A concise description of the prescription and it's components. a must-know for every pharmacy students (and sometimes even pharmacists!!!!)

1. PRESCRIPTION

2. HISTORY
 Ancient prescriptions – China, Egypt and Rome
 Rx:
• Egyptian ‘Eye of Horus’
• symbol denoting health;
• symbolic appeal by physicians to Jupiter for a prescription's
success.
• Latin word recipere ( ‘take’ or ‘take thus’)
• direction to the pharmacist, preceding the physician's ‘recipe’.
Definitions of Prescription
 An order to take certain medications.
 Health-care program implemented by a physician or other
medical practitioner in the form of instructions that
govern the plan of care for an individual patient.
 An order for medication, issued by a properly licensed
medical practitioner, dentist or veterinarian.

3. Eye of Horus

4.  Communication between the physician and the
pharmacist.
 May include orders to be performed by a patient,
caretaker, nurse, pharmacist.
 Legal implications: the prescriber takes responsibility for
the clinical care of the patient and in particular for
monitoring efficacy and safety.
 Originally directed at the pharmacist to take a certain
amount of each ingredient and to compound the
medicine.
 Today, it is directed to the patient to ‘take’ the medicine
(consuming it).
 ‘Pre’ and ‘script’ – ‘to write before’ a drug can be
prepared.

5.  The word ‘Prescription comes from the Latin
word ‘Praescriptus’.
 The prefix ‘pre’ means ‘before’ and ‘scriptus’
means ‘writing’. So, a prescription has to be
written before a drug is compounded.

6. PRESCRIBING PROCESS
Prescribing:
• Evaluate the patient.
• Evaluate the need for medication.
• Select the right medication.
• Determine interactions & allergies.
• Prescribe the medications.
Transcription:
• Transcribe the prescription or order.
• Transmit the prescription or order to pharmacy.

7. • Right patient
• Right drug
• Right dose (strength per unit dose)
• Right dosage schedule, dosing interval, time of
day
• Right route of administration
• Right date
• Right number of refills
• Right duration of treatment
• Right to informed consent
• Right to refuse treatment
‘RIGHTS’ OF A PRESCRIPTION

8. COMPONENTS OF A PRESCRIPTION
 Superscription, Inscription, Subscription and Signa
Superscription
• Symbol ‘Rx’ separates the superscription from the
inscriptions sections.
• Contains date the prescription order is written; patient
details and Rx symbol.
Inscription
• Body of the prescription (defines the medication)
• Composed of:
 a ‘Basis’ or chief ingredient intended to cure (curare)
 an ‘Adjuvant’ to assist Basis’ action and make it cure
quickly (cito)
 a ‘Corrigen’ or corrective to prevent or lessen any
undesirable effect (tuto)
 a ‘Vehicle’ or ‘excipient’ to make it suitable for
administration and pleasant to the patient (jucunde)

9. Components (contd’.)
Subscription
• Contains dispensing directions to the pharmacist.
• May be compounding instructions or quantities.
Signa (Sig or Signatura)
• Contains directions to the patient (how to take the
medication)
• Interpreted and transposed onto the label by the
pharmacist.
• Refills: the number of refills permitted for the patient.

11.  The patient's name and address
• ensures right medication goes to the correct patient;
identification and record-keeping purposes.
 Patient’s weight, age, BSA
• for medications whose dosage involves calculation.
• include both the calculated dose and the dosage
formula
(eg.: 240 mg Q8H and 40 mg/kg per day)
• allows other health care professionals to double-check
the prescribed dosage.
• Pharmacists should always recalculate dosage
equations when filling these prescriptions.

12.  Prescription pad blanks – imprinted with a heading
containing the physician’s name, address and phone
number of the practice site.
 Institutional blanks – don’t bear physician's
information.
 Controlled substances prescriptions – the name,
address and Drug Enforcement Agency (DEA)
registration number of the physician.

14.  Proprietary Prescriptions
• The medications are indicated by their trade names.
 Non-proprietary Prescriptions
• The medications are indicated by their generic names.
 Pediatric prescriptions
• Include the age of the child (< 12 yrs.; < 5 months).
• Weight of the child.

15.  Modern prescriptions: ‘extemporaneous’ and ‘non-
extemporaneous’.
 Extemporaneous prescriptions
• prescription is written ‘on-the-spot’ for a specific
patient with a specific ailment.
• ‘Compound prescriptions’ ( pharmacist mixes or
compounds the medication in the pharmacy for the
specific needs of the patient).
 Non-extemporaneous prescriptions
• generic recipe for a general ailment.
 Modern prescriptions evolved with the separation of the
role of the pharmacists from that of the physician .

16. • Contraindicated drug
• Incomplete order
• Allergy
• Transcribing error
• Wrong dose / frequency
• Wrong drug
• Illegible order
• Omission
• Altered order
• Wrong patient
• Wrong route
SOME PRESCRIBING ERRORS

17. WHAT SHOULD YOU TELL THE PATIENT?
• What the drug is
• It’s purpose
• How it works
• How to take it
• Precautions
• Duration of treatment; risks of discontinuation
• Side-effects

18. Reading Prescription Abbreviations
 These abbreviations tell when to take the medication:
• a.c. ante cibum before meals
• ad lib ad libitum as much as you want
• b.i.d. bis in die twice a day
• cc cum cibos with food or cubic centimeters
• dieb. alt. diebus alternis every other day
• hs hora somni at bedtime
• p.c. post cibum after meals
• p.r.n. pro re nata as needed
• q.d. quaque die once a day
• q.i.d. quater in die four times a day
• q.h. quaque hora hourly
• q.2h. every 2 hours
• q.3h. every 3 hours
• q.4h. every 4 hours
• t.i.d. ter in die 3 times a day

19.  Medication form, instructions to the pharmacist:
• caps capsules
• comp. compound
• daw dispense as written
• gt gutta drop
• nebul nebula a spray
• po per os by mouth
• p.r. by rectum
• sol solutio solution
• supp suppositorium suppository
• susp suspension
• syr syrupus syrup
• tab tabella tablet
• top topical
• ung unguentum ointment
• ut dict ut dictum as directed
• vag vaginally
• w with
• w/o without
• X times

20.  Warning about side effects:
• D drowsiness
• H habit forming
• I interaction
• X SOS contains a substance that could cause problems
• ASA contains acetylsalicylic acid (aspirin)
• C caution
• G glaucoma
• S diabetes

22. THANK YOU!!!