1. Joseph R. Sabino, MS, RPh jsabino@ltcrxsolutions.com

2. MANNER OF ISSUANCE OF A PRESCRIPTION 4729-5-30 Ohio Administrative Code A prescription, to be valid, must be issued for a legitimate medical purpose by an individual prescriber acting in the usual course of his/her professional practice The responsibility for the proper prescribing is upon the prescriber, but a corresponding responsibility rests with the pharmacist who dispenses the prescription

3. MANNER OF ISSUANCE OF A PRESCRIPTION An order purporting to be a prescription issued not in the usual course of bona fide treatment of a patient is not a prescription and the person knowingly dispensing such a purported prescription, as well as the person issuing it, shall be subject to the penalties of law. Same language found in 21 CFR 1306.04

4. Requirements for a Prescription Be dated as of and on the day when issued Contain the manually printed, typewritten, or preprinted full name, professional title, and address of the prescriber Indicate a telephone number where the prescriber can be personally contacted during normal business hours Indicate the full name and residential address of the patient

5. Requirements for a Prescription Indicate the drug name and strength Indicate the quantity to dispense Indicate the appropriate and explicit directions for use Specify the number of times or the period of time for which the prescription may be refilled. If no such authorization is given, the prescription may not be refilled A prescription marked "Refill P.R.N." or some similar designation is not considered a valid refill authorization.

6. Requirements for a Prescription Manually signed on the day issued by the prescriber in the same manner as he/she would sign a check or legal document If issued by a physician assistant with prescriptive authority, contain the certificate number of the physician assistant's certificate to prescribe

7. Requirements for a Prescription Unless a prescriber handwrite “dispense as written,” or “D.A.W.,” on the written prescription, or, when ordering a prescription electronically or orally, the prescriber specifies that the prescribed drug is medically necessary a pharmacist may dispense a generically equivalent drug product

8. Recommendations to Correct Error-Prone Aspects of Prescription Writing National Coordinating Council for Medication Error Reporting and Prevention All prescription documents must be legible. Prescribers should move to a direct computerized, order entry system Prescription orders should include a brief notation of purpose (e.g., for cough), unless considered inappropriate by the prescriber

9. Recommendations to Correct Error-Prone Aspects of Prescription Writing All prescription orders should be written in the metric system except for therapies that use standard units such as insulin, vitamins, etc. Prescribers should include age, and when appropriate, weight of the patient on the prescription or medication order Prescribers should not use vague instructions such as “Take as directed” or “Take/Use as needed” as the sole direction for use

10. Weapon of Mass Destruction.

11. Recommendations to Correct Error-Prone Aspects of Prescription Writing Use of Decimals Always precede a decimal expression of less than one with a leading zero: e.g. 0.5 mg “.5 mg” may be read as “5 mg” Never use a trailing zero “5.0 mg” may be read as “50 mg”

12. Do Not Use Abbreviations!!

13. The Pen is Mightier than the sword. Edward Bulwer-Lytton, 1839

14. ..and can be just as deadly!! J. Sabino, 2012

15. Questions