Prescription

1. Prescription
Presented by
Miss Sudipta Roy
Associate Professor
East Point College of Pharmacy Bangalore India

2. • A prescription is a written or electronic order
from a qualified healthcare professional,
typically a licensed physician or other
authorized prescriber, to a pharmacist or other
appropriate healthcare provider. This document
contains specific instructions regarding the
medications, dosages, administration routes,
frequency, and duration of treatment for a
patient. Prescriptions are a legal and essential
component of the healthcare system, ensuring
that medications are dispensed safely and
appropriately in accordance with a healthcare
professional's assessment of a patient's
medical condition.

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A prescription typically consists of several key
components, providing specific instructions for the
dispensing and administration of medication. Here
are the main parts of a prescription:
Superscription:
This part includes the symbol "Rx," which stands for
the Latin word "recipe," meaning "take" or "to take."
It is often written at the top of the prescription,
indicating that it is a medical order.
Inscription:
The main body of the prescription is the inscription,
where the specific name and dosage of the
medication are written. This section also includes
the strength of the medication.

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Subscription:
This part specifies the form of the medication, such as
tablets, capsules, liquid, or injectable, as well as the quantity
to be dispensed. It also includes directions for the
pharmacist on how to prepare the medication.
Signatura (Sig):
The signatura, often abbreviated as "Sig," contains the
directions for the patient on how to take the medication. This
includes details on dosage, frequency, duration, and any
specific instructions, such as whether to take the medication
with food.
Physician's Signature:
The prescribing healthcare professional signs the
prescription to validate and authorize the order. The
signature may be handwritten or, in electronic prescriptions,
may be a secure electronic signature.

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Dispensing Date:
The date on which the prescription is issued is important for
tracking the timing of the medication order. In some cases,
there may also be a specified start date for taking the
medication.
Patient Information:
The prescription includes essential details about the patient,
such as their name, age, weight (if relevant to dosing), and
any other relevant patient-specific information.
Prescriber Information:
The prescribing healthcare professional's information is
included, providing details such as their name, credentials,
contact information, and sometimes their DEA (Drug
Enforcement Administration) registration number for
controlled substances.

6. • It's crucial for patients to follow the instructions
on the prescription accurately and to
communicate with their healthcare provider or
pharmacist if they have any questions or
concerns. Additionally, healthcare
professionals need to ensure that prescriptions
are clear, accurate, and in compliance with
legal and ethical standards.

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The eligibility to write prescriptions is typically
regulated by healthcare licensing boards and varies
based on the country or region. In the United States,
for example, the following healthcare professionals
are commonly eligible to write prescriptions:
Physicians (Doctors of Medicine or Doctors of
Osteopathic Medicine):
Medical doctors (MDs) and doctors of osteopathic
medicine (DOs) have the authority to write
prescriptions for a wide range of medications and
treatments.
Dentists:
Dentists are authorized to prescribe medications
related to dental procedures and oral health.

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Veterinarians:
Veterinarians have the authority to write prescriptions
for medications for animals.
Nurse Practitioners (NPs):
In many states, nurse practitioners have prescriptive
authority, allowing them to write prescriptions for
certain medications. However, the scope of their
prescribing authority may be regulated by state laws
and may require collaboration or supervision by a
physician.
Physician Assistants (PAs):
Physician assistants may have prescriptive authority,
often under the supervision of a physician. The
specific regulations vary by state.

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Optometrists:
Optometrists can prescribe medications related to eye care
in some jurisdictions.
Podiatrists:
Podiatrists have prescribing authority for medications related
to foot and ankle conditions.
It's important to note that the specific drugs and treatments
that each professional can prescribe, as well as any
limitations on their prescribing authority, are determined by
laws and regulations at the state or country level. Additionally,
regulations may differ internationally, and in some countries,
other healthcare professionals may also have prescription-
writing authority.
Healthcare professionals must adhere to ethical and legal
standards when prescribing medications, ensuring patient
safety and appropriate medical care.

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Prescription handling involves various steps to ensure
the safe and effective administration of medications.
Here's an overview of the process:
Patient Assessment:
The healthcare provider assesses the patient's medical
history, current health status, and any existing
medications to determine the appropriate treatment.
Prescription Writing:
The healthcare provider writes a prescription, including
details such as the patient's name, medication name,
dosage, frequency, route of administration, and any
specific instructions. The prescription is signed or
electronically authenticated by the provider.

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Patient Education:
The healthcare provider educates the patient about the
prescribed medication, including its purpose, potential
side effects, and proper administration. Clear
communication is essential for patient understanding
and adherence.
Transmission of Prescription:
The prescription is transmitted to the pharmacy by the
healthcare provider. This can be done electronically or
through a physical prescription.
Pharmacy Verification:
Pharmacists review the prescription to ensure it is
complete, accurate, and legible. They may contact the
healthcare provider if clarification or additional
information is needed.

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Dispensing Medication:
Pharmacists dispense the prescribed medication,
providing the correct dosage and quantity. They may
also counsel the patient on how to take the medication,
potential side effects, and any necessary precautions.
Patient Pick-Up:
The patient picks up the medication from the pharmacy.
Pharmacists may offer additional counseling and
answer any questions the patient may have.
Insurance Processing:
Pharmacies often process insurance information to
determine coverage and copayments. This step
ensures that patients have access to their prescribed
medications.

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Record Keeping:
Both the healthcare provider and the pharmacy maintain
detailed records of the prescription. This includes the original
prescription, any communications between the provider and
pharmacy, and information on dispensing.
Follow-Up and Monitoring:
Healthcare providers may schedule follow-up appointments
to monitor the patient's response to the medication, adjust
the treatment plan if necessary, and address any concerns or
side effects.
Adherence Monitoring:
Pharmacists and healthcare providers may monitor patient
adherence to the prescribed medication regimen. This
involves assessing whether patients are taking medications
as instructed and addressing any barriers to adherence.

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Reporting Adverse Events:
Healthcare providers and pharmacists play a
crucial role in reporting any adverse reactions or
events associated with the prescribed
medications to the relevant health authorities.
Effective prescription handling involves
collaboration between healthcare providers,
pharmacists, and patients to ensure accurate,
safe, and optimal medication use.
Communication, education, and regular
monitoring are key components of this process.

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Prescription labeling is a crucial aspect of
medication safety, providing essential
information to patients and healthcare
professionals. Here are the key components
typically included in prescription labels:
Patient Information:
The prescription label includes the patient's
name to ensure that the medication is intended
for the correct individual.

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Prescriber Information:
This section provides details about the
healthcare provider who prescribed the
medication, including their name, title, and
contact information.
Pharmacy Information:
The label includes details about the dispensing
pharmacy, such as its name, address, and
contact information.

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Prescription Number:
A unique identification number assigned to the
prescription helps in tracking and record-keeping.
Date of Dispensing:
The date when the medication was dispensed by
the pharmacy is recorded on the label.
Drug Name:
The generic and/or brand name of the
medication is clearly stated to avoid confusion.

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Dosage Strength:
The concentration or strength of the
medication per unit (e.g., per tablet or milliliter)
is specified.
Dosage Instructions:
Clear and concise instructions on how the
medication should be taken, including dosage,
frequency, and any specific administration
guidelines (e.g., with or without food).
Route of Administration:
Information on how the medication should be
administered, such as orally, topically, or by
injection.

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Quantity Dispensed:
The total quantity of medication dispensed to the patient is
indicated on the label.
Refill Information:
If applicable, the label provides details about whether the
prescription can be refilled and the number of authorized
refills.
Expiration Date:
The expiration date indicates the date until which the
medication is expected to remain effective and safe for use.
Storage Instructions:
Recommendations on how the medication should be stored
to maintain its stability and effectiveness (e.g., store at room
temperature, refrigerate).

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Special Instructions or Warnings:
Any specific precautions, warnings, or special
instructions related to the medication are highlighted.
This may include information about potential side
effects or interactions.
Patient Instructions:
Additional information provided to the patient, such as
how to deal with missed doses, potential side effects,
and when to seek medical attention.
Prescription labeling is designed to facilitate safe and
accurate medication use, helping patients understand
how to take their medications correctly and providing
important information for healthcare professionals and
pharmacists. Clear, legible, and comprehensive labeling
is essential to promote patient safety and adherence.

21. Dispensing label
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A dispensing label is a label affixed to a
medication container or packaging by a
pharmacy when dispensing a prescription. The
dispensing label provides important
information about the medication, instructions
for use, and other relevant details. Here are the
key components commonly found on a
dispensing label:
Patient Information:
The patient's name is prominently displayed to
ensure the medication is intended for the
correct individual.

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Prescriber Information:
Details about the healthcare provider who
prescribed the medication, including their
name, title, and contact information.
Pharmacy Information:
The label includes details about the dispensing
pharmacy, such as its name, address, and
contact information.
Prescription Number:
A unique identification number assigned to the
prescription for tracking and record-keeping
purposes.

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Date of Dispensing:
The date when the medication was dispensed by the
pharmacy is recorded on the label.
Drug Name:
The generic and/or brand name of the medication is
clearly stated to avoid confusion.
Dosage Strength:
The concentration or strength of the medication per
unit (e.g., per tablet or milliliter) is specified.
Dosage Instructions:
Clear and concise instructions on how the medication
should be taken, including dosage, frequency, and any
specific administration guidelines (e.g., with or without
food).

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Route of Administration:
Information on how the medication should be
administered, such as orally, topically, or by injection.
Quantity Dispensed:
The total quantity of medication dispensed to the
patient is indicated on the label.
Refill Information:
If applicable, the label provides details about whether
the prescription can be refilled and the number of
authorized refills.
Expiration Date:
The expiration date indicates the date until which the
medication is expected to remain effective and safe
for use.

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Storage Instructions:
Recommendations on how the medication should be stored to
maintain its stability and effectiveness (e.g., store at room
temperature, refrigerate).
Special Instructions or Warnings:
Any specific precautions, warnings, or special instructions
related to the medication are highlighted. This may include
information about potential side effects or interactions.
Manufacturer Information:
The label may include details about the manufacturer or
distributor of the medication.
Dispensing labels are essential for patient safety, providing
clear and accurate information to ensure that individuals take
their medications as prescribed. These labels help prevent
medication errors, enhance adherence, and facilitate
communication between healthcare providers, pharmacists,
and patients.

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The process of filling a prescription involves several
steps to ensure accurate dispensing of medication to
the patient. Here's an overview of the typical steps
involved in filling a prescription:
Prescription Reception:
The pharmacy receives the prescription from the
patient, either as a physical written prescription, a fax,
an electronically transmitted prescription, or a verbal
prescription (in compliance with local regulations).
Patient Information Verification:
The pharmacy staff verifies the patient's identity and
checks the accuracy of the information on the
prescription, including the patient's name, date of
birth, and any other relevant details.

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Prescription Review:
The pharmacist reviews the prescription to ensure it is
complete, accurate, and complies with legal and ethical
standards. They may contact the prescriber for clarification
or additional information if needed.
Medication Selection:
The pharmacist selects the appropriate medication, ensuring
that it matches the prescription, and checks for any potential
drug interactions with the patient's other medications.
Labeling:
A dispensing label is generated, containing essential
information such as the patient's name, medication name,
dosage instructions, and any warnings or special instructions.
The label is affixed to the medication container.

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Counting or Measuring:
The pharmacist or pharmacy technician counts or
measures the prescribed quantity of medication to be
dispensed, ensuring accuracy.
Product Check:
A final check is performed to verify that the dispensed
medication matches the prescription details, including
the correct drug, dosage strength, and form.
Counseling:
The pharmacist may provide counseling to the patient,
offering information on how to take the medication,
potential side effects, and any precautions. This is
particularly important for new prescriptions or
medications with complex regimens.

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Insurance Processing:
If applicable, the pharmacy processes the patient's
insurance information to determine coverage and
copayments. This step ensures that patients have
access to their prescribed medications.
Patient Pick-Up:
The patient picks up the dispensed medication from
the pharmacy. Pharmacists may offer additional
counseling and answer any questions the patient may
have.
Documentation:
The pharmacy maintains accurate records of the filled
prescription, including details such as the dispensing
date, quantity dispensed, and any relevant patient or
prescriber communication.

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Refill Authorization:
If the prescription includes refills, the pharmacy may
document and communicate with the prescriber to
obtain authorization for subsequent refills.
Communication with Prescriber:
In case of any issues or concerns related to the
prescription, the pharmacist may communicate with
the prescriber for clarification or guidance.
Filling a prescription involves a combination of
technical expertise, attention to detail, and effective
communication between healthcare providers and
pharmacists to ensure patient safety and adherence to
treatment plans. The process also adheres to legal and
regulatory standards governing prescription dispensing.

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To avoid confusion in interpreting prescriptions,
standardized units of measurement and clear,
unambiguous language are crucial. Here are some key
conversion strategies and practices:
Use of Standardized Units:
Ensure that all measurements are in standardized units
of measurement, such as milligrams (mg), micrograms
(mcg), milliliters (mL), and liters (L). Avoid using
abbreviations that may be misinterpreted (e.g., writ
e "micrograms" instead of "μg").
Avoid Ambiguous Abbreviations:
Eliminate or limit the use of abbreviations that may be
misread or misunderstood. For example, "U" for units
can be misinterpreted as "0" or "4," leading to a dosage
error.

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Spell Out Numbers:
Write out numbers instead of using numerals to
minimize the risk of misinterpretation. For example,
write "five milligrams" instead of "5 mg."
Include Leading Zeros:
Include leading zeros for decimal points to prevent
misinterpretation. For example, write "0.5 mg"
instead of ".5 mg."
Use Tall Man Lettering:
Employ Tall Man lettering for drugs with similar
names to highlight the differences. For instance,
writing "hydrOXYzine" and "hydrALAZINE"
emphasizes the dissimilarities.

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Clarify Frequency and Duration:
Clearly specify the frequency and duration of
medication administration. Avoid using ambiguous
terms like "as needed" without clear instructions.
Provide Clear Instructions:
Use explicit language when providing instructions for
medication administration. For example, instead of
writing "take daily," specify the time of day and any
specific instructions (e.g., "take one tablet every
morning with food").
Check for Look-Alike, Sound-Alike Medications:
Be vigilant for medications with similar names that
could be easily confused. Include both the brand and
generic names on the prescription to reduce the risk of
errors.

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Avoid Trailing Zeros:
Omit trailing zeros after decimal points to prevent
misinterpretation. For example, write "2 mg"
instead of "2.0 mg."
Electronic Prescribing Systems:
Utilize electronic prescribing systems that offer
standardized formats, automatic checks for
potential errors, and clear displays of information.
Clearly Indicate Concentrations:
Clearly indicate concentrations for liquid
medications to avoid dosage errors. For example,
specify "amoxicillin 250 mg/5 mL" instead o
f "amoxicillin 5 mL."

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Use a Decimal Point for Doses Less Than One:
Use a leading zero before the decimal point for doses less
than one. For example, write "0.5 mL" instead of ".5 mL."
Include Indications for Use:
If appropriate, include indications for use on the prescription
to reinforce the intended purpose of the medication.
Double-Check Handwritten Prescriptions:
If prescriptions are handwritten, ensure legibility and double-
check for any potential errors before dispensing.
Clear communication and attention to detail in prescription
writing and interpretation are essential for patient safety.
Implementing these practices helps reduce the risk of errors
and enhances the accuracy of medication administration.

36. • While there are many standard and widely
accepted abbreviations in medical practice, it's
important to note that the use of abbreviations
in prescriptions can lead to misinterpretation
and errors. In fact, many healthcare
organizations and regulatory bodies encourage
the avoidance of certain abbreviations to
enhance patient safety. Here are some
common prescription abbreviations, but it's
crucial to exercise caution and adhere to
guidelines to prevent confusion:

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AC:
Before meals (ante cibum)
PC:
After meals (post cibum)
QD:
Once a day (quaque die)
BID:
Twice a day (bis in die)
TID:
Three times a day (ter in die)
QID:
Four times a day (quater in die)
QHS:
At bedtime (quaque hora somni)

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PRN:
As needed (pro re nata)
UD:
As directed (ut dictum)
PO:
By mouth (per os)
IM:
Intramuscular
IV:
Intravenous
SL:
Sublingual (under the tongue)

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PR:
Rectally (per rectum)
INH:
Inhalation
Top:
Topical (for application on the skin)
OD:
Right eye (oculus dexter)
OS:
Left eye (oculus sinister)
OU:
Both eyes (oculi uterque)

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Disp:
Dispense
NR:
No refills
Sig:
Write (used before directions on a prescription)
It's important to be cautious with abbreviations, as they can be
misread or misunderstood, potentially leading to medication
errors. The use of tall man lettering (e.g., hydroXYZine vs.
hydrALAzine) for look-alike, sound-alike medications is
recommended to enhance clarity and reduce confusion.
Additionally, healthcare professionals are encouraged to use
clear, unabbreviated language whenever possible and to adhere
to organizational guidelines to ensure patient safety. Electronic
prescribing systems often incorporate safety checks to identify
and prevent the use of potentially confusing abbreviations.