicaid
• Qualities of these prescription forms is accomplished through the use of security
paper, erase resistant paper, thermochromatic ink (VOID) and/or embedded
holograms.
e-prescribing/e-prescriptions

• The use of electronic means for the generation and transmission of prescriptions is
accepted throughout the US
• In-patient and out-patient setting, a medication order, for a patient is entered into an
automated data entry system as a personal computer or handheld device loaded with e-
prescribing software and sent to a pharmacy as an e-prescription
• When received, a pharmacist immediately reduces the order to a hard copy and/or
stores it as a computer file
Advantages:

• Reduced errors due to prescription legibility

• Concurrent software screens for drug interactions
 • Reduced incidence of altered or forged prescriptions (efficiency for both RPh and
MD)
• Convenience to the patient, whose prescription would likely be ready for pick-up
upon aarrival at the pharmacy
Military Time

• Used not only in the military but in civilian life as well

• Its use provides an unambiguous expression of time
• In health care institutions, military time may be used to record the time of a patient’s
admission, when a medication was administered, the time of surgery and so forth
• Ex: 2300 hours (twenty-three hundred hours), 1331 or 13:31 hours (31 minutes past 1
o’clock in the afternoon), 13:31:42

Range of Prescription and Medication Order Calculations

• Provides the framework for the majority of the calculations, including calculations of the
following:
• Doses
• Compliance
• Drug concentration
• Rate of drug administration
• Compounding
• Chemical-physical factors
• Pharmacoenomics
• Doses
• Including the quantity of a prescribed dose, the total number of doses
prescribed, and the number of days the prescribed medication will last
• Compliance
• The patient’s or caregiver’s compliance in meeting the prescribed directions for
dosing
• Drug concentration
 • The quantity of an active therapeutic ingredient to use to achieve the desired
drug concentration
• Rate of drug administration
• The quantity of drug administered per unit of time to meet prescribed dosing
schedule
• Example: mg/min, drops/min, ml/hr for the administration of an intravenous fluid
• Compounding
• The quantities of active and inactive components to use in the extemporaneous
preparation of a pharmaceutical product, including the use of stock solutions
and/or prefabricated dosage units in the process
• Chemical-physical factors
• Including calculations to make solutions isotonic, iso-osmotic, equimolar, or
buffered
• Pharmacoeconomics
• Including medication costs, cost-benefit analysis, cost-effectiveness analysis,
altenative treatment plans, and medication pricing
SI units

• The quantities of ingredients to be used almost always are expressed in SI metric units
of weight and measurement or units of the apothecaries’ system
• In the use of the SI, the decimal point may be replaced by a vertical line that is
imprinted on the prescription blank or hand drawn by the prescriber
o Whole or subunits of grams of weight and mililliters of volume are separated by
the vertical line
o Sometimes the abbreviations g (for gram) and ml (for mililliters) are absent and
must be presumed

Prescription and Medication Order Accuracy

• It is the responsibility of the pharmacist to ensure that each prescription and medication
order received is correct in its form and content; is appropriate for the patient being
treated; and is subsequently filled, labeled, dispensed, and administered accurately.
Each medication should be:
• Therapeutically appropriate for the patient
 • Prescribed at the correct dose
• Dispened in the correct strength and dosage form
• Correctly labeled with complete instructions for the patient or caregiver
• For the patient in a hospital or other health care facility, each medication must be
administered to the correct patient, at the correct time, and by the correct rate and
route of administration
Errors and Omissions

• To ensure such accuracy, the pharmacist is obliged to review each prescription and
medication order in a step-by-step manner to detect errors of omission and commission
• A review of the completeness and correctness of a prescription or medication order is an
important initial step in the process of ensuring accuracy.

Items that the RPh should check for the correct reading and interpretation:

• Prescriber information
• Date of the order and its currency to the request of filling
• Patient information
• Drug prescribed, including dose, preparation strength, dosage form and quantity
• Clarity of any abbreviations, symbols and/or units of measure
• Clarity and completeness of directions for use by the patient or caregiver
• Refill and/or generic substitution authorization
• Need for special labeling s/a expiration date, conditions for storage and foods and/or
other medications not to take concomitantly
• A listing of the ingredients and quantities for orders to be compounded
Before dispensing, check:

• The filled prescription or medication order contains the correct drug, strength, dosage
form, and quantity
• Placing a medication’s indication on the prescription label
• The pharmacy-imprinted serial number on the label matches that on the order
• The label has the name of the correct patient and physician; the correct drug name,
quantity and strength; the name or initials of pharmacist who filled the order and the
number of refills remaining
Use of Roman Numerals on Prescription

• Roman numerals commonly are used in prescription writing to designate quantities

1. Quantity of medication to be dispensed
2. Quantity of medication to be taken by the patient per dose
3. Eight letters of fixed values used in the Roman system:

Rules: Roman Numerals

1. A letter repeated once or more, repeats its value (e.g. xx = 20)

2. One or more letters placed after a letter of greater value increases the value of the
greater letter (e.g. vi = 6)
3. A letter placed before a letter of greater value decreases the value of the greater letter
(e.g. iv = 4)
Use of Abbreviations and Symbols

• Medication errors can result from the misuse, misinterpretation, and illegible writing of
abbreviations, and through the use of ad hoc, or made-up abbreviations
• The use of a controlled vocabulary, a reduction in the use of abbreviations, care in the
writing of decimal points, and the proper use of leading and terminal zeros have been
urged to help reduce medication errors
Examples of prescription directions to the pharmacist:

a) M. Ft. ung
b) Ft. sup. no xii
c) M. ft. cap. d.t.d. no xxiv
Examples of prescription directions to the patient:

a) caps i q.i.d. p.c. et h.s.

 b) gtt. ii o.d. q.am
c) tab ii stat tab 1 q6h x 7d
Medication Scheduling and Patient Compliance

• Medication scheduling may be defined as the frequency (times per day) and duration
(length of treatment) of a drug’s prescribed or recommended use
• Patient compliance with prescribed and nonprescribed medications is defined as patient
understanding and adherence to the directions for use. The compliant patient follows
the label directions for taking the medication properly and adheres to any special
instructions provided by the prescriber or pharmacist.

Patient Compliance includes:

o Taking medication at the desired strength

o In the proper dosage form
o At the appropriate time of the day and night
o At the proper interval of the duration of the treatment and
o With proper regard to food and drink and consideration of other concomitant
medications and herbal remedies
Patient noncompliance

- is the failure to comply with a practitioner’s or labeled direction in the self-administration

of any medication.
Noncompliance may involve:

• Underdosage/overdosage
• Inconsistent or sporadic dosing
• Incorrect duration of treatment
• Drug abuse or misunderstanding of medications

Factors: Patient noncompliance

• Unclear or misunderstood directions

• Undesired side effects of the drug that discourage use
• Lack of patient confidence in the drug and/or prescriber
• Discontinued use because the patient feels better or worse
• Economic reasons based on the cost of the medication
• Absence of patient counseling and understanding of the need for and means of
compliance
• Confusion over taking multiple medications
• Patient forgot taking the medications

Consequences: Patient noncompliance

• Worsening of the condition

• The requirement of additional and perhaps more expensive and extensive treatment
methods or surgical procedures
• Increased total total health care cost