PRESCRIPTION WRITING ALOND WITH VARIOUS EXAMPLES

Detailed methods of writing prescription with examples

1. PRESCRIPTION WRITING EXERCISES

2. Principles of prescription writing A prescription is a written order or communication from a registered medical practitioner or other licensed practitioner to a pharmacist embodying salient instructions regarding the dispensing of prescribed medication for a particular patient. Prescriptions are written in a blank or universally accepted format or may be made in pads. A typical prescription consists of the following parts.

3. 1. Physician (Prescriber) Information: Doctor's name, designation and Registration Number. a. Address with phone number and e-mail. b. Date of issue of prescription. 2. Patient Information: The name, address, age and sex of the patient 3. Superscription: The superscription which consists of the heading where the symbol Rx an abbreviation for recipe, the Latin for 'take thou' or 'you take' is found.

4. 4. Inscription: The inscription (body of prescription) comprises an important part of prescription containing- a) Name(s) of drug(s) and their quantities, b) Instruction regarding dosage form like tablet, capsule, suspension, mixture, etc c) Dose and quantity of prescription 5. Subscription : The subscription gives specific directions for the pharmacist on how to compound the medication.

5. 6. Transcription or Signatura : The signatura which gives instructions to the patient, How, how much, When, and how long the drug is to be taken. These instructions are preceded by abbreviation 'Sig.' from the Latin, meaning 'mark.' The signatura should always be written in English; however, physicians continue to insert Latin abbreviations, e.g., ' 1 cap t.i.d . pc' which the pharmacist translates into English as 'take one capsule three times daily after meals'. It may also contain special instructions, warnings, followed by the signature of the prescriber.

6. 7. Refill: The number of times a prescription is to be repeated is written by the physician under renewal instructions. 8. Signature: Finally the prescription must bear the signature of the prescriber to impart it the legal validity.

7. Prescription Audit Guidelines – Annexure A & B

8. 1. 55year aged old male diagnosed to have Hypertension with a BP – 170/100 mmHg & HR – 112/mt. Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur,Chennai Patient’s details: Mr. Ramasamy,65/M, 55 kgs , Mount road, Chennai Diagnosis: Hypertension TAB. AMLODIPINE 5mg once a day in the morning for 2 weeks TAB. ATENOLOL 25mg once a day in the morning for 2 weeks Signature Advice: Salt restricted diet To review after 2 weeks

9. 2.Pregnancy induced Hypertension in 28 year old primi gravida Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur,Chennai Patient’s details: Mrs.Ranjani,28/F, 52 kgs , Mount road, Chennai Diagnosis: Pregnancy induced Hypertension TAB. ALPHAMETHYL DOPA 250 mg three times daily for 15 days Signature Advice: To review after 15 days Daily weight recording and monitor BP regularly Follow up immediately if blurring of vision, seizures occur

10. 3. 50year aged old male diagnosed with Hypercholesterolemia (Total Cholesterol – 280 mg/dl & Triglycerides – 120 mg/dl) Doctor’s name: Date:19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s name: Mr. Rajendran,50/M, 56 kgs , Mount road, Chennai Diagnosis: Hypercholesterolemia TAB. ATORVASTATIN 10 mg once a day at bedtime for 1 month Signature Advice: To avoid fatty food Regular exercise To review after 1 month

11. 4. 50year aged old male diagnosed with Hypercholesterolemia (Total Cholesterol – 246 mg/dl, Triglycerides – 210 mg/dl & LDL – 180 mg/dl) Doctor’s name: Date:19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s name: Mr. Rajendran,50/M, 56 kgs, Mount road, Chennai Diagnosis: Hypercholesterolemia TAB. ATORVASTATIN 10 mg once a day at bedtime for 1 month TAB. FENOFIBRATE 100 mg once a day at bedtime for 1 month Signature Advice: To avoid fatty food Regular exercise To review after 1 month

12. 5. 40year old male diagnosed to have new onset Type II Diabetes mellitus with FBS – 160 mg/dl & PPBS – 170 mg/dl. Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Raja, 40/M, Chennai Diagnosis: Type II Diabetes mellitus TAB. METFORMIN 500 mg twice a day for 2 weeks to be taken with food Signature Advice: Meal plan, exercise To review after 2 weeks

13. 6. 40year old male diagnosed to have new onset Type II Diabetes mellitus with FBS – 240 mg/dl & PPBS – 310 mg/dl. Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Raja, 40/M, Chennai Diagnosis: Type II Diabetes mellitus TAB. METFORMIN 500 mg twice a day for 2 weeks to be taken with food TAB. GLIMIPRIDE 1 mg once a day for 1 week to be taken before breakfast Signature Advice: To review after 1 week with FBS and PPBs Regular walking for minimum 20-30 minutes/ day Follow diabetic diet Consult if any warning signs like tremors, giddiness, sweating

14. 7. Acute gastritis in 30 year old male Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur,Chennai Patient’s details: Mr. Deva,30/M, 56 kgs , Mount road, Chennai Diagnosis: Acute gastritis TAB. RABEPRAZOLE 20 mg once a day to be taken half an hour before food for 5 days SYP. ANTACID 10 ml three times a day; to be taken 2 hours after food Signature Advice: Syrup to be taken if there is pain To avoid spicy food To review after 5 days

15. 8. H. pylori infection in 35 yr male Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deva, 35/M, 56 kgs, Mount road, Chennai Diagnosis: H. Pylori infection CAP. AMOXICILLIN 1000MG BD TAB.LANSOPRAZOLE 30 MG OD for 2 weeks TAB.CLARITHROMYCIN 500 MG BD Signature Advice To avoid spicy food To review after 2 weeks

16. 9. Migraine prophylaxis in 35 year old female Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s details: Mrs. Priya, 35/F, 56 kgs, Mount road, Chennai Diagnosis: Migraine Prophylaxis TAB. PROPRANOLOL 40 mg once a day in the morning for 10 days Signature Advice To review after 10 days Proper sleep To avoid the triggering factors Consult physician if there is giddiness

17. 10. Severe migraine with vomiting and aura in 35 year old female Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mrs. Gayathri, 35/F, 66 kgs, Mount road, Chennai Diagnosis: Acute attack of severe Migraine with vomiting and aura TAB. IBUPROFEN 400 mg twice a day TAB. RANITIDINE 150 mg twice a day to be taken before food x 3 days TAB. DOMPERIDONE 10 mg twice a day to be taken before food Advice: Review after 3 days Proper sleep To avoid the triggering factors

18. 11. Acute attack of severe migraine in a 35 yr old female Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mrs. Gayathri, 40/F, 66 kgs, Mount road, Chennai Diagnosis: Acute attack of severe migraine TAB. SUMATRIPTAN 100 mg STAT to be repeated once within 24 hours if headache persists TAB. PARACETAMOL 650 mg STAT AND SOS TAB. DOMPERIDINE 10 mg SOS for vomiting Signature Advice: Review after 1 month Proper sleep To avoid the triggering factors

19. 12. Obesity in 40 year old male Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deepak, 40/M, 35 kgs, Mount road, Chennai Diagnosis: Obesity CAP. ORLISTAT 120mg twice a day for 10 days Signature Advice: Adopt proper diet as advised by the nutritionist Review after 10 days Walking at least 20 minutes/day To consult physician in case of abdominal discomfort

20. 13. Mild bronchial asthma in 20 year old male; symptoms less than once daily, normal in between attacks Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deepak, 20/M, 35 kgs, Mount road, Chennai Diagnosis: Mild bronchial asthma INHALER LEVOSALBUTAMOL 1 -2 PUFFS (100 MICROGRAM) at onset of each episode To be repeated if symptom persistent Signature Advice: Avoid exposure to allergens

21. 14. Seasonal asthma in 20 year old male Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deepak, 20/M, 35 kgs, Mount road, Chennai Diagnosis: Seasonal asthma INHALER BUDESONIDE 1 -2 PUFFS (100 MICROGRAM) twice daily; to be started 3-4 weeks before season starts To be continued 3-4 weeks after the season ends Signature Advice: Avoid exposure to allergens

22. 15. Bronchial asthma in 20 year old male; symptoms once daily with subnormal ventilatory performance Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No - 52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deepak, 20/M, 35 kgs, Mount road, Chennai Diagnosis: Bronchial asthma INHALER BUDESONIDE 1 -2 PUFFS (100 MICROGRAM) twice daily TAB. DERIPHYLLINE 150mg twice a day for 2 weeks TAB. MONTELEUKAST 10 mg once daily at bedtime Signature Advice: Avoid exposure to allergens Review after 2 weeks

23. 16. Severe asthma in 20 year old male Doctor’s details: Date: 19/8/24 Dr. Vinoth, MBBS Reg No-52971 Tiruvanmiyur , Chennai Patient’s details: Mr. Deepak, 20/M, 39 kgs, Mount road, Chennai Diagnosis: Severe bronchial asthma INHALER FLUTICASONE 250 MICROGRAM 2 PUFFS twice a day ; through spacer device INHALER SALMETEROL 25 MICROGRAM 2 PUFF twice a day; through spacer device for 1 week TAB. MONTELEUKAST 10 mg once daily at bedtime Signature Advice: Avoid exposure to allergens Review after 1 week; Consult physician immediately in case of breathlessness