PRESCRIPTION

 Prescription:

Definition: Prescription is a written order from a registered medical practitioner  or other licensed practitioners, such as dentist, veterinarian etc to a registered pharmacist to compound and dispense a specific medication for the patient.

Types of prescription:

1.Compounded prescription: 

These precriptions are also known as formula magistralis, Each required drugs in the prescription is written on a separate line in a sequence.

Ingredients in the prescription are written in the following pattern.

i) Basis: This includes the principal drug which gives its primary action to the prescription.

ii) Adjuvant: This includes the substance which helps in increasing the action of main ingredient.

iii) Vehicle: This is used as a solvent in the solution in order to increase the size and volume or dilute the mixture.

2.Non compounded Prescription:

These prescriptions are also called formula officinalis. It is a pre-compounded order comprising of either a single drug or a mixture of drugs provided by a pharmaceutical company by its official name.

Parts of prescription:

1.Date: Date is essential for a pharmacist to identify the cases. It is mandatory for a prescriber to mention date on the prescription for narcotic or other habit-forming drugs.

2. Name ,age ,Sex and address of the patient: Name, age , sex and address of the patient must be written in the prescription because it serves to identify the prescription. Age and Sex of the patient especially in case of children , help the pharmacist to check the prescribed dose of medication.

3. Superscription: It is represented by a symbol Rx which is written before written the prescription. Rx is an abbreviation of the Latin word recipe, meaning " You take" . This symbol was considered to be originated from sign of Jupiter. God of healing.

4. Inscription: This is the main part of the prescription contains the names and quantities of the prescribed ingredients. it is devided into 3 parts 

i) Base: The active medicaments which are intended to produce the therapeutic effect.

ii) Adjuvant: This includes the substance which helps in increasing the action of main ingredient.

iii) Vehicle: It is included in the prescription either to dissolve the solid ingredients or to increase the volume of preparation.

5. Subscription:This comprises direction to the pharmacist for preparing the prescription and  number of doses to be dispensed.

6. Signatura: This consists of the direction to be given to the patient regarding the adminstration of the drug.

The instruction may include the following

a) The quantity to be taken.

b) The frequency of administration or application.

c)The mode of administration .

d)The special instructions such as dilution direction.

7. Renewal instructions: The prescriber indicate on every prescription order , whether it may be renewed and if so how many times It is very important particularly in the prescription containing the narcotic and other habit forming drug.

8. Signature, address and registration number of the prescriber: The prescription must bear the signature of the prescriber along with its registration number and address.

Handling of Prescription:

1.Receiving

2.Reading and checking

3.Collecting and weighing the material

4.Compounding, labelling and packaging

Receiving:

       The prescription should be received from the patient by the pharmacist himself. While receiving a prescription pharmacist should not change his facial expression which gives ann impression to the patient that he is surprised or confused.

Reading and Checking:

 i. On receiving a prescription , always check it that it is written in a proper format i.e doctor's pad  or OPD slip of the hospital and signed by the prescriber along with date.

ii. A prescription should be screened behind the counter in case of any issue  or doubt the pharmacist should consult the other pharmacist or the prescriber. Pharmacist should never guess about the meaning of any confused word

 Collecting and weighing the material:

     Before compounding the prescription , all the material required for it should be collected on the left hand side of the balance, while compounding, the lebel of every stock bottle should be read three times in order to avoid any error.

Compounding , labelling and packaging:

      

       Compounding should be carried out in a neat place . All the equipment required should be thoroughly cleaned and dried. Only one prescription should be compounded at one time .The filled containers are suitably labelled. All the ingredients should be compounded according to the directions of the prescriber . The compounded medicament should be filled in a suitable container.

While delivering prescription to the patient ,the pharmacist should explain the mood of administration, direction for use and storage.

Sources of Error in Prescription:

1. Abbreviation: Abbreviation presents a problem in understanding parts of the prescription order.  Pharmacist should not guess at the meaning of an ambiguous abbreviation.

example: To dispense Achromycin for "Achro" may cause difficulty when the intention of the prescriber is to dispense Achrostatin.

2. Name of the drug: There are certain drugs whose name look or sound like those of other drugs,

then it may cause confusion .

example: Digitoxin               Digoxin

                

                 Indocin                  Lincocin

                 Dridon                   Doxidon

3.Strength of the preparation: It is essential when various strengths of a product are available in the market.

example: It will be a worng decision on the part of a pharmacist to dispense paracetamol tablet 500 mg when prescription for paracetamol tablet is received with no specific strength.

4. Dosage form of the drug prescribed: Many medicines are available more than one dosage form e.g liquid, tablet, capsule and suppository . The pharmaceutical form of the product should be written on the prescription in order to avoid error.

5. Dose: Unusually high or low doses should be discussed with the prescriber . Paediatric dosage may present a problem so pharmacist should consult paediatric posology to avoid error.

 

6. Instructions for the patient: Instructions for the patient which are given in the prescription are incomplete or omitted . The quantity of the drug to be taken , the frequency and timing of administration , and rout of administration should be clearly given in the prescription.

7. Incompatibilities: It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in a prescribed preparation and that different medicines prescribed for the same patient do not interact with each other to produce any harm to the patient.