Prescription: definition, parts and handling

1. Prescription
Mahendra Patel
Associate Professor
Sri Aurobindo Institute of Pharmacy, Indore

2. prescription
 A prescription contains handwritten instructions for the dispensing and
administering of medications.
 It can be more than an order for drugs as it can also include instructions for the
patient, nurse, pharmacist or a lab technician for orders for lab tests, X-rays, and
other assessments.
 A pharmacist must take reasonable steps to ensure that the dispensing of a
medicine in accordance with a prescription is consistent with the safety of the
person.

4. Prescriptions have following sections:
• The heading with the date and the patient’s name, address, age, etc.
•Superscription (Symbol Rx) - the Rx stands for "recipe" which in Latin means "you take"
•Inscription - the information about the medication. It has the name of the ingredients and the
amount needed. It includes the main ingredient, anything that helps in the action of the drug,
something to modify the effects of the main drug, and the "vehicle" which makes the medicine
more pleasant to take.
•Subscription - The subscription section tells the pharmacist how to dispense the drug. This will
have instructions on compounding the drug and the amount needed.
•Signatura - The signatura has the directions that are to be printed on the medicine. The word
"sig" means "write on label."

5.  In dispensing a prescription, a pharmacist has to exercise an independent
judgment to ensure the medicine is safe and appropriate for the patient, as well as
that it conforms to the prescriber’s requirements. If there is any doubt, the
prescriber is to be contacted.
 In conforming to the above principle, dose, frequency and route of
administration, duration of treatment, the presence or absence of other
medicines, the patient’s illness, medication history, and other relevant
circumstances need to be taken into account.

6. Handling of Prescription
 The following procedure should be adopted by the pharmacist while handling the
prescription for compounding and dispensing.
1. Receiving
2. Reading and Checking
3. Collecting and weighing the materials
4. Compounding, labelling and packging

7. Care required in dispensing Prescription
 Always keep the prescription in hand while taking out the medicine from the self.
 Always check the dispensing balance before weighing the ingredients which are
required during dispensing,
 Replace containers of stock preparation or drugs in their proper position after
use.
 Keep the label in proper position during weighing solid ingredients especially
the potent drugs such as morphine HCl to serve as a constant reminder that the
correct drug is being used.

8. Care required in dispensing Prescription……………
 When pouring or measuring the ingredients, keep the label upward in order to prevent surplus
liquid running down of the bottle and staining the label.
 Care should be taken to keep the dispensing balance clean. The powder should be transferred
from the stock container by using a clean spatula.
 Medicines which are used externally such as lotions, liniments etc. should be supplied in
vertically fluted or ribbed bottles in order to distinguish it by touch. They must be labelled in red
or against a red background.
FOR EXETERNAL USE ONLY

9. Sources of Error in Prescription:
 Lack of Concentration
 One of the chief causes of error in dispensing. The work should not be carried out while
engaged in a conversation or when the mind is struggling with other problems. Ones whole
attention must be given to the dispensing operation in hand, no matter how simple.
 Checking
 The name on the container of the substance being weighed or measured should be checked
when the container is removed from and when it is returned to the self..
 Failure deliberately to check calculations of quantities to be weighed are measured is a serious
dispensing mistake.

10.  Labelling Error
 The label should always be written before the dispensing is done and carefully
checked before affixing.
 Weighing Error
 Weights should be checked when removing them from the box and when returning
them after the weighing has been completed.
 Arithmetic Slips
 Only careful concentration, and the realisation that even the simplest operation
requires ones whole attention, will avoid such errors.

11.  Abbreviation:
 They presents a problem in understanding parts of the prescription order.
Pharmacist should not guess at the meaning of an ambiguous abbreviation e.g. to
dispense Achromycin for “Achro” may cause difficulty when the intension of the
prescriber is to dispense Acrostatin.
 Names of the drug:
 There are certain drugs whose name look or sound like of those of other drugs.

12. Some of the examples of such drugs are as under
• Indosin
• Prednisone
• Digoxin
• Doridon
• Pabalate
• Ananase
• Lincocin
• Prednisolone
• Digitoxin
• Doxidan
• Robalate
• Orinase

13.  Strength of the preparation:
 The strength of the preparation should be stated by the prescriber. Ex. It will be
wrong decision on the part of a pharmacist to dispense paracetamol tablet 500mg
when prescription for paracetamol tablet is received with no specific strength.
 Doses form of the drug prescribed:
 Many medicines are available in more than one dosage form e.g. liquid, tablet,
capsule, and suppository. The pharmaceutical form of the product should be written
on the prescription.

14.  Dose:
 Unusually high or low doses should be discussed with the prescriber. Pediatric dosage
may present a problem. So pharmacist should consult pediatric posology to avoid any
error. Care should be taken in the case of sustain release dosage form.
 Instructions for the patient:
 The instruction for the patient which are given in the prescription are omitted when
incomplete. The quantity of the drug to be taken, the frequency and timing of
administration, and route of administration should be clearly given in the prescription
so as to avoid any confusion.

15.  Incompatibilities:
 It is essential to check that there are no pharmaceutical or therapeutic
incompatibilities in a prescribed preparation.
Certain antibiotics should not be given with meals since it significantly decrease
the absorption of the drug.

16. Latin Terms and Abbreviations
Quantities of Ingredients
 Quantum Sufficiat (or Sufficit) (q.s.) – As much as is sufficient
 Ad – Up to , Sufficient to produce
 Ana (aa) – Of each

17. Remedies/ Preparations
 Auristillae (auristill) – Ear Drops
 Capsula (caps.) – A Capsule
 Charta (chart.) – A Powder
 Collunarium (collun.) – A nose wash
 Collutorium (collut.) – A mouth wash
 Cremor (crem.) – A Cream
 Emulsio (emul.) – An emulsion
 Gargarisma (garg.) – A gargle
 Gelatina (gelat.) – A jelly
 Guttae (gtt.) – Drops

18. Remedies…………….
 Haustus (ht.) – A draught
 Injectis (inj.) – An injection
 Liquor (liq.) – A solution
 Lotio (lot.) – A lotion
 Mistura (m., mist.) – A mixture
 Naristillae (narist.) – Nasal Drops
 Nebula (neb.) – A spray solution
 Pasta (past.) – A paste
 Pigmentum (pigm.) – A paint (like throat paints)

19. Remedies…………….
 Pilula (pil.) – A pill
 Pulvis (pulv.) – A powder
 Tabella (tab.) – A tablet
 Trochiscus (troch.) – A lozenge
 Unguentum (ung.) – An ointment
 Vapor (vap.) – An inhalation

20. Instructions Relating to Preparation
 Adde, Addatur (add.) – Let (it) be added or simply add
 Calefac, Calefiat (calef.) – Let (it) be warmed or warm it
 Dividatur – Be divided
 Dividatur in partes aequales (div. in pt. aeq.) – Divide into equal parts
 Fiat (ft.) – Let (it) be made; make it
 Fiant (ft.) – Let them be made; make them
 Misce. Misceatur (m.) – Mix it
 Misce secundum (m.s.a.) – Mix Pharmaceutically
 Solve – Dissolve
 Infricetur (infric.) – Let (it) be rubbed in

21. Instructions Relating to Preparation
 Instillandus (instilland.) – To be dropped in
 Miscendus (miscend.) – To be mixed
 Signa (sig.) – Label
 Sumendus (s. or sum.) – To be taken
 Ut antea (u.a.) – As before
 Utendus (u. or utend.) – To be used

22. Dosage
• Ad libitum (ad. Lib.) – As much as you please
• Dimidium (dimid.) – Half
• Dosis (dos.) – A dose
• Guttatim (guttatim) – Drop by drop
• Mensura (mens.) – By measure
• Pro (pro) – For; on behalf of
• Pro dosi – As a dose
• Reliquum (reliq.) – The remainder

23. Qty. to be sent and manner of sending
 Duplum – Twice the quantity
 In phiala - In a bottle
 Mitte (mitt.) – Send
 Phiala prius agitata (p.p.a) – Shake the bottle first
 Quantitas duplex (qt. dx.) – Twice the qty.
 Talis, Tales, Talia (tal.) - Such

24. Time of administration/application
• Semel in die. (sem in die) – Once a day
• Bis in die. (b.i.d or b.d.) – Twice a day
• Ter in die. (t.i.d or t.d.) – Thrice a day
• Quarter in die. (q.i.d or q.d.) – Four times a day
• Vel – Or
• Bis terve in die (b.t.i.d.) – Two or three times a day
• Ter quaterve die (t.q.d.) – Three or four times a day
• Quotidie (quot.) – Daily
• Vices (vic) – Time
• Ad tres vices (ad 3 vic) – For three times

25. Parts of the Day
• Primo mane (prim. m) – Early in the morning
• Mane (m.) – in the morning
• Omni mane (o.m.) – Every morning
• Jentaculum (jentac.) – Breakfast
• Meridie – Noon
• Prandium (prand.) – Dinner
• Vespere (vesp.) – Evening
• Nocte (n.) – Night
• Inter noctem (inter noct.) – During the night

26. Parts of the Day……….
 Hora decubitus (h.d) or Hora somni (h.s.) – At bedtime
 Hac nocte (hac noct.) – To-night
 Cras vespere (cras vesp.) – Tomorrow morning
 Mane sequenti (m.seq.) – The following morning

27. Correlated time & Other Terms
• Ante cibos. or Ante cibum (a.c.) – Before meals or food
• Post cibos or Post cibum (p.c.) – After meals or food
• Inter cibos or Inter cibum (i.c.) – Between meals or food
• Dolore urgente – When the pain is severe
• Frequenter – Frequently
• Lente – Slowly
• Si opus sit (s.o.s.) – when required or when necessary
• More dicto or Modo dicto (m.d.) – As directed
• Pro re nata (p.r.n) – Ocassionally

28. Correlated time & Other Terms………
• Quoties opus sit (quot.o.s.) – As often as necessary
• Saepe – Often
• Statim (stat.) – Immediately; at once
• Tussi urgente (tuss. Urg) – When cough is troublesome

29. Parts of the body
 Auris dexter (a.d.) - To right ear
 Auris laevus (a.l.) - To left ear
 Oculis dexter (o.d.) - To right eye
 Oculis laevus (o.l.) - To left eye
 Brachis (brach.)- To the mouth
 Jugulo (jug.)- To the throat
 Naso – To the nose
 Os, oris (o.s.)- To mouth
 Pro oculus (pro. Ocul.)- For the eyes
 Sterno (stern.)- To the chest

30. General Dispensing Procedures and Labelling
 Dispensing means to prepare and supply of a medicine to an individual in accordance with the
prescription of a practitioner.
 Always wear a white overall coat. It helps to protect the clothes and reduces contamination of
dispensed products with fibers and other foreign particles.
 Keep a duster, clean glass-cloth and sponge in your drawer.
Glass cloth-------- Polishing containers
Duster-------------- wiping of bench
Sponge------------- Cleaning the surface of the balance

31. General Dispensing Procedures………………
 Work in a clean and tidy manner. Do not accumulate stock bottles and used equipment in the
working area, in order to reduce the risk of errors and contamination.
 Read the prescription carefully. Make sure that it is legally correct and there is no doubt in
understanding it.
 Consult the pharmacopoeia or any other reference book, in case there is a need to find the
formula of the preparation.
 Check the dosage of prescriptions which are meant for internal use.
 Check that there is no incompatibility in the preparation.
 Consult the official book or reference book to find the storage conditions for the preparation
or medicaments. This information will determine the choice of container and label.

32. General Dispensing Procedures………………
Work out the calculations.
Check the calculations.
 Collect the correct container and closure.
 Prepare the label as per requirement of the container.
 Make the preparation, transfer to it into the container and polish it.
 Fix the label to the container.
 Check the finished preparation.
 Wrap the container. Write the name and address of the patient on the wrapper.
 Maintain the record of the preparation which is dispensed.

33. Preparation of labels for dispensed medicines
 The label on the dispensed medicines should provide the following information:-
1. Name and address of the patient:
This is done to minimise confusion with other members of the same family with similar
medicines.
2. Name and address of the supplier and date of supply:
The name and address of the pharmacy where the drug is dispensed.
3. Precise details regarding contents of the container when dispensed:
 The name of the medicine

34. Preparation of labels for dispensed medicines……………..
 The strength of the medicine
 The quantity in the container
4. Storage conditions and self life of the products:
 Temperature: Suppositories below 150
Immunological products and insulin injections b/w 20 - 80
 Humidity: For solid dosage form and powders
 Light: light sensitive products stored in amber colored containers.
5. Instruction to the patients:
 Directions: These includes the quantity to be taken or the amount to be used, frequency and
timing of administration or application and the route of administration.

35. Preparation of labels for dispensed medicines……………..
 Shake the bottle before use: Emulsion, Suspension and Aerosols.
 Take with water: Mixtures which can cause gastro-intestinal irritation.
Mixtures for adult patient having a dose of 10 ml.

36. Cautionary and advisory labels
1. For external use only: ointment, creams, pastes and dusting powder.
2. Not to be taken: used for the preparation that are neither administered by mouth nor used on
the skin.
“ For nasal use only or For rectal use only”
3. Drowsiness warning: used for the medicine which causes drowsiness, dizziness, or blurred
vision. The following wording may be written on the label.
Warning: May cause drowsiness. If affected, do not drive or operate
machinery, avoid alcoholic drink.

37. Cautionary and advisory labels
4. Potential interactions with food or drink:
 Drugs in which absorption is improved if taken before food.
 Drugs which causes gastro-intestinal irritaion or are absorbed with the food.
Warning: To be taken an hour before food or an empty stomach.
Warning: To be taken with or after food.

38. Cautionary and advisory labels………..
 Drugs such as antibiotics where the absorption is significantly decreased by the presence of
food and acid in the stomach.
5. Potential interactions with other medicines:
 Drugs which chelate with calsium, magnesium, and iron and are not well absorbed in the
presence of these ions.
Do not take milk, iron preparation with this medicines.
Warning: To be taken an hour before food or an empty stomach.

39. Cautionary and advisory labels………..
6. Special method of administration:
 The drugs formulation which is required to be dissolved in the mouth.
 The drugs which are to be absorbed through the sublingual mucosa.
 The drugs which are soluble in water or for powders or granules to be dispersed in water
before taking.
To be sucked or chewed.
To be dissolved under the tongue.
Dissolve or mix with water before taking

40. Cautionary and advisory labels………..
 The drugs which are to be used for enteric coated, sustained release or having unpleasant
taste.
Cautions in use:
 The preparation which may induce photosensitization.
 The preparation which contains a high proportion of flammable solvent.
To be swallowed whole, not to be chewed.
Avoid exposure of skin to direct sunlight.
Keep away from naked flames.

41. Special labelling instructions for particular type of dispensed dosage forms.
 Aerosol inhalations:
 Applications:
Pressurised container, keep away from heat source.
Shake before use
Do not exceed the prescribed dose.
Follow the instructions
For external use only.

42. Special labelling instructions for particular type of dispensed dosage forms.
 Capsules:
 Cream:
 Dusting powders:
Swallow with a drought water
Store in a cool place.
For external use only.
For external use only.
Not to be applied to open wound or to raw or weeping surfaces.

43. Special labelling instructions for particular type of dispensed dosage forms.
 Ear drops:
 Emulsion:
 Enemas:
Store in a cool place.
For external use only.
For rectal use only.
Warm to the body temperature before use.
Shake the bottle before use.

44. Special labelling instructions for particular type of dispensed dosage forms.
 Eye drops:
 Eye lotions:
 Gargles and mouth washes:
To be used within 30 days after first opening
Not to be swallowed in large amounts.
To be used within 24 hours after first opening

45. Special labelling instructions for particular type of dispensed dosage forms.
 Liniments and lotions:
 Mixtures:
For external use only.
Shake the bottle before use.
Do not apply on broken skin.
To be taken after diluting with water.
Shake the bottle before use.

46. Special labelling instructions for particular type of dispensed dosage forms.
 Nasal drops:
 Ointments:
 Pastes:
 Pessaries:
For nasal use only.
For external use only.
For external use only.
For vaginal use only.
Store in cool place.

47. Special labelling instructions for particular type of dispensed dosage forms.
 Solutions:
 Suppositories:
 Tablets:
• For soluble or dispersible tablets
For nasal use only.
For rectal use only.
Dissolved or dispersed in water before taking.
Store in cool place.

48. Special labelling instructions for particular type of dispensed dosage forms.
 Tablets:
• For chewable tablets
• For sustained release, enteric-coated or unpleasant tasting tablets
Chew before swallowing.
Do not crush or chew.

49. Thanks