DISPENSING II

M E D I C AT I O N - R E L AT E D P R O B L E M S , M E D I C AT I O N S A F E T Y,
M E D I C AT I O N C O U N S E L L I N G A N D O T H E R P H A R M A C Y
S E RV I C E S
PRESCRIPTION AND MEDICATION ORDERS
OUTLINE:

• Describe prescription and identify its parts.

• Name the different types of prescriptions
• Describe the type of prescription errors
• How is prescription process
• Describe medication orders and other types of orders
 PRESCRIPTION

Origin comes from Latin praescriptio, meaning a written order

Prescription: the action of writing [that takes place] before [a

drug is dispensed]pre- (before)script/o- (write)-ion (action)

A prescription is a written order (handwritten or electronic) by

a registered physician directing the pharmacist to prepare or
dispense pharmacological agents/medications for the diagnosis,
prevention or treatment of a disease.
PARTS OF PRESCRIPTION
 PARTS OF PRESCRIPTION

 Prescriber’s Information. The name of the physician or dentist,

his specialty, clinic address, contact number and clinic hours.
 Patient information. The full name and address of the patient
are necessary for identification purposes.
 Date. Prescriptions are dated at the time they are written. The
date is important in establishing the medication record of the
patient especially in filling prescriptions for controlled
substances
 Rx Symbol or Superscription. The Rx symbol is a Latin verb
“recipe” meaning take thou or you take
 PARTS OF THE PRESCRIPTION

Medication Prescribed or Inscription. Body or main part of

the of the Rx order. It contains the names and quantities of the
prescribed ingredients or drugs, dosage form and potency.

• The name of the product must be written both in: Nonproprietary

(generic name) Proprietary (brand)
• Chemical
• Dosage form- the physical entity of medication (tablet, capsule)
• Strength – potency of drug (250 mg, 100IU)
• Quantity to be dispensed – this includes the amount and the unit
measure (grams, milligrams, tablets)
 PARTS OF THE PRESCRIPTION

 Dispensing Directions to Pharmacist or Subscription.

Directions to the pharmacist for preparing the prescription. These can be
used for:
• Preparations (compounding)
• Labeling ( information to be put on the label )

 Directions for the Patient or Transcription. Instructions on

the number of dosage units per dose (one tablet), route of
administration, frequency of dosing (every 4 hours), duration of
dosing (one week, for one month) and use of the drug
(optional)
 PARTS OF THE PRESCRIPTION

 Refill Information. If refill information is not supplied, it is

generally assumed that no refills are authorized

 Prescriber’s Signature. The name and signature of the

physician, veterinary or dentist who wrote the prescription order.
Below the signature of the physician are the licensed number to
practice his profession, PTR ( Privilege Tax Receipt) no. and TIN
(optional)
EXERCISE

• Try to identify the parts of the prescription:

 TYPES OF PRESCRIPTION

A. Based on ingredient:

1. Simple Prescription or Pre

compounding prescription:
-it contains 1 active ingredient.
-Prescription for already prepared drug
(by pharmaceutical
companies)

2. Cpmpounded or Extemporaneous
prescription:
- It contains more than one ingredient.
-The pharmacists prepare the
medication according to the drugs and
dosages directed by the physician.
 TYPES OF PRESCRIPTION
EXAMPLE:

Pre compounding prescription: Extemporaneous prescription

 TYPES OF PRESCRIPTION

Based on ingredient:

3. Polypharmacy Prescription
- With more than 2 prepared pharmaceutical
HERA GO 08-01-21
Example:
Losartan 50mg #30
Take 1 tab OD for a month

Atorvastatin 10mg #30

Take 1 tab once a day before bedtime
Clopidogrel 75mg #30
Take 2x a day

Omeprazole 20mg
Take once a day 30 mins before breakfast

JDoe
 TYPES OF PRESCRIPTION

B. Based on mode of prescribing

1. Written prescription
• handwritten on a single preprinted form from a prescription pad
• must be written in ink
• must be recorded in the patient’s medical record
• traditional way in which prescriptions have been written for centuries

2. Computerized prescription
• typed into the medical office’s software system
• copy of prescription is printed outsigned by the physician and given to the patient
• may be faxed directly to the pharmacist
 TYPES OF PRESCRIPTION

B. Based on mode of prescribing

3. Verbal prescription
• given over the telephone
• if not for a controlled substance, the pharmacist can fill the prescription
• without having a printed-out prescription
• without having the physician’s signature
 TYPES OF PRESCRIPTION

C. Magistral Prescription – prescribed very often by the same

doctor, same ingredient and compounded by the same
pharmacist.

D. Coded Prescription – is also called “blinded prescription”

and consist of words, symbols, to represent the name of the
drugs. This is unethical practice of doctors and pharmacist

E. Yellow Prescription – It is used for regulated and controlled

drugs with special license. It is made in triplicate copy.
 HOW TO PROCESS PRESCRIPTION

R
Prescription written Prescription is checked for
Patient presents
by authorized completeness; prescriber Correct patient info is
prescription to the
prescriber info, drug name, strength, entered into computer
pharmacy
dose, and directions system

LABEL

Prescription is prepared.
Pharmacy label is generated.
Correct amount of med Prescription is interpreted and
Make sure all the legal items
prescribed is measured and confirmed by pharmacy system. Third
are identified
placed into container party is billed online (optional)

Pharmacist provides counseling on

Prescription is prepared by Patient receives script, pharmacy
the medication prescribed and all
pharmacy technician, and assistant must offer counseling to the
 DISPENSING
FILLING AND RECORDING PROCEDURES

1. Dispensing should be done by Pharmacist

2. Partial Filling is allowed and must be reflected in the prescription
3. The prescription once filled must be retained by the pharmacist for
a period of two years
4. The prescription must be recorded in Rx book and ready for
inspection by FDA/DOH when the outlet is open for operation
anytime
TYPES OF ERROR IN PRESCRIPTION

• Erroneous Prescription
• Impossible Prescription
• Violative Prescription
 ERRONEOUS PRESCRIPTIONS

• Where the brand name precedes the generic name

• Where the generic name is the one in parenthesis
• Where the brand name is not in parentheses
• Where more than one drug product is prescribed on one prescription
form.

What to do with erroneous prescriptions

Erroneous prescriptions shall be filed. Such prescription shall also be
kept and reported by the pharmacist of the drug outlet or any other
interested party to the nearest DOH office for appropriate action. 

 
 VIOLATIVE PRESCRIPTIONS
•  Where generic name is not written
• Where the generic name is not legible and a brand name which is legible is
written
• When the brand name is indicated and instructions added (such as the phrase "
no substitution") which tend to obstruct, hinder or prevent proper generic
dispensing.

What to do with violative prescriptions

Violative prescriptions shall not be filed. They are kept and reported by the
pharmacist of drug outlet or any other interested party to the nearest DOH office
for appropriate action. The pharmacist shall advise the prescriber of the problem
and/or instruct the customer to get the proper prescription.
 IMPOSSIBLE PRESCRIPTIONS

When only the generic name is written but it is not legible.

• When the generic name does not correspond to the brand name
• When both the generic name and the brand name are not legible
• When the drug product prescribed is not registered with FDA

What to do with impossible prescriptions

Impossible prescription shall not be filed. They shall be and reported by the
pharmacist of drug outlet or any other interested party to the nearest DOH
office for appropriate action. The pharmacist shall advise the prescriber of the
problem and/or instruct the customer to get the proper prescription.
MEDICATION ORDERS AND OTHER
TYPES OF ORDERS
 MEDICATION ORDERS

• Order for a drug written on the agency’s (hospital, nursing

center) physician’s order form for a patient or resident.
 PARTS OF A DRUG ORDER ALL DRUG ORDERS AND
PRESCRIPTIONS MUST CONTAIN:

• Person’s full name

• Date
• Drug name
• Route of Administration
• Dose
• Frequency
• Duration of order
 4 TYPES OF DRUG ORDERS:

• STAT Order Drug- A single does of a medication is

administered immediately
• Single Order Drug - is to be given at a certain time & only
one time
• Standing Order Drug - is to be given for a certain number of
doses or for a certain number of days
• PRN Order Drug - is to be administered when necessary or as
needed based on the patient’s needs
• Only to be administered by nurse or physician
• Cannot be administered by Medication Assistant
ORDERING METHODS DOCTORS CAN GIVE DRUG
ORDERS IN SEVERAL WAYS:

1. Physician’s order sheet - is used to write medication orders for a patient in the
2. Verbal Order (Telephone Orders)- when a patient is in the hospital, physician
may give a verbal order over the phone to a licensed nurse. The nurse writes the
order on the physician’s order sheet. It is marked as a verbal order (V.O.)the
nurse signs her name. Physician must personally sign the order within a specific
amount of time.
3. Standing Orders - group of specific orders, preprinted on the facility’s
physician’s order sheet. Often pertain to protocol of treatment to a specific
disease or surgical procedure. In addition, a physician would also write more
specific medication orders to address a particular patient’s medical needs.
4. Automatic Stop Orders- originates with the hospital pharmacy and not the
physicianfor certain types of drugs (controlled substances)only valid for a
certain number of days. Determined by hospital's Pharmacy Committee policy