Handling Of Prescription

In this article, we will discuss the handling of prescriptions but before going to the details of the handling of prescription we will have a look at the definition of prescription.

Prescription And Its Parts

A prescription is a written order which is generated by the physician, dentist or another registered medical practitioner (RMP) to the pharmacist to compound and dispense medicines to the patients.

In simple words, the prescription is a piece of paper that is written by the registered medical practitioner (RMP)  according to the patient's disease condition.

Prescriptions contain not only the medicines but also contain all other important information regarding the dose of medicine, when to take it, how to take etc.

The patient, after consulting the registered medical practitioner (RMP) , goes to the pharmacy along with the prescription and hands it over to the pharmacist and then the pharmacist dispenses the medication according to the prescribed order.

The pharmacist creates a bridge between the patient and RMP by supplying the correct medicines, pharmacists not only give medicines to the patient but also gives instructions regarding the use of medicines according to the prescriber's advice.

Prescriptions are written in the native language of the area but some Latin words are also used for indication of dose instructions.

 Parts Of Prescription

A good and complete prescription consists of the following parts or components,

• Date

• Name & Address

• Gender & Age

• Superscription

• Inscription

• Subscription

• Signatura

• Signature, Address & Registration Number

Date

The date is an important factor that ensures updation of the prescription and the date is mentioned on the prescription when a patient visits the prescriber.

The same date is mentioned on the prescription on the day when the patient is checked by the physician and this date helps pharmacists to understand that the prescription is updated and is dispensed as soon as possible.

If a patient comes to the pharmacist to dispense medicines according to the prescription which bears one week old date,it will be questionable by the pharmacist, that is it still be able to full fill patients' needs.

The date on prescription also helps to track treatment duration and to know when the last prescription was filled.

Name & Address

The name and address of the patient must be written on the prescription to ensure delivery of medicines to the right person and the complete name of the patient should be written to avoid confusion.

Gender & Age

The gender and age of the patient are also mentioned on the prescription to ensure the proper dose is prescribed.

Superscription

Superscription is the symbol represented by Rx and it is written at the start of the prescription.

Rx is an abbreviation of the Latin word recipe which means "you take"

Inscription

The inscription is the main part of the prescription and consists of the following,

• Name of the medicine

• Dose of medicine

• When to take

Subscription

This part of the prescription contains directions for the pharmacist, in case of a drug if it has to be compounded in the pharmacy.

 Signatura

It is indicated by Sig. and this part contains directions for patients regarding the use or administration of the medicines and all these directions are mentioned on the label of medicines if these are to be compounded by the pharmacist in the pharmacy.

 Signature, Address & Registration Number

For the authenticity of the prescription, it must bear the signatures of the prescriber on the prescription and also bear the address and registration number of the prescriber.

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Handling Of Prescription

Quality Assurance

Total Parenteral Nutrition | TPN | PPN

TPN is a medical term and tpn means total parenteral nutrition, it is the type of parenteral nutrition in which nutrients are administered to the person through the veins, bypassing or avoiding the gastrointestinal tract.

What Is Parenteral Feeding Or Parenteral Nutrition?

Parenteral feeding or parenteral nutrition is a broader term and is used for the administration of nutrient fluids into the body using veins instead of the GI tract.

Parenteral Feeding is further divided into two types one is TPN (total parenteral nutrition) and the other is PPN (Peripheral parenteral nutrition)

What IS TPN / Total Parenteral Nutrition

In simple words, TPN is a liquid preparation containing all the important ingredients required to the body and are administered through the large vein known as superior vena cava.

TPN is also defined as the feeding system which bypasses the GIT system.

The TPN system was first developed by Dr Stanley Dudrick in 1960.

What IS PPN?

PPN is the type of intravenous feeding or parenteral feeding in which nutrients are administered to the body using peripheral intravenous lines rather than central lines. It is used for short term or temporary supply of nutrients.

When To Use TPN

As we discussed earlier TPN is the bypassing of GIT so it is used when there is a serious problem in the functioning of GIT or in any disease condition which makes it impossible to take food or nutrients orally.

For Whom TPN Is Used

Although TPN is the method of nutrition administration, it is not a normal feeding system, which means it is not used for healthy patients.

• TPN is used for those patients who are not able to take food through the gastrointestinal tract due to some disease conditions.

• TPN is used for those patients who are in a coma and are not able to take food through gastrointestinal tracts.

• TPN is used for premature babies to improve their health.

• TPN is used for those patients who are elderly and their GIT absorption is reduced.

• TPN is administered to those patients who have a blockage in their GIT.

• TPN is administered to those patients who have a leakage in their GIT.

• TPN is also administered to patients suffering from short bowel syndrome.

• TPN is administered to the patients having severe diarrhoea.

• TPN is used for cancer patients.

• TPN is also administered to patients who are suffering from intestinal bleeding.

• TPN is administered to the patient who is recommended for long-duration bowl rest.

What Are Complication Of TPN

As we know that TPN is not the method of oral administration and it is administered through veins so it may result in the following complications,

• Catheter Infection may occur due to the administration of TPN using a needle system.Septic shock may result in harm to life.

• Blood clotting may occur.

• Long term usage of TPN may fail the liver functioning or may result in the fatty liver.

• Feeling of hunger.

• Administration of medicines along with TPN may result in severe complications due to incompatibility.

Components OF TPN

Patients receiving TPN are dependent on intravenous fluids so TPN solutions should contain all the essential and required nutrients so that the basic dietary needs of patients may be met.

Before TPN administration patients nutrient requirements are calculated and then TPN is administered according to the condition.

Following are the main components of TPN Solution,

• Lipids

• Amino Acids

• Fats

• sugar

• Vitamins

• Dextrose

• Potassium

• Calcium

• Sodium

• Chloride

• Magnesium Ions

• Trace elements

• Added substance

Added substances are mixed in tpn preparations depending on patient requirements.

Preparation Of TPN

TPN is prepared by qualified pharmacists in hospital pharmacy. For accurate administration of nutrients, TPN calculations are done daily according to the patient's conditions and requirements.

TPN Route Of Administration

TPN is administered by using a catheter into the central vein which directly leads to the heart.

Duration Of TPN

Parenteral nutrition is recommended to patients for short term and long term duration.

The administration of TPN fluid usually takes 10-12 hours a day.

Life with TPN is somewhat difficult because a long duration is required for its administration.

Instructions For TPN

Following instructions should be followed for TPN,

• Always check Patient name before administration.

• Do not administer a TPN bag if it is expired.

• Do not administer the TPN bag if it leaked.

TPN at Home Or Hospital

TPN can be administered to the patient both at home or hospital depending upon the condition of the patient.

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Quality Assurance

Prescription And Its Parts

Hospital Pharmacy

Hospital pharmacy is the department or health care service inside the hospital which is involved in purchasing,  dispensing, and storage of medicines and medical devices.

Hospitals are the places where a large number of patients come for treatment and check up and for their treatment and checkup medicines, medical devices are required which are provided to them from the pharmacy located inside the hospital.

Definition Of Hospital Pharmacy

Hospital pharmacy is the department inside the hospital that is run under the supervision of a qualified pharmacist and is involved in procurement,  preparation,  dispensing and storage of medicines.

Division Of Hospital Pharmacy

For easy and simple understanding hospital pharmacy is divided into the following subdivisions.

• Main Store

• Central Pharmacy

•  Satellite Pharmacy

• Outpatient Pharmacy

Main Store

The main store is also known as a warehouse for bulk storage of medicines and medical devices.

 It is the place where after purchase medicines and supplies are stored in bulk.

It is under the supervision of a qualified pharmacist and all the record of supply is maintained here properly.

To keep a balance between supply and demand new purchase orders are generated according to the requirements.

The main store is the place from where medicines and related supplies are provided to the centralised and outpatient pharmacy.

Central Pharmacy

Central pharmacy is the main pharmacy situated inside the hospital which provides medicines and related supplies to indoor patients. Central pharmacy is also responsible to provide medicines and related supplies to different wards and intensive care units.

Basic Requirements For Central Pharmacy

Following are some basic requirements  of central pharmacy,

• It should be located at the centre of the hospital so that it can easily be accessible to all the wards of the hospital.

• It should have sufficient space for storage of medicines and supplies.

• It should have a proper area for compounding and dispensing of required medicines.

Satellite Pharmacy

Satellite Pharmacy is the remote extension of the centralised pharmacy within the hospital to provide fast and specific medicines in specific wards.

Explanation

Satellite pharmacy is the branch of centralised pharmacy which is located on the floor of each ward.

Suppose if a hospital has 10 wards then it is very difficult for every ward to take medicines and other supplies from a centralised pharmacy for each patient,  that is why on the floor of every ward a small pharmacy is located which has all the necessary medicines and supplies specifically for that ward.

These satellite pharmacies ensure fast and accurate delivery of medicines.

Outpatient Pharmacy

Outpatient Pharmacy is the pharmacy situated in the hospital which is responsible for the supply of medicines to the outpatients.

Responsibilities Of Hospital Pharmacist

Following are some important duties or roles of a hospital pharmacist,

• Compounding of medicines to the hospital patients.

• Dispensing of medicines to the patients.

• Labelling of medicinal containers.

• Maintain proper stock of medicines.

• Ensure proper stock of anti-dots.

• Maintain all required records.

• Prepare an annual product review.

• Ensure a good source for the purchase of medicines and supplies.

Also Read

Prescription And Its Parts

Basics Of Pharmacognosy

Basics Of Drug Routes