Erroneous, Violative or Impossible Prescription

We often admire pharmacy personnel in reading prescriptions. Most doctors’ handwritings are unrecognizable and still, these professionals would know how to read these drug orders. Definitely, they follow some codes. They have basis to consider and they have their drug indexes for references.

Yet, drugstore personnel do encounter problems from time to time.

The Prescription

By definition a prescription is a written order and instruction by a registered physician 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 between the two. It usually includes the following:

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

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Reading the prescription

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

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 drug 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 pescription and the Violative or Impossible prescription.

Erroneous prescription

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

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Violative or impossible prescription

• Violative prescription can also be referred 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.

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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 DOH Officer for appropriate action. The pharmacist shall advise the prescriber of the problem and/or instruct the customer to get the proper prescription.

On the other hand, most pharmacies do their best in filling their customers' drug orders. If they can decode the prescriber’s prescription then why not fill it? Most customers need to take their medication immediately. They cannot afford to undergo hassles 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 drug order.

 Reference:

The Generics Pharmacy Manual 2009