Made By Shayan

Prescription

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

The order is accompanied by directions for the pharmacist to prepare a specific type and
quantity of preparation for a patient. The prescription also include the directions for the patient
regarding the mode of administration of drugs, which is dispensed for him. Thus prescription is a
media through which treatment is provided for a patient by the combined skill and services of
both the physician and the pharmacist.

The prescriptions are generally written in the English language but Latin words or abbreviations
are frequently used in order to save time. So it becomes necessary for a pharmacist, to become
familiar with the common Latin terms and abbreviations used by the prescriber while writing the
prescription.

PARTS OF A PRESCRIPTION:

Prescriptions are generally written on a typical format which are usually kept as pads. A typical
prescription consists of following
parts:

1. Date
2. Name, age, sex and address of the patient
3. Superscription
2. Name, age, sex and address of the patient
4. Inscription
5. Subscription
6. Signatura
7. Renewal instructions.
8. Signature, address, and registration number of the prescriber.

1. Date:

It helps a pharmacist to find out the date of prescribing and date of presentation for filling the
prescription. The prescription which prescribe narcotic or other habit forming drugs, must bear
the date, so as to avoid the misuse of prescription if it is presented by the patient, a number of
times for dispensing.

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. In case, if any of these information is missing in the prescription, the
same may be included by the pharmacist after proper enquiry from the patient. Age and sex of
the patient, especially in case of children. help the pharmacist to check the presented dose of
medication.

3. Superscription:

It is represented by a symbol R which is written before writing the prescription. R is an

abbreviation of the Latin word recipe, meaning "You take (Take thou). In olden days, the symbol
was considered to be originated from the sign of Jupiter, God of healing. This symbol was
employed by the ancient in requesting God for the quick recovery of the patient.

4. Inscription:

This is the main part of the prescription order, contains the names and quantities of the
prescribed ingredients. The names of ingredients are generally written in English language but
com mon abbreviation used can be written both in English and Latin languages.

Extreme care should be taken by the pharmacist in interpreting the abbreviations, otherwise it
can lead to serious errors.

The medicament may be prescribed as an official preparation, a proprietary product, a

non-proprietary product (generic), not official or a special or individual formula. In case of special
or individual formula,

the quantity of each ingredient will be stated together with a description of the type of the
preparation, e.g., cream, mixture, lotion etc.

The name of each ingredient is written on a separate line along with its quantity. In complex
prescriptions containing several ingredients the inscription is divided into following parts:

(a) Base:

The active medicaments which are intended to produce the therapeutic effect.

(b) Adjuvant:

It is included either to enhance the action of medicament to improve the palatability of the
preparation.

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

Nowadays, the majority of the drugs are prescribed which are already in a suitable formulation.
The pharmacist is required to dispense the readymade form of drugs. So, compounding of
prescription is almost eliminated.

5. Subscription:

This comprises direction to the pharmacist for preparing the prescription and number of doses
to be dispensed. Thesedays, the prescribers are omitting the specific instructions to the
pharmacist because the majority of the prescriptions are not compounded and dispensed:

6. Signatura:

This consists of the direction to be given to the patient regarding the administration of the drug.
It is usually written as Sig' on the prescription. The instructions given in the prescription are
required to be transferred to the label of the container in which the medicament is to be
dispensed, so that the patient can follow it. The instructions may include:

(a) The quantity to be taken or amount to be used.

(b) The frequency and timing of administration or application.

(c) The route of administration.

(d) The special instructions such as dilution direction.

7. Renewal instructions:

The prescriber indicate on every prescrip tion 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 drugs to prevent its misuse.

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. It is very important particularly in the prescription containing the narcotic and other
habit forming drugs, to prevent its misuse.

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 packaging

1. Receiving:

The prescription should be received from the patient by the pharmacist himself. While receiving
a prescription, a pharmacist should not change his facial expression which gives an impression
to the panes that he is surprised Or confused after seeing the prescription.

2. Reading and checking:

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/nursing home and signed by the prescriber along with date.

A prescription should always be screened behind the counter. In case of any difficulty in reading
or any doubt regarding the prescription ingredients or directions, the pharmacist should consult
the other phar macist or the prescriber. But under no circumstance patient should come to know
about it. Pharmacist should never guess about the meaning of any illegal or confused word. It
may lead to serious consequences.

Sometimes a prescription is received on telephone by senior pharma In such case, after taking
down the prescription, it should be cist verified by repeating it on phone to the prescriber. It is
very important because nowadays, the number of drugs with almost the same pronunciation
and spelling are available in the market.

For example:

Acidin ® Apidin ®

Prednisone Prednisolone

Digoxin Digitoxin

Althrocin Eltroxin

If there is any omission of any important particulars, such as the dose, the prescriber should be
contacted.

3. Collecting and weighing material:

Before compounding the prescription, all the materials required for it, should be collected on the
left hand side of the balance. After weighing the material it should be shifted to right hand side
of the balance. This gives a check of ingredients which have been weighed. While
compounding, the label of every stock bottle should be read at least three times in order to
avoid any error:

(a) When taken from the shelf or drawer

(b) When the contents are removed for weighing and measuring

(c) When the containers are returned back to its proper place.

4. Compounding, labelling and packaging:

Compounding should be carried out in a neat place. All the equipment etc. required should be
thoroughly cleaned and dried. Only one prescription should be com pounded at one time. All the
ingredients should be compounded according to the directions of the prescriber or according to
pharmaceuti cal art. The compounded medicaments should be filled in suitable containers
depending on its quantity and use. The filled containers are suitably labelled. White plain paper
of good quality should be used for labelling the containers. The size of the label should be
proportional to the size of the container which is written or typed, giving all the desired
information. The label should be fixed with a good quality of adhesive, almost in the centre
leaving equal space from the bottom and top of the container. The container is polished so as to
remove the finger prints. While delivering the prescription to the patient. the pharmacist should
explain the mode of administration, direction for use, and storage.

Latin Term Abbreviation Mean in Eng

Auristille auristil Ear Drops

Capsula caps A capsule

Cataplasma cataplasm A poultice

Charta chart A powder

Collutorium collut A mouth wash

Collyrium collyr. An eye wash

Cremor crem A Cream

Emulsio emul An emulsion

Enema A enema

Haustous ht A drought

Injectis inj An injection

Insufflatio insuff An insufflation

Linctus lin A linctus

Linimentum lin A liniment

Liquor hq A solution

Lotio lot A lotion

Mistura. m, mist A Mistura

Naristillae narist Nasal drops

Nebula neb A spray solution

Pasta. past A paste

Pessus. pess. A passary

Pilula. pil A pill

Pulvis pulv powder

Solutio sol A solution

Suppositorium. suppos A suppository

Tabella. tab. A tablet

Unguentum ung An ointment

Addendus. addend To be added

Applicandus. applicand. To be applied

Applicat --- Let (him) apply

Capiendus capiend To be taken

Dandus Dand To be given

Deglutiendus deglut To be swallowed

Extendendus. extend To be spread

Infricandus infricand To be rubbed in

Inhaletur inhal Let (it) be inhaled

Instillandus instilland To be dropped in

Miscendus miscend. To be mixed

Signa sin Label

Sumendus S or sum To be taken

Utendus U or utend To be used

Semel in die sem in die Once a day

Bis in die. Bis die b.i.d., b.d. Twice a day

Ter in die t.i.d., t.d. Three times a day

Quater in die qid, qd Four times a day

Sexies in die sex.i.d Six times a day

Primo mane prim. m Early in the morning

Mane m In the morning

Omni mane 0.m Every morning

Omni nocte o.n Every night

Inter nocte inter nocte During the night

Nocte n At night

Hora somani h.s At bed-time

Inter noctem inter nocte During the night

Jentaculum. jentac Breakfast

Nocte et mane [Link].m Night and morning

Nocte maneque n.m Night and morning

Prandium prand Dinner

Vespere vesp In the evening

Omni hora o.h Every hour

Omni quarta hora o.q.h Every fourth hour

Singulis horis sing. hora Every hour

Alternis horis alt. hor. Every two hours

Tertis horis tert. hor. Every three hours

Quartis horis quart. hor. Every four hours

Sextis horis sext. hor. Every six hours

Anti cibos a.c Before meals

Post cibos p.c. After meals

Inter cibos i.c. Between meals

Dolore urgente [Link]. When the pain is severe

Frequenter freq frequently

Lente -- -- Slowly

[Link] p.r.n Occasionally

More dicto m.d. As directed

Mode dicto m.d As directed

Si opus sit S.O.S When required or When

necessary

Si. dolar urgeat si. dol. urg. If the pain is severe

Statim. stat Immediately

Quoties opus sit quot.o.s As often as necessary

Tussi urgent tuss. urg. When the cough is

troublesome
Ante meridiem a.m before noon.

Matutinus matut. of the morning

Post meridiem p.m Afternoon

Pomeridianus. pomerid of the afternoon

amplum. amp

Cochleare-magnum. coch-mag. One tablespoonful

maximum. max

Cochleare medium. coch. med. One

dessertspoonful

Cochleare minimum coch. min. One teaspoonful

cum c. With

Cum duplo. c. dup. With twice as much

Cum parte aequale. c. pt. aeq. With an equal

quantity

Cum tanto. c. tant. With as much

Cyathus amplus cyath. amp. A tumbler

Cyathus magnus. cyath. mag. A tumbler

Cyathus vinosus. cyath. vin. A wine glass

Poculus poc A cup

[Link] e. lact. With milk

[Link] ex. aq. With water

Auris dexter a.d To right car

Auris laevus a.l To left ear

Brachis. brach. To the body

Jugulo jug To the throat

Naso --- To the nose

Oculis dexter o.d To right eye

Oculis laevus o.J To left eye

Os, oris o.s To mouth

Pro oculus [Link]. for the eyes

Sterno stern to the chest

Ad ad. To,upto

Ana aa. Of each

Ante. a. BEFORE

Aqua aq. Water

Aqua distillata aq. dest. Distilled water

Cibos cibos meals food

Fiat ft. Make, let it be made

Gutta, guttae gtt. A drop, Drops

Hora h An hour

Laevo l left

Misce m Mix, let it be mixed

Mitte mitt. Send

Mitte tales mitt tal send such

More dicto [Link] in the manner

prescribed

Omni omn. Every

Pro dosi --- As a dose

Quantum sufficiat. q.s as mush as is sufficient

Recipe Rx Take

Semi ss Half

Solve. --- Dissolve

Talis, tales tal such

MODERN METHODS OF PRESCRIBING

Nowadays, the majority of the drugs are available in the market as readymade formulations
manufactured by different pharmaceutical com panies. There is no need to dispense the drugs
by the pharmacist. In the present days, the role of pharmacist is to hand over the readymade.
preparations to the patients and provide advice if demanded regarding its mode of
administration, dose schedule, drug interactions and adverse reactions etc. The practice of
writing long, complicated prescriptions containing several ingredients, adjuvants, vehicles is not
required.

In the present day set up, the writing of prescription is more signifi cant. The prescription should
be precise, accurate, clear and easily readable. As far as possible, the Latin terms should be
avoided. In olden days the Latin language was used to conceal certain facts from the patient.
But nowadays, the prescriptions are written in English language and dose is prescribed in metric
system for the convenience of the patients.

The drugs should be prescribed by its official (generic) name and not by its proprietary or trade
name. There are certain advantages and disadvantages of prescribing the drugs by its
proprietary names, which are as under:

Advantages of prescription:
[1] It is easy to remember proprietary names because they are very catchy e.g.. Librium
(chlordiazepoxide), Calmpose (diazepam), and Crocin (paracetamol).

[2] It is easy to communicate with the patient.

[3] The continuity can be maintained by prescribing the same proprietary name every time.

[4] The bioavailability of drugs changed with the change of adjuvants used in drug formulations
manufactured by different manufac turers. So only those proprietary drugs can be prescribed
which have a better bioavailability.

Disadvantages of prescription:

[1] It is cheaper to prescribe the drugs by its official name.

[2] It becomes difficult for a pharmacist to dispense the substitute of the drug which is available
in the stock

There are four types of prescriptions which are generally received by the retail drug store:

● Prescription in general practice

● Private prescriptions

● Hospital prescriptions meant for 'out patients'

● Hospital prescriptions meant for 'in patients'

CARE REQUIRED IN DISPENSING PRESCRIPTION

Following precautions should be taken while dispensing a prescription.

(1) Always keep the prescription before you. Take the prescription with you while taking out the
medicine from the shelf. It will serve as a constant reminder of the name and strength of the
preparation required and help to avoid mistakes.

(2) Always check the dispensing balance before weighing the ingre dients which are required
during dispensing.

(3) Replace containers of stock preparations or drugs in their proper position after use.

(4) Keep the label in upper position during weighing solid ingredi ents especially the potent
drugs such as morphine hydrochloride to serve as a constant reminder that the correct drug is
being used.
(5) When pouring or measuring the liquid ingredients, keep the label upward in order to prevent
surplus liquid running down of the bottle and staining the label.

(6) Care should be taken to keep the dispensing balance clean. The powder should be
transferred from the stock container by using a clean spatula. The scale pan should be cleaned
immediately
after use.

(7) Medicines which are used externally such as lotions, liniments, paints 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 EXTERNAL USE ONLY

(8) Before handing over the medicine to the patient, again check that the correct preparation, in
the correct strength, has been supplied and correct direction has been stated on the label.

Sources of Error in Prescription

[1] Abbreviation :

Abbreviation presents a problem in understanding parts of the prescription order. Extreme care
should be taken by a pharmacist in interpreting the abbreviation. Pharmacist should not guess
at the meaning of an ambiguous abbreviation e.g.. to dispense Achromycin for "Achro" may
cause difficulty when the intention of the prescriber is to dispense Achrostatin. The abbreviation
"SSKI" represents the use of a short hand for saturated solution and chemical symbols for
potassium iodide

[2]. Name of the drug:

There are certain drugs whose name look or sound like those of other drugs. Some of the
examples of such drugs are as under:

Digitoxin Digoxin
Prednisone Prednisolone
Indocin. Lincocin
Doridon Doxidan
Pabalate Robalate
Ananase Orinase

Name of the pharmaceutical products have been changed on certain occasion due to the
possible confusion with the name of the other product e.g. the name of potassium supplement
was changed from Kalyum to Kolyum because of the possible confusion of the former
designation with valium.

[3]. Strength of the preparation:

The strength of the preparation should be stated by the prescriber. It is essential when various
strengths of a product are available in the market. For example, it will be a wrong 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 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 in
order to avoid ambiguity.

[5]. Dose:

Unusually high or low doses should be discussed with the prescriber. Paediatric dosage may
present a problem. So pharmacists should consult paediatric posology to avoid any error.
Sometimes a reasonable dose is administered too frequently e.g., a prescription for sustained
release formulation to be administered after very four hours should be thoroughly checked
because such dosage forms are usually administered only two or three times a day.

[6]. Instructions for the patient:

The 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 route of
administration should be clearly given in the prescription so as to avoid any confusion.

[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. Certain Antibiotics should not be
given with meals since it significantly decrease the absorption of the drug.