Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K.

Vishwakarma 1

1.PRESCRIPTION

DEFINITION
It is an order written by a physician, dentist, veterinarian or a registered medical practitioner (RMP) to
a pharmacist to compound and dispense a specific drug for the patient.
OR
Prescription is a written order for medication, issued by physician or RMP

 Prescription is relationship between physician and pharmacist.

Physician (RMP) Pharmacist patients
 The word "prescription" is derived from the Latin term praescriptus (Prae - 'before' and
scribere- meaning 'to write').
 Prescription means 'to write before' which means prescription had to be written before a drug
could be compounded and administered to a patient.

A. PARTS OF A PRESCRIPTION

A typical prescription consists of the following parts:

1. Prescriber office information
2. Date
3. Patient information (Name, Age, Sex And Address Of The Patient)
4. Superscription (symbol ℞)
5. Inscription (Medication prescribed)- Main part of prescription
6. Subscription(Direction to Pharmacist/Dispenser )
7. Signatura or Transcription (Direction for Patient)
8. Renewal instructions
9. Prescriber’s signature and registration number.
1. Physician (Prescriber) office Information:
 Information about physician is essential so that the patient could be contact in emergency.
 Following information is mentioned on the prescription
i. Doctor's or office name.
ii. Address with phone number and e-mail.
iii. Prescription number, (required when calling the pharmacy for a refill)
2. DATE
 It helps a pharmacist to find out the date of prescribing.
 It also helps in know when the medicines were last dispensed if the prescription is brought for
redispens.
 In case of habit forming drug the date prevents the misuse of the drug by the patient.

3. PATIENT INFORMATION (Name, Age, Sex and Address of the Patient)

 Name and address of the patient for identification purpose.
 Age and sex of the patient is required for child patient to check the prescribed dose.

4. SUPERSCRIPTION (symbol ℞)
 It is represented by ℞ (Latin term) „recipe‟ which means „take thou‟ or „you take‟.
 In olden days, the symbol was considered to be originated from the sign of Jupiter.
 Jupiter is the Greek God of healing.
 This symbol was use for requesting God for the quick recovery of the patient.

5. INSCRIPTION (Medication prescribed)

 It is the main part of the prescription.
 It contains the names and quantities of the prescribed medicaments.
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 2

 The medicament may be official preparation or nonofficial preparation.

a.) Official preparation (i.e. from pharmacopoeia) – Only name of the preparation is written
E.g. Piperazine Citrate Elixir IP
b.) Nonofficial preparation- Quantity of each ingredient will be given and type of
preparation will also be given
6. SUBSCRIPTION (Direction to Pharmacist)
 In this part the prescriber gives direction to the pharmacist-
a) Regarding the dosage form to be prepared.
b) Number of doses to be dispensed.

7. SIGNATURA (Direction for Patient) - To be placed on the label.

 It is usually written as „Sig.‟.
 The signatura written in english and use some Latin abbreviations like
t.i.d (thrice a day), b.i.d (twice a day) and o.d (once a day)
 Instructions should be written on the label of container so that the patient can follow them.
 The instructions may include
a) Quantity to be taken(dose of drug)
b) Frequency and timing of administration of the preparation (dose interval)
c) Route of administration
d) Special instruction (if any)

8. RENEWAL INSTRUCTIONS
 The number of times a prescription is to be repeated is written by the physician.
 It is very important for the case of habit forming drugs to prevent its misuse.

9. PRESCRIBER’S SIGNATURE AND REGISTRATION NUMBER

 The prescription must be signed by the prescriber by his / her own hand.
 Registration number should be written in the case of dangerous and habit forming drugs.

B. TYPES OF PRESCRIPTION
 Prescriptions can be classified as
a) Compounded prescription
b) Noncompounded prescription

a). Compounded prescription-

 Also known as extemporaneous prescription.
 It is an order that requires mixing of one or more ingredients (active medicaments).
 It contains several ingredients which are divided into the following parts:
(a) Base: The active medicaments (Produce the therapeutic effect).
(b) Additives-
1) It enhances the action of the drug.
2) It makes the preparation more elegant (attractive) and palatable.
(c) Vehicle: It is the main carrier of the drug.
E.g. -In liquid preparations solvent (water) used as vehicle.
 Now a day‟s compounding is omitted from prescription.
E.g.
Sodium bicarbonate 3g
Simple Syrup 6ml
Purified Water (q.s.) 100ml

b). Noncompounded prescription

 Does not require compounding of pharmaceutical product.
 Precompounded drugs supplied by a pharmaceutical company by its official or proprietary name.
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 3

C. Legal Requirements for a Valid Prescription

1. Prescription should be written in indelible (can not erased) ink (may be handwritten or
computer generated)
2. Prescription must be signed in indelible ink by the practitioner using his own name.
3. Prescription must be dated by the prescriber.
4. Prescription should state address of the practitioner
5. if issued by a dentist the words „for dental use only‟
6. Prescription always writes legibly.
7. Prescription always space out words and numbers to avoid confusion.
8. Prescription always contains complete medication orders.
9. Avoid abbreviations.

 Now a day‟s electronic prescriptions use, to minimize medication errors.

 The use of Latin word in prescription writing is traditional.
 Now a day‟s Latin has slowly gone.

An example of a typical prescription is given as follows:

KAILASH NURSING HOME

Gorakhpur date- x/y/z
Name: Mr. N. Sharma Age: 42 years Sex: Male
Address: 32, Azad Nagar, Gorakhpur, weight:- 52Kg

℞ (Superscription)
Arachis oil 50ml
Inscription Simple Syrup 6ml
Purified Water q.s. 90ml

Fiat emulsio. (Subscription)

Sig. Cochleare magnum ter in die post cibos sumenda.
(Signatura)

Refill: x/y/z Sing

Dr. A.K Sharma
Reg. No. 14328

Emulsio (Emulsion)
Cochleare Magnum (Table Spoon)
Post Cibos ( After Lunch)
Ter In Die (Thrice a Day)
Sumenda (To be taken)
Latin Terms

Latin term / phrases Abbreviation English Translation

Semel in die or omne in die o.d Once a day
Bis in die, Bis die b.i.d. or b.d. Twice a day
Ter in die, Ter die t.i.d. or t.d. Thrice a day
Quartar in die q.i.d., q.d. Four times a day
Si opus sit s. o.s When required
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 4

2.HANDLING OF PRESCRIPTION

 The following procedures should be adopted by the pharmacist while handling the prescription
for compounding and dispensing:

I. Receiving
II. Reading and checking
III. Collecting and weighing the materials
IV. Compounding, packaging and labeling
(I) Receiving
 The prescription should be received by the pharmacist.
 While receiving a prescription, a pharmacist should not change his/her facial expression.
 It gives an impression that he/she is confused or surprised after seeing the prescription.

(II) Reading and checking

 After receiving the prescription it should be screened behind the counter.
 Prescription authenticity should be checked.
 The signature of the prescriber and the date of prescription should be checked.
 The pharmacist should read all the lines and words of the prescription.
 He/she must not guess any word.
 If there is any doubt, the pharmacist should consult with the other pharmacist or the
prescriber over telephone.

(III). Collecting and weighing the material

 Before compounding a prescription all the materials should be collected from the shelves or
drawers.
 All the materials kept in the left hand side of the balance.
 After measuring each material should be kept on the right hand side of the balance.
 After compounding of the prescription materials are replaced back to the shelves / drawers.
While compounding every container of material should be checked thrice in the following manner:
(i) When collected from the shelves/drawers.
(ii) When the materials are measured.
(iii) When the containers are replaced back to the shelves/drawers.
(IV). Compounding, packaging and labeling
 Only one prescription should be compounded at a time.
 Compounding should be done on a clean table.
 All equipment required should be cleaned and dried.
 The preparation should be prepared according to the direction of the prescriber or as per
methods given in pharmacopoeia or formulary.
 The compounded preparations should be filled in suitable containers.
 Label the container.

CARE REQUIRED IN DISPENSING PRESCRIPTION

Following precautions should be taken while dispensing a prescription.
1.The prescription must be carried with the pharmacist while taking the medicine out of the shelves.
2.The dispensing balance should always be checked before weighing any ingredient.
3.All the chemicals should be replaced back in to their original positions in the shelf.
4.Care should be taken to keep the balance clean after each measurement.
5.Liquid preparations for external use the label must display FOR EXTERNAL USE ONLY in red
ink.
6.Before handing over the medicine to the patient, again the preparation should be checked.
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 5

3. ERROR IN PRESCRIPTIONS
1. Abbreviation
In most of the prescriptions abbreviated terms are used by the prescriber that leads to major errors
during interpretation by the pharmacists.
E.g. „SSKI‟ is the abbreviated term of „Saturated Solution of Potassium Iodide‟. It is preferable to
avoid these types of misleading abbreviations.

2. Name of the drugs

Names of some drugs (especially the brand names) either look or sound alike. So any error in the
name of a drug will lead to major danger to the patient.
e.g. Althrocin – Eltroxin, Acidin – Apidin , Digoxin- Digitoxin etc.

3. Strength of the preparation

Drugs are available in the market in various strengths. So a drug must not be dispensed if the strength
is not written in the prescription.
E.g. Paracetamol tablet 500mg should not be dispensed when no strength is mentioned in the
prescription.
4. Communication failure
Failures during the process of patient management - Includes illegible handwriting, incomplete
prescribing order.
Common errors include: „g‟ mistaken for „mg‟

4. Dosage form of the drug prescribed

Many drugs are available in more than one dosage forms.
E.g. liquid, tablets, injections or suppositories.
The dosage form intended for the patient must be mentioned in the prescription to reduce ambiguity.

5. Dose
If unusually high or low dose is mentioned in the prescription then it must be consulted with the
prescriber. Some time a sustained release (SR) dosage form is prescribed thrice or more times daily.
Actually SR dosage forms should be given once or twice a day.

6. Instructions to the patient

Some times the instruction for a certain preparation is either omitted of mentioned partially. The route
of administration should be mentioned clearly.

7. Incompatibilities
 It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in the
prescription.
 If more than two medicines are prescribed then it is the duty of the pharmacist to see whether
their interactions will produce any harm to the patient or not.
 Certain drugs have interactions with food.
E..g, Tetracycline should not be taken with milk or antacid.
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 6

LABELING OF DISPENSED MEDICINES

After dispensing the medicine in a container, a label is attached by adhesive. The label on the
dispensed medicines should provide the following information:–
1. Name of the preparation-When the prescriber mentions the name in the prescription the same
name must be displayed on the label.
e.g. PIPERAZINE CITRATE ELIXIR IP
If it is a non-official preparation then the name of the dosage form should be given on the label.
e.g. THE MIXTURE, THE EMULSION, THE DUSTING POWDER
2. The strength of the medicine- The strength of the active ingredient in the preparation must be
displayed if it is intended for internal (oral) purpose.
The amount in each unit of dose should be mentioned.
e.g. In case of oral liquids “Each 5ml contains 250mg”
e.g. In case of tablet “Each tablet contains 500mg”.
The values must be written in whole numbers and if decimal is not avoidable then a zero is placed
before the decimal point. E.g. instead of 0.1g it should be 100mg, and instead of .5% it should be
0.5%.
In case of an official preparation the strength is not required to be given, because the name with
reference to the pharmacopoeia is sufficient. E.g. CHLORAMPHENICOL ORAL SUSPENSION
IP.
3. The quantity supplied in the container
The total quantity of the product dispensed in the container should be indicated on the label. E.g.
50ml, 4tabs etc.
1. Storage conditions and shelf life (expiry date) of the product
(a) Temperature: Many preparations are required to be kept below 150C. In these cases the label
should indicate KEEP IN A COOL PLACE.
Suppositories and pessaries melts at 370C so the label should indicate KEEP IN A COOL
PLACE.
Insulin injections should be stored at 2 to 80C so the label should indicate KEEP IN
REFRIGERATOR.
(b) Humidity: Powders, tablets and capsules should be stored in an air-tight container. The label
should indicate KEEP THE BOTTLE TIGHTLY CLOSED.
(c) Light: Drugs those degrade in presence of light should be stored in dark place. The label
should indicate KEEP IN A DARK PLACE.
6. Instructions to the patient
(a) Directions
The directions are normally written by the prescriber. These include
(i) the quantity to be taken
(ii) the frequency or timing of administration
(iii) the route of administration
(iv) or the method of use
The phrases used are generally „to be taken‟, „to be given‟, or „to be used‟.
e.g. One tablet to be taken thrice daily after meal.
(b) Warning label:
For external use In case of external preparations like ointment, pastes, dusting powders
only. etc.
Drowsiness Warning: May cause drowsiness. Do not drive or operate machinery or
warning. car.
Potential (i) Drugs in which absorption improves if taken before food:
interactions with Warning: To be taken an hour before meal or in empty stomach.
food or drink (ii) Drugs causing gastrointestinal irritation
Warning: To be taken with or after meal.
(iii) In case of metronidazole Warning: Avoid alcoholic drink.
Interactions with Tetracycline complexes with calcium, iron, magnesium and inhibits its
other medicine absorption, Do not take milk, iron preparation or antacids with this
medicine.
Kailash Institute of Pharmacy and Management, Pharmaceutics-I (Unit-I), D.K. Vishwakarma 7

Special methods of (i) The drug formulation that is required to be dissolved in the mouth
administration To be sucked or chewed.
(ii) Oral powders or granules are required to be dissolved in water
To be dissolved in water before taking.
(iii) Drugs causing gastro-intestinal irritation
To be taken with plenty of water.
Cautions (i) Preparation that may produce photosensitization
Avoid exposure of skin to direct sunlight.
(ii) The preparation that may produce unusual effect.
The preparation may color the urine or stool.
(iii) In case of inflammable preparation
Keep away from naked flame.

Special instructions to particular dosage form

Application For external use only.
Capsules Swallow with a draught of water.
Creams For external use only and Keep in a cool place.
Dusting powder For external use only.
Not to be applied to open wounds or weeping surfaces.
Ear drops For external use only.
Emulsions Shake the bottle before use.
Enemas For rectal use only and Warm to body temperature before use.
Eye drops To be used within 30days after first opening.
Gargles & mouthwashes Not to be swallowed in large amount.
Linctuses To be sipped and swallowed slowly without addition of water.
Liniments and lotions For external use only.
Shake the bottle before use.
Do not apply on broken skin. ( Because it will produce irritation)
Mixtures Shake well before use.
Nasal drops For nasal use only
Ointments, Pastes and For external use only.
Paints
Pessaries For vaginal use only
Suppositories For rectal use only and Store in a cool place.