- A communication bw the prescriber and the pharmacist

- The neneficiary of the prescription should be the patient

 - Should communicate in an unambiguous way so the patient is not harmed

- Some patients have died bc of miscommnications bw precriber and pharmacist

What types of percriptions exist?

- Written

- Telephonic- only in certain circumstances

- Electronic

    Many institutions are going to this style bc of advantages

        - Can see the other prescriptions the patient is taking

      - Can notice drug-drug interactions easily

       -Reduce errors bc of bad handwriting

        - Prepopulated fields for dosage, formulation, etc so that error is reduced

        Reduce miscommunication

Fax-

    Less trusted bc could fax to multiple pharmacies and get mulitple doses

    Must be followed up with a hard copy

    Not enough checks and balances for this system

    Nursing homes and hopsitals have a good enough relationship with pharmacy that can do this. 

Prescription Pad

Also called a prescription blank

New regulations to deal with forgery in the next couple of weeks

Mutli-doctor practice pads--the name of the prescriber must be circled bc the pharmacist might not be able to read the signature (Helps them to know who to call if there are problems)

-Demographic data on top

-Patients Name

-Date Line

-Address of patient does not have to be on there if it is not a controlled substance  (if controlled...patients address must be on there)

-Two signature lines

    "Dispense as written"--You have to give the non generic if this is signed.

    " Product/Selection Permitted"-- you can give the generic drug 

-Can buy commercially available prescription pads which utilize forgery protection devices

- UAB uses pads that say void when they are photocopied

- By April 1st of 2008 All medicaid patients will have to be on tamperproof pads with at least 1 tamper proof mech

    -Eventually will have three tamperproof mech

        1. Void on photocopies

        2. Erasure evidence

        3. etc

Most percribers will use these even for non-medicaid patients

What information goes on the top portion of the prescription blank

Patient name

age

date

address if controlled substance

Rx: = recipe= Superscription

Line 1: Inscription 

    Name of Drug (trade name or generic)

    Strength or concentration (if it comes in more than one concentration--if not then it does not matter)

    Formulation of the drug

        Tablets, capsule, solution, ointment, syrup (if only one formuation then it doesnt matter)

Second Line :

    Subscription-- quanitity to be dispensed by the pharmacist at the time the percription is filled 

        most pharmacies limit to 30 day supply

Third line signatura

    The part the patient reads which instructs them how to take the medication

       Needs to be clear and unambiguous (pharmacist can change if not exactly clear

        Write it out in english 

        Some latin abbreviations should not be used at all 

        Refills should be on there

Middle portion of Rx blank 

Name of medication (trade name or generic)

On the second line of the middle portion

contains the qunitity of the drug to be dispensed by the pharmacist at the time the pescription is filled 

Found in the lower left portion of the prescription blank

"Drug Enforcement Agency"

Some pharcamcies and insurance plans like to have it for an id number 

can access dosages, formulations, costs, etc

Can see if a drug is commercially available 

PDA programs exist

     (ePocrates is a free download)

        -pedriatric dosages, indications, contraindications, formulations, pregnancy categories, costs, etc

    -Updated weekly 

Write legibly

Avoid abbreviations and Decimals

Use proper latin abbreviations

Avoid trailing seros such as X.0-- just use X

Dont abbreviate drug name

Avoid naked decimals such as .X--> better if 0.X