Prescription Writing

Outline of Today’s Practical

 Irrational Prescribing
 Problems in Irrational Prescribing
 Prescription
 Parts of Prescription
 Label
 Prescription pattern in JJ Hospital
 Steps to avoid errors
 Summary
Irrational Prescribing
Problems in Irrational
Prescribing
 Dispensing Errors

 Dispensing errors include any inconsistencies or deviations from the

prescription order, such as dispensing:
 The incorrect drug, dose, dosage form
 Wrong quantity
 Inappropriate, incorrect, or inadequate labelling
 Confusing or inadequate directions for use
 Incorrect or inappropriate preparation, packaging, or storage of medication prior to
dispensing
Brand name Generic name

1. Combantrin Pyrantel pamoate

Combactin Dicyclomine + Pectin + Kaolin + Neomycin

2. Alcillin Ampicillin

Amicline Chloroquine + Diidohydoxyquinoline +

Metronidazole + Oxytetracycline

3. Flumed Fluconazole

Flumeg Fluoxetine

4. Mox Amoxycillin

Lox Lignocaine

5. Febex Ferrous fumarate + Folic acid + Vit B12

Febrex Paracetamol
 Problems

 Symptoms caused by incorrect medication can range from short-term dizziness

and sickness to very serious conditions requiring hospital admission, additional
medication and treatment

 The most serious medication incidents can lead to organ transplants and sadly
sometimes even death
Prescription
 Definition

 Prescription is defined as a physician’s written order to a pharmacist for

preparing and dispensing a medicine

 A medicolegal document
Parts of Prescription
 Four Main Parts

1. Superscription

2. Inscription

3. Subscription

4. Transcription
 Superscription

  Information about the prescriber (name, address and telephone number)

 Information about the patient (full name, address, gender, DOB, weight & height
if necessary)

 Rx symbol -It is an abbreviation of Latin term “Recipe”, meaning “to take” or

“take thou”
 Inscription

 Main part of the prescription

 It gives the information about the name of the drug (generic or trade name), its
formulation and unit dosage
 If more than one ingredient:
i. Basis- the principal active drug
ii. Adjuvants- other corrective drugs to assist the action of basis
iii. Correctives- make the formulation acceptable
iv. Emulsifying/ suspending agents- to make emulsion or suspension
v. Vehicle/ excipient/ base- the medium in which the active ingredients are distributed
 Vertical line in Inscription→ decimal line, denotes decimal point
 Used instead of decimal point so as to avoid mistakes in dispensing

 First letter of all the official names of drugs → in ‘capitals’

 Abbreviations and chemical formulae→ avoided

 Subscription

 Directions to the pharmacist as to:

 Mode of compounding

 Amount to be compounded

 Form of final medicament

 Division into doses, if required

 Transcription

 Directions to the patients regarding

 Method of administration
 Dose
 Time of administration
 Any other instructions

 Signature of the physician

 His registration number

Label
 Label

 Should be prepared by pharmacist

 Attached to the container
 Includes information about:
 Type of preparation e.g. mixture, lotion, ointment etc
 Special direction e.g. shake well before use, for external use only
 Name, age, gender and address of the patient
 Directions to the patient
 Signature of the pharmacist
 Date and address of dispensing pharmacy
 Order of medications

 If more than one dosage form given by different routes:

1. Injections

2. Oral preparations in this order

i. Capsules
ii. Tablets
iii. Liquids

3. Topical preparations
 Common Abbreviations

Abbreviation Full Latin Form English Meaning

o.d. Omnie die Once a day
b.i.d. Bis in die Twice a day
t.d.s. Ter die sumendum Thrice a day
q.i.d. Quarter in die Four times a day
Inj. Injectio Injection
p.p. Post prandial After meal
s.o.s. Si opus sit If needed
Stat Statim At once
Tab Tabella Tablet
Ung Ungentum Ointment
hs Hora Somni At bed time
Prescription pattern in
JJ Hospital
Maharashtra Model Prescription Format
Steps to avoid errors
 If loose drugs are dispensed

 Only one medicine dispensed in one packet

 Packet labelled with:

 Patient’s name
 Dose
 Quantity
 Expiry date/date of dispensing

 Instructions in local language

 Points to be aware of

1. Official non-proprietary name followed by recognised abbreviations → printed

in more conspicuous manner than trade name

2. Net contents of all active ingredients

3. Name and address of manufacturer

4. Distinctive batch number; with manufacturer and date of expiry of potency

5. Alcoholic contents if more than 3%

6. Schedule G, H and X drugs. Labels of these drugs should have a conspicuous at
least 1 mm thick line on left side

7. Symbol- R for schedule H drugs

- N R in red for narcotic drugs

- X R for schedule X drugs

8. Expiry date is applicable provided the drug is stored under specified conditions

9. Store in ‘cool place’ means between 10-20° C

10. Store in ‘cold place’ means at temperature not exceeding 8° C

 It should be confirmed that the prescription is correct and complete

 A prescriber or pharmacist must be aware of look-alike, sound alike drugs

 Extra care should be given with zeros and abbreviations

 All prescriptions should be checked thoroughly

 Thorough patient counselling should be provided

Summary
 Prescription is a medicolegal document

 All precautions should be taken to give a rational prescription to the patient

 Directions of use should be explained to the patient in detail and any doubts of
the patient should be clarified

 A proper well written prescription can go a long way in reducing health hazards
to the patient