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Medical Prescriptions

o Written order by doctor directing for drugs to be dispensed in stated


forms for a particular patient
Doctor, dentist
o
o
o

Used as evidence in the court of law


In PI, illegal to prescribe regulated drugs without prescription
Should be written plainly
Simple or compound
Simple - one ingredient - parasetimol
Compound - combo of 2 antihistamines
Chlorephenomine/
Official
Approved by FDA
Not drugs that are not registered by your country (fly by night)
List of drugs that are official --Extemporaneous - put together a compound in doses suited to
disease
Cream or lotion by two ingredients
Aka non official -- not usual way of prescribing it
Doctors mix a lot of ingredients, but it's allowed; not harmful
Anti-cough, congested --- more convenient for patient to
take it

Structure
o
o

o
o

Patient's name
Age
Will guide the pharmacist
5 year old boy given a capsule; pharmacist feels that boy can't
take capsule; makes call to doctor and tells him the situation of
the boy's age
Address
Pharmacist makes a mistake - don't give whole dosage that you
paid for; address makes you look for patient
Date
Don't want to give another refill
Important because you have to identify the name
Helpful to patient, relatives
Mom has 3 kids; need to know which med is for which
kid
Helpful to even the pharmacist --- who may have forgot
who the medicine is for

Rx - superscription
Symbol
Recipe in latin; take though ---this is the medicine that the
patient will be taking
Rx pad aka prescription pad

Inscription

Names - single, compound

Amount of remedial agents prescribed


And appropriate vehicle to be take by the patient
Basis - drugs from which dr. expects true remedial effect
Parasetimol -- lowers body temp (true effect)
Main factor
Adjuvant Inc or intensify the action; several drugs that synerge
the parasetimol
Corrective to those other drugs to minimize the
undesirable effect of basis
Flavoring agents
Orange, banana flavors to disguise the unattractive
tastes
But some drugs just not palatable

Subscription
Embodies the Dr's direction to pharmacist as to method and of
preparation of drugs and amount of the drug
Only preparation and number of pills dispensed
Example --- in capsule
SIS - Capsule can be in suspension (syrup)
Too much to sell; should be in bottle depending on
Two bottles of remedial agent
Could be in cream, in solution, in lotion form, in powder form

Signature aka S
If you look at prescription given, no signature given
But some others like the one shown in manual has it
Not dr's signature
Direction of doctor to the patient; if child, direction to guardian,
or if patient is hospitalized, direction to hospital personnel
To save money, some nurses sent to the house ---sig. is
given to the nurse
Includes how the patient has to take it
One time, with glass of water, time of administration,
frequency
Example - take 1 capsule every 8 hours for one
week; get this when you have computed the
medication that you will prescribe; have to justify
these directions
Not the certification by the physician - finally guar

Cert by Physician

License number
Official signature that you're certifying the Rx

Different Kinds of Prescription in Philippines punishable by Law


o Violative prescription
Instead of generic name written, you write down the brand
name
Generic name not legible
Brand name is indicated, but you add another word wherein dr.
doesn't want pharmacist to change brand name ---- "no
substitution please"
Have to give patient or buyer chance to choose his own brand
name
o

Erroneous prescription
Where brand name receives the generic name
Ex -- write a big Amoxil 50 mg; and a tiny little amoxycilin (tiny
words)
Generic name is in parenthesis
More than one drug product is prescribed in order not to waste
your space on the Rx paper
Economical

Impossible prescription
When only the generic name is written but NOT legible;
pharmacist cannot read it (impossible to read); hence the
term "chicken scratch"
Generic name doesn't correspond to the brand name
Amoxycillin (500 mg) and you put ventolin
You know they don't coincide; doctor should be
penalized
When both generic and brand name are not legible
They want you to buy in his drug store; only staff
members can read it; others can't read it
When drug prescribed that's not registered with the BFAD
Even if the generic name is already approved by BFAD,
but if there's no such thing as brand (not registered);
whether brand name or generic name
Impossible = it doesn't exist

How to differentiate generic vs. brand name


Generic - true name of the remedial agent
Brand name --- name given by drug company
Example -- amoxycilin - generic; amoxyl - brand
Amoxycilin - comes with dozens of brand names
in some countries
Some opinions that doctors use patients just to become
rich; losing tenderness and warmth to them

Correct Prescription
o Name of patient
o Age
o Date

Address

o
o

Superscription
Inscription
If you don't write brand name, it's still correct
If you do, it should be smaller than generic and in parenthesis
Can't be reversed (erroneous)
Capsule - and amount
Signature
Direction to patient
"one capsule every 8 hours for 1 week"
Last Tuesday, Dr. Formalino gave also abbreviations; do
not give abbreviations to patients ---- Prn (if necessary)
- Read and know all abbreviations ----- P c4
PRN, STAT, OU
Certification

Usually prescriptions are copied; not required because you have your own index card
for each patient -- own file --- contains diagnosis that only you know and understand
o Some have blue, yellow copy -- - so that the drug company can
reimburse you for how many drugs you prescribed
o If dr. didn't indicate brand name, pharmacist can offer other brand
names to the patient; pharmacist has privilege to offer it; patient not
obligated to buy it though -- he wants a cheaper one
o Not recommended to write more than one brand name
Dr. tells patient to buy cheaper generic one for patient to
choose written on a different Rx paper
Ex combipack for TB or entepack -----all the same
Practical
o
o

Take a paper --A 20 year old man came to clinic due to fever and cough for 5 days
duration;
Adult patient - use empirical

Pedia patient example


8 year old boy came due to fever and cough for 5 days
Diagnosis - bronchopneumonia

Give amoxycillin and parasetimol


2 prescriptions
Amoxycillin usually given btw range of 50-100 kg BW
(whole of total dose you give each day)
Preparation -- 250 mg/5ml or one teaspoon
(suspension/syrup_
Bottle -- 60 ml
1 teaspoon = 5 ml

25 kg
How many teaspoons per day if use 250 mg =
2500 g
How many ml do you need a day?
Computation
Have 5 ml. how many do you need per
day? 10 (5ml) or 10 teaspoons
Formula
2,500ml/x = 250 ml/5 ml
X = 50 ml or 10 teaspoons
1 teaspoon = 5 ml

Can you give 3 teaspoons every 8 hours? 2


teaspoons every 8 hours? ----still in the range
Parasetimol ---->
Give 10-20 mg per kg per dose
Usually given every 4 hours due to fever; for
pain PRN (if necessary)
In syrup ---at age 8
125 mg per teaspoon (5ml)
60 ml or 120 ml
Also 250 mg per teaspoon (5ml)
250/5 = x/10
Higher volume, so cheaper
Choose between the two

Tablet --- 8 years


325 mg per tablet
500 mg per tablet
Up to you what to us

Computation

Boy weighs 25 kg body weight

Need 10 teaspoons a day; 7 days --- need 70 teaspoons


o How to convert in bottles?
o 12 teaspoons
6 bottles ----72 teaspoons
o
when you say
4 times a day, you tell the patient during times he's not sleepy
Only awake hours
6 times, you assume patient is awake at all times
Wake at 6, 12, 6, 12 midnight
o

Use every 6 hours

Prescription Written
E.R. Caangay, MD
Emergency Medicine
6/29/06
Name
Address
Rx
o

Subscription
i.
amoxicillin
250 mg/5ml
60 ml bottles # 7

Signature
2 1/2 teaspoons every 6 hours for 7 days
subscription

Certification

Parasetimol
o Name, date, address
o superscription
o Subscription
Paracetamol 250 mg/5m
120 ml bottlel
o

Sig

Take 1 teaspoons every 4 hours as needed

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