This presentation tries to explain various components of a prescription and their importance. The use of prescriptions as examples in this presentation is solely for academic purpose and not to comment/ criticize the prescriber.

2. Defining a Prescription…
• A prescription is a written order by a registered physician directing
the pharmacist to prepare or dispense pharmacological agents for the
diagnosis, prevention or treatment of a disease.
• Broadly has 4 components:
• Superscription
• Inscription
• Subscription
• Signature

3. Types of Classification
• According to the Health Facility
• Outpatient Prescription
• Inpatient Prescription (Patient
Order Chart, Chart Order, Cardex)
• According to the Formulations
being prescribed
• Pre-compounding prescription
• Extemporaneous prescription
• According to the Prescriber
• Medical Prescriber (Hand-written
or Computer Generated)
• Nurse Prescriber (Hand-written
or Computer Generated)
• Pharmacist Prescriber
• Optometrist Prescriber
• Dental Prescriber

4. Elements of A Prescription
A. Prescriber related:
1. Name
2. Licence Classification
(Professional Degree)
3. Address
4. Contact Number(s)
• Prescriber’s credential should be
verifiable
• Should be available if any
queries arises

5. Elements of A Prescription
5. Date
• Signifies when was prescription
written
• Too old prescription should not be
refilled
B. Patient related:
6. Name
7. Address
• Proper identification

6. Elements of A Prescription
C. Body of Prescription:
8. Medication name (Brand/generic)
9. Medication strength (metric units/apothecary)
10. Dispensing quantity, dosage (appropriate to duration
of therapy, the cost, need for continued contact with
the clinic or physician, the potential of abuse,
potential for toxicity/abuse)
11. Direction for use (Patient-specific and drug specific;
simpler and few drugs/dosages)
• Instructions should include:
• How and when to take medications, duration of therapy,
purpose of medication
• Must be clear ad conscise
• Latin abbreviation apothecary not preferred, but still in
use.

7. Elements of A Prescription
D. Others:
12. Refill information
13. Requirement of childproof containers
14. Additional warnings
E. Prescriber’s identification:
15. Prescriber’s name
16. Prescriber’s signature
17. Prescriber’s registration number

8. Outpatient Prescriptions… Any Lackings??
Mr. XXX XXXX (##Y/M)
Mr. XXX XXXX

9. Outpatient Prescriptions… Any Lackings??

10. Outpatient Prescription..
What’s Missing?
Mr. XXX XXXX

11. Inaptient Prescription… What are the
elements?
• Contents are specified in the medical
staff rules by the Hospital’s Pharmacy
and Therapeutics Committee
• Patient’s name: typed or written on the
form
• Order’s include:
• Name and strength of medication
• Dose, route and frequency of
administration
• Date and Time
• Signature of the prescriber
• Duration: usually not mentioned

12. Types of Prescription
Pre-compounding prescription
Extemporaneous (Impromptu) prescription
It is the prescription that contain drugs available in pre-
compounded form and is dispensed as it is.
A working definition of extemporaneous dispensing or
compounding is the mixing together of the ingredients of a
prescription or drug formula and generally refers to a manual
process performed for individual orders by a dispenser or
pharmacist.
Pharmacists or Nursing Staff dispense the drugs as directed
by the physician
Pharmacists or Nursing Staff prepare the medication
according to the drugs and dosages as directed by the
physician
More common these days
Seen in limited scenario, e.g. Ayurvedic prescriptions, ICU
prescriptions
Comparatively safer as the dosage forms are not modified.
Higher risk: The ‘peppermint water case’ of UK: wrong
strength of chloroform water leading to the death of a child

13. Extemporaneous Prescription

14. Abbreviations used in Prescriptions

15. Abbreviations used
in Prescriptions

16. Types of Prescription
Prescriber Issued to Remarks
Medical Prescriber
Hospital Bed Nurse Prescriber
Supplementary Prescribers
General Practice Patients
Hospital Outpatients
Drug Addict Patients
Prescription from Medical
prescriber common in Nepal
Dental Prescribers Dental patients Common in Nepal
Nurses
Supplementary Prescribers
General Practice Patients
Independent Medical Services Service Personnel
Private prescribing of Controlled
Drugs
Private Patients
Ref: Practitioner Services – Pharmacy, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB

17. Prescribing Errors
• Omission of Information
• “Resume pre-op medication”
• “Continue present iv fluids”
• “Continue eye drops”
• “prn” authorization without clear
instructions on what conditions will
justify the use
• Poor prescription writing
• Illegible handwriting
• Ambigious decimal point, using “0”
properly, using “/”
• Using “U” for units
• Prescribing doses in micrograms
• One ampoule of a drug when more
than 1 size ampoules are available
• Confusing abbreviations
• Inappropriate drug prescription
• Failure to recognise
contraindications imposed by co-
morbidities
• Failure to ilicit drug history of the
patient
• Failure to realise Drug-drug
interaction

18. To Conclude:
• Prescription should be legible, unambiguous, dated, signed properly
• Contain sufficient information so that any possible errors could be
discovered easily
• Thank you!