MAKALAH RESEP INGGRIS

DOCTOR PRESCRIPTION

( RULES OF WRITING RECIPE )

INTRODUCTION

Physician prescription is very important for a doctor in the process of prescribing medications for

their patients . Doctors in realizing rational therapy , requires a systematic step with the motto 5T

( Right medication , Right dose , Right way , and schedule as well as the provision of appropriate

patient BSO and to the right ) . Good prescription must be written in the blank prescriptions lege

artist .

GENERAL UNDERSTANDING OF RECIPES

Recipe is defined as a written request from a doctor , dentist or veterinary pharmacy pharmacist

manager ( APA ) to provide and submit the drug for patients in accordance with the norm of

applicable laws . Correct prescription is written in a clear, legible , complete and meet the laws

and rules that apply . Examples of the correct recipe :

dr . Sarah Ayu

SIP . 087/2007

Home address / practice :

Jl . 10 Boxwood Surakarta

Surakarta , June 15, 2008

R / Paracetamol 100 mg

Sacch . lactis q.s

m.f.l.a. pulv.d.t.d. No. . VI

I s.p.r.n.t.d.d.pulv

Pros : Susi ( 2 years )

Address : Penumping half Surakarta

The elements of the recipe :

1 . identity Doctor

The name , license number practice , practice address and home prescribers and can be equipped

with a phone number and days and hours of practice . Usually printed on the prescription form .

2 . The name of the city ( already printed in the blank recipe ) and the date of written

prescriptions

3 . Superscriptio

Written by the symbol R / ( recipe = hope is taken ) . Usually printed in the blank . If it takes

more than one dosage form drug / prescription formula , required writing R / again .

4 . Inscriptio

It is a core part of the recipe , contains the drug name , strength and quantity of drug required and

clearly written

5 . Subscriptio

This section lists the drug dosage form ( BSO ) and in number . Way of writing ( the Latin

abbreviation ) depending on the kind formula recipe used .

example :

- M.f.l.a. pulv . d.t.d.no. X

- M.f.l.a. sole

- M.f.l.a. pulv . No. XX da in caps

6 . Signatura

Contains information about the rules for use of the drug for the patient which includes the

frequency , number of medications and current medications taken , etc. .

Example : stddtab.Iuhpc ( tick one tablet three times a day one hour after eating )

7 . The identity of the patient

Generally already included in the prescription form ( writing pro and age ) . Role in the patient's

name imprinted pro . Should also include the patient's weight so that control can be accurate

dosage by the pharmacy .

PROCEDURE FOR WRITING RECIPE

There is no standard in the world of writing prescriptions . For Indonesia , the recipe is complete

according to the Minister of Health Decree No. RI . 26/2981 ( Chapter III , Article 10 ) includes :

1 . Name , address , driver's license number Practice Physician ( NSIP )

2 . Date of prescription

3 . The name of each drug / drug components

4 . Signs R / on the left side of each prescription

5 . Signatures / initials prescribing doctor

6 . Exclamation marks and initials doctor for a prescription drug containing doses exceeding the

maximum

STEP PRESCRIPTION

1 . The selection of the right drug

In doing practice , doctors must first perform a history and physical examination on patients both

for diagnosis . After that , considering the circumstances ( disease pathology , course of the

disease and its manifestations ) , the goal of therapy with the drug to be determined . Then it will

be done properly drug selection , in order to produce a rational therapy .

It is very important to be considered in selecting drugs :

a. What about the risk -benefit ratio with selected drugs

b. How safety ( side effects , contraindications ) selected drug

c. What type of drug ingredients ( raw materials , standard formula , generic ingredient or

substance patent ) selected

d. Consideration of the cost / price of drugs

Taking into account the above , the drug doctors hoped would be the appropriate

prescription based on the benefits , safety , economy , and suitable for people

In order to realize the rational drug therapy and to improve the effectiveness and efficiency

as well as cost , then a physician need to understand the criteria ingredients in prescription

drugs . The ingredients in the recipe including inscriptio element and part of the raw

material , the standard drug ( drug raw formula / formal , generic preparations ) or finished

material / patent Name of the drug can be selected with the generic name ( official name in

the book Indonesian Pharmacopoeia ) or patent name ( the name given the plant ) . Users

need to pay attention to the type of drug patents and the strength of the active ingredient or

drug composition contained in it so that rational drug selection can be achieved and

pharmacy services do not encounter any problems .

Example : If the therapy should be given Paracetamol drug substance , the raw materials can

be selected ( in the pharmacy ) , bearing the generic preparations ( tablets or syrup

paracetamol or patent preparation )

The number of drug prescriptions written in the old tergatung of administration and

frequency of administration . Parameters required to determine this is a long course of the

disease , the goal of therapy , and the condition of the patient . The number of drugs are

written in Roman numerals for the type of finished dosage / patent

Example : Tab . Sanmol 500 mg no. X or Tab . Sanmol 500 mg da X

Materials / preparation based prescription drug in the legislation can be categorized :

a. Narcotic drug classes or O (ct : codeine , morphine , pethidin )

b . Hard drug classes or G or K Differentiated menajadi 3 :

- Type of certain drugs or Psychotropic Loud ( diazepam and its derivatives )

- Group Hard drugs or K (ct : amoxicillin , ibuprofen )

- Group of mandatory drug pharmacy or OWA (ct : famotidine , allopurinol , topical

gentamycin )

c . Limited free drug classes or W (ct : paracetamol , pyrantel palmoat )

d . Free drug classes ( ct : Vitamin B1 , Vitamin C )

At the writing of narcotic drugs and psychotropic / special ) the amount of the drug is not

enough just to numbers alone , but accompanied by the number of letters , eg X ( DECEM )

and in order to be valid doctor's signature ( not initials ) . This is done to avoid the misuse of

drugs in society .

2 . Determination of mode of administration and dosage appropriate rules a. How drug

delivery Drugs administered in various ways (orally , rectal , parenteral , topical , etc. ) . It is

necessary to determine the mode of administration of drugs :

- The goal of therapy

- The patient's condition

- Physico-chemical properties of drugs

- Bioaviabilitas drug

- The benefits ( profit-and- loss drug delivery )

Preferred mode of administration is the optimal clinical benefit and provide safety for the

patient . Suppose a drug delivery Gentamicyn necessary for systemic purposes , it should be

chosen through parenteral . NSAIDs should be given to people with gastritis do rectal

administration .

b . Rules dose ( dose and schedule of administration ) of drugs

DOSE

The ideal dose is the dose given per individual . It is given that the patient response to the

drug is very individualistic . Determination of the dose needs to consider : 1 ) the condition

of the patient ( such as age , body weight , physiology and organ function ) 2 ) the condition

of the disease ( acute , chronic , heavy / light ) 3 ) therapeutic index drugs ( wide / narrow )

4 ) variation of kinetic drug

5 ) how / child dose calculation formula ( select the most thorough )

Calculation of the ideal dose in children using basic physical size ( weight or body surface

area ) . If the child dose calculated by comparison with the adult dosage , the dose calculation

using the formula children (eg Young , Clark ) , it is necessary to note about the accuracy of

the formula used .

SCHEDULE OF GIVING

This includes the schedule of frequency , dose per unit time and the time / timing of drug

delivery . In the recipes contained in the element Signatura .

FREQUENCY

Means the frequency of how many times the drug is administered to the patient . The number

of part- time administration of the drug dependent , BSO , and therapeutic purposes . Anti-

asthma drugs given when packed ( prn ) namum when to guard against the attacks of asthma

can be administered on a regular basis eg 3 times a day ( tdd ) .

WHEN / TIME GIVING

It is necessary for the administration of certain medications in order to have an optimal effect

, safe and easy to follow patient . For example : The drug absorbsinya distracted by the food

should be given on an empty stomach 1/2 - 1 hour before a meal (1 / 2-1 hac ) , drugs that

irritate the stomach is given after meals ( pc ) and drugs for sleep memepermudah given at

bedtime ( hs ) , etc. .

GIVING OLD

The duration of the course of disease or drug use based treatment guidelines that have been

defined in the literature / RS . Suppose antibiotics within a specified time ( 2 days after

symptoms disappear to avoid germs resistance , symptomatic drug should be given only

when symptoms appear ( prn ) , and in chronic penyaklit ( eg, asthma , hypertension ,

diabetes ) required continuous administration of drugs or throughout life ( ITER! )

3 . Selection of the appropriate BSO

Selection of BSO in prescriptions should be considered that the optimal drug delivery and

affordable prices . Patient adherence factor , factor medicinal properties , bioaviabilitas and

socio-economic factors can be used as an electoral considerations BSO

4 . Selection of the proper prescription formula

There are three prescription formulas that can be used for prescriptions menyusunan doctor (

Formula marginalis , officialis the specialty AAU ) . Selection of the formula needs to

consider :

- Who can guarantee the accuracy of dose ( individual doses )

- The stability of the drug can menajaga

- In order to maintain patient compliance in taking medication

- The cost / affordable prices

5 . Writing prescriptions in the correct prescription blank ( lege artist )

Prescription lege artist intention is clearly written , complete ( contains 6 elements that must

exist in the recipe ) and in accordance with the rules / guidelines as well as the standard

standard Latin abbreviations , the standard form ( size 10-12 cm width , length 15-18 cm )

6 . Provision of information to the right people

How rules must be in writing or complete the prescription , but the doctor also remains to be

explained to the patient . Likewise, the things that need to be delivered or warnings about

drugs and treatment , ie whether the drug should be taken until the end / no , side effects , etc.

. This is done for patient compliance and achieve rational prescribing

GUIDELINES TO WRITING DOCTOR PRESCRIPTION

1 . Prescription blank size ( width 10-12 cm , 15-18 cm long )

2 . Writing the name of the drug ( Part Inscriptio ) :

a. It starts with a capital letter

b . Written in full or with an official abbreviation ( in pharmacopoeia Indonesian or

international nomenclature ) eg : ac . Salic ; acetosal

c . Not written with the chemical name ( eg : time chloride with KCl ) or other abbreviations

with capital letters ( eg clorpromazin with CPZ )

3 . Writing the number of drugs

a. Unit weight : mg ( milligrams ) , g , G ( g )

b . Sataun volume : ml ( milliliters ) , l ( liters )

c . Unit : IU / IU ( International Units )

d . Writing with a number of drugs seed unit using Roman numerals . For example : - Tab

Novalgin no. XII

- Stesolid 5 mg Tab no. X ( DECEM )

- M.fl.a.pulv . dt.d.no. X

e . Writing tools graduated :

Known in the Latin abbreviation : C = tablespoon ( 15 ml volume ) Ex . = Teaspoon ( 5 ml

volume )

Gtt . = Guttae ( 1 drop = 0.05 mL )

Note : Avoid using a teaspoon and eat senok households do not always have the volume to

15 ml and 5 ml tablespoons to teaspoons . Use a plastic spoon ( 5 ml ) or other instrument

( volume 5 , 10 , 15 ml ) liquid sediaaan included in the patent .

f . Meaning percentage ( % )

0.5 grams in 100 grams of preparation0.5 % ( w / w )

0.5 grams in 100 ml of the preparation0.5 % ( w / v )

0.5 ml in 100 ml dosage0.5 % ( v / v )

g . Avoid writing with decimal numbers ( eg, 0 , ... ; 0.0 .... ; 0.00 ... )

4 . a. Writing the power of the drug in finished dosage ( generic / patent ) on the market with

some force , then the force required to be written , for example Tab . Primperan 5 mg or Tab .

Primperan 10 mg

b . Writing the volume of heavy drinking and drug dosage in a tube of topical preparations so

/ patents available some packaging , it must be written , for example :

- Allerin exp . That the volume of 60 ml or 120 ml

- Garamycin cream 5 mg / tube or 15mg/tube

5 . Writing dosage form of the drug ( subscriptio part ) is written not only for formulas

magistralis , but also for the formula and the specialty officialis

For example : m.f.l.a.pulv . No. . X

Antangin mg Tab 250 mg Novalgin Tab X 250 X

6 . Writing dosing schedule / usage rules ( section Signatura )

a. Must be written correctly

For example : s.t.d.d. pulv . I.p.c or s.p.r.n.t.d.d.tab.I

b . To use such a complicated use of " tapering up / down " using sign SUC ( intestinal

cognitus = user already knows ) . Explanation to the patient on a paper written in a language

that is understood .

7 . Each recipe is marked finished writing a cover closing line ( for 1 R / ) or separator

between R / ( to > 2R / ) and initial / signature on each R / .

8 . Prescriptions written once so , should not be in doubt, avoid streaks , smears and

oppression .

9 . Writing a sign Iter ( Itteretur / hope is repeated ) and NI ( Ne Iterretur / should not be

repeated )

Recipes that require pengulanagan can be marked : Iter n X in the top left of the recipe is

repeated for the entire recipe . If not all of the recipes , it is written under each recipe is

repeated .

Prescriptions that should not be repeated , can be marked : NI at top left of recipes for the

entire recipe that should not be repeated . If not all of the recipes , it is written under each

recipe is repeated .

10 . Writing Cito sign or PIM

If a prescription is required in order to be served as soon as the drug is necessary for the

patient , it can be marked Cito recipes or PIM and must be written on the right above recipe .

PRESCRIPTION DRUG DOSAGE AND DETERMINATION OF PRESCRIPTION

INTRODUCTION

Prescription medicine physician requires precision dose given and the selection of the right

formula anyway . Prospective physicians must be able to understand how to determine the

proper dose of medication with the correct calculation and must understand the right formula

recipe used to realize a rational therapy .

PRESCRIPTION DRUG DOSAGE IN

Appropriate dose is needed so that the optimal effect of the drugs and the risk of side effects

as small as possible . Magnitude -dose drug therapy is usually included in the range / range of

doses , eg 250 -

500 mg . The range of dose levels showed a safe drug that can be administered in a medical

practice . When the doctor gave doses below / above the range of doses , it can give adverse

effects for the patient and can pose questions to the pharmacy that receives the prescription .

Dose is the amount of prescription drugs in dosage per time for the patient and may be given

several times a day according to the frequency of which is written in the recipe .

Determination of the dose obtained darai therapeutic dose ( usual dose ) that are listed in the

literature . For children the dose is usually imprinted with eg 20-40 mg / kg / day . Thus

extending the dosing adnya carefully for the child . There are several medications that

include dosage for adults only , so if the drug will be given to the child it is necessary

perhituanan by comparing the adult dose , using the formula ( eg, R. Clark , R. Young , etc. )

METHOD OF CALCULATION DOSAGE CHILDREN

There are several ways to calculate child doses . For that reason , chosen to demonstrate

pengetrapan individual doses . For drugs that have a narrow therapeutic range , it requires

high accuracy in determining the dose for children . Example : Calculate dose of

Amoxycillin for children 4 years old with 17 kg BB

Given: Dose BB Amoxycillin children under 20 kg is 20-40 mg / kg / day given in divided

doses every 6-8 hours .

For adult dose is 250-500 mg , given every 6-8 hours .

calculation :

1 . Based on the individual with the physical size of BB :

17 X ( 20-40 ) mg = 340-780 mg / day

When selected given 3 times a day , the dose per administration time = 113.33 to 226.67 mg

2 . Based on an adult dose of the formula Clark

17 X ( 250-500 ) mg = 60.71 to 121.43 mg / times

20

3 . Based on the formula of Young adult dose

4 x ( 250-500 ) mg = 62.5 to 125 mg / times

16

4 . Based on the Table J.Hahn adult dose :

5 . Children 4 years old , weight 13.0 to 16.3 kg = 23% of the adult dose

= 57.5 to 115 mg / times

The above results show that the calculation method produces different doses . Taking into

account the condition of the disease and the condition of the patient , the physician can

determine the size of the dose per time and per day in a recipe .

Suppose decided give 125 mg amoxycillin per time

When the frequency is 3 times a day , the dose is 375 mg per day .

FORMULA RECIPES

There are 3 formulas in prescribing ( magistrlis , and the specialty officinalis ) . Factors to

consider in determining the type of formula that will be used : 1 ) the accuracy of the dose , 2

) drug stability is assured , 3 ) patient compliance , 4 ) ease of getting drugs / preparations ,

5 ) affordable price

FORMULA MAGISTRALIS

This formula is known as racikan.Dalam this recipe , besides the doctor write the

ingredients , also additional material . Additional ingredients are added depending on the

desired dosage . Therefore , it is important note the nature of the drug , pharmaceutical

interactions , dosage forms and kinds of additives that can be used as well as prescribing

guidelines magistralis .

The things that are important to be considered in the formula magistralis :

1 . Ingredients , wherever possible using raw materials . Use of finished dosage / patent

( tablet , syrup , etc. ) often cause problems both in service ( eg can not be smooth , not

homogeneous , and unstable ) as well as rationalization of therapy ( among others, changes in

formula preparation , medication bioaviabilitas changes , changes in absorption , decreased

concentration drugs ) . Mixing materials is more than one kind of interaction should be

considered ( pharmaceutical and pharmacology ) and rationality of drug .

2 . Bntuk preparations to choose from include powders ( pulveres and pulvis adspersorium ) ,

capsule , solution ( abruption , infusion ) , suspension , unguenta , cream and pasta .

3 . Determination of additives ( corrigen saporis , corrigen odoris , corrigen coloris , and

constituent / vehiculum ) .

Sample preparation magistralis prescription formula :

1 . Doctors Siti Beautiful , SIP 087/2008 address at JL . No. Solar . 1 Surakarta on June 15

2008 writing a prescription formula pulveres magistralis the dosage form ( powder ) 10 packs

, each pack containing paracetamol 120 mg . This powder is given to Sari ( 2 years , 12 kg )

with rules of use : when the heat is given 3 times a day , each time a pack

dr . Siti Beautiful

SIP . 087/2008


Jl . Solar 1 Surakarta


R / Paracetamol 120 mg

Sacch . lactis q.s

m.f.l.a. pulv.d.t.d. No. . X

s.p.r.n.t.d.d.pulv I ( febrile )

Description :

Fetch paracetamol 120 mg and sacch lactis to taste , mix and make according to the rules of

the powder as much as 10 packs , each pack containing 120 mg of paracetamol and sacch

lactis taste . Mark : when the heat can be given 3 times a day 1 wrap

Pros : Sari ( 12 kg ) Age : 2 years

dr . Siti Beautiful

SIP . 087/2008




R / Paracetamol 1.2

Sacch . Lactis q.s m.f.l.a. pulv . No. . X s.p.r.n.t.d.d.pulv I ( febrile )

Description :

Fetch paracetamol 1.2 g and sacch lactis taste , mix and make according to the rules of the

powder as much as 10 packs . Mark : when the heat can be given 3 times a day 1 wrap

Pros : Sari

Age : 2 years , 12 kg

2 . Doctors Siti Beautiful , SIP 087/2008 address at JL . No. Solar . 1 Surakarta on June 15,

2008 to write a prescription formula magistralis with ointment dosage forms containing as

much as 20 grams of boric 5 % and use basic ingredients vaseline album . This ointment is

given to Tono ( 20 years )

with the rules of use : given two times a day , for foreign drugs

dr . Siti Beautiful

SIP . 087/2008




R / Ac . Boric 5 % vaseline alb . q.s m.f.l.a. ungt . 20 s.b.d.d. u.e

Pros : Tono

Age : 20 years

Recipes with this formula means that the drugs used are generic drugs and generic

preparations available Dalan ( BPOM MOH ) or preparation standards ( Formulary

Indonesia) . By using this formula , means that doctors already know the composition of the

active ingredient and its usefulness . The writing is fast and simple and cheaper.

Example officinalis formula :


2008 wrote prescriptions using cough medicine contra tussim Potio nigra , a standard formula

in the formulary Indonesia and given to Bp . Tono to the rules of use : when cough can drink

4 X

one tablespoon a day , for 10 days

dr . Siti Beautiful

SIP . 087/2008




R / Pot nigr . c . Tuss . 300 ml s.p.r.n. 4.d.d. C. I ( when coughing )

Description : Doctors munggunakan standard formula in Indonesian formulary . The

composition of the drug :

Pot nigr . c . Tuss . 300 ml

Succus liquiritae 10

Amm . chloride 6

Sol amm.spirt . anis 6

Aqua dest . Ad 300 ml

Use of 4-5 d.d. C.I

Pros : Tono

Age : 20 years


2008 wrote prescriptions using the generic logo sediaaan Chlorampenicol eye ointment ( 1 %

) and given to Bp . Tono to the rules of use : 2 X a day applied to the left and right eye ,

morning and afternoon

dr . Siti Beautiful

SIP . 087/2008




R / Chloramphenic.ungt.ophth 1 % 5 g s.b.d.d. ungt.ophth . od and os

Description :

With the prescription , the doctor uses a standard formula in the finished dosage generic

logo .

The composition of the drug :

Ungt . Ophth . Chlorampenicol 1 % . Each gram of ointment contains 10 mg Chlorampenicol

eyes , the weight of each tube 5 grams

Pros : Bp . Tono

Age :

the specialty FORMULA

Prescriptions written by this formula is patented drugs from the drug factory . Sometimes

drug manufacturer to make drugs with different dosage , strength , and a combination of

drugs . If the prescription is less clear or incomplete can mengakibatklan errors in service at

the pharmacy .

Examples of the specialty prescription :


2008 wrote prescriptions using patent sediaaan Allerin expektorant 120 ml and given to Bp .

Tono to the rules of use : 3 times a day 2 teaspoon ( liquid volume of drugs taken was 10 ml )

.

dr . Siti Beautiful

SIP . 087/2008




R / Allerin exp . 120 ml lag I

s.t.d.d. C.th. II

Pros : Bp . Tono

Age :

Description :

With the prescription , the doctor uses the specialty formulas and using drugs with patent

name . Dosage form : syrup

Composition : Each 5 ml of syrup contains : 50 mg Glyceryl guaiacolate

Sodium citrate 180 mg Diphenhydramine HCl 12.5 mg Phenylpropanolamine HCl 12.5 mg

Packaging : Bottle volume of 60 ml and 120 ml


2008 wrote prescriptions using patent sediaaan Kalmoxicillin 500 mg caplets of 20 seeds and

given to Bp . Tono to the rules of use : 3 times a day .

dr . Siti Beautiful

SIP . 087/2008




R / Capl Kalmoxicillin No. 500 mg . XX

s.t.d.d. Capl . I

Description :

With the prescription , the doctor uses the specialty formulas and using drugs with patent

anam . Dosage form : syrup

Composition : Each caplet contains Amoxycillin trihydrate mg Kalmoxicillin500

In addition to these preparations , there are 250 mg capsules , dry suspension 125 mg / 5 ml

to 60 ml bottles , dry suspension 250 mg / 5 ml to 60 ml bottles , injection ( powder

1g/vial )

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MAKALAH RESEP INGGRIS