This document discusses prescriptions and factors involved in prescribing medications. It defines a prescription as a document written by a doctor detailing a patient's medication. Prescriptions are not always necessary as some medications can be self-administered or over-the-counter. Whether a prescription is needed depends on doctor and patient factors. When prescribing, doctors consider a drug's effects, the patient's details, and ensuring no harm is done. Proper prescriptions include legible writing of patient details, diagnosis, drug name, dosage, and doctor's credentials. Explaining instructions clearly to patients can help maximize compliance.

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Prescriptions
Dr. Chamath Fernando
Lecturer
Department of Family Medicine
FMS
USJP

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 What is a prescription?
A document where the doctor writes down the medication to be taken with
details of how to administer etc.
 What other modes of medication are there?
Self medication, OTC
 Is a prescription always necessary?
No. Charge for the consultation and not for the drugs.
 What factors influence that?
 Doctor’s preference, experience, post graduate training, usual pattern of prescribing
 Patients factors: expectations, socio-economic cultural factors,
 Setting: SL vs Australia

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 Purposes of prescribing?
 Cure – Antibiotics for skin sepsis
 Symptomatic relief – Anti-emetics for patients undergoing chemotherapy
 Prevention of complications – Aspirin in HT and DM
 Control of a ongoing disease process – Steroid for Asthmatics
 Prevention of disease progression – Acyclovir for Chickenpox (Varicella
zoster) exposed patients
 Some other reasons (Tactical)
 Trials,To buy time till a definitive diagnosis is reached,To terminate the
consultation/ Placebo effect
 Make sure no harm done

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 What to prescribe?
 Patient factors:
 Age, (biological age) and Sex
 Severity of symptoms and the disease, Coping strategies of the patient
 Co-morbidies
 Physiological factors : Pregnancy- teratogenic drugs,even ; local isotrexin, Breast
feeding – chemotherapy drugs, amiadarone, lithium, retenoids
 Drugs the patient is already on
 Patient’s preference among choices given
 Family support and whether compliance can be expected
 Functional factors / Occupational – e.g Exams
 Economic factors
 Religious/cultural beliefs e.g OCP for certain ethnic groups

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 Drug factors:
 Adverse effects profile
 The benefit over risk ratio
 Drug- patient, drug-drug (Antibiotics and oral contraceptives.Varies.
Significant – Only Rifampicin)), drug disease interactions
 Therapeutic effect
 Cost

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 Writing a Prescription
 Paper with letterhead
 Legible
 Components
 Patient’s name
 Age
 Sex
 Address and Contact details
 Date
 (If it’s a computer generated prescription all these details will be there by
default)
 Presenting complaint or the diagnosis / DD

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●
Rx – Recipe
●
Name of the drug/s (Generic/ Brand name)
●
Dosage
●
Route of administration
●
Frequency (bd/tds or 6H/8H)
●
Relationship to the intake of meals
●
Duration
●
Total number of tablets/ capsules etc to be issued
●
Whether the recipe cannot be repeated (Anxiolytics, steroids)
●
Doctor’s details
 Name
 SLMC registration number
 Qualifications
 Designation
 Signature
 Address
 Contact details – Telephone/ e-mails


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 At the end:
 Inform the patient regarding the name of the drug, how it should be
taken, importance of compliance, possible side effects
 Ask for concerns
 To make sure the patient has understood well, ask him/her to repeat the
instructions.
 Relatives’, guardians’ help

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 For optimum compliance
 A strong doctor-patient relationship – patient believes in the doctor
 Effective two way communication – active listening, genuine interest,
empathy and concern
 A simple affordable regimen
 Clear and concise instructions – no jargon, nor too little neither
excessive information, write clear instructions on the reverse of the
prescription paper
e.g. How to take Cloxacillin 6H 
Divide waking hours to 4

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 Thank you!