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Prescription drug

A prescription drug is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription. Different jurisdictions have different definitions of what constitutes a prescription drug.

Dispensation of prescription drugs often includes a monograph (in Europe, a Patient Information Leaflet or PIL) that gives detailed information about the drug.Ritalin-SR-20mg-1000x1000.jpg

Regulation in United States

In the United States, the Federal Food, Drug, and Cosmetic Act defines what requires a prescription. Prescription drugs are generally authorized by veterinarians, dentists, optometrists, and medical practitioners. It is generally required that an MD, DO, PA, OD, DPM, DVM, DDS, or DMD write the prescription; basic-level registered nurses, medical assistants, clinical nurse specialists, nurse anesthetists, and nurse midwives, emergency medical technicians, psychologists, and social workers as examples, do not have the authority to prescribe drugs.

The package insert for a prescription drug contains information about the intended effect of the drug and how it works in the body. It also contains information about side effects, how a patient should take the drug, and cautions for its use, including warnings about allergies.

The safety and effectiveness of prescription drugs in the US is regulated by the federalPrescription Drug Marketing Act of 1987. The Food and Drug Administration is charged with implementing this law.

As a general rule, over the counter (OTC) drugs are used to treat conditions not necessarily requiring care from a health care professional and have been proven to meet higher safety standards for self-medication by patients. Often a lower strength of a drug will be approved for OTC use, while higher strengths require a prescription to be obtained; a notable case is ibuprofen, which has been widely available as an OTC pain killer since the mid-1980s but is still available by prescription in doses up to four times the OTC dose for use in cases of severe pain not adequately controlled by the lower, OTC strength.

Herbal preparations, vitamins, minerals, and food supplements are not regulated by the FDA, so the individual consumer must be aware of the potential negative effects of using these preparations and also the potential interactions with prescription drugs they may be taking.

In the United States, the term "prescription drug" is most commonly used, but they are also called Rx-only drugs or legend drugs, after the Federal and State laws which mandate that all such drugs bear a "legend" prohibiting sale without a prescription; though more complex legends have been used, on most original drug packaging today the legend simply says "Rx only". In the United Kingdom, they are referred to asPrescription Only Medicine or POM.

Also, pharmacies operated by membership clubs, such as Costco and Sam's Club, by law must allow non-members to use their pharmacy services and must charge the same prices as to members.

Physicians may legally prescribe drugs for uses other than those specified in the FDA approval; this is known as off-label use. Drug companies may not promote or market drugs for off-label uses.

In recent years, large U.S. retailers who operate pharmacies and pharmacy chains have used inexpensive generic drugs as a way to attract customers into stores. Several chains, including WalMart, Target, and several others, offer $4 monthly prescriptions on select generic drugs as a customer draw.

Regulation in United Kingdom

n the United Kingdom, according to the Home Office, the Medicines Act 1968 governs the manufacture and supply of three categories of medicine

  • Prescription only drugs which can be sold by a pharmacist if prescribed by a doctor
  • Pharmacy medicines which may be sold by a pharmacist without prescription
  • General sales list medicines which may be sold without a prescription in any shop

Again according to the Home Office, possession of prescription only medicines without a prescription is a serious offence[2]

A patient visits a medical practitioner (GP) who is able to prescribe medication. If given an NHS prescription, this can be taken to a pharmacy to be dispensed. District nurses and health visitors have had limited prescribing rights since the mid-nineties where prescription for dressings and simple medicines would have had to have been signed by a medical practitioner. This charge is paid entirely to the NHS through the pharmacy, while the pharmacy claims the cost of the medicine dispensed.

Each "item" can cover any prescribed item in a very large or very small quantity according to the prescribers' prescription. This means that the patients perceived "value" of the charge varies enormously - the actual cost of the medicine given out will routinely vary from a few pence to hundreds of pounds. However, medical practitioners can prescribe a maximum three-month supply of the medication in order for it to be covered under the NHS. If a medical practitioner wishes to prescribe a supply in excess of three months, the prescriber must write a separate, privateprescription for the balance of the medication supply over three months which the patient must pay full-price for. Certain groups of patients are exempt from this charge, such as those over 60, under 16 (or under 19 if in full-time education), patients with certain medical conditions, those on certain benefits and those with an HC2 certificate. which is issued if a patient can prove their income is under £8,000 per year. However, inWales prescription charges have been abolished and in Scotland prescription charges have been reduced to £5 (as of 1 April 2008) as a first phase of abolishing them over the next three years.

An HC2 certificate can be applied for– although not automatically granted– by those on a low income or in receipt of incapacity benefit. Claimants of "Jobseekers" and "Income support" automatically receive free prescriptions and dentistry.

Those requiring regular prescriptions may make a saving by purchasing a pre-payment certificate which covers the cost of all prescriptions required for three months or a year. As of 1 April 2008 they cost £27.85 for 3 months and £102.50 for 12 months (offering savings to anyone who needs more than 3 prescriptions in 3 months or 14 prescriptions in 12 months).

Many of the prescriptions dispensed on NHS are exempt from charges. This is because of the large number of precription drugs needed by, for example, the elderly or those with medical exemptions. NHS prescriptions can also be written for certain items. Some patients also receiveprivate prescriptions, typically either from a medical practitioner seen privately or for medicine not covered on the NHS. For these, the patient will pay the pharmacy directly for the cost of the medicine and the pharmacy's markup


List of abbreviations used in medical prescriptions

This is a list of abbreviations used in medical prescriptions (sometimes referred to as "sig codes"). Its listing here does not mean such abbreviations should be used. See main article for discussion on the use of abbreviations. This listing does not include abbreviations for actual pharmaceuticals (which is a separate article in itself). Capitalization and the use of a period is a matter of style. In the attached list, Latin is not capitalized whereas English acronyms are. The period is used wherever there are letters omitted in the abbreviation.
Partial list of prescription abbreviations
AbbreviationLatinMeaning
aaanaof each
adadup to
a.c.ante cibumbefore meals
a.d.auris dextraright ear
ad lib.ad libitumuse as much as one desires; freely
admov.admoveapply
agitagitastir/shake
alt. h.alternis horisevery other hour
a.m.Ante Meridiemmorning, before noon
amp ampule
amt amount
aqaquawater
a.l., a.s.auris laeva, auris sinistraleft ear
A.T.C. around the clock
a.u.auris utraqueboth ears
bisbistwice
b.d./b.i.d.bis in dietwice daily
B.M. bowel movement
bol.bolusas a large single dose (usually intravenously)
B.S. blood sugar
B.S.A body surface areas
BUCCbuccainside cheek
cap., caps.capsulacapsule
c, c.cumwith (usually written with a bar on top of the "c")
cib.cibusfood
cccum cibowith food, (but also cubic centimetre)
cf with food
comp. compound
cr., crm cream
CST Continue same treatment
D5W dextrose 5% solution (sometimes written as D5W)
D5NS dextrose 5% in normal saline (0.9%)
D.A.W. dispense as written
dc, D/C, disc discontinue
dieb. alt.diebus alternisevery other day
dil. dilute
disp. dispense
div. divide
d.t.d.dentur tales dosesgive of such doses
D.W. distilled water
elix. elixir
e.m.p.ex modo prescriptoas directed
emuls.emulsumemulsion
etetand
ex aqex aquain water
fl., fld. fluid
ft.fiatmake; let it be made
g gram
gr grain
gtt(s)gutta(e)drop(s)
H hypodermic
h, hrhorahour
h.s.hora somniat bedtime
ID intradermal
IM intramuscular (with respect to injections)
inj.injectioinjection
IP intraperitoneal
IV intravenous
IVP intravenous push
IVPB intravenous piggyback
L.A.S. label as such
LCD coal tar solution
linlinimentumliniment
liqliquorsolution
lot. lotion
manemanein the morning
M.miscemix
m, minminimuma minimum
mcg microgram
m.d.u.more dicto utendusto be used as directed
mEq milliequivalent
mg milligram
mist.misturamix
mittemittesend
mL millilitre
nebulnebulaa spray
N.M.T. not more than
noct.nocteat night
non rep.non repetaturno repeats
NS normal saline (0.9%)
1/2NS half normal saline (0.45%)
N.T.E. not to exceed
o_2 both eyes, sometimes written as o2
o.d.oculus dexterright eye
o.p.d. once per day
o.s.oculus sinisterleft eye
o.u.oculus uterqueboth eyes
oz ounce
perperby or through
p.c.post cibumafter meals
pig./pigm.pigmentumpaint
p.m.Post Meridiemevening or afternoon
prnpro re nataas needed
p.o.per osby mouth or orally
p.r. by rectum
pulv.pulvispowder
qquaqueevery
q.a.d.quoque alternis dieevery other day
q.a.m.quaque die ante meridiemevery day before noon
q.d.s.quater die sumendusfour times a day
q.p.m.quaque die post meridiemevery day after noon
q.h.quaque horaevery hour
q.h.s.quaque hora somnievery night at bedtime
q.1h, q.1°quaque 1 horaevery 1 hour; (can replace "1" with other numbers)
q.d.quaque dieevery day
q.i.d.quater in diefour times a day
q.o.d. every other day
qqhquater quaque horaevery four hours
q.s.quantum sufficiata sufficient quantity
QWKevery week
R rectal
rep., rept.repetaturrepeats
RL, R/L Ringer's lactate
ssinewithout (usually written with a bar on top of the "s")
s.a.secundum artumuse your judgement
SC, subc, subcut, subq, SQ subcutaneous
sig write on label
SL sublingually, under the tongue
solsolutiosolution
s.o.s., si op. sitsi opus sitif there is a need
sssemisone half
statstatimimmediately
suppsuppositoriumsuppository
susp suspension
syrsyrupussyrup
tabtabellatablet
tal., ttalussuch
tbsp tablespoon
trochetrochiscuslozenge
tsp teaspoon
t.i.d.ter in diethree times a day
t.d.s.ter die sumendumthree times a day
t.i.w. three times a week
top. topical
T.P.N. total parenteral nutrition
tr, tinc., tinct. tincture
u.d., ut. dict.ut dictumas directed
ung.unguentumointment
U.S.P. United States Pharmacopoeia
vag vaginally
w with
wf with food (with meals)
w/o without
X times
Y.O. years old