ERRORS IN THE PRESCRIPTION

Following are the sources of errors which arise in prescription:

1) Abbreviation:

• Abbreviation presents a problem in understanding parts of the prescription order. Extreme care should be taken by a pharmacist in interpreting the abbreviation.

• Pharmacist should not guess at the meaning of ambiguous abbreviation.

• Eg: To dispense “Achro” Abbreviation Pharmacist will confuse Achromycin or Achrostatin.

2) Name of the Drug: There are certain drugs whose name look or sound like those of other drugs. Some of the examples of such drugs are as under:

Examples of Drugs often Confused -

Digitoxin Digoxin

Prednisone Prednisolone

Doridon Doxidan

Althrocin Eltroxin

Confusing in brand names -

E.g: Flex - Ofloxacin Ocimix- Ciprofloxacin

Flexi- Ondasetron Ocimax- Omeprazole Epitab- Phenytoin

Epitan- Phenobarbitone

3) Strength of the Preparation: The strength of the preparation should be stated by the prescriber.

For example, it will be a wrong decision on the part of a pharmacist to dispense paracetamol tablet 500 mg when prescription for paracetamol tablet is received with no specific strength.

4) Dosage Form Prescribed: Many medicines are available in more than one dosage form such as liquid, tablet, capsule and suppository. The pharmaceutical form of the productshould be written on the prescription in order to avoid ambiguity.

5) Dose: Unusually high or low doses should be discussed with the prescriber.

For example, a prescription for sustained release formulation to be administered after every four hours should be thoroughly checked because such dosage forms are usually administered only two or three times a day.

6) Instructions for the Patient: The quantity of the drug to be taken, the frequency and timing of administration, and route of administration should be clearly given in the prescription so as to avoid any confusion.

7) Incompatibilities: It is essential to check that there are no pharmaceutical or therapeutic incompatibilities in a prescribed preparation and that different medicines prescribed for the same patient do not interact with each other to produce any harm to the patient.

E.g:

Tetracycline capules should not be taken with milk - Tetracycline is inactivated by calcium present in the milk.

8) Poor or Illegible handwriting: by physicians is riskier than poor handwriting by other professionals.

9) Trailing zero: After a decimal point when writing a dosage. This can lead to 10 fold medication error.

E.g: Writing a medication dosage as 1.0 mg may be misinterpreted as 10 mg, if the decimal point is not seen. However, a zero should always precede a decimal

point.

E.g: a medication written as .1 mg could be misinterpreted as 1 mg if the decimal point is missed, leading to a patient receiving 10 times the amount of medicine needed.