Write every prescription with utmost care and responsibility.
1. Prescription is the document, which a patient carries with him wherever he goes, and it speaks of the doctor who has written it. A good prescription means that he has visited a good Doctor. Conversely, a mistake in writing can be harmful to the patient and to your reputation. So you must write every prescription with utmost care and responsibility. 2. prescription should contain the patient’s name & age, and date. [ideally, it should also contain weight, & important signs like B.P. if hypertensive, urine sug if diabetic, Temp. if febrile]
- Start with the sign ‘Rx’- Write injections first, then tablets & syrups, (antibiotic first), then instructions. - Write legibly- For each drug, write clear instructions – dose, how many times for how many days, - No short forms should be written on prescriptions. It is for the patient who does not understand the meaning of BD, TDS, PC, etc, - At the end, write when to report back.
1. Generally, a prescription should be limited to 3 or 4 drugs. When it comes to the fifth drug, think whether all 5 drugs are really needed! Yes, some patients may need more but can any of the drugs be avoided this time? In particular, patients already taking regular drugs for H.T., diabetes etc, they would not like too many drugs. 2. Prescribe minimum drugs to children. In most children it is a very difficult task to feed them medicines. 3. if the patient is a well controlled Diabetic or Hypertensive, do not change his drugs, without a specific indication for change. Let him continue what he is taking, even though your favourite drug is some other! 4. write drugs which are available next door. If specific drugs are not available in town or available at specific place,tell the patient from where to by. Otherwise, patients roam several shops & towns and come back, saying ‘it’s not available. That’s not good. 5. Patient should buy the drugs, come back, show the drugs and get explained how to take them. Especially if he is illiterate. A well educated patient may be explained with the prescription. 6. Think whether the patient can afford the drugs prescribed. In poor patients, prescribe the least expensive drug. If the patient cannot afford, omit costly tonics and use your judgment to give most essential drugs only. Otherwise a patient of typhoid may end up buying useless tonics and leaving Ciplox halfway
Prescribing to poor patients:
1. Prescribe the least expensive drug, though it may not be the most effective. It’s not use prescribing the Best drug, when you know that he will never buy it! 2. Give some medicines from your sample collection. That is the best way to utilize sample medicines and create goodwill. 3. Don’t ask for costly investigations, unless unavoidable. Don’t ask for investigations that will not affect the treatment. Eg.
i) In hypertension, treat Hypertension. No need t do Lipid profile, echocardiography etc. ii) In angina, if the patient cannot afford – bypass surgery, there is no point in doing stress test & angiography. iii) In jaundice, if clinically icterus is reducing, there is no need to do S.Bilirubin repeatedly.
Let the patient spend the same money on drugs, which will help him more.
Here are few examples
Disease/Symptom prescribe May not afford
Hypertension Adelphane – E Envas. Minor infections Septrain Terramycin Baciclox, Cephalosporins. Pain Brufen, Disprin Tramadol After stroke/IHD Aspirin Ticlodipine Anemia Fersolate Liquid iron Prep.s Amoebiasis Metronidazole Secnidazole/Tinidazole Epilepsy Dilantin Tegretol Angina Sorbitrate Monotrate/Diltiazem Diabetes Bovine Insulin Human/procine insulins Infective hepatitis Liv52 Phospholipids Disease Name
Printed instructions on Prescription: Treatment:- Here are some of the important instructions, which may be printed on the prescription, some are for the benefit of the patient, some are medico-legally important, while top lines are statements of your clinic. Choose only those few sentences that appeal to you most and have them printed on your prescription pad. BOTTOM LINES:Bring this prescription at your next visit.Please adhere to Clinic timings, except in Emergency. TOP LINES: SHRI or any auspicious sign I prescribe, He curesMay God Bless you with Good Health Born to serve BACK OF PRESRIPTION PAD: This medicine has been prescribed for your current ailments only. Do not take it more often or for a longer period than advised. If you notice any untoward reaction like skin rash, itching, epigastric burning, or breathlessness – stop taking the medicines and consult your doctor immediately. Do not share medicines with others without consultationAvoid self medicationIf any medicine has caused allergy or acidity in past, inform the doctor about it. For the Pharmacist: Please do not substitute brands. Or No Substitute PleaseDo not dispense again, unless re-prescribed. Storage: Keep all medicines out of reach of children. Keep the medicines in the original strip or container until used. Store in a cool, dark place – away from direct sunlight, heat & moisture.
