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Prescription

Prescription can be defined as a written request from a doctor to the pharmacist to


prepare, mix and provide the medications to the patient. A good prescription must
be written clearly, readable, and complete in an appropriate prescription form with
the ideal size of 10 to 12 cm in width and 15 to 20 cm in length.
The aim of prescription writing is to facilitate the doctors in performing the
healthcare service in pharmacy area and to minimize the mistakes in providing the
drugs to the patients. It also facilitate the patients to access the medications
needed according to the diseases as the generally pharmacy installations open
longer than the medical practice. Prescription can also facilitate the healthcare
providers in performing surveillance of medicine distribution as not all drugs can be
given freely to all people. The prescription itself can function as the medical record
of the patient.
Since prescription includes the detail of the medication given to the patient, it may
provide the information regarding the patients condition. Therefore, prescription is
confidential and can only be accessed by the doctors who prescribe the prescription
and take care of the patient, the patient and family, paramedics who give the
healthcare service to the patient, pharmacists, and insurance for payment claim.
Prescription can be divided into several types such as:
1. Standard prescription (R/. officinalis): a prescription which its composition has
been standardized and adopted to pharmacopoeia.
2. Magistralis prescription (R/. polypharmacy): a prescription which has been
modified by the physician who prescribed it. It can be comprised by the
mixture of the several active ingredients.
Prescription Format
There is no standardized regulations regarding the prescription writing worldwide
since each country has its own regulations. In Indonesia, a complete prescription
must be in accordance to Kepmenkes No. 280/Menkes/SK/V/1984, which includes:
1. The doctors name, address, and license number
2. Date of prescription

3. Name of each drug or drug component


4. R/ sign on the top left of prescription, followed by the drug or the composition
of drug prescribed
5. Doctors signature
Therefore, the proper prescription is divided into these parts:
1. Inscription
This part consists of:
a. name of the doctor who published the prescription with the license
number, doctors address with phone number. This part mostly has been
printed in the prescription form.
b. Town and date of prescription
c. Also included in this part is written with the symbol of R/ which is derived
from a Latin word recipe meaning please take... This part has usually
been printed in the form. If the patient needs more than one drugs, R/
must be written again separately.
2. Prescription
This part is the core of the prescription which consists of the name of drugs,
dose of each drug preparation, and the amount of drugs needed.
3. Signature
This part consists of method of drug usage, drugs dosage forms, the amount
of drugs, appropriate usage time.
4. Pro
This part includes the identity of the patient, including name, age, body
weight (especially pediatric patient), and patients address.
5. Subscription
This part consists of doctors signature.
Requirements of good prescription:
1. Prescription must be written clearly and complete according to the format
2. One sheet of prescription can only be applied to one patient only
3. The amount of drugs prescribed cannot be in half of partial
4. The doctor must write signature after each drug (after Signatura part) to
5.
6.
7.
8.

legalize the drug given


The amount of drug given must be in Roman numerals
Pro should include name and age of the patient
Patient name and age must be written clearly
Especially for narcotic drugs, it must be signed by the doctor and the
patients address must be added to prescription and the prescription

cannot be repeated
9. Do not add informal abbreviation of the drugs
10.Avoid unreadable writings that may confuse those who have to interpret
the prescription

11.Keep the confidentiality of the prescription


Steps of drug prescription
1. Choosing the appropriate drugs
In order to prescribe the appropriate drugs to the patient, firstly the doctor
must conduct the thorough anamnesis and physical examination to
establish the diagnosis. After that, also considering the condition of the
patient

(including

the

history

of

the

disease,

progression,

and

manifestation), the goal of the therapeutic plan can be concluded to


create a rational therapy. There are several considerations in choosing the
rational therapy for the patient, such as:
a. The benefits must outweigh the risk of the drugs chosen
b. The safety of the drugs, including the adverse

effects

and

contraindications of each drugs


c. The dosage forms of drugs administered
d. The cost of drugs and the socioeconomic condition of the patients
2. Choosing the right method of administration and appropriate dosage
Drugs can be administered using several method of administration (per
oral, per rectal, parenteral, topical, etc). This consideration is in
accordance with the aim of the therapy, patients condition, drug
characteristics, and bioavailability of drugs.
Ideal dosage should be given for each individual since the respond of the
patient is not the same, influenced by severity of disease, therapeutic
index, body weight, age, and organ function. Things need to be considered
regarding the dose are frequency, time of administration, and duration.
3. Appropriate dosage form
4. Appropriate prescription formula and writing (lege artis)
5. Sufficient information and education for patient

Examples of prescription
Dr. Stefanus Raditya
SIP 1006804823
Fakultas Kedokteran Universitas Indonesia
Jalan Salemba Raya no 6
Jakarta Pusat
Jakarta, 19 April 2016
R/ Isosorbide dinitrate 10 mg tab No. X
S 1 dd 1 SL p.r.n nyeri dada
----------------------------------------------------- SR

Pro: Tn. Purba


Usia : 60 tahun
Dr. Stefanus Raditya
SIP 1006804823
Fakultas Kedokteran Universitas Indonesia
Jalan Salemba Raya no 6
Jakarta Pusat
Jakarta, 19 April 2016
R/ Captopril 25 mg tab No. XXX
S 3 dd tab I p.c
----------------------------------------------------- SR
R/ Simvastatin
S 1 dd tab I
------------------------------------------------------ SR
Pro: Tn. Purba
Usia : 60 tahun