Common Clinical abbreviations used in handling medications

Module 6 Lesson 1

DEFINITION

A prescription is a written order (handwritten or electronic) by a registered physician directing

the pharmacist to prepare or dispense pharmacological agents/medications for the
diagnosis, prevention, mitigation, treatment, and cure of a disease.

Types of Prescription

There are mainly two types of Prescription:

1)Pre-compounding prescription: Prescription for already prepared rug (by pharmaceutical

companies) e.g. Cap. Ciprofloxacin (500 mg) etc.

2)Extemporaneous prescription: The pharmacists prepare the medication according to the

drugs and dosages directed by the physician.

Difference between Pre-compounding and

ExtemporaneousPrescription

PARTS OF PRESCRIPTION
An ideal prescription should have the following parts:
Date
Superscription
Inscription
Subscription
Transcription
Signature

PARTS OF PRESCRIPTION
An ideal prescription should have the following parts:

Date
Superscription
Inscription
Subscription
Transcription
Signature

PARTS OF PRESCRIPTION
DANGEROUS DRUG PRESCRIPTION

Triplicate copy.
Date
Superscription

Inscription
Subscription

Transcription
Signature

Prescription
• E-prescribing / E-prescription
• Medications are encoded into an automated data entry system

Advantages:
• Reduced errors due to prescription legibility
• Concurrent softwares are screened for drug
interaction
• Reduced incidence of altered or forged prescriptions
• Efficiency for both prescribers and pharmacists
• Convenience to the patient
Medication order:
• Forms used in institutional or hospital setting
• Other forms may be used depending on the unit
• Infectious disease, cardiac care, pediatric, obstetrics, othopedics etc.
• Drug-specific forms may also be used
• Heparin dosing, electrolyte infusions, morphine sulfate in patient controlled anesthesia
• Special forms used by clinical drug investigators for their study protocol

Date:
- Prescription is still valid
- To know when the medicines were last dispensed
- To prevent the misuse of the drug by the patients

Superscription:
- Information about the prescriber (name, address and telephone number)
- Information about the patient (full name, address, gender, DOB, weight & height if
necessary)
- Rx symbol
-It is an abbreviation of Latin term “Recipe”, meaning “to take” or “take thou”

Inscription:
-Main part of the prescription.
-It gives the information about the name of the drug (generic or trade name), its formulation
and unit dosage.
Subscription:
-Subscription provides information to the pharmacists about the quantity and dosage form of
the drug to be dispensed.

Transcription:
-Transcription is the prescribers direction to the patient contains instruction about the amount
of drug, time and frequency of doses to be taken.

Signature & Instructions:

- Prescription should be signed by the prescriber.
-Refill instructions (if needed)
-Special instructions (if any)
*Suspension – Shake well before use
(Auxilliary label)

A Prescription should be:

-Kept simple
-Abbreviations free (if necessary Latin abbreviations
should be used)
-Trailing zeros should be avoided, Leading zeros must be
added
-It should provide clear and specific directions

Errors and Omissions

Before dispensing, ensure that the prescription and medication orders are correct for the
following aspects:

- Prescriber information (including address & telephone number)

- DEA ( Drug Enforcement Administration) number for authority to prescribe
narcotics (S2 license)
• ID or License number of the physician
• Date of the Rx
• Patient information
- Dose relevant information like age or weight
• Drugs prescribed
- Dose, preparation strength, dosage form, quantity
• Clarity of any abbreviations or symbols and/or units of measure
• Refill and/or generic substitution
• Need for special labeling
• Expiration date, conditions for storage, foods and/or other medications that should not be
taken concurrently
• Listing of ingredients to be compounded

Types of Medication Errors

Prescribing errors
Omissions Errors
Wrong Time Errors
Unauthorized Drug Errors
Improper Dose Errors
Wrong Dosage Form Errors
Wrong Drug preparation errors
Wrong Administration technique errors
Deteriorated Drug Errors
Monitoring errors
Compliance errors

Use of Abbreviations and Symbols

Recommendations to Reduce Errors in the Interpretation Rx & Medication Orders

• Whole number should not be written with a decimal point or terminal zero
- 4 g not 4.0 g
• A quantity less than one should be shown with a zero preceding the decimal point
- 0.4 g not .4g
• Leave a space between a number and a unit
- 4 mg not 4mg
• Use whole numbers and not decimal fractions if possible
- 100 mg not 0.1 g
• Use the full names of drugs and not their abbreviations
- Phenobarbital not PB
• Use USP designation for the units of measure
- For grams, use g not Gm
• Spell out "units" and do not abbreviate International Units
- "Units" instead of "U", can be misread as u
- "International Units" instead of IU, can be misread as IV
• Certain abbreviations that could be mistaken for other abbreviations should be written
• Avoid using "d" for day or dose because of profound differences between terms
- As in mg/kg/day or mg/kg/dose
• Integrate capital letters to distinguish between "look alike" drug names
• Amplify the prescribers directions on the prescription label when needed for clarity
- Swallow one (1) capsule with water in the morning, rather than AM

Erroneous Prescription
Where the brand name precedes the generic name
• Where the generic name is the one in parenthesis
• Where the brand name is not in parentheses
• Where more than one drug product is prescribed on one prescription form

What to do with erroneous prescriptions?

Erroneous prescriptions shall be filed. Such prescription shall also be kept and reported by
the pharmacist of the drug outlet or any other interested party to the nearest DOH office for
appropriate action

Violative Prescription
• Where generic name is not written
• Where the generic name is not legible and a brand
n a m e which is legible is written
• When the brand name indicated and instructions added (such as the phrase " no
substitution") which tend to obstruct, hinder, or prevent proper generic dispensing
• What to do with violative prescriptions

What to do with violative prescriptions?

Violative prescriptions shall not be filed. The pharmacist shall advise the prescriber of the
problem and/or instruct the customer to get the proper prescription

Impossible Prescription
• When only the generic name is written but it is not legible
• When the generic name does not correspond to the brand name
• When both the generic name and the brand name are not legible
• When the drug product prescribed is not registered with FDA

What to do with impossible prescriptions?

Impossible prescription shall not be filed. They shall be and reported by the pharmacist of
drug outlet or any other interested party to the nearest DOH office for appropriate action.
The pharmacist shall advise the prescriber of the problem and/or instruct the customer to get
the proper prescription.

Ten Steps To Minimize Prescription Error

1. Correct entry of the prescription must be ensured.

2. It should be confirmed that the prescription is correct and complete.
3. A prescriber or pharmacist must be aware of look-alike, sound alike drugs.
4. Extra care should be given with zeros and abbreviations.
5. Workplace must be organized.
6. Distraction should be reduced when possible.
7. Focus must be given on reducing stress and
balancing heavy workloads.
8. Drugs should be stored properly taking
adequate time.
9. All prescriptions should be checked thoroughly.
10. Thorough patient counseling should be
provided.

Drug Labeling

Principal Display Panel

● GENERIC NAME ENCLOSED IN A BOX
● BRAND NAME PLACE BELOW THE GENERIC NAME
● QUANTITY
● POTENCY
● DOSAGE FORM
● THERAPEUTIC CATEGORY
● RX SYMBOL IF IT IS A PRESCRIPTION DRUG
● NAME OF TRADER, MANUFACTURER AND DISTRIBUTOR

Side Informations
● FORMULATION ON ACTIVE COMPONENT INDICATION
● DOSAGE INFORMATION FOR CHILDREN AND ADULT
● CONTRAINDICATIONS
● PRECAUTIONS
● MANUFACTURE DATE
● LOT NUMBER
● EXPIRY DATE
● PRESCRIPTION REQUIREMENT (IF PRESCRIPTION DRUG)