Prescription full.pptx

Pharmaceutics 1

1. Venugopal N Assistant Professor PHARMACEUTICS - 1 PRESCRIPTION

2. CONTENT Definition Parts of Prescription Latin terms and abbreviations used in prescription. Handling of Prescription Errors in Prescription

3. Prescription from through to

4. Definition Prescription is a written order from a registered medical practitioner/doctor/physician or other licensed practitioners, such as dentist, veterinarian, etc. through a patient for a pharmacist to compound and dispense a specific medication. OR Prescription is a written order from a registered medical practitioner/doctor/physician or other licensed practitioners, such as dentist, veterinarian, etc. to a pharmacist to compound and dispense a specific medication for the patient .

5. Parts of Prescription Date Name, age, sex, and address of the patient Superscription Inscription Subscription Signatura Renewal Instructions Signature, address and registration number of the prescriber.

6. 1. Date Every prescription must bear the date on it. It helps a pharmacist to find out the date of prescribing and date of presentation for filling the prescription. This helps the pharmacist to keep day-day Patient’s record in chronologic order which helps the pharmacist or a physician to refer the old case in future. To avoid misuse of the narcotic or other habitat forming drugs containing prescriptions by the patient a number of times for dispensing. 

7. 2. Name, Age, Sex, Address of Patient Name, Age, Sex and Address of the patient must be written on the prescription. Name helps the pharmacist to identify the correct Patients avoiding any chance of giving the medicine to a person other than the one it is dispensed for. Note: patient’s full name must be written instead of nicknames or surnames.

8. Age of the patient becomes important in the case of the Pediatric (children) and Geriatric (old people) cases. Because the dose of drugs in such cases varies(due to their differences in ability to metabolize drugs). Hence dose of the drugs are calculated based on the age factor in such cases. Note: In some cases weight and height of the patients are also required. Sex/Gender of the patient also plays major role in prescription because dose of drugs may also vary based on the sex/gender of the patient(as their abilities to metabolize/ response towards drugs may vary in many cases). Address of the patient is generally recorded to contact the person at the later stage or to deliver the medication personally

9. 3. Superscription This part of the prescription is represented by the symbol “R X ”. It is used as a abbreviation for the Latin term “Take Thou” which means “you take” In the ancient times it is considered as a prayer to Jupiter, the God of healing for the fast recovery of the patient.

10. 4. Inscription This is considered as the main part of the prescription order. It contains the names and quantities of the prescribed ingredients. The name of each ingredient is written on a separate along with its quantity.

11. In the complex prescription containing several ingredients the inscription can be divided into following parts: Base (active medicament of therapeutic action) Adjuvants(substances added to increase action of medicament/ its palatability) Vehicle(substance used to dissolve medicament/increase volume of preparation) Nowadays, the majority of the drugs are prescribed which are already in a suitable formulation. The pharmacist is required to dispense the ready-made form of drugs. So, compounding of prescription is almost eliminated.

12. 5. Subscription This part of the prescription contains directions of the prescriber to the pharmacist regarding the type and compounding of dosage form along with number of doses to be dispensed. This is important because dose of drug also depends on the type of the dosage form. * fiat – make, mistura – Mixture = Make a mixture

13. 7. Signatura This part of the prescription contains directions to the patient regarding the administration of the drugs. It is generally represented as ‘ Sig ’ on the prescription. * cochleare magnum – one tablespoon * ter in die – three times a day *post cibos – after meals * sumenda – to be taken

14. 8. Refill/Renewal Renewal instructions: In this part, the prescriber whether the prescription can be renewed or not. It also should include the specifications like how many times it can be renewed It is of utmost importance incase of narcotic/other habitat forming drugs.

15. 8. Signature, address & Registration number of prescriber The signature and Regd.no of the prescriber turns the prescription into legal and authentic order to the pharmacist. This helps in preventing the use of spurious drugs. Regd.no is of utmost importance in prescription containing narcotic drugs to prevent its misuse.

16. Latin terms used in prescription

17. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION DOSAGE FORMS tab Tabella Tablet caps Capsula Capsule pulv Pulvis Powder collyr Collyrium Eye wash crem Cremor Cream emul Emulsio Emulsion collut Collutorium Mouth wash lin Linctus Linctus lini Linimentum Liniment

18. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION lot Lotio Lotion m, mist Mistura Mixture narist Naristillae Nasal drops past Pasta Paste pill Pilula Pill auristill Auristille Ear drops ung Unguentum Ointment suppos Suppositorium Suppository inj Injectis Injection

19. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION TIME OF ADMINISTRATION Sem in die Semel in die Once a day b.i.d , b.d Bis in die, Bis die Twice a day t.i.d , t.d Ter in die Three times a day CORRELATED TIME a.c Anti cibos Before meals p.c Post cibos After meals i.c Inter cibos Between meals

20. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION DIFFERENT TIME OF THE DAY Prim. m Primo mane Early in the morning m Mane In the morning o.m Omni mane Every morning o.n Omni nocte Every night Inter nocte Inter nocte During the night jentac Jentaculum Breakfast n.m Nocte et mane Night and morning

21. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION HOUR TIME o.h. Omni hora Every hour o.q.h . Omni quarta hora Every fourth hour alt. hor. Alternis horis Every two hours tert . hor. Tertis horis Every three hours Quart. hor. Quartis horis Every four hour Sext. Hor. Sextis horis Every six hours

22. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION METHOD OF ADMINISTRATION OR APPLICATION addend Addendus To be added applicand Applicandus To be applied capiend S or sum Capiendus Sumendus To be taken dand Dandus To be given deglut Deglutiendus To be swallowed inhal Inhaletur To be inhaled miscend Miscendus To be mixed U or utend Ultendus To be used

23. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION VEHICLE USED Coch amp mag max Cochleare Amplum Magnum Maximum One tablespoon Coch.med . Cochleare medium One teaspoonful c cum With c. dup. Cum duplo With twice as much c. pt. aeq . Cum parte aequale With an equal quantity Cyath . Amp. Cyathus amplus A tumbler e. lact . E.lacte With milk Ex.aq Ex.aqua With water

24. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION PARTS OF THE BODY a.d. Auris dexter To right ear a.l. Auris laevus To left ear brach . Brachis To the body Jug. Jugulo To the throat _ Naso To the nose o.d. Oculis dexter To right eye o.l Oculis leaves To left eye o.s. Os,oris To mouth

25. ABBREVIATION FULL LATIN WORD ENGLISH TRANSLATION MISCELLANEOUS ad Ad Upto a Ante Before cibos Cibos Meals, food ft. Fiat Make it h Hora An hour om Omni Every Rx Recipe Take ss Semi Half omn Omni Every

26. Handling of Prescription

27. Steps The following steps are to be followed during handling of a prescription for compounding and dispensing: Receiving Reading and checking Collecting and weighing the material Compounding, labeling and packing

28. 1. Receiving The prescription should be received by the pharmacist himself. While receiving, he shouldn't change any facial expressions, which gives an impression to the patient that he is surprised or confused after seeing the prescription.

29. 2. Reading and checking On receiving the prescription the pharmacist should check the prescription whether it is written in a proper format. The prescription should always be screened behind the counter. Any doubts in case of prescription ingredients or drugs and directions he should discuss with another senior pharmacist or physician but not with the patient. Pharmacist should never guess about the meaning of any illegal or confused word.

30. What to check in a prescription… ? Error in dosage Wrong drug or dosage form Contra indicated drugs Synergistic and Antagonistic drugs Drug interactions. Sometimes prescription is received on telephone by senior pharmacist. In such case, after taking down the prescription, it should be verified by repeating it on phone to the prescriber.

31. 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

32. 3. Collecting and Weighing the material Before compounding the prescription, all the materials required for it are collected on the left side of the balance. After weighing each material should be shifted on to the right side of the balance. Note: while compounding label of the stock bottle should be read at least three times to avoid any error: When taken from the shelf When the contents are removed for weighing/measuring When containers are returned back to its proper place

33. 4. Compounding, labeling and packaging Compounding should be carried out in a neat place. All the equipment required are cleaned and dried thoroughly. Only one prescription should be compounded at a time. The compounded materials should be filled in a suitable container based on quantity and use. The size of the label should be proportional to the size of the container. Label should contain the required suggestions/directions to the patient.

34. Errors in Prescription

35. Errors Abbreviation Name of the drug Strength of the preparation Dosage form and drug prescribed Dose Instructions to patient Incompatibilities

36. 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 , eg : to dispense achromycin for “ achro ” may cause difficulty when the intention of the prescriber is to dispence achrostatin The abbreviation “SSKI” represents the use of a short hand for saturated solutions and chemical symbols for potassium iodide.

37. 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 Indocine Linococin Prednisone Prednisolone Doridon Doxidon Pabalate Robalate Digoxin Digitoxin Althrocin Eltroxin

38. Name of the pharmaceutical products have been changed on certain occasion due to the possible confusion with the name of 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

39. 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.

40. 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.

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

42. 6.Instructions for patients The instruction for the patient which are given in the prescription are completed or omitted The quantity of the drug to be taken , the frequently of the drug to be taken, the frequently and timing of administration, and route of administration should be clearly given in the prescription so as to avoid any confusion.

43. 7.Incompatibilities It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in a 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

44. QUESTION BANK Define Prescription and enlist the different parts of prescription. Explain in brief the different parts of old prescription with a neat labeled diagram. Explain the steps involved in handling of prescription. Discuss the different errors may occur in prescription.

45. THANK YOU