PRESCRIPTION DR. J. DOMENECH

1. PRESCRIPTIONDR. J. DOMENECH

2. OBJECTIVES: At the end of the lecture the students will be able to: • Define prescription. • Explain the different parts of prescription. • Interpret the information on the prescription. • Process the prescription order / Handle the prescription. • Define the different types of prescription. • Define Electronic prescribing and how it works. • Compare the advantages and disadvantages of Electronic prescribing.

3. DEFINITION: Prescription is an order from a physician, dentist or any other registered medical practitioner to a pharmacist for the supply of medicine ,dressing or appliance for the patient.

4. HISTORY: • The concept of prescriptions dates back to the beginning of history. So long as there were medications and a writing system to capture directions for preparation and usage, there were prescriptions. • Modern prescriptions are actually "extemporaneous prescriptions" from the Latin (ex tempore) for "at/from time"."Extemporaneous" means the prescription is written on the spot for a specific patient with a specific ailment. This is distinguished from a non-extemporaneous prescription which is a generic recipe for a general ailment.

5. PARTS OF PRESCRIPTION • Prescribers office information • Patient information • Date • Rx symbol or Superscription • Medication prescribed or Inscription • Dispensing directions to the pharmacist or Subscription • Direction for patient or Signatura • Refill ,special labeling ,and /or other instructions • Signature and registration number of prescriber

6. SAMPLE PRESCRIPTION:

7. INFORMATION ON THE PRESCRIPTION: • The patient’s name , address and age if under 12 years. • The names and quantities of the medicaments to be supplied. • Instructions for the patient. • The prescriber’s profession ,address and signature. • The date on which the prescription was written or signed. • Proper name labeling requirement(NP)

8. PROCESSING THE PRESCRIPTION ORDER: • Receiving • Reading and checking • Numbering and dating • Collecting the materials • Dispense the medicine • Counsel the patient • Endorse the prescription • Collect any fee • Dispose of the prescription • Make the appropriate records and filing • Pricing

9. TYPES OF PRESCRIPTION: • NHS prescription • Private prescription • Prescription for hospital inpatients • Prescription for hospital outpatients • Prescription for patients discharged from the hospital.

10. TYPE OF PRESCRIPTION FORM AND DISPOSAL: • NHS form -------------Retain until the end of month • Private form for prescription only medicine ----------------------- Retain to 2 years • Hospital inpatient form ------------- Return to ward • Hospital outpatient form --------------- Retain in pharmacy (usually 2 years)

11. ERRORS IN WRITING PRESCRIPTIONS: • Medication errors affect more then 1.5 million Americans each year in hospitals alone, according to the Institute of Medicine. • Error can be made in the following areas: • Similar spellings / pronunciations / names • Inderal and Adderrall • Zyrtec and Zantac • Celebrex and Cerebyx • Others include Aciphex (for stomach reflux) and Aricept (for memory), Allegra (for allergies) and Viagra (for erectile dysfunction) or Fosomax (for bone) and Flomax (for veins and arteries).

12. Cont……. • Incorrect dosage • Drug interactions • Human error • Doctors, notorious for bad handwriting, may choose the right drug, but the pharmacist may read it incorrectly. • Sometimes the prescription gets transferred by phone from the doctor's office to the pharmacy, but the people making or receiving the phone calls make mistakes.

13. ELECTRONIC PRESCRIBING: Electronic prescribing or e-prescribing is the electronic transmission of prescription information from the prescriber's computer to a pharmacy computer.

14. SAMPLE e PRESCRIPTION:

15. How it works? • The doctor logs on to the system and authenticates their identity.(i.e. log on their passwords) • The doctor looks up the patient in the system. • A drug is chosen, with parameters including strength, quantity, directions, and number of refills . • The patient's active medication list and known allergies are reviewed for potential adverse drug reactions

16. Cont…….. • The software may suggest alternative drugs that are either more effective or less costly. • Select a pharmacy that will process the order, and place the order. • The connection may be direct peer-to-peer, but usually it is indirectly routed over a commercial network of pharmacies such as Sure Scripts or eRx Network.

17. CONT…… • Orders take the form of standardized electronic messages that both the prescriber's system and the pharmacist's system must implement. • The order appears in the pharmacists computer system, where it may be filled. • The patient shows up at the pharmacy to pick up and pay for their medications.

18. BENEFITS: • It improves beneficiary health outcomes • It improves quality and efficiency • It helps in reducing costs by actively promoting appropriate drug usage • It speeds up the process of renewing medications • It reduces the incidence of drug interaction • It saves the time of pharmacist

19. CONT…… • Each prescription can be checked electronically • Reducing / eliminating the error. • Information on prescription can be linked with the patient’s medical records. • Refill request can be expedited. • Facilitation of data transfer between physician and pharmacist.

20. DISADVANTAGES: • Accidental data entry errors such as selecting the wrong patient or clicking on the wrong choice in a menu of dosages. • Inadvertently divulging protected health information on the internet through inadequate security practices • Inability to use electronic prescribing when the power is out

21. USE OF COMPUTER SYSTEM TO PROCESS PRESCRIPTIONS:

22. THANX FOR ATTENTION REFERENCES: • Pharmaceutical practice DM Collett Pg # 61 -72 • The science and practice of pharmacy Remington Pg #1823-1839