A prescription is a written order issued by a registered medical practitioner, physician, dentist,

veterinarian, or any other licensed practitioner to dispense or supply a specific medication at a

particular time.
Also known as extemporaneous prescription. It is an order that
Compounded
requires mixing one or more ingredients (active medicaments).
Types of
prescriptions Does not require the compounding of pharmaceutical
Non- products. Pre-compounded drugs supplied by a pharmaceutical
compounded company by its official or proprietary name.

• PARTS OF A PRESCRIPTION: The following are the parts of a prescription:

1. Prescriber’s information (address, contact numbers, and other relevant information)
2. Patient information 3. Date 4. Superscription
5. Medication prescribed or inscription 6. Subscription 7. Signa or Signatura
8. Renewal or refilling instructions 9. Prescriber’s signature

▪ PATIENT INFORMATION:
It includes the name, age, sex, and address of the patient. It is important to check the age of the
patient to ensure that the prescribed dose is correct. Weight can also be mentioned to calculate
the appropriate dose.
▪ DATE
Prescriptions are dated at the time of writing them. It is an important factor in establishing the
medication record of the patient. Date is also important to a pharmacist in filling prescriptions
for controlled substances. It helps to prevent the patient from producing the prescription
repeatedly at later dates.
▪ SUPERSCRIPTION
This is denoted by the symbol ℞, which is an abbreviation of the Latin verb “recipe,” meaning
“take thou” or “you take.” Some historians believe the symbol originated from the sign of
Jupiter, the god of healing.
▪ INSCRIPTION
This is the body or principal part of the prescription order. It includes the medication prescribed
and contains the names and quantities of the prescribed drugs. The medications may be
prescribed under their brand names or generic names. Pharmacists are required to dispense the
trademarked product when prescribed unless the prescribing physician and the patient permit
the substitution of an equivalent product.
The medicament may be official preparation or nonofficial preparation.
a.) Official preparation (i.e. from pharmacopeia) – Only the name of the preparation is written
E.g. Piperazine Citrate, Elixir IP
b.) Nonofficial preparation- The quantity of each ingredient will be given and the type of
preparation will also be given.
▪ SUBSCRIPTION
This part of the prescription contains directions to the pharmacist for preparing the
prescriptions and for dispensing them. In a large majority of prescriptions, the subscription
merely serves to indicate the dosage form (tablets, capsules, syrup, etc.) and the number of
dosage units to be supplied.
▪ SIGNATURA
This is usually abbreviated as “Signa” or “Sig,” meaning “mark thou.” In this portion of the
prescription, the prescriber indicates directions to the patient regarding the use of the
medication. The directions are usually written using abbreviated forms of English or Latin
terms or in combination.
▪ RENEWAL OR REFILLING INSTRUCTIONS
The number of authorized refills should be indicated on each prescription by the prescriber.
This is especially important for prescriptions containing narcotic and habit-forming drugs to
prevent their misuse.
▪ PRESCRIBER’S SIGNATURE
This is a necessary part of the prescription and is required to validate the prescription order.
 A budget is described as an instrument through which hospital administration, management
at the department levels, and the governing bodies can review the hospital services in
relationship to the prepared plan in a comprehensive and integrated form expressed in
financial terms.
• OBJECTIVES
1. Development of standards
2. Comparison of actual results with standards
3. Identification of deviation or fluctuation
4. Analysis of deviation
5. The responsible person will use the budget details to determine whether the
proposal is economically feasible and realistic.
6. To monitor the hospital's financial activities.
7. Estimate the cost of completing the objectives identified in the proposal.
• ADVANTAGES
1. Develop better financial planning.
2. Gives a better focus on decision-making to the management.
3. Effectively manage the financial aspects of the hospital.
4. Exposes the reasons for expenditure.
5. Helps to focus on hospital priorities.
6. Enhance the efficiency of staff and others.
• PREPARATION OF A HOSPITAL BUDGET
The hospital formulary system is a method whereby the medical staff of a hospital with the
help of the pharmacy and the therapeutic committee selects and evaluates medical agents
and their dosage form which are considered most useful in patient care.

CONTENTS OF A HOSPITAL FORMULARY

1. Information on drug products: This section is the heart of the formulary. It consists of
descriptive entries for each item to facilitate its use. Entries in the formulary such as:
• Generic name of the drug
• Common names (brand names),
• Dosage forms, strength, and packaging,
• Formulation (name of the active ingredient and formulation of the product),
• Dose for adults and pediatrics,
• Administration route, and
• Cost.
❖ Indexes to the Drug Product Listing:
There are two ways of making the indexes included either at the beginning or at the end of
the section to facilitate the use of a formulary:
a) Generic Name/Brand Name:
• Indexed with page numbers for easy reference.
b) Therapeutic or Pharmacological Index:
• This index is based on the therapeutic category, e.g., antihistaminic drugs, anti-
infective drugs, etc.
2. Information on Hospital Policies:
The formulary provides the following information regarding the hospital policies and
procedures for drug usage:
• Drug Usage Policies: Procedures and restrictions on drug use.
• Membership and responsibilities of the PTC.
• Hospital Regulations: Governing the prescribing, dispensing, and administration of
drugs, generic names, drug orders, investigational drug policies, rules to be
followed by medical representatives, emergency drug products, etc.
• Operating Procedures: Hours of services, outpatient prescription policies,
prescription labelling, packaging and practice, in-patient drug distribution
procedure, patient education program, etc.
• Formulary Use: Procedures for drug entry and organization in the formulary.
3. Special Information:
• Drug Dosage Schedule: Specific schedules for drug administration.
• Hospital-Approved Abbreviations: Standard abbreviations used in the hospital.
 • Additional Information:
Nutritional products list
Equivalent dosages of similar drugs
Guidelines for pediatric dose calculation
List of sugar-free drug products
Emergency box inventory
Metric conversions and tables
Drug interaction tables
Poison control distribution

PREPARATION AND REVIEW OF A HOSPITAL FORMULARY

▪ Preparation:
1. Formation of a Proficient Pharmacy and Therapeutics Committee (PTC):
The PTC is responsible for overseeing the development and maintenance of the hospital
formulary.
Key Decisions Made by PTC:
Type of Publication:
• Hospital’s Own Formulary: A formulary developed and maintained internally by
the hospital.
• List of Drugs: A simple listing of drugs without detailed information.
• Purchased Formulary Service: Acquisition of a formulary from an external
service provider.
2. Establishment of Evaluation Rules:
• To set standards and criteria for evaluating and including drugs in the formulary.
• Criteria for Drug Selection: Guidelines for assessing efficacy, safety, cost-
effectiveness, etc.
• Review Procedures: Regular intervals and methods for reviewing and updating
the formulary.
3. Content Sections to be included in the Formulary:
• Prescription Writing: Guidelines and formats for writing prescriptions.
• Use of Drugs: Information on the proper use and administration of drugs.
• Table of Metric Weights: Conversion tables for measurements.
• Tables of Common Laboratory Values: Reference values for interpreting lab
results.
• Section on Calculation of Doses for Children: Guidelines for dosing pediatric
patients.
• Pharmacological Index: Index of drugs based on their pharmacological
properties.
• Section on Reagents: Information on reagents used in diagnostic tests and
procedures.
4. Format of the Formulary:
• Size:
Determination of the physical dimensions of the formulary.
• Binding Style:
Loose Leaf: Pages can be added or removed as needed.
Bounded: Pages are permanently bound together.
• Printing Method:
Printed: Professionally printed copies.
Mimeographed: Duplicated copies, possibly less formal.
• Extent of Categorization and Indexing:
Categorization: Organization of drugs and information into categories.
Indexing: System for easy reference and navigation through the formulary.

▪ Review:
Procedure for Adding New Drugs:
• Adding a new drug involves a complex procedure.
• The Pharmacy and Therapeutics Committee (PTC) consults with external
experts due to limited in-house expertise for evaluating therapeutic agents.
Formulation Disclosure:
• Preparations with undisclosed formulas are excluded from the formulary.
Policy Guidelines:
• The PTC, in consultation with medical staff, has established guidelines for adding
or removing drugs.
Annual Revision:
• The formulary should be revised annually to accommodate new drugs, remove
outdated ones, and reflect changes in hospital policies and procedures.
Revision Methods:
• Supplement Sheets: One method involves attaching formulary supplement sheets
to the back cover of the formulary book.
• Color-Coded Covers: Another method uses different cover colors for each edition
to distinguish between current and past editions.
Regular Review:
• The revised formulary system should be regularly reviewed to ensure the use of
the most cost-effective products, which may lead to the removal of some drugs
from the formulary.
 Defined by the World Health Organization as
‘The extent to which a person's behavior [in] taking medication...corresponds with
agreed recommendations from a health care provider’
Medication adherence is one of the most important factors that determine
therapeutic outcomes, especially in patients suffering from chronic illnesses.
Treatment Adherence Outcome
• CAUSES OF MEDICATION NON-ADHERENCE
SOCIAL AND ECONOMIC DIMENSION
Limited English language proficiency
Low health literacy
Lack of family or social support network
Unstable living conditions; homelessness
Burdensome schedule
Limited access to healthcare facilities
Lack of health care insurance
Inability or difficulty accessing the pharmacy
Medication cost
Cultural and lay beliefs about illness and
treatment
HEALTH CARE SYSTEM