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Prescription writing
This document discusses prescription writing guidelines and best practices. It provides information on who can write prescriptions (physicians, nurse practitioners, pharmacists), prescription format, avoiding errors, and legal aspects. The key points are: - Prescriptions were traditionally addressed to apothecaries in Latin for accuracy, but now address patients directly. - Only certain medical professionals like physicians and dentists can prescribe, and they must be registered and have recognized qualifications. - There are different types of prescriptions like compounded and pre-compounded. - Guidelines are provided on prescription format, abbreviations to avoid, dosage writing, and ensuring legibility to prevent errors and legal issues.
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Prescription writing
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- 2. What is aprescription?
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- 4. Whom it addresses? •Ancient prescriptions were directed to apothecaries. • Contained multiple ingredients. Were complex to prepare. • So for sake of accuracy – Latin used. • Modern day prescriptions more or less address the patients directly.
- 6. Who can prescribe? •RMP, nurse practitioners and pharmacists. • RMP - Registered with Medical Council & possessing degree recognized by any Schedule of Indian Medical Council Act, 1956. • Dentists, Vet • Particular specialty only. Eg, Sildenafil Citrate only by Urologist, Psychiatrist, Endocrinologist, Dermatologist or Venerologist.
- 7. Types of Prescriptions •Compounded/ Extemporaneous/ Magistral. • Pre-compounded.
- 8. MODEL PRESCRIPTION FORMAT(MCI) Dr. Shashank Pandey (MBBS, MD Medicine) Regn. No. DMC/R/2204 Medicine O.P.D. No. 12, Vardhaman Hospital, Delhi – 92 Phone : 011-22775035, Email : [email protected] Date: 23/03/2016 Name of the patient Satya Sharma Address 17-D, Pocket – C, Mayur Vihar Phase – 2, Delhi – 110091 Age and Sex 62 years/ Male Rx Tablet GLYCERYL TRINITRATE 5milligram SUBLINGUAL STAT (IN CAPITAL LETTERS ONLY) One tablet should be taken. If symptoms do not resolve, may be repeated at 5 minute intervals for three doses. Signature (Dr. Shashank Pandey) DISPENSED Date : 23/03/2016 Pharmacist : Mr. Rajesh Name of the Pharmacy City : Delhi
- 9. Legal Aspects • Legiblehandwriting - a legal duty – Court can impose punishment. Source: J R Coll Gen Pract, 1989: 347-8 (WHO) • Refills. • Schedule H. • Schedule X.
- 10. Errors in DrugOrders • Institute of Medicine (IOM) estimates - 44,000 and 98,000 deaths (Kohn et al., 2000). • By being alert to common problems that can occur with medication orders and communicating with the patient’s physician, pharmacists and other healthcare professionals can assist in reducing medication errors. (Murray et al., 2009).
- 11. AVOIDING ERRORS… Abbreviations writtenout in full – 1 cap t.i.d. pc – written as "take one capsule three times daily after meals“. Write the generic name in brackets if brand prescribed. Prefix zero before decimals. - Digoxin 0.125 mg, Clonazepam 0.25 mg
- 12. Avoid unnecessary decimalpoints. Avoid trailing zeros in decimals. Write "mL" instead of "cc" or "cm³" to avoid misreading 'c' as ‘0’. Write micrograms. Avoid using /.
- 13. Write units insteadof IU or U. Avoid writing “teaspoons” or “tablespoons”. Quantities of 1 gram or more should be written as 1 g, 1.5 g etc. When "as needed" written. • specify indication. • maximum amount & frequency. Avoid ambiguity of intent.
- 14. Where possible specifyevents or times. - after breakfast & dinner. - at 8 am & 9 pm instead of twice daily. Writing numbers as words and numerals (“dispense thirty”). Do not use older units and symbols of measure (pints (O), ounces (℥), drams (ℨ), scruples (℈), grains (gr), and minims (♏). Warn about common adverse effects. Give emergency contact numbers (personal or hospital).
- 15. Good prescription writing… •Presence of patient. • Write without hesitation, with determination and concentration. • Avoid distractions while writing. • Do not make any changes or cross-outs. • Set aside for a few minutes and proof read before affixing signature. • Never loan your prescription pads to anyone.
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Editor's Notes
- #3 It is a written order from a prescriber to dispenser to dispense a specific treatment and containing appropriate instructions for the patient.
- #6 We can see how elaborately prescriptions were written. But the patient could not understand it.
- #12 It is the legal duty of the doctor to write a rational, legible and complete prescription. All prescriptions should be written in ink.
- #14 An inpatient order written as “cyclophosphamide 4g/m2 days 1-4” or “cyclophosphamide 4g/m2 over 4 days” when the intent was for “cyclophosphamide 1g/m2 each day for 4 days” could prove fatal.