ARTICLE

ROLE IN THE EFFORT TO INCREASE SAFETY OF PHARMACEUTICAL MEDICAL PROBLEMS IN

WRITING PRESCRIPTION

To Fulfill The Final Assignment

Of English Course

Arranged by :
AMAR SULTHAN FAUZI (AKF18129)
ARDIANUS ARSON ARDIKA KOSE (AKF18127)
DWI BAYU PAMBUDI (AKF18114)
THERESIA MARTHINA MOI NEDE (AKF18130)
TITIN PRIHATINI (AKF18106)

AKADEMI FARMASI PUTRA INDONESIA MALANG

2019
A. Definition of Prescription
Prescription is a letter of demand from doctors, dentists, veterinarians and other
health professionals licensed pharmacist in order to make the drug in a particular dosage
form for certain patients with certain disease states at any given time. Thus we can say
that the recipe is a medium of communication between prescribers with other health
professionals, in this case is a pharmacist, to provide a drug that specifically required for a
particular patient (Joenoes, NZ, 2006).
Prescription in the narrow sense is a written request from a doctor, veterinarian or
dentist for pharmacists to make drugs in certain preparations and give it to the patient.
Recipes must be clear and complete, if the recipe is not readable or incomplete, the
pharmacist must ask the doctor to prescribe prescription (Anief M, 2007).In general, the
demand letter was written using handwriting with ink that are not easily removed.
However, it does not cover the possibility of a request made by telephone or other
communication device. If the pharmacist receives a request by telephone or other
komunakasi tool, then the pharmacists have to write down the complete data in certain
formats and request a signature to prescribers on other occasions (Jas, A. 2007).
Prescription is also a medium of communication between prescribers and other
health workers to provide specific medicines needed by patients, clear communication is
a very important stage in drug therapy. (Anief M., 2007) The recipe is a medium of
communication between prescribers to pharmacists dispensing medicine. Therefore, a
recipe may not contain the correct on not confusing, and contain all the essential
components required by pharmacists for dispensing and patients to use drugs
appropriately so that the therapeutic effect can be achieved (Jas, A. 2007).
According to the law are allowed to write prescriptions were general practitioners,
veterinarians, dentists, or specialists. For specialists there is no limitation on the type of
drugs given to patients (Joenoes, 2001). Indonesian Health Ministry Decree No. 1072 /
Menkes / SK / IX / 2004 standard pharmaceutical services in pharmacies (Menkes, 2004),

B. The role of pharmacists in prescribing

1. Responsible for managing the activities at the pharmacy include:
a.Creating a vision and mission.
b.Making strategies, goals, objectives, and work programs.
c.Create and set rules or Standard Operating Procedures (SOPs) for each function,
activity at the pharmacy.
d.Creating a monitoring system and control SPO and work programs for each function,
activity at the pharmacy.
e.Planning, executing, controlling and analyzing the results of operational performance
and financial performance pharmacy.
f.Determine the direction of all activities
g.Determine the system or the regulations that will be used
h.SPO and oversee the implementation of the work program
i.Responsible for the performance of acquired (Anonymous, 1981a),

2
 2. Giving information of the drug to the patient

Pharmacists must provide correct information, clear and easy to understand,

accurate, unbiased, ethical, thoughtful, and current. Drug information to patients at a
minimum, include: how to use the drug, how the drug storage, treatment period, activity and
food and beverages should be avoided during therapy. Pharmacists should provide
counseling, regarding pharmaceutical, medicine and other medical supplies, so as to improve
the quality of life of patients or concerned to avoid the dangers of misuse or use of any
pharmaceutical or other medical supplies. For people with certain diseases such as
cardiovascular, diabetes, tuberculosis, asthma, and other chronic diseases, pharmacists must
provide counseling on an ongoing basis (McEvoy, K 2002).

3. Set the drug stocks

Definition of stock or inventory according to is as an asset which includes the
company's goods with intent to sell within a period of normal business (Raymond McLeod,
Jr., 1998). In this case the system used to monitor the stock and out is to use the drug
inventory system. Drug inventory system is a system that is responsible for planning and
overseeing the drug inventory from initial receipt of the stock until the distribution to the
customer. So that hospitals obtain optimum benefit the inventory system should aim as
follows:

• maximum customer service

• Low operating costs
• minimal inventory investment

Because the inventory stored in warehouses, then physical inventory management

and Gudang closely related. In some cases, the inventory may be stored for a certain
period. In other situations, inventory turnover is very fast and pharmaceutical warehouse
serves as a distribution center (Raymond McLeod, Jr., 1998).

4. Checking time expired drugs

A pharmacist should be observant to determine what type of medicine should be

stored in a particular storage and should be able to take action if it finds that a drug
approaching expiration date or expiration date. many traderspharmaceutical (PBF), which
provide opportunities for pharmaceutical means to change drug approaching the expiration
date on the condition that does not exceed a certain tempo. If the discovery of defective or
expired drugs because under the control of a pharmacist who had been given knowledge
about the storage and replacement of medication by PBF when approaching the expiration
date or expiration date (the City Health Office Yogyakarta, 2012).

5. Screening recipe

Pharmacists screening recipes include:

1) The administrative requirements:
 The name, SIP and address of the doctor.
 Date prescription.

3
  Signatures / initials prescribers.
 Name, address, age, sex, and weight of the patient.
 Name of the drug, potency, dose, amount mints.
 How to use the obvious.
 More information.
2) Suitability of pharmaceuticals: the dosage form, dosage, potency, stability,
incompatibility, cars and duration of administration.
3) Clinical Considerations: allergies, side effects, interactions, suitability (dose, duration,
number of medications and others) .If there are doubts about the prescription should be
consulted kepadadokter prescribers to give consideration and approval alternatifseperlunya
if necessary use after notification(Department of Health 2009),

C. The case study on prescription

1. Lack of clarity in prescribing

Drug Related Problems Identified for feedback so they can do the correction of DRPs
happened. The correction is realized in the form of feedback provided by pharmacists to
dokter either directly (direct feedback) or indirectly (letter to doctors). (Blix, HS, et al., 2004).
Unclear prescription can lead to inaccuracies in the process of reading / interpretation of the
recipe so could cause errors in the process. Recipes are not clear this should be confirmed to
the prescribing doctor or nurse if they are concerned with the identity of the patient (Ansari,
M., & Neupane, D., 2009). Replacement drugs by the pharmacy for prescriptions beyond the
formulary and medication is not available is set through internal policies Hospital. Pharmacy
still to confirm with the doctor who prescribed despite getting the authority in order to
maintain communication and coordination with doctors. The vagueness of this recipe was
found that all of the recipes that require a doctor's confirmation has been made the changes.
Confirmation / feedback do pharmaceutically accepted by physicians with criteria that
doctors give a solution to the uncertainty on prescriptions and doctors to change
prescriptions based on information, advice and other explanations given by the pharmacy as
well as of communication both sides of physician and pharmacy (Ansari, M., & Neupane, D.,
2009).
Errors in prescribing the others are as follows:
1). Rules are not written in full, it is not appropriate or is not written as rules of use /
"signa".
2). Not to mention the name of the drug required to clear, such as drugs written with a
specific code (usually for a drug with repeated prescription or prescription copie).
3). Not to mention the strength prescription medicine that are required when the drug is
available in a variety of strengths.
4). There is no age of the patient, especially for pediatric patients.
5). No signature physician / prescriber.
6). The prescribed medication had dicontinued more than 3 months (no longer
manufactured) and no drug stock.
7). Prescribed dosage form does not correspond or different to that required patient.
8). Drug name is not clear because the writing is difficult to read.
9). Date prescription was not written.
10). Writing a drug with similar properties more than 1 time in 1 sheet of recipes, both with
the same or a different brand name.

4
11). Patients do not fit or experienced side effects during drug administration.
12). Not to mention the required dosage form when the drug is available in a variety of
forms (Nadeem, 2001)

5
 REFRENCE
Anief M., 2007, Science dispensing medicine, Gadjah Mada University Press, Yogyakarta.
Anonymous, 1981a, the Minister of Health of the Republic of Indonesia No. 278 / Menkes /
V / 1981 About Conditions and Procedures for Management of Pharmacy, MOH,
Jakarta
Ansari, M., & Neupane, D., (2009). Study on Determination of Errors in Prescription Writing:
A Semi-Electronic Perspective, Kathmandu University Medical Journal, 7 (3), 238-
241.
Blix, HS, et al., (2004). The Majority of Patients hospitalized have Drug-Related Problems:
Result from a Prospective Study in a General Hospital, European Journal of Clinical
Pharmacology, 60 (9), 651-658
City Health Office Yogyakarta, 2012, SK Kadinkes Yogyakarta No. 183 Year 2012 on the
Establishment of Technical Team Elimination and Destruction of Medicine,
Reagents, and Health Supplies Damaged / Expired Owned / Wealth Yogyakarta
government. City Health Office Yogyakarta, Yogyakarta
Jas, A. 2007. About Recipes & Dosage and Prescription Writing Exercise. Issue I. North
Sumatra University Press. Field
Joenoes, NZ 2006, Rational Recipes, Volume 2, Airlangga University Press, Surabaya.
McEvoy, K 2002, AHFS Drug Information, American Society of Health-System Pharmacists,
Wisconsin.
Menkes. 2004. The Indonesian Health Minister Decree No. 1072 / Menkes / SK / 2004 on
Standards of Pharmaceutical Services in Pharmacy. Minister of Health of the
Republic of Indonesia. Jakarta
Ministry of Health of the Republic of Indonesia, (2004). StandardPharmacy services
HospitalJakarta: Directorate General of Pharmaceutical Services and Medical
Devices.
Ministry of Health., 2009, Government Regulation 51 of 2009 on Pharmaceutical Works.
Nadeem, H., 2001, A Survey of Prescription Errors in General Practice, Pharm J:
Vol 267, p 55Zillich, AJ, McDonough, RP, Carter, BL, & Doucette, WR (2004)
Influential Characteristics of Physician / Pharmacist Collaborative Relationships.
The Annals of Pharmacoteraphy, 38 (5), 764-770

6
Attachment I

Figure 1: recipe unclear because Figure 2: the identity of the drug are not clear
illegible handwriting

Figure 3: Rules pemakaain incompatible with drug packaging (vs. spray drops)

Figure 4: The recipe is not clear because Figure 6: Prescription with drug interactions need
the postnot in accordance with the strength to be confirmed
of the drug