Medical Prescription From A to Z

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If you are interested in a prescription for ED drugs – you will be useful to learn about general prescriptions.

Once in a while each of us comes up with a need of getting a medical prescription. This health-care program has been implemented by physicians to guide patients through their individual plan of care. In other words, prescription is a medical detailed instruction that has particular orders to take certain medicines.

Prescriptions are legal official implications. Still with many new manufactured products the definition of this word becomes more complex and broadened. Today “prescription” might include not only pills and tablets and how-to-take guide, but also clinical assessments and laboratory tests.

Let’s define what medical prescription really is, who is allowed to write legal prescriptions, which forms they should use, etc.

Definition

Physicians use preprinted medical prescription forms where they write their orders by hand. These forms can be assembled into pads. Doctors are also allowed to print prescriptions using a computer, use electronic format such as faxing or directing orders over the phone.

Each prescription form should identify itself as a prescription. This paper must include prescriber’s full name and a registration number (in the USA doctors use DEA number). Of course, the medical prescription must include the patient’s full name, date and directions how to take the prescribed medications.

℞ is a symbol that means “prescription”. Many healthcare providers use it. Sometimes people call prescriptions “scripts”, because this is a legal written order on how patients should take a compound medicine.

Prescription is a way of pharmacists and prescribers communicate.

Short History

Prescriptions existed since the very old times. Traditional composition of a prescription includes 4 parts:
Superscription (the date it was written, patient full name, age, address, etc.);
Inscription (it explains what medication is);
Subscription (this section includes the instructions to the pharmacist);
Signature (instructions to the patient).

Most prescriptions today can be called “extemporaneous”. This word comes from the Latin. It (“Ex Tempore”) is translated as “at”, “from time”. It means that the order is intended for a definite patient with a particular illness.

Who Writes Prescriptions

Prescriptions are governed by national and local legislation. In most countries prescriptions can be written by physicians.

This doesn’t mean that other healthcare professions (dentists, veterinarians, clinical pharmacists, optometrists, nurse practitioners, etc.) can’t write prescriptions. They are also allowed to do so according to their field of practice.

Handling the Prescription

Prescribers can write the actual medicine’s manufacturer and the date it was dispensed. In many cases they may need to sign the document. If this is a computerized pharmacy, its workers should print and staple information to the prescription (labels can be used in this case).

Prescriptions that are written by pharmacists must include an exclusive to the pharmacy number. Americans use abbreviation “Rx#”, for example, which appears right in the document. Sometimes it is required to reference this number for repeats and medicine insurance claims.

If the original prescription should be archived in the pharmacy, patients can receive only a copy of it. The original document is stored for up to 6 years.

Some pharmacies today offer special services to the patients. They can send prescription repeats to the patient’s home.

Storage of Prescriptions

Most countries ask prescribers to maintain three separate files for their prescriptions.

If prescription contains controlled substances, it should be marked with the “C” in red color. It should be about 1 inch high.

A copy of the original prescription should include a serial number. It is best to maintain it in chronological and numerical order. All prescriptions must be stored for at least 5 years since the date of dispensing.

If pharmacies keep records using computer generated labels, these labels should appear in such a way so that it won’t obscure data on the document’s face.

How to Protect Prescriptions from Stealing

It is a well-known fact that some prescriptions might be forged. This especially concerns narcotics prescriptions that can be cheaper and safer in pharmacies than on the street.

In order to protect medical prescriptions from counterfeit usage, some practitioners use special prescription pads with serious security measures, just like the ones that appear on bank checks. Sometimes legislation mandates that it is allowed to print prescriptions using certain printers. Another way to protect the document is to write the numbers in words for dosages and quantities of drugs prescribed.

Certain drugs require special “triplicate prescriptions” when one copy is retained by a medical practitioner, the second one goes to the pharmacist and the third one should appear in the regulating agency.

Different states have different laws that help to protect prescription blanks from stealing and inappropriate usage.

Controlled substance prescriptions might include these security features (at least, they should in some states):
When you photocopy the prescription, it should contain a repetitive “void” pattern in blue that appears across the whole document.
A watermark should appear on the document’s back side.
RX symbol should also appear in the document.
Check-off boxes and no advertisements.
Logo that symbolizes professional practice or hospital.
Each per prescription blank can have only 1 prescription others it is void.
Refill options are to appear above the signature line.
Name of the practitioner and license number should be either printed, preprinted or stamped.

Other security rules might require prescriber to have prescription blanks of a particular size.

Prescriptions for Non-Prescription Medicines

Doctors write prescriptions even for non-prescription drugs. This is because over-the-counter medicines should be taken under the orders of a medical worker so that the patient will benefit from using them.

Still, if the patient begs for no prescription for over-the-counter medications, pharmacists write the medicine name to the patient on paper. In this case it is easier to avoid any misunderstanding of the document in the future.

What Prescription Includes or Can Include

As you know drugs can be either brand or generic. Even though they should be therapeutically equivalent, physicians write in prescriptions whether they allow pharmacists to substitute a brand drug version by a generic version.

Sometimes preprinted prescription forms have 2 signature lines. You can find “dispense as written” underneath the first line, and “substitution permitted” underneath the second one. The first line has a check box that is checked off by the prescriber.

Some countries require prescriptions written for kids under 12 years old to include their age in the document. Sometimes physicians should also include the child’s weight.

Sometimes patients are able to get refills or repeats of the prescribed medication. In this case their medical “recipe” should specify the number of times they can get more of the same pills. Some prescribed drugs are not allowed to be refilled.

“Green prescriptions” indicate that a patient needs a healthy diet or exercising program.

Modern prescription forms sometimes include pre-defined choices (units, frequencies, pills quantities). The prescriber can just circle the right choice instead of writing information out. It is believed that such forms can reduce errors.

Example of a Legal Prescription

Legal prescription should include these steps:

1. Patient’s full name and real address.

2. Name of the medicine prescribed.

3. Dosage of the medication and directions how to take it.

4. The date a prescription is dispensed.

5. Prescriber’s personal information (name, address, phone number, license, registry number).

6. The condition for which the medicine is prescribed (clear and legible) if patient is ok with this.

7. An identification number and characteristics of the manufacturer of the medicine dispensed.

8. The price charge.

9. Written prescriptions should be signed up by a nurse, medical practitioner or physician (physician assistant).

10. Written prescriptions should also contain the signature of a person who received a verbal prescription.

11. Electronic prescriptions transmitted from prescribers to pharmacies should include both image and text prescriptions.

Using Abbreviations and Avoiding Doubts

Prescribers have come up with many rules for writing prescriptions. Their goal for clear conventions is supposed to help to avoid doubts, misinterpretation and misunderstanding.

Here are some of the rules followed by doctors to avoid doubts:
Use 3 mL instead of 3.0 mL; use 0.3 instead of .3 or .30 to avoid misinterpretations.
Use “mL” instead or “cm3” or “cc” to be clear.
Specify the quantity of medication in the field with “as needed” directions.
Specify directions for times (for example, 8 am, 10 pm instead of writing twice a day).
Use permanent ink while filling in the prescription.
If a patient is allowed to get refills for the drugs, specify the least period between the refills and the number of repeats.
Don’t use “teaspoons” and “tablespoons”. Specify the exact amounts.
Spell out numbers as words, for example “30 (thirty) just like in a bank check.
Always use metric units (micrograms, grams) instead of apothecary symbols such as ounces, grains, minims, etc.
Don’t use the degree symbol. Instead, write the whole word “degrees”.

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