Legal requirements and interpretation pf Prescription

1. Legal requirements & interpretation
of prescription
Submitted To :
Dr. KANCHAN VOHRA
Assistant Professor
Submitted By :
Mohd. Rafi Bhat
Department of pharmaceutical
science & Drug Research

2. “Prescription”
means the written direction given by the doctor to
the chemist for the
compounding of medicine suitable to a patient’s
case.

3. Additional information-
 Recent legislation has legialised electronic
communication of prescriptions.
 New technology has also made it easier to alter or forge
prescriptions.
 It is therefore important for pharmacists and
pharmacist’s assistants to develop good pharmacy
practice habits in handling, interpreting,
authenticating and recording of prescriptions.
 It is equally important for doctors and patients to
understand their rights and obligations with regard to
prescriptions.

4. Doctors –
 • have an obligation to prescribe accurately and write their
prescriptions correctly and legibly in accordance with relevant
legislation
 • must keep accurate records of their prescriptions on their
patient profiles
 • must include international classification of disease and health
related problems ( ICD10) diagnostic codes on the prescription,
if it is to be submitted to a medical scheme for payment
 • have a right to expect the dispenser to carry out their
prescription instructions accurately
 • have a right to expect to be consulted about any changes or
corrections to the prescription that may affect treatment
outcomes.

5. Patients
• Have a right to ask for a written prescription and to
have the prescription dispensed by the pharmacy of
their choice.
• Have a right to retain an original repeat prescription
until the last repeat has been dispensed.
• Have a responsibility to supply the original
prescription to the pharmacist and present the original
for endorsement of each repeat.
• Legally may not be in the possession of any schedule 3
to 6 medicine if they do not have a legitimate prescription
for that medicine.

6. Pharmacists and pharmacist’s assistants-
• Have an obligation to verify the authenticity of any
prescription (electronic, faxed or written).
• Must retain prescriptions for a period of five years in orderly
files that can be easily retrieved.
• Must dispense strictly in accordance with the doctor’s
instructions.
• Must endorse the prescription with any necessary changes
made including, repeats given, notes of confirmation or
communication with the prescriber, and notes of reasons for
not dispensing any specific items or insistence by the patient
or the doctor that only the original product must be supplied.
• Have the right to expect the patient to present the original
prescription and the doctor to follow verbal instructions with
a written prescription.

7. PARTS OF PRESCRIPTION
1) Prescriber information
2) Patient information
3) Date of prescription
4) Superscription
5) Inscription
6) Subscription
7) Direction to patient (Transcription)
8) Signature of prescriber

9. PRESCRIPTION
 Parts of prescription:-
1.Prescriber information-
 Name
 Qualification
 Practice number
Address of the prescriber

10. 2.Patient information----
Name , address, age and weight of patient in the
case of a prescription
 The name and address of the person to whom the
medicines are delivered in the case of a
prescription issued by a Veterinarian

11. 3. Date of prescription
• Date of issue of the prescription or Order

12. 4. Superscription
RX
RX is an abbreviation for the Latin word
“recipe” which mean “to take” or
“ take thou”.
The symbol is said to designate jupiter “The God of
Healing”

13. 5. Inscription
 It is main part of prescription. It contain the name and
quantity of prescribed ingredients.
 It also contain manner in which medicine should be
taken.

14. 6.Subscription:-
 This parts contains the prescriber direction to the
pharmacist.
 It includes-
Type dosage form to be prepared
No of dose to be dispensed

15. 7.Transcription
 Transcription is the prescriber direction
to the patient contains instruction about
the amount of drug , time and frequency
of doses to be taken.

16. 8.Signature of physician:-
 Prescription must be signed with
prescribers own hand.
o Address and Registration no. should be written in
case of dangerous drugs

17. Handling of Prescription
Receiving
Dosage calculation
Compounding
Finishing
Pricing
Delivering

18. Receiving the prescription:-
 Pharmacist should himself receive the
prescription.
It includes
Reading the prescription
Checking the prescription

19. Reading the prescription:-
 Prescription should be completely and
carefully read from top to bottom.
Checking of prescription:-
 Prescription should be checked for any
incompatibility.

23. Compounding:-
The ingredients are compounded by
accurate method.
For weighing electrical machines should
be used

24. Finishing the prescription:-
 It includes
Packaging
Filling
Labeling
 Rechecking

26. Labeling
The filled container should be
suitably labeled.
The label should be affixed on smooth
surface of bottle.

27. Label information
 Type of prescription
 Name, age & sex of patient
 Date of dispensing
 Storage condition
 Name and address of pharmacy
 In case of liquid preparation attach auxiliary
label
Shake well before use
 Route of administration

28. Rechecking
 Each prescription should be rechecked
 After labeling container should be
thoroughly polished to remove finger prints.
Recording
A variety of prescription files are available
which serve to maintain and preserve
original prescription in numerical order

29. Pricing of prescription :-
 The prescription should be priced
immediately after receiving it & informed
the patient about it. This should be done
before starting the compounding to avoid
any dispute..

30. INTERPRETATION OF PRESCRIPTION
Drug use is a complex process and there are many
drug related challenges at various levels ,
involving prescriber, pharmacists and patients.
While medication misadventure can occur any
where in the health care system from prescriber to
dispenser to administration and finally to patient
use, the simple truth is that many errors are
preventable, and pharmacists assume active role
in appropriate use of drugs.

31. Medication errors
? Incomplete patient information (not knowing about
patients’ allergies, other medicines they are taking ,
previous diagnoses, and lab results for example)
? Unavailable drug information (such as lack of up-to date
warnings)
? Miscommunication of drugs orders, which can involve poor
handwriting , confusion between drugs with similar
names, misuse of zeroes and decimal points, confusion of
metric and other dosing units, and inappropriate
abbreviations.
? Lack of appropriate labeling as a drug is prepared and
repackaged into smaller units and
? Environmental factors, such as lighting, heat, noise, and
interruptions that can distract health professionals from
their medical tasks.

32. Dispensing errors
“Error of wrong interpretation of doctor
prescription and especially in children.”
Dispensing error refers to medication errors
linked to the pharmacy and includes error of
commission (dispensing the wrong drug or dose)
and those of omission (failure to counsel on safe
use of medicine ). Most dispensing errors involve
the dispensing of an incorrect medication, dosage
strength or dosage form. Look alike and sound
alike drug often causes confusion with ineligible
prescriptions or verbal medication orders and
errors are likely inaccurate calculation of dose.

33. Causes for errors
? Too many telephone calls (62%)
? Overload/ unusually busy day (59%)
? Too many customers (53%)
? Lack of concentration (41%)
? No one available to double check (41%)
? Staff shortage (32%)
? Similar drug names (29%)
? No time to counsel (29%)
? Illegible prescription (26%)
? Misinterpreted prescription (24%)

34. Common types of medication
errors
The Institute for Safe Medication Practices(ISMP) identifies
the following areas as potential causes of medication
errors.
? Poor drug distribution practices.
? Workplace environmental problems increasing the job
stress.
? Complex or poorly designed technology.
? Access to drugs by non-pharmacy personnel
? Dose miscalculations
? Lack of information to prescribers
? Lack of patient information
? Lack of patients’ understanding of their therapy

35. Medication errors due to failure to follow
label instruction
? Failure to “shake well”
? Crushing medications
? Medications taken with food or antacids
? Sublingual tablets which should not be
swallowed
? Use of inappropriate solvents

36. Conclusion
Pharmacists should ensure that “right ” patient is
receiving the “right” drug in a “right” dose.
Pharmacists and other health care professionals
involved in the medication use process must work
together to develop a systems approach to
medication use & error reduction.