Principles of Prescription Writing Pre compounding prescription:

History • Prescription for already prepared drug

 Prescriptions (by pharmaceutical companies) e.g.
have been in Cap. Ciprofloxacin (500 mg) etc.
use since
Extemporaneous prescription:
ancient times
 Latin adopted • The pharmacists prepare the medication
as standard according to the drugs and dosages
language directed by the physician (nowadays not
 “Rx” = in practice)
prescription
Writing Prescriptions
Prescription Drug Who can write an Rx?
Drug that requires a prescription because it is
 Practitioners
considered potentially harmful if not used
under the supervision of a licensed healthcare  physicians, veterinarians,
practitioner dentists, podiatrists
 Mid-level Practitioners
Definition
 nurse practitioners, physician assistants,
A prescription is a optometrists, pharmacists
written, verbal, or
Current Prescription Formatting
electronic order
from a practitioner or  Heading
designated agent to a
pharmacist for a  Body
particular  Closing
medication for a specific patient

The word
“prescription” is
derived from the Latin
term praescriptus
which made up of two
Latin words prae a
prefix meaning
‘before’ and scribere
meaning ‘to write’
Current Prescription Formatting
 Heading
 Name, address, and telephone number
Types of Prescription of the prescriber
 Name, sex and age of the patient
  Date of the prescription
Contents of the Prescription
 Patient Name and Address
 Full first and last name
 Middle initial may be helpful
Date of Birth – not required, but will be
helpful in further identifying the correct patient
to prevent medication errors
 Practitioner’s Name, Address, and
Phone number
 Validates prescription
 Provides contact information to
clarify any questions
 Date
 Date the prescription is issued or
written
 Allows the determination of the life
of the prescription to validate refills
 Ensures continual patient
supervision
 Promotes patient follow - up
 Body
 The Rx symbol
 Name of drug
 Dose size or concentration (liquid) of
the drug
 Amount to be dispensed
 Directions to the patient
Superscription:
It is
represented by
symbol Rx.
Rx is the
abbreviation of
Latin word recipe, meaning ‘take thou’
or ‘You Take’.
In older 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.
 Nowadays, the majority of the drugs are
prescribed which are already in a
suitable formulation.
 The pharmacist is required to dispense
the ready-made from of drugs. So,
compounding of prescription is almost
eliminated.
Subscription:
 This part contains the prescriber’s
directions to the pharmacist . It
includes
 Type dosage form to be prepared
 No of doses to be dispensed
Contents of the Prescription
 Selecting the drug
 Medication Allergies
 Availability
 Cost
 Name of the drug
 Multiple drugs per prescription can
add to confusion
 KEEP IT SIMPLE

 Name of the drug - CAUTION:
Look Alike/Sound Alike drug names
 Massive number of new drug releases
 Massive number of reformulations
 Drug marketing strategy
 Build on established names
 New combination drugs – Use
converged names
 Name of the drug
AVOID THE USE OF:
 Abbreviations
 Many drugs identified with abbreviations
 EX: HCT for hydrochlorothiazide
MSO4 for morphine sulfate
 Attempts to standardize abbreviations
have been unsuccessful
List of dangerous abbreviations, acronyms,
and symbols
 Strength of the drug
 Be familiar with drugs and their
various dosing strengths and
dosage forms
 When in doubt, use references
Dosing cont;
 Weight – based dosing
 Always convert patient weight to
correct units (kg)
 Liquid medications
 One product may be available in a
number of concentrations
 Be familiar with various product
concentrations
 Indicate BOTH concentration and
dose of medication
 Example: Cephalexin suspension
125 mg/ 5 ml 1 teaspoon/ every 8 h
 Strength of the drug
 Decimal points
 Avoid trailing zeros.
EX. 5 mg vs. 5.0 mg; can be mistaken
for 50 mg
 Always use leading zeros.
EX. 0.8 ml vs. .8 ml; can be mistaken
for 8 ml
 Quantity of the drug
 Prescribe only necessary
quantity
 Write for specific quantities
rather than time period (for
example: dispense #30 vs.
dispense for 1 month)
 Calculate: quantity = frequency
per day x treatment days
 Writing out “Dispense # X” is
helpful
Rules for writing quantity of drug:
 Quantities of 1 gram or more should
be written in grams.
 Ex - write 2 g.
 Quantities less than 1 gram but
more than 1 milligram should be
written in Milligrams For eg, write
100 mg, not 0.1 g
 Quantities less than 1 milligram
should be written in micro / nano
gram as appropriate.
 DO NOT abbreviate micro/
nanograms; since that can lead to  Determine preference for brand or
Prescribing errors. For eg. write 100 generic product
micrograms, not 0.1 mg, nor 100  Brand vs. generic
mcg, nor 100 μg  Is Brand always better? NO
 Use ml or mL for milliliters  If practitioner prefers brand, must
 For some drugs, a maximum dose indicate in print, - do not
may need to be stated ( for eg. substitute
ergotamine in migraine & colchicine
in gout). Sample Prescription
 Eg: Ergotamine 1 mg at onset of
attack & repeat every 30 min if
necessary . Do not take more than 6
mg in one day or more than 12mg in
one week

 Directions for use

 Write out in full English or
use Latin abbreviations
 Latin abbreviations – more
convenient, more potential
for mistakes
 Avoid Dangerous
Abbreviations  Indication
 Provide clear and specific  Encouraged, seldom practiced
directions  Helps confirm appropriateness of
 Should be clearly indicated medication
Atenolol 100mg once daily  Reminds patient of drug’s purpose
Amoxicillin 250mg t.d.s.  Facilitates communication
 - Tell the patient what you mean be between health care providers
these times a day/ four times a day!

 Closing
 Prescriber’s signature
 Refill instructions
 Generic substitution
instructions
SIGNATURA
 It is usually written as ‘Sig’ on the
prescription.
 It consist of the direction to be given
to the patient regarding the
administration of the drug.
  Usually the quantity of medicament
or number or dosage unit to be Prescription for controlled drugs
taken, how many times in a day or at must(e.g.morphine)
what time it should be taken. 1. Be completely written in the
 Instruction must be written on the prescriber’s hand writing in ink
label of container. 2. Be signed & dated
3. Carry the prescribers’ address
 Refills 4. Carry the name & address of the
 To avoid interrupting patient
maintenance therapy, 5. State the form of the drug
practitioners can authorize 6. State the total quantity of the drug
refills on a written or the number of dose units to be
prescription disposed in both words & figures
 Refills authorized are valid 7. State the exact size of each dose in
only for life of the both words & figure
prescription – 1 year
CASE #1
Renewal instruction :
• The prescriber indicate on every
prescription order, whether
it may be renewed and if so, how many
times.
 It is very important particularly in
the prescription containing the
narcotic and habit forming drugs to Poor handwriting contributed to a
prevent its misuse. medication dispensing error that resulted
in a patient with depression receiving the
Signature, address & registration number antianxiety agent Buspar 10 mg instead of
of the prescriber : Prozac 10 mg
Information about physician is essential so
that the doctor could be contacted in
emergency.
 Prescription must be signed with CASE #2
Prescriber’s own hand.
 Address and Registration No. should
be written in case of narcotic or
other habit forming drugs to prevent
its misuse

 Definition - a prescription drug A hypertensive patient accidentally

whose use and distribution is tightly received Vantin 200 mg instead of Vasotec
controlled because of its abuse 20 mg when a pharmacist misread this
potential or risk prescription
 Regulation is more strict
MAXIMIZE PATIENT SAFETY
 ALWAYS write legibly.
 ALWAYS space out words and
numbers to avoid confusion.
 ALWAYS complete medication
orders.
 AVOID abbreviations.
 When in doubt, ask to verify.

 Date of the order

 Patient Name and Address
 Name of the drug
 Strength of the drug
 Quantity of the drug
 Directions for use
 Practitioner Name, Address,
Telephone number