Funny or Not: The Violative Prescription

You wait outside the counter for fifteen minutes. You are in a hurry. It’s getting late and you still have some errands to do. But you need the medicine for your sick child. Finally, a pharmacy staff, approaches you to fill out your order. As he studies your prescription, you take out your wallet, ready to pay. Suddenly, he stifles a smile and calls out for the pharmacist.

 The pharmacist frowns upon seeing your prescription. He takes it from his assistant and heads for you. Solemnly, he tells you, “Madame, there’s a problem with your prescription. We can’t possibly fill it. By any chance, can you return the prescription to your doctor?”

What? The feeling of annoyance hits you. You need the medicine very badly and these people are telling you that they can’t help you?

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We often admire pharmacy personnel in reading prescriptions. Most doctors’ handwriting are bad (probably because they are always on the go) and yet, these professionals would know the drug orders written in any prescriptions. Definitely they follow some codes. They have basis to consider and they have their drug indexes for references.

But drugstore personnel also encounter problems from time to time.

The Prescription

By definition a prescription is a written order and instruction by a registered physician, veterinarian or a dentist to the pharmacist for the specific use of a drug product for a patient. It has two types- the ordinary and the narcotic prescription.

The ordinary prescription is the most common among the two. It usually includes the following:

1. Date
2. Patient profile (age, sex, address etc.)
3. Superscription (Rx symbol- recipe, meaning to take or give)
4. Subscription (dispensing direction to the pharmacist on compounding a drug)
5. Inscription (principal part of the prescription that gives the name of the drug and the required quantity
6. Signa (direction to the patient on how to use the drug)
7. Signature of the prescriber including his license number

Image by Mae

Reading the Prescription

Pharmacy personnel rely on three things- the patient profile, inscription and the sigma.

Since the inscription includes the name of the drug, they will automatically look for it.  If the inscription is unreadable or lacking the generic name, the Pharmacist or his assistant would check the medicine in the drug index. Established, deleted or newly registered drugs may not be found in the Mims or drug index. If that would be the case, they tend to pay attention to the patient profile or the signa. Most likely, they also ask questions about the patient’s condition. If the customer is unsure of his medicine, the drug outlet won’t be able to fill the prescription. They may call the prescriber but often, they would advise the customer that they should return their prescription to their physician.

Unethical Prescriptions

In the Philippines, unethical prescriptions are classified into two: The Erroneous and the Violative prescriptions.

Erroneous

This type can be filled since they only commit minor errors. This includes the following:

• The brand name precedes the generic name.
• The generic name is the one in parenthesis.
• The brand name is not in parenthesis.
• More than one drug product is prescribed in one prescription form.

Image by Mae

Violative

Pharmacy personnel usually laugh with this type. Violative prescription can also be referred to as impossible prescription. The following are some instances:

• The generic name is not written.
• The generic name is not legible and a brand name which is legible is written.
• The brand name is indicated and instructions added, such as the phase ‘No Substitution’ which tends to obstruct, hinder or prevent proper generic dispensing.

Violative prescriptions shall not be filled. They shall be kept and reported by the pharmacist of the drug outlet or any other interested party to the nearest health department for appropriate action. The pharmacist shall advise the prescriber of the problem or instruct the customer to get the proper prescription.

On the other hand, most pharmacies do their best in filling their customer’s prescription. If they can decode the prescriber’s order then why not fill it? Most customers need to take their medication immediately. They cannot afford to undergo hassles such as returning or searching for their doctors. Anyway, drugstore outlets want to earn, too. As long as they can be sure that the patient will be taking the right medicine, these pharmacies will serve the prescription.

 Image by Mae

 Final Words for Our Doctors

Violative or impossible prescriptions may be amusing. Yet, your patients suffer the most. Sure they can always call or go back to you as their physician but there are certain cases that a busy professional like you can be out of reach.

Dear Sir and Madame prescribers: Your prescription is very valuable. Please, write your prescriptions ethically.