prescription definition,parts and handling

Prescription definition, parts, handling:

Prescription: The word "prescription" comes from the Latin term "praescriptus" . It is a combination of two words, prae and scriber. "Prae" meaning  before and scriber meaning to write = to write before. Historically, a prescription was written before the drug was prepared and administered.

Defn: Prescription is an order for medication issued by a physician, dentist, veterinarian or any other properly licensed registered medical practitioner.

Prescriptions designate a specific medication or drug  and dosage form to be administered to a particular patient at a specified time and by a specific route.

Parts of prescription:

1. Date: It is important to avoid misuse of prescription if it is presented by the patient, a number of time for dispensing.

2. Name, age, sex & add of the patient: The Name, age, sex & address of the patient is important for proper handling of prescription & also identification of patient .Age & sex is important especially for children to check prescribed dose of medication.

3. Superscription: Rx stands for Latin word recipe meaning ‘you take’ or take thou. It is the symbol in the name of god of healing called Jupiter to pray for quick recovery of patient.

4. Inscription: This is main part of  the prescription contains the medication prescribed. The medicine prescribed may be of proprietary or generic or any special formula from the physician.  It contains the name of drug, base, Adjuvant and vehicle or name & quantities of the prescribed ingredients.

5. Subscription: Direction to the pharmacist for preparing dosage form as instructed with quantity. Ex. ‘Mix’,‘ Send tablets’, or ‘capsules’ , dispense 20 tablets etc. With diminished number of compounded prescription and available prefabricated dosage forms these directions are less frequent.

6. Signature: It consists of the direction to be given to the patient regarding administration of the drug. It includes how to take medication, when to take, with which vehicle it is to be administered.

7. Renewal or refilling  instructions: The prescriber indicate on every prescription order whether it may be renewed & if so, how many times. It is important particularly in the prescription containing the narcotic & other habit forming drugs to prevent misuse.

8. Signature, address & registration number of the prescriber: The prescription bears signature, address & registration number of the prescriber. It is important particularly in the prescription containing the narcotic & other habit forming drugs to prevent misuse

Dispensing of prescription includes all of the steps necessary to translate a medication order (prescription) into an individualized medication supply that is both safe and appropriate. It includes following steps.

Step 1 Receiving the Prescription:  It is necessary to receive the receive the prescription by the pharmacist, this will enhance the patient-pharmacist relationship. It is necessary to obtain the correct name and address and other information of the patient.

Step 2Reading and checking the prescription: A member of the pharmacy team will enter the prescription into your profile, checking the: doctor’s information, medication/dose, indications from the prescriber, and quantity of the medication. The pharmacy system will check for possible interactions or other potential issues through the Drug Information System. If something is illegible or it appears that there is an error it may be clarified with fellow pharmacist or prescriber.

Step 3Labelling: The pharmacist will perform a clinical check of your medication, which includes an assessment for drug interactions, allergies, as well as reviewing previous medications for the same use and ensuring it is the most appropriate drug, dose and duration for your condition.  A pharmacist or pharmacy technician will perform a technical check on the accuracy of the information entered into the pharmacy software system, the label and the contents of the vial or package. They will also print off counselling documents to provide the patient with more information on the medication.

Step4Preparing the prescription: After checking the prescription order pharmacist should decide the correct procedure of compounding or dispensing of prefabricated dosage forms. Pharmacist should carefully check the name of dosage form prescribed and with the name of mfg company, its dose, dosage form type then qty required and take correctly number of doses required and put into the container.

Step5Rechecking, delivering and patient counseling,: The patient will pick up their medication and the pharmacist will provide counseling to the patient on the medication.  If it is adding and  refill, this may include an assessment regarding how well the medication is working for you, and whether you are experiencing any side effects.  

A detailed description of the dispensing process can be viewed as given below:

1.       Input & Initial Check (Do we have all of the information we need?)

2.       Therapeutic Check (Is the prescription right for you?)

3.       Preparation

4.       Technical Check (Is the prescription filled accurately?)

5.       Supply and Educate

1. Input & Initial Check (Do we have all of the information we need?) 

·         Prescriber details

·         Patient details (age, weight, medical conditions, allergies, etc.)

·         Medical insurance coverage details

·         Confirm medication/items to be dispensed

·         Confirm indication

·         Preference details (safety caps, etc)

·         Prescription meets legal requirements (date, drug, strength, instructions, signature, etc)

2. Therapeutic Check (Is the prescription right for you?) 

·         Ensure dosage is both safe and appropriate based on age, weight, etc.

·         Ensure the medication is compatible with current medical conditions and allergies

·         Ensure the medication is compatible with other medications being taken

·         Ensure the prescription is appropriate for the condition being treated

3. Preparation 

·         Select appropriate drug, brand, strength, form, quantity

·         Repackage when necessary

·         Prepare when necessary (reconstitute or compound from raw ingredients)

·         Review expiry, instructions

·         Apply cautionary labels

·         Complete documentation and records

·         Organize counselling aids (e.g. written materials)

4. Technical Check (Is the prescription filled accurately?) 

·         Ensure correct drug, brand, strength, form, quantity

·         Ensure correct formula/methodology has been used for compounded products

·         Confirm successful medical insurance processing

5. Supply and Educate 

·         Confirm patient identity

·         Educate the patient/caregiver on the appropriate use of the medication

·         Clarify any patient issues & questions

·         Obtain patient/caregiver signature for supply when necessary

Modern methods of prescribing.

1. Now a days role of pharmacist is to hand over the ready made preparations to the patients and provide advice if demanded regarding its mode of administration, dose schedule, drug interactions etc.

2. In present day set up, the writing of prescription is more significant. The prescription should be precise, accurate, clear and easily readable. As far as possible Latin terms should be avoided.

3. The drugs should be prescribed by its official (generic) name not by its proprietary or trade name.

Advantages of prescribing the drugs by its proprietary names

1) Easy to remember

2) Easy to communicate with the patient.

3) The continuity can be maintained by prescribingthe same proprietary name every time.

4) Only those proprietary drugs can be prescribed which have better bioavailability.

Disadvantages of prescribing the drugs by its proprietary names

1) It is cheaper to prescribe the drugs by its official name.

2) It becomes difficult for a pharmacist to dispense the substitute of the drugs which is available in the stock