PH 3.

1 INTRODUCTION TO
PRESCRIPTION WRITING-
PRINCIPLES AND
PRACTICES
Dr. Lavakumar S., MBBS MD.
Professor
Dept. of Pharmacology; SSSMCRI
 SLO
• Define a prescription
• Enlist the Components of an ideal prescription
• Enumerate the Guidelines for a rational
prescription
• Illustrate with an Example of a typical
prescription
• Enlist the features of an ideal prescription
• Take home messages
 What is a prescription?
• Proe- Before
• Scribo-write
 DEFINITION
• proe – before
• scribo – write
• A written or a verbal order of information by a
professionally qualified person to the
pharmacist to dispense the medicaments to
the particular patient in suitable quantity to
for use
 WHO CAN PRESCRIBE?
• Physician
• Dentist
• Veterinarian
 What is it?
• Instruction to pharmacist to dispense
medicament in suitable quantity to the
particular patient
 Prescription is a written communication

• Is an important therapeutic transaction

between the physician and the patient
• It must communicate clearly with pharmacist
and adequately instruct the patient on how to
take the prescribed medication
 COMPONENTS
• Presciber (Doctor) information
• Patient information
• Date
• Diagnosis (provisional)
• Rx symbol
• Drug information
• Dispensing direction for the pharmacist
• Dosage
• Prescriber signature
 Prescription indicates a decision of
management of patient
To be conveyed in writing:
• to pharmacist to prepare and dispense drugs
• To patient about how to take the drug
 Extremely important document
• Date
It is a medico-legal document
• A Must information
Identity of prescribing
indoctor
prescription:
• Identity of patient
• Body of prescription
• Signature of prescribing doctor
 Plan before you write it!
• Following rational steps are taken before and
while writing a prescription
Steps to be taken in writing a prescription

• Make a specific diagnosis

(provisional/presumptive)
• Consider pathophysiology of the diagnosis
• Select a specific therapeutic objective
Plan the basis for selection of the drug

• Diagnosis
• Specific characteristic of the patient e.g. age,
sex, pregnancy, lactation, diseases of heart,
liver, kidney and nervous tissue
• Lab tests
• Total cost of the drug therapy
 Plan the details
• Choose appropriate formulation
• Dosing regime(dose, frequency and duration)

• These are decided by pharmacokinetics of the

drug
• Consider the liver and kidney functions
 Plan about monitoring of drug action
How the action of drug will be monitored?
• By lab tests
• Improvement of signs and symptoms
• Appearance of toxicity
• Blood levels
• Determine end point for the therapy
• Advice to the patient (specific education)
 Precautions while writing
• Always write with ink
• Handwriting must be legible
• Write generic name
• The generic name can be followed by brand
name in bracket (with details like
manufacturers name etc)
• First letter of the drug name must be in capital
e.g. Aspirin
• If “as required”, elaborate
• Actual time of administration
• After food or on empty stomach
• Strength of formulation
• e.g. in ampoule- Paracetamol 150 mg/ml, 2 ml
ampoule
 Parts of a prescription

 Prescriber’s information
 Patient information
 Superscription
 Inscription
 Subscription
 Transcription / Signatura
 Prescriber’s information
• Name of the doctor
• Qualification
• Medical Registration No.
• Address (home and Hospital/clinic)
• Contact number
• Date of prescription
• Validity period of prescription
• Date of follow up and repeat prescription
 Patient details
• Name
• Age
• Sex
• Address
• Provisional/ final diagnosis
Superscription- Heading

• This symbol is the

abbreviation for the
Latin word “receipe”
• It means“Take Thou”
• You take! (Pharmacist,
You take the following
instructions)
 Inscription
(Body of Prescription)
• Name/s and quantity of the ingredients
• Basis/Principle drug-Most active drug having
therapeutic value
• Adjuvant- enhances action of principle drug
• Corrigen/corrective-It counteracts unwanted actions
of principle drug
• Vehicle- It is the medium in which medicament is
dissolved or suspended (water)
 Precautions
• No abbreviations about the names of drugs
• Use metric system
• For solids 1 g or more
• If less than 1 g, it is written in mg e.g. 500 mg and not
.5 g
• No 0 after decimal e.g. 1 mg. not 1.0 mg
• Write 0.5 ml and not .5 ml
• If range, use same units e.g. 0.5-1g and not 500 mg-
1g
 Subscription
• Directions to Pharmacist
• Mode of compounding
• Amount to be compounded
• Form of final medicament
• Division in doses
 Subscription……
• Form of remedy- Tab,
• How to prepare
• Quantity to be sent (dispensed) and manner
of dispensing
 Transcription/Signatura
• Directions to patient
• Method of administration/application
• Dose to be taken
• Time of administration
• Duration and frequency
• Part of the body to which applied and how (for
topical formulations)
• Any other specific instruction
 Signature of physician
• The prescription is valid only if physician signs
the prescription
 Label
• Details of patient (name, age, sex and address)
• Name of formulation
• Directions for use (in local language)
• Special mention prominently if for external use only (
E.g. Poison)
• Signature of Pharmacist, date and address of
Pharmacy
• Date of manufacturing, expiry
 Commercial label

• Generic name first and more • Name and address/ location

conspicuous (bigger and bold of manufacturer
font) • Batch No.
• Pharmacopia-IP, BP, USP and • Date of manufacturing and
NF expiry
• Brand name latter, smaller • Instructions for storage
font • Alcoholic content if more
• Net contents of active than 3%
ingredients
 Brand names may be confusing Verify

• Flumed- Fluconazole (Anti-fungal)

• Flumeg- Fluoxetine (Anti-depressant)
• Mox-Amoxycillin (Antibiotic)
• Lox-Lignocaine (Local Anaesthetic)
• Febex-Ferrous fumarate+Folic acid+Vitamin
B12 (Hematinic)
• Febrex-Paracetamol (analgesic)
 Instructions for storage
• Expiry date is valid subject to proper storage
• Extremely important for vaccines, hormones
and antibiotics
 Storage……
• Store in cool place (10-20 C°)
• Store in cold place (not
exceeding 8 C°)
• When temperature not mentioned room
temperature, dry place, not in direct sunlight
and ALWAYS AWAY FROM CHILDREN
 Dispensing
• One drug should be dispensed in one packet
 Prescribing more than one formulation:

Following sequence is conventionally followed

• Injection/s
• Oral formulation/s- capsules, tablets, liquids
• Topical formulation/s
 Common prescribing errors
• Incorrect
• Illegible
• Incomplete
• Inappropriate
 Ideal prescription is……
• Correct
• Complete
• Clear to self, pharmacist/chemist and patient
• Compatible for patient
• Represents comprehensive patient care
 Role of Pharmacist is vital
• Buffer between Doctor and Patient
• Transfers instruction from doctor to patient
 PARTS OF A PRESCRIPTION
• 1. Superscription:
• Rx and also includes the patient details
• 2. Inscription:
• Ingredients and the quantity of each used
• 3. Subscription:
• Directions to the dispenser
• Directions to the patient
• Signature with date
 GUIDELINES FOR A RATIONAL
PRESCRIPTION WRITING
• Make a specific diagnosis
• Consider the pathophysiological implications
of the diagnosis
• Select a specific therapeutic objective or goal
• Select a drug of choice with possible drug
interactions at the back of your mind
• Determine the appropriate dosing regimen
• Monitor the drug actions and adverse effects
 EXAMPLE
• Name: Age & sex: Hosp No: Date:
Address:
Diagnosis: Upper respiratory tract infection
Rx
Tab. AMOXYCILLIN 500mg tds/1-1-1 for 3-5 days
Tab. CETRIZINE 10mg HS/0-0-1 for 3 days
Tab. PARACETAMOL 500mg tds/1-1-1 for 1 – 2
days or SOS
• 1. Prescribe for a male patient Mr.
Christopher aged 45 yrs with severe
hypertension with B.P. of 170/100 mm Hg.
• Doctor’ name: Dr.
• Qualiication:
• Reg No:
• Address:
• Patient name: Age: Gender:
• Patient Address

• Diagnosis: Severe Hypertension

• Rx
• 1. Tab. Atenolol 50 mg OD – in the morning
after food for 15 days.
• 2.Tab. Hydrochlorothiazide 12.5 mg OD in the
morning after food for 15 days.
• Advice: Salt restricted diet and review after 15
days.

• Signature
NAMES THAT SOUND SIMILAR - BEWARE

• COTRIMOXAZOLE – CLOTRIMAZOLE
• AMINOPHYLLINE – AMITRIPTYLINE
• AMIODARONE – AMILORIDE
• GLIPIZIDE – GLICLAZIDE
• IMIPRAMINE – IMIPENEM
• CHLORPHENIRAMINE – CHLORPROMAZINE
• CYCLOSPORINE – CYCLOSERINE
• CLOMIPHENE – CLOMIPRAMINE
• DOMPERIDONE – DROPERIDOL
• PENICILLIN - PENICILLAMINE
 TAKE HOME MESSAGES
• GENERIC NAME IN CAPITAL LETTERS
• AVOID UNNECESSARY DECIMALS IN NUMBERS
• Eg: 3 mg and not 3.0 mg
• Denote microgram as mcg and not as μg,
because it can create confusion
• Use ml instead of cc
• Avoid overwriting and striking off
• Write legibly
• For Insulin units please write it as
• 16 U – 0 – 20 U
• Explain to the patient how to use the
prescribed medicines
• Explain the importance of drug compliance to
the patient
 FINALLY……
• Presription writing is a art and
science conveying message from the
prescriber to the patient
THANK YOU & ALL THE BEST