Prescribing Medication

what roles do medicines have?

Prevent life-threatening diseases
Help to change previously life-threatening illnesses to long-term conditions
Improve the quality of life for people
Reduce mortality

what is prescription?

A written order from a qualified medical prescriber to supply a medicine under their authority.

what are legal classifications of prescriptions?

Over the counter (OTC) medicines
Prescription-Only Medicine (POM)
Controlled substances
Special categories

what are over the counter medicines?

Over-the-counter (OTC) medicines’ covers all general
sales list medicines and pharmacy medicines.
The description conveniently distinguishes medicines that can be bought from those that must be prescribed.

what are prescription only medications?

Medicines classified as ‘prescription only’ can be exclusively obtained against a valid prescription issued by an authorised health professional.
The prescription needs to be taken to a pharmacy where the medicine is prepared under the supervision of a pharmacist.

what are opioids?

Used in pain management
Risk of dependency, overdose and misuse
Examples are Morphine, Oxycodone and Codeine

what are benzodiazepines?

Used to manage anxiety, insomnia and as anticonvulsants
Long-term use have a risk of dependency and cognitive impairment
Examples are Diazepam, Lorazepam and Temazepam

what is schedule 1?

High Abuse Potential:
No legitimate medical use in the UK
Highest potential for abuse and pose significant harm if consumed
For approved research only
Tight regulations to prevent unauthorised access
Examples include Heroin, LSD, ecstasy and cannabis

what is schedule 2?

Drugs with High Potential of Abuse:
Drugs in this category have a high potential for abuse but may also have recognised medicinal uses under strict regulation.
These substances are subject to strict regulation due to potential of misuse
Usually prescribed for pain management
Examples include Morphine, oxycodone etc

what is schedule 3?

Low Potential for Abuse:
While these drugs have recognised medical uses, they are subject to prescription requirements and may have restrictions on their sale and distribution.
Require careful and regular monitoring
Available on prescription only
Prescribed for anxiety, insomnia or as sedatives
Examples include Benzodiazepines, Barbiturates and Midazolam

what is schedule 4?

Low Potential for Abuse:
Drugs in this category have legitimate uses but are commonly abused by athletes
Prescribed by healthcare professionals only
Special licences may be required to possess them
Used to enhance the performance by professional athletes and individuals looking to improve physical appearance
Examples include anabolic steroids and growth hormones

what is schedule 5?

Very low Potential for Abuse:
Medicines that contain small amounts of controlled substances with a low potential for abuse.

Purchased from pharmacies without a prescription
Restrictions on purchased quantity
Examples include codeine & pseudoephidrine

what are examples of special categories for scheduling?

Additional restrictions due to high risk of adverse effects or misuse
• Prescribed under strict guidelines by MHRA
Isotretinoin (prescribed for severe nodular or cystic acne)
Risk of causing birth defects during pregnancy. Also may cause dry skin, liver toxicity and mood changes

Thalidomide (prescribed for multiple myeloma)
Clozapine (prescribed for schizophrenia)

what is a superscription?

Heading with the symbol "R" or "Rx", which stands for the word recipe:
The inscription, which contains the names and quantities of the ingredients;
The subscription or directions for compounding the drug;
The signature which is often preceded by the sign "s" standing for signa, giving the directions to be marked on the container.

what are the 4 main components of a prescription?

1. Signature - a verification of the rx authenticity. (required for the rx to be valid)
2. Address and particulars of prescriber (such as their - identifies the prescriber
3. Date - the date the rx was written (most rx are valid for 6 months)
4. Patient details - name, age/DOB, address.

what is shared care prescribing?

Collaborative arrangement
– Specialist and primary care providers
– Complex and long-term conditions
Initiated by specialist
Clear communication/agreed protocols
Shared responsibility
Patient-centric approach
Ongoing monitoring
• Example: – Methotrexate (rheumatoid arthritis) & Anti-epileptics (epilepsy)

what are the benefits of shared care prescriptions?

Improves patient access to medications
Reduces strain on specialist services
Ensures the involvement of primary care professionals

what are the challenges of shared care prescriptions?

Requires clear guidelines and effective communications
Need of additional training for primary care clinicians
Risk of delay in treatment if roles/responsibilities are not clear

what is the importance of documentation?

Legal compliance: – Adherence to regulatory and legal standards, Minimises risk of non-compliance
Patient safety: – Prevents error in prescribing, avoids adverse drug reactions, provides clear instructions for prescribed medication
Accountability : Record of action by prescribing professional, traceability of decisions and interventions
Medicine management: Tracking of medication usage, monitoring and adjusting dosage