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Prescription Writing

Prescription Writing (Structure)

A prescription must contain at least two identifying attributes of the patient. In the United States we use name and date of birth (DOB). Patient’s address can be written, however, it is optional. Of course the prescription should have the doctor’s information and signature for it to be complete.

Following is a sample prescription.

Drbeen Sample Prescription

Rx Symbol

There are many theories for the origin of the Rx. For our purpose this is sufficient to know that the Rx is transliteration of a latin symbol for recipe. Recipe in latin means take.

Drug Administration Instructions

Prescribed drug is written with the following structure:

  1. Name
  2. Strength
  3. Amount
  4. Route
  5. Frequency
  6. Total quantity to dispense
  7. Refills

Before we get into the understanding of how to write each component. Let us look at an example of a drug prescription.

Prescribe 250mg Amoxicillin tablets. Take by mouth, two tablets at one time, three times a day, for 7 days. Dispense for all of the 7 times. No refills. 

Prescription will look like this

Amoxicillin 250 mg tablets. ii tablets p.o. t.i.d. x 7 days
Dispense# 42 (forty two)
Refills: none

Here is how it will look in handwritten note:

 

Drbeen Sample Prescription 04.png

When written on a leaf from the prescription paper it looks like the following.

Drbeen Sample Prescription copy 2

Let us now label various parts of this prescription.

Drbeen Sample Prescription copy 3.jpg

Practice writing this prescription on your own: orders are to:

  • Prescribe 250mg Amoxicillin tablets.
  • Taken orally, two tablets at one time, three times a day, for seven days.
  • Dispense all the tablets together.
  • No refills.

In the next part of this series we will discuss terms for each part so that you can prescribe various amounts, routes, and frequencies.

 

 

 

 

 

 

Categories
Prescription Writing

Prescription Writing (General Considerations)

Objective of the prescription is to convey the Physician/Practitioner’s intent to a pharmacist holistically and completely. The chain of drug administration can be broken at any point from the sequence below:

  • Ordering (Physician/Practitioner.)
  • Transcribing (Physician/Practitioner/Other Healthcare Staff.)
  • Dispensing (Pharmacist and their team.)
  • Administering (Pharmacist/Nurse/Patient/Other help.)

 

In my opinion latin terms have added to the issue unnecessarily. Top it off with the abbreviations  and we have increasing risk of errors. (Yes I realize that the abbreviations are for efficiency but error in prescription is more harmful than the advantage of writing fast.)

There are many studies, guidances, best practices, etc. to help with this situation. The series of articles here is intended to simplify and present how to write a prescription. Examples given are by no means intended as prescriptions for any patient.

General Considerations

Here is a list of points to keep in mind while prescribing, transcribing, dispensing, or administering the medication:

  • Strive to be clear even if it means sacrificing the use of an efficient term. Follow-up with the pharmacist and/or patient for the sake of clarity.
  • Be verbose where confusion can occur. For example: JCAHO asks to not use q.d. for the word daily, they suggest to spell out the word instead.
  • Take special care when writing a, o, and numbers.
  • Decimal point and zeros need special care.
  • Legibility is important. Our chicken-scratches make the drug administration error prone.
  • Some ePrescription programs lack good data in their databases. In such cases an  attempt to force a prescription through the system by using notes section etc., can cause errors.
  • Never shy away from double checking if you feel that you need further clarity.

In the next part we will look at the structure of a prescription/recipe and the terms used for various parts of it.