Prescription Interpretation and Processing
Overview
Proper interpretation and processing of prescription is important in pharmacy practice.
It requires skills and knowledge in order to transcribe the prescription order correctly
and properly. Errors in interpreting a prescription order may compromise patient safety
and overall health. In this lesson, the students will interpret information on the
prescription or medication order using skills learned during the course. The students
will also learn how to prepare the prescription for dispensing to the patients.
Definitions
In-patient is a patient that stays in the hospital while receiving medical care or
treatment.
Out-patient is a patient who comes to the hospital, clinic for diagnosis and/or
treatment but does not require an overnight stay.
Medication order refers to a written request on a physician’s order form or a
transcribed verbal or telephone order in an inpatient setting.
Prescription order refers to an instruction written by a medical practitioner that authorizes a
patient to be issued with a medicine or treatment.
Generic Name refers to a name applied to a unique medication chemical entity. Also
referred to as the non-proprietary name of the drug.
Brand Name or trade name is a name trademarked by a pharmaceutical manufacturer
for their version of a given drug product.
Auxiliary labels are used to provide pertinent warnings about the medication
Signa or Signatura from the Latin term Signa meaning to “write”, “make” or “label’,
this section of the prescription contains the directions to the patient.
MEDICAL ABBREVIATIONS USED IN PRESCRIBING
Commonly, medical and measurement abbreviations are in Latin terms. Latin terms are
universally understood by healthcare personnel, the language is historically used by
health providers in writing prescriptions. Terms and abbreviations are used to express
dosing schedules, routes of administration, quantities and symptoms, as well as other
information. It is important to understand the term definition and abbreviation in order
to avoid confusion and interpretation error. When in doubt, it is important to verify the
prescription with the prescriber to ensure that the right medication is dispensed to the
right patient.
Dosage Schedule or Time of Administration Abbreviations
Medical
Abbreviation
Q
QD or Q.D.
BID or B.I.D.
Latin Phrase
English Translation
Quaque
Quaque die
Bis in die
TID or T.I.D.
Ter in die
QID or Q.I.D
Quarter in die
QOD or Q.O.D.
H, HR, or HRS
A
P
A.C.
P.C.
C or
S or Š
P.M.
A.M.
HS or H.S.
P.R.N. or PRN
STAT
UT. DICT. or UD
Hora
Ante
Post
Ante cebum
Post cebum
Cum
Sine
Post meridiem
Ante meridiem
Hora somni
Pro re nata
Statim
Ut dictum
every
every day
two times daily or two
times a day
three times daily or
three times a day
four times daily or four
times a day
every other day
hour(s)
before
after
before meals
after meals
with
without
evening
morning
at bedtime
as needed
now, immediately
as directed
Dari translation
Route of Administration Abbreviations
Abbreviation
Latin Translation
A.U.
A.D.
A.S.
O.U.
O.D.
O.S.
P.O.
SL
Auris utraque
Auris dextra
Auris sinistra
Oculus uterque
Oculus dextra
Oculus sinistra
Per os
-
PR
PV
IM
SQ, SUB Q, or
SC
IV
S&S
Per rectum
Per vaginam
-
English
Translation
each ear
right ear
left ear
both eyes
right eye
left eye
by mouth or orally
sublingual (place
under the tongue)
rectally
vaginally
intramuscularly
subcutaneously
Dari Translation
intravenously
swish and
spit/swish and
swallow
Quantity Abbreviations
Abbreviation
AA or
SS or
G, GM or GM
GR
GTT or GTTS
Q.S. or QS
QSAD or
Q.S.A.D.
Latin Translation
ana
semis
gutta
Quantum sufficiat
Quantum sufficiat ad
English Translation
of each; AA is also
used as an
abbreviation for
"affected area."
one half
gram
grain
drop or drops
a sufficient quantity
a sufficient quantity
up to
Dari Translation
Quantity Abbreviations
Abbreviation
i, I
ii, II
iii, III
iv, IV
v, V
X
L
C
D
M
TSP
tbsp
℥
Translation
one
two
three
four
five
ten
fifty
hundred
five hundred
thousand
teaspoonful (5 ml)
tablespoonful (15 ml)
Ounce symbol (30ml)
Dari Translation
Symptoms Abbreviations
Medical
Abbreviation
C&C
N & V or N/V
HA
S.O.B.
Short-hand Translation
Dari Translation
cough and cold
nausea and vomiting
headache
shortness of breath
Miscellaneous Abbreviations
Abbreviation
caps
tabs
Disp.
S.; Signa; Sig
et
M
ung
AAA
Translation
capsules
tablets
dispense
write directions
and
mix
ointment
apply to affected area
Dari Translation
Prescription Processing
Pharmacies process prescriptions and medication orders differently based on
their organization-specific policies and computer systems. Prescription orders may be
hand-written or verbally given by the physician. You may receive prescriptions directly
from the patient or from the care giver. Typically pharmacy personnel process
prescriptions using a pharmacy computer program. When a computer program is not
available, pharmacy personnel will process prescriptions manually.
Steps in Prescription processing
1.
Patient identification. The pharmacy technician and / or the pharmacist must
make sure that the prescription is filled for and dispensed to the correct patient. Proper
attention needs to be given to similar or same names to make sure the medication is
given to the proper patient.
2.
Prescription screening. Although the process for screening a prescription may
vary depending on an organization’s requirements, it is important to validate the
information. Check the prescription for completeness, legibility, and general
information. For out-patient prescription orders, it is important to screen the
prescription for accuracy and authenticity. The pharmacy technician should always
check for clarity and completeness of the prescription including legibility problems and
validity of abbreviations. If in doubt, the pharmacist must be consulted and the
physician must be contacted for clarification. Making assumptions may compromise
patient safety. The minimum information required on the prescription is outlined in the
prescription component section:










Hospital or Facility Name
Doctor’s Name
Doctor’s address and contact information
Doctor’s License or Registration number
Patient’s name
Patient’s gender and date of birth
Patient’s Father’s name
Patient’s medical condition, if available or known
Date the prescription was written
Drug name ( generic or brand name)




Drug strength and dose to be administered
Instructions for use, including route of administration, frequency and duration
Quantity to be dispensed
Doctor’s signature
Some medications ordered by the physician may not be included in the hospital
formulary. If the product is not covered by the formulary, it is important to consult and
discuss the situation with the pharmacist on duty or the Chief of Pharmacy, so that
alternative action may be discussed with the physician.
3.
Prescription Quantity Calculation. Mathematical skills learned during
Pharmaceutical Calculation notes will be used to calculate the quantity of the
medication to be dispensed. It is important to provide the patient the right quantity of
medication to improve patient compliance with the treatment.
Examples:
1.
RX:
Sig:
Amoxicillin Capsule 500mg
1 cap tid x 10 days
What is the quantity to be dispensed?
Calculation: 1 capsule multiplied by 3 times daily = 3 x 10 days = 30
Answer:
30 capsules of amoxicillin 500mg
2.
Rx:
Atenolol 50mg tablet
Sig: 1 tab po od x 3 months
What is the quantity to be dispensed?
Calculation: 1 tablet to be taken once daily x 90 days (3 months) = 90
Answer:
90 tablets of Atenolol 50mg to be dispensed
3.
Rx:
Sig:
Dextromethorphan 5mg/ml syrup
1 tsp q8h prn x 5 days
What is the quantity to be dispensed?
Calculation: 1 tsp = 5 mls x every 8 hours in one day (3) when needed x 5 days
Answer:
75mls of Dextromethorpan 5mg/ml syrup to be dispensed
4.
Rx:
Sig:
Humulin N 1000U / 10 ml vial
Inject 35U qam and 40U qpm x 1 month
What is the quantity to be dispensed?
Calculation: 35U + 40U = 75 U of insulin per day x 30 days = 2250U per month
2250U/ 1000U per vial = 2.25 vial
Answer:
3 vials of Humulin N to be dispensed since we cannot dispense a partial
insulin vial.
4.
Prescription labeling. Prescription labels are important in order to provide the
patient accurate direction or instruction how to use or take the medication and other
information about the medication.
Components of Prescription label








Hospital or facility name
Patient’s name
Doctor’s name
Date the prescription is filled
Name of the drug (generic or brand), strength and dose
Quantity to be dispensed
Directions for use
Auxiliary labels, if applicable
It is important that the instruction or direction on the label is clear and written in a
way that the patient will understand. Instruction for the patient must include at least
the following:
1.
Administration directions depending on the route of administration:
“Apply”
Dosage Form - Topical creams, ointments, lotions, and topical patches
Route - Topically on skin, in eyes, or in mouth
“Chew”
Dosage form: chewable tablets or gum
Route: by mouth
“Dissolve”
Dosage form - Reconstituted powder, oral disintegrating tablets, and topical powders
Route - By mouth or used topically
“Give”
Dosage form - May be used for all dosage forms when caregiver administration is
required
Route - All routes
“Inhale”
Dosage form - Solution, suspensions, and aerosolized powders
Route - In nose or by mouth
“Inject”
Dosage form - Injectable solutions and suspensions
Route - Intramuscularly, subcutaneously, intravenously
“Insert”
Dosage form - Suppositories, vaginal creams tablets, and birth control rings
Route - In vagina or rectum
“Instill”
Dosage form - Solution and suspension
Route - In eyes, ears, or nose
“Place”
Dosage form – Solution, oral disintegrating tablets, and suspensions
Route - Sublingual (under the tongue), in eyes, ears, or nose
“Shampoo or Rinse”
Dosage form - Topical creams, shampoos, and mouthwashes
Route - Topically or by mouth
“Soak”
Dosage form - Reconstituted powder, solutions, and suspensions
Route – Topically
“Spray “
Dosage form - Solution and suspension
Route - Sublingually, in nose, or topically
“Take”
Dosage form - Capsules, tablets, suspension, solution
Route – By mouth
2.
Number of unit equivalent to one dose and the dosage form:
“ two tablets”
“ one tablespoonful”
“two suppositories”
3.
Route of administration:
“ by mouth”
“rectally”
“subcutaneously”
4.
How frequently or what time of the day:
“three times daily”
“in the morning and in the evening”
“at bedtime”
5.
Length of time or duration of medication treatment:
“ for 10 days”
“until infection is clear”
“ for 2 months”
6.
Indication or use of medication (if applicable):
“ for infection”
“for high blood pressure”
“for diabetes”
7.
Auxiliary labels may be attached to the label as required:
“take with food”
“for external use only”
“refrigerate medication, do not freeze”
Common Auxiliary Labels
Auxiliary labels are used to provide important warnings about the medication.
They are placed on the prescription container or label as an addition but not as
replacement for patient counseling. Auxiliary labels can help a patient remember the
route of administration, how to use or store the medication and common side effects
after the patient has left the pharmacy.
Route
• For external use only
• For the eyes
• For the nose
• For the ears
• For rectal use only
• For vaginal use only
Usage
• Keep in refrigerator
• Consult provider before taking medication
• Shake well before using
• Take on empty stomach
• Take with food/milk
• Take with orange juice or a banana
• Take plenty of water
• Chew tablets before swallowing
• Finish all medication
• Do not crush or chew tabs
• Use as a gargle
Effects
• May cause drowsiness
• May cause discoloration of urine
• Avoid prolonged exposure to sunlight
Drug/ Food Interactions
• Do not drink alcohol
• Do not take dairy/antacids
• Avoid aspirin products
Complete Signa
The pharmacist or the pharmacy technician is required to translate and explain
the prescription to the patient including producing a prescription label to be attached to
the prescription container. The label contents must be easily understood by the patient.
Translating Signa. Clarity and accuracy are essential when translating abbreviations.
Translation guidelines include the appropriate action verb used when interpreting and
typing the completed signa. The correct dosage form must be indicated on the typed
prescription label and the route must be indicated.
Examples:
Rx: Paracetamol 500mg tablet
Signa: 1 tab po q 4 h
Translation: Take one tablet by mouth every 4 hours
Rx: Salbutamol 200mcg inhaler
Signa: ii po puffs Q4-6h prn S.O.B.
Translation: Inhale 2 puffs by mouth every 4 to 6 hours when required for shortness of
breath
Rx: Amoxicillin 250mg/5ml suspension
Sig: 1 tsp po q8h x 10 days
Translation: Take 1 teaspoonful by mouth every 8 hours for 10 days
Labeling Examples
Dawood Khan National Military Hospital
Pharmacy Department
Dr. Mohammad Abdullah
Date: 20 April 2013
Patient: Rooz Syed
Father: Abdul Syed
Medication: Mefenamic Acid 500mg
Quantity:
30 capsules
Directions: Take one capsule two times daily when needed for pain and swelling.
*Take with food and plenty of water
*Auxiliary label
Dawood Khan National Military Hospital
Pharmacy Department
Dr. Omar Aziz
Date: 20 April 2013
Patient: Ahmed Mubarak
Father: Abdullah Mubarak
Medication: Salbutamol 100mcg Inhaler
Quantity:
1 inhaler
Directions: Inhale 2 puffs every 4 to 6 hours when needed for shortness of breath.
*Shake well before using
*Auxiliary label
Pictograms
Pictograms give health professionals a means of communicating medication
instructions to people with no common language and / or who may be illiterate.
Pictograms may also be used for those who have slight cognitive impairment or
difficulties seeing such as the elderly. To help improve communication, various formats
of the medication instructions can be printed and given to the patient. Pictograms may
help the patient understand the instructions on how and when to take the medication
prescribed.
‫‪Example of pictograms below:‬‬
‫اشکال مختلفه ادویه جات‪:‬‬
‫استفاده از طریق ریکتم یا مقعد‬
‫جابجا کردن در تحت السان‬
‫استفاده در گوش‬
‫اخذ توسط دهن‬
‫استفاده در بینی‬
‫تطبیق موضعی‬
‫استفاده در چشم‬
‫کیفیت‪:‬‬
‫‪:‬دیگر شکل های دوز‬
‫‪:‬تابلیت‬
‫‪:‬کپسول‬
‫اوقات اخذ ادویه‪:‬‬
‫در بستر‬
‫چاشت یا بعد از ظهر‬
‫شب‬
‫صبح‬
‫اضافی‪:‬‬
‫شکم خالی اخذ گردد‬
‫توسط دهن گرفته نشود‬
‫نباید جویده شود‬
‫با غذا اخذ گردد‬
‫اخذ با آب‬
‫ممکن سبب گنگسیت گردد‬
Generic Name refers to a name applied to a unique medication chemical entity. Also
referred to as the non-proprietary name of the drug.
Example:
Salbutamol
Metformin
Ceftriaxone
Ramipril
Cephalexin
Brand Name or trade name is a name trademarked by a pharmaceutical manufacturer
for their version of a given drug product.
Example:
Ventolin
Glucophage
Rocephin
Altace
Dalacin