The Pharmaceutical Agent Order
Course
Practicum in
Health Science Pharmacology
Unit II
Communication
Essential
Question
What are the
essential
components to a
prescription
written by a
physician?
TEKS
130.205 (c)
1A, 1B, 2A
Prior Student
Learning
Students should
have some
personal
experience with
what a medicine
bottle looks like
and the
information
written on it.
Estimated time
1-2 hours
Rationale
To avoid serious effects on a patient, both prescriber and pharmacist must
render the highest of professional services. Accurate diagnosis, proper
selection of medication, proper dose, correct dispensing, and correct
packaging all must be provided.
Objectives
Upon completion of this lesson, the student will be able to:
 Identify the critical components of a prescription, physician’s order,
and prescription label
 Interpret samples of prescriptions, physician’s orders, and prescription
labels
Engage
Bring in a few training samples of prescriptions written by a local pharmacist
showing what an actual physician’s order looks like. Have the students try to
read and interpret the orders.
Key Points
I. Prescription is an oral or written record of a physician’s order to the
pharmacist to dispense medication to the patient.
A. Script – written form
1. Superscription is the heading of a prescription; it contains
a. the symbol Rx (an abbreviation for "recipe") the Latin for
"take thou"
b. prescriber’s name and title (MD, DDS, DMD, DO, etc.)
c. prescriber’s office address
d. prescriber’s phone number
e. patient’s name and address
f. patient’s age
g. date on which prescription was written
2. Inscription is the actual body of the prescription indicating the
drug name, strength and dosage form
3. Subscription contains the directions to the pharmacist, usually
consisting of a short sentence such as: "make a solution," "mix
and place into 20 capsules," or "dispense 20 tablets"
4. Signature -- not to be confused with the prescriber’s signed
name -- contains clearly written and understandable
instructions
a. may be written in Latin, using commonly accepted medical
terminology and abbreviations
b. directions need to be translated into plain English for the
patient when transcribing instructions to prescription label
c. Sig. should contain amount of medication to be taken, the
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frequency, and the route of administration
d. may also include reason for taking the medication
5. Refill instructions
6. Prescriber’s signature
7. Prescriber’s DEA number
a. Drug Enforcement Agency (DEA) is the federal agency
within the Department of Justice overseeing controlled
substance traffic
b. required for all prescriptions containing controlled
substances
c. special duplicate scripts are required for schedule II drugs
B. Physician’s Order (Written Form) – Form to order medication for the
hospitalized patient.
1. Category and dosage forms of drugs may be different than in
retail pharmacy e.g., IV administration, cytotoxic drugs, etc.
2. Major elements of the physician’s order
a. patient’s name and hospital number
b. patient’s room or ward location
c. attending physician
d. patient’s date of birth
e. allergies or sensitivities to drugs, foods, and other
substances
f. diagnosis
g. date of admission
h. patient’s condition
i. services to be performed (i.e. tests, activities, diet, etc.)
j. medications ordered
k. strength of each medication ordered
l. dosage form specified to avoid any questions regarding the
form to be administered – most drugs come prepared in
more than one dosage form; patient’s condition often
determines route of administration
m. directions for use or frequency of administration for each
drug nurse’s or physician’s signature with date and time of
entry on the physician’s order
C. Oral Prescriptions
1. Phoned in – usually done by a prescriber known to pharmacists;
not applicable to schedule II drugs
2. Components of oral prescription
a. doctor’s name
b. doctor’s phone number
c. patient’s name
d. patient’s address
e. patient’s phone number
f. DEA number
g. name of drug
h. quantity of drug
i. directions
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j. refill instructions
D. E-Prescribing is a prescriber's ability to electronically send an
accurate, error-free and understandable prescription directly to a
pharmacy from the point-of-care, and is an important element in
improving the quality of patient care.
II. Prescription Label is an identification label placed on the outside of the
bottle
A. A prescription serial number (referred to as the RX number) and the
date the prescription was filled
B. Patient’s full name
C. Clearly typed (or printed) instructions for taking the medication
1. The first word of the directions should infer the route of
administration, e.g.,
a. “take” for internal/oral route
b. “instill” or “place for eye/ear/nose
c. “apply” for topical medication
d. “insert” for rectal/vaginal application
D. Name of the drug (labeling), unless specifically requested by
prescriber not to label
E. Pharmacist’s initials and initials of the tech preparing the drug for
dispensing
F. Prescriber’s name
G. Drug’s expiration date (usually can be obtained from stock bottle,
except in case of freshly reconstituted medication according to
manufacturer’s recommendation
H. Number of refills left available, if any, or no refills, if none
I.
Additional labels, “strip labels”, accessory labels, informing patient
of particular way to take medication assuring optimal effect, e.g.
TAKE ON EMPTY STOMACH, DO NOT TAKE WITH MILK, KEEP
REFRIGERATED, SHAKE WELL BEFORE USE, etc.
Activity
I.
Interpret the sample prescription labels for accuracy.
II.
Transcribe sample prescriptions into prescription labels.
III.
Complete the Pharmacology Abbreviations Worksheet.
Assessment
Correct completion of prescription labels
Accurate transcription of prescription and physician’s orders
The Drug Order
Materials
Prescription Checklist
Pharmacology Abbreviations Worksheet Key
Blank labels to be used as prescription labels
Copyright © Texas Education Agency, 2013. All rights reserved.
Samples of physician’s hospital orders
Samples of prescriptions
Reference materials, e.g. PDR, etc.
The Drug Order Key
“Show and tell” samples
Accommodations for Learning Differences
For reinforcement, the student will develop flashcards for key terms.
For enrichment, the student will research prescriptive errors (causes,
consequences, and steps of preventions) and present results to class.
National and State Education Standards
National Health Science Cluster Standards
HLC02.01 Communications
Health care workers will know the various methods of giving and obtaining
information. They will communicate effectively, both orally and in writing.
HLC 10.01 Health Care Workers will apply technical skills required for all
career specialties. They will demonstrate skills and knowledge as
appropriate.
TEKS
130.205(c)(1)(A) interpret data from various sources in formulating
conclusions;
130.205 (c)(1)(B) compile information from a variety of sources to create a
technical report;
130.205 (c)(2)(A) accurately describe and report information, according to
facility policy, observations, and procedures;
Texas College and Career Readiness Standards
English/Language Arts
I. A. Compose a variety of texts that demonstrate clear focus, the logical
development of ideas in well-organized paragraphs and the use of
appropriate language that advances the author’s purpose.
B.1 Listen critically and respond appropriately to presentations
B.2 Listen actively and effectively in a one-on-one communication
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NAME:
DATE:
THE DRUG ORDER
1. Prescriptions come in two forms: _________________ and _____________________.
2. The format that has been translated from the original prescription into a language
clearly understandable by the patient is the ______________________________.
3. In complete, well-structured sentences compare and contrast prescription, prescription
label, and physician’s order.
4. Define Drug Formulary.
5. What do the letters Rx stand for? __________________________________
Copyright © Texas Education Agency, 2013. All rights reserved.
Answer Key to Unit Quiz:
THE DRUG ORDER
1. prescription; physician’s order
2. prescription label
3. prescription -- Written record of a physician’s order to the pharmacist to dispense
medication to the patient; usually used for ambulatory, non-hospitalized patients.
prescription label -- Identifies the patient and instructs the patient on how to take
medication ordered by physician; should be clearly typed or printed in language easily
understood by the patient.
physician’s order -- Form to order medication for the hospitalized patient; not all items
pertaining to the prescription apply to the physician’s order.
4. listing of drugs available in the hospital; reviewed by the Pharmacy Therapeutics
Committee (PT Committee); recommended for inventory based on therapeutic and
economic benefits
5. Latin for recipe; “take thou”
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Prescription Checklist
1. Legitimate prescription blank with prescriber’s information clearly written or printed on the
blank?
2. Patient’s full name written on script? Initials are not acceptable – present potential for
errors.
3. Date the prescription was written – important because controlled substances should not
be filled or refilled (if refills permitted) more than six months after script was issued to
patient.
4. Patient’s address – a legal requirement for prescriptions containing controlled substances:
 A good practice to complete on ALL scripts
 Helpful in preventing potential errors especially where common family names occur
frequently, or specific names are customary for a particular region
5. Is inscription complete? If unclear regarding the medication, e.g. old drugs with new
modifications or uses, or new drugs, if existence of drug cannot be established.
6. Does the quantity seem adequate? Learn the customary length of treatment for the most
common ailments.
7. Directions written clearly enough to avoid misinterpretation by the patient?
8. Refill instructions? If no refill instructions indicated must be interpreted as NO REFILLS
ordered.
 legally clearly defined requirements and timeframes for refills
 refills should be entered on the back of the script, noting date, dispenser’s initials,
and quantity dispensed – even if computerized system is used to record keeping
9. Prescriber’s signature? DEA number?
 signature, DEA number and office information legally required on all prescriptions
for controlled substances
 if prescription written at the practitioner’s office, it should be signed
 telephone orders do not require signature for non-controlled substances; also holds
true for limited (!) number of controlled substances
10. Check with the patient for any known drug allergies! Physician can be expected not to
prescribe any medications that might trigger allergic reactions, but
 patients may have forgotten to report previous allergic reactions to physician
 patients may see more than one physician for same or different condition and
physician not aware of same
Copyright © Texas Education Agency, 2013. All rights reserved.
Interpret Prescription Labels
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.: 3108145
Rx No.: 026598
Rx No.: 17192356
Patient:Mr.Peanut
Patient:ImaSick
Patient:O.N.Abed
M&Mplain(50)
Tussinex Liqu.
Take one by mouth as needed for
energy
Refills remaining: 3
Date: 12/24/00
Pharmacist: RMS
CPhT: SM
(120 ml)
Take 1 tablet by mouth three times
daily for cough
Refills remaining: 0
Date: 01/01/01
Pharmacist: CPR
CPhT: HR
Tyelnol#3(12)
Take one teaspoon every 8 hours
as needed for pain
Refills remaining: 0
Date: 11/11/01
Pharmacist: VIT
CPhT: BP
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.: 9876543
Rx No.: 12345678
Rx No.: 19922000
Patient:MollyMalone
Patient:SamGoody
Patient:W.J.Clinton
DarvocetN‐100(30)
MycelexCream(1)
Take one or two twice daily
Apply to affected areas twice daily
as directed
Inderal40mg(50)
Refills remaining: 2
Date: 02/31/01
Pharmacist: ABC
Refills remaining: 2
Date:
Pharmacist: CK
CPhT: DKY
CPhT: OYE
Take 80 mg daily
Refills remaining: 0
Date:
Pharmacist: GWB
CPhT: AG
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.: 78561254
Rx No.: 19734628
Rx No.: 0973164825
Patient:DonaldDuck
Patient:OsayCanusee
Patient:AidaSoprano
Synthroid 100 mcg (100)
Cardizem 30 mg Tablets
(120)
Zantac 150 mg Tabs (100)
Take one tablet by mouth every
day
Refills remaining: 0
Date: 04/01/02
Pharmacist: HMP
CPhT:
One tablet twice daily
One qid before and after meals
Refills remaining: 1
Date: 12/31/99
Pharmacist: GW
CPhT: AL
Refills remaining: 3
Date:
Pharmacist: NO
CPhT: YES
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.: 8256497
Rx No.: 28641973
Rx No.: 1597536842
Patient:MaryHadalittlelamb
Patient:M.IKneehurts
Patient:I.Dontfeelgood
Tagamet 300mg/15 ml
(480)
Liver and Onion (7)
Sleep 8 hours (365)
Take one per day at lunch for
anemia
Take one at bedtime for fatigue
800 mg at bedtime
Refills remaining:
Date: 11/11/00
Pharmacist: RPH
CPhT: CT
Refills remaining: 0
Date:
Pharmacist:
CPhT: NYC
Refills remaining: 0
Date:
Pharmacist: REP
CPhT: ONE
1. Interpret the above prescription labels for accuracy. Are there any mistakes? Any omissions?
Make corrections as indicated.
2. Recreate what the original prescription may have said, using proper terms and abbreviations
used in the medical language.
Copyright © Texas Education Agency, 2013. All rights reserved.
TRAINING CLINIC
123MAPLEDRIVE
SUITE425
MED,TEXAS76543
(555) 555-2454 EXT. 45
Dr.R.U.Sick,Dr.A.Puddentane,Dr.I.Feelbetter
Patient Name: _____________________________________________ Date: ________________
Address: _____________________________________________________ Age: ________
TRAINING TOOL !
[ ] Contents are labeled unless checked
Refills: 0 1 2 3 4
Signed _________________________________M.D.
Date: __________, 2____ DEA No. ______________
TRAINING CLINIC
123MAPLEDRIVE
SUITE425
MED,TEXAS76543
(555) 555-2454 EXT. 45
Dr.R.U.Sick,Dr.A.Puddentane,Dr.I.Feelbetter
Patient Name: _____________________________________________ Date: ________________
Address: _____________________________________________________ Age: ________
TRAINING TOOL !
[ ] Contents are labeled unless checked
Refills: 0 1 2 3 4
Signed _________________________________M.D.
Date: __________, 2____ DEA No. ______________
Copyright © Texas Education Agency, 2013. All rights reserved.
PHYSICIAN’S ORDER SHEET
TRAINING CENTER
MED, TEXAS
PATIENT IMPRINT
A GENERIC EQUIVALENT MAY BE DISPENSED UNLESS THE BOX AT THE RIGHT IS CHECKED
DATE
TIME
C
H
A
R
T
C
O
P
Y
DATE
TIME
C
H
A
R
T
C
O
P
Y
DATE
TIME
C
H
A
R
T
C
O
P
Y
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Prescription Labels
1. Create appropriate prescription labels for the sample prescriptions. Remember that most patients are
not familiar with medical jargon and need to be able to clearly understand what the label says.
2. Based on the type of medication, what auxiliary or warning label would you attach to the medication
bottle, if any?
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.:
Rx No.:
Rx No.:
Patient:
Patient:
Patient:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
CPhT:
CPhT:
CPhT:
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.:
Rx No.:
Rx No.:
Patient:
Patient:
Patient:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
CPhT:
CPhT:
CPhT:
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.:
Rx No.:
Rx No.:
Patient:
Patient:
Patient:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
CPhT:
CPhT:
CPhT:
TRAINING PHARMACY
TRAINING PHARMACY
TRAINING PHARMACY
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
123 Maple Drive, Med, Texas 76543
(555) 555-2454
Rx No.:
Rx No.:
Rx No.:
Patient:
Patient:
Patient:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
Refills remaining:
Date:
Pharmacist:
CPhT:
CPhT:
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CPhT:
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013. All rightss reserved.
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013. All rightss reserved.
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013. All rightss reserved.
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013. All rightss reserved.
Pharmacology Abbreviations
Abbreviation
Meaning
a.c., ac
ACE
ad lib
APAP
ARB
b.i.d., bid
c
Caps
Cc
FDA
gm, g
gtt
h
h.s., hs
H2 blocker
HRT
IM
INH
IV
MAOI
mg
mil, ml
NPO
NSAID
p
p.c., pc
PCA
PDR
PO, p.o., po
p.r.n., prn
Pt
q
q.h., qh
q2h
q.i.d., qid
q.s., qs
qAM
qPM
Rx
s
SERM
Sig.
SL
s.o.s.
SSRI
SQ
tab
TCA
t.i.d., tid
Copyright © Texas Education Agency, 2013. All rights reserved.
Pharmacology Abbreviations – Key
Abbreviation
a.c., ac
ACE
ad lib
APAP
ARB
b.i.d., bid
c
Caps
Cc
FDA
gm, g
gtt
h
h.s., hs
H2 blocker
HRT
IM
INH
IV
MAOI
mg
mil, ml
NPO
NSAID
p
p.c., pc
PCA
PDR
PO, p.o., po
p.r.n., prn
Pt
q
q.h., qh
q2h
q.i.d., qid
q.s., qs
qAM
qPM
Rx
s
SERM
Sig.
SL
s.o.s.
SSRI
SQ
tab
TCA
t.i.d., tid
Meaning
Before meals
Angiotensive-converting enzyme
Freely, as desired
Acetaminophen (Tylenol)
Angiotensin II receptor blocker
Two times a day
with
Capsules
Cubic centimeter
US Food and drug Administration
Gram
Drops
Hour
At bedtime
Histamine H2 receptor antagonist
Hormone replacement therapy
Intramuscular
Isoniazid – antituberculosis agent
Intravenous
Monoamine oxidase inhibitor
Milligram
Milliliter
Nothing by mouth
Nonsteroidal anti-inflammatory drug
After (post)
After meals
Patient-controlled analgesia
Physician’s Desk Reference
By mouth
As needed; as necessary
Patient
Every
Every hour
Every 2 hours
Four times a day
Sufficient quantity
Every morning
Every evening
Prescription
Without
Selective estrogen receptor modulator
Directions – how to take the medication
Sublingual
If it is necessary
Selective serotonin reuptake inhibitor
Subcutaneous
Tablet
Tricyclic antidepressant
Three times daily
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