This document discusses prescription writing guidelines. It defines a prescription and outlines the rational steps for prescribing. It describes the parts of a prescription including the superscription, inscription, subscription, and transcription. It provides guidance on writing drug names, dosages, and directions. It also covers prescribing controlled substances and abbreviations commonly used in prescriptions. Computerized physician order entry is introduced as a method to reduce errors related to handwritten prescriptions.
This document discusses prescription writing guidelines. It defines a prescription and outlines the rational steps for prescribing. It describes the parts of a prescription including the superscription, inscription, subscription, and transcription. It provides guidance on writing drug names, dosages, and directions. It also covers prescribing controlled substances and abbreviations commonly used in prescriptions. Computerized physician order entry is introduced as a method to reduce errors related to handwritten prescriptions.
This document discusses prescription writing guidelines. It defines a prescription and outlines the rational steps for prescribing. It describes the parts of a prescription including the superscription, inscription, subscription, and transcription. It provides guidance on writing drug names, dosages, and directions. It also covers prescribing controlled substances and abbreviations commonly used in prescriptions. Computerized physician order entry is introduced as a method to reduce errors related to handwritten prescriptions.
This document discusses prescription writing guidelines. It defines a prescription and outlines the rational steps for prescribing. It describes the parts of a prescription including the superscription, inscription, subscription, and transcription. It provides guidance on writing drug names, dosages, and directions. It also covers prescribing controlled substances and abbreviations commonly used in prescriptions. Computerized physician order entry is introduced as a method to reduce errors related to handwritten prescriptions.
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Prescription writing
200 9
Dr.Saeed Ahmed
A prescription: A physician's order to prepare / to dispense a specific Tr -usually medication- for an individual patient.
Rational prescribing: Like any other process in health care, writing a prescription should be based on a series of rational steps: 1- Make a specific diagnosis 2- Consider ! pathophysiologic implications of ! diagnosis 3- Select a specific therapeutic objective 4- Select a drug of choice 5- Determine ! appropriate dosing regimen 6- Devise a plan for monitoring ! drugs action & determine an end point for therapy 7- Plan a program of patient education.
In ! hospital setting, drugs are prescribed on a
particular page of ! patients hospital chart called ! physicians order sheet/ chart order. There are 3 common types of Rx : 1- Prescription in general practice 2- Hospital prescription for in-patients 3- Hospital prescription for an (external pharmacy).
Parts of prescrition: Superscription: name, professional degree, contact no. address of ! prescriber, ! date when ! order is written. name, address & age of ! patient; & ! symbol Rx (an abbreviation for "recipe," ! Latin for "take thou." _ Inscription : ! body of ! Pres. containing ! name, strength of each drug, & dosage form of ! Tr. Subscription: quantity to be dispensed. ! directions to ! pharmacist, usually consisting of a short sentence: "make a solution," "mix & place into 10 capsules," or "dispense 10 tablets." Transcription : labeling of instruction to ! Patient, prescriber's signature.
When writing ! drug name:
either generic name (nonproprietary name) is used. OR ! brand name (proprietary name) - ! strength of ! medication should be written in metric units (Not apothecary). 1 gr = 60 mg 15 gr = 1 g 1 ounce (oz) by volume = 30 ml 1 tsp = 5 ml 1 tbsp= 15 ml 20 drops= 1 ml 2.2 ponds (Ib) = 1 kg.
Principles for writing pres. for both
controlled & uncontrolled drugs Prescribers should: ALWAYS write legibly in ink (clear writing) Use metric system (g, L) ALWAYS sign & date ! the prescription Precise Accurate Use precautions to remind patients about SE NEVER abbreviate drug names
When writing ! INDIVIDUAL DOSE:
for STRENGTHS >1g use grams for STRENGTHS <1g use milligrams e.g.100mg for STRENGTHS <1mg use micrograms e.g. 100 microgram (NEVER use 'g') AVOID unnecessary decimal points e.g. use 300 mg NOT 0.3 g.
Previous adverse pres./ allergies; ask for drug
history or medical record Check other medication charts (anticoagulants, insulin) Specify time course; if ! drug is taken for a number of days/ continuously (course of antibiotic, antihypertensive/ antiparkinson drugs. As required medications Indication, frequency, minimal time interval btw doses & maximum dose in 24 hr period.
! instructions should be sufficient for a nurse
to administer a drug accurately in ! hospital, or for a pharmacist to provide a patient e both ! correct drug & ! instructions on how to take it.
Medication error is ! most common
medical mistake.
Prescription for uncontrolled drugs include:
- date - identification of patient: name, hospital number, age, sex - name of ! drug - dose of ! drug - frequency of administration - route & method of administration - amount to be supplied - ! prescriber's signature.
Controlled drugs: Substance, which may
produce physical, psychological dependence / both Prescribed for not > than 2 weeks because sudden withdrawal may lead to withdrawal symptoms..
Classification of controlled substances . Based on estimated addiction liability
Class Potenti -al for abuse I High abuse potential
Rationale for category & Rx rules
Examples
No accepted medical use, All no research
use forbidden, can Not be prescribed lack of accepted safety as drug
Heroin, LSD (Lysergic
Acid Diethylamide), marijuana
II
Current accepted medical use but abuse
may lead to severe physical/ psychic dependence
Opioids as morphine, amphetamines
III
< class II Current accepted medical use. moderate
or low potential for physical & high potential for psychologic dependence, No refills, Rx must be rewritten after 6 months
Weaker opioids such
as codeine, some amphetamine-like drugs
IV
< III
Medical use is accepted. Limited / low potential for dependence
Diazepam, phenobarbital, chloral hydrate etc
Schedule V
< IV
Medical use is accepted. ! least potential for abuse
cough syrups e codeine , antidiarrheal e diphenoxylate etc
Schedules of Controlled Drugs: ! drugs are divided into 5 schedules:
Schedule I Drugs in this schedule have no accepted medical use & have a high abuse potential. Ex. heroin, marijuana, LSD, etc. Schedule II Drugs in this schedule have a high abuse potential e severe psychic or physical dependence liability. Included are certain narcotic analgesics, stimulants, & depressant drugs. Ex. opium, morphine, codeine, methadone, cocaine, amphetamine. Schedule III Drugs in this schedule have an abuse potential < than those in Schedules I & II & include compounds containing limited quantities of certain narcotic analgesic drugs, & other drugs such as barbiturates. pentobarbital. Schedule IV Drugs in this schedule have an abuse potential < than those listed in Schedule III & include such drugs as barbital, phenobarbital, chloral hydrate, chlordizepoxide, diazepam, oxazepam etc. Schedule V Drugs in this schedule have an abuse potential < than those listed in Schedule IV & consist primarily of preparations containing limited quantities of certain narcotic analgesic drugs used for antitussive & antidiarrheal purposes.
Rx for controlled drugs:
Should not be typed & written by hand Written in ink Signed & dated Carry ! prescriber's full name, address & registration number State ! form of ! drug State ! total quantity of ! drug or ! number of doses units (10.0 mg i.e. ten milligrams) Not be refillable > than 5 times in a 6 months period for schedule III-IV-V Rx; No refilling for schedule II Rx.
Abbreviation \
Meaning
. a. c
before meals
.p.c
After meal
cap
Capsules
gram
.h
hour
mg
milligram
ml
milliliter
Bid
Twice daily
. p. o
by mouth, orally
. p. r . n
when necessary
. q. d
once a day
. q.i.d
times a day 4
. q. h
every hour
. q.2h
every 2 hours
. t.i.d
times a day 3
IA
Intra-arterial
IM
Intramuscular
IV
intravenous
Hs
At bed time
Cap
Capsule
Sup, supp
suppository
Susp
suspension
Tab
tablet
Stat D/C CD
At once Discontinue Controlled drugs
Computerized physician order entry (CPOE):
is a process of electronic entry of physician instructions for ! tr of patients (particularly hospitalized patients) under his or her care. These orders are communicated over a computer network to ! medical staff (nurses, therapists, pharmacists, or other physicians) or to ! departments (pharmacy, laboratory or radiology) responsible for fulfilling ! order.
CPOE advantages: - decreases delay in order completion, - reduces errors related to handwriting or transcription,?? - provides error-checking for duplicate or incorrect doses or tests, & - simplifies inventory & posting of charges.
