RX PERSCRIPTION WRITING

first step in rational prescribing

Make a specific diagnosis

what are the next steps in rational prescribing?

•Pathophysiological implications of the diagnosis

•Select a specific therapeutic objective (e.g., pain relief, disease control)

•Select a drug of choice (pt. characteristics and clinical presentation)

should NOT be written in a prescription

Take as directed

'bid' in a prescription

Twice a day

What is the first step in managing a medication regimen?

Determine the appropriate dosing regimen

What should be devised to monitor a drug's action?

Device a plan for monitoring the drug's action

What is necessary to establish for therapy?

Determine an end point for therapy

What is important to include in patient care in prescription writing ?

Plan a program of patient education

What should be considered when determining the quantity of medication in a prescription?

Duration, cost, toxicity, or overdose.

What is the recommended initial quantity of medication in a prescription?

The initial quantity should be small, with larger refills.

What should directions for use in a prescription be based on?

Drug-specific and patient-specific factors.

What is a key principle for writing prescriptions?

Must be simpler.

What should be minimized in a prescription?

Fewer drugs and doses.

What lifestyle factors should be checked before prescribing medication?

Eating habits and lifestyle patterns.

What essential information should be included in a prescription?

Drug name, purpose, and duration.

What does 'Take as directed' imply in a prescription?

It indicates that the patient should follow the prescribed instructions.

example of poor prescription writing

1.0 mg

FDA program collecting adverse drug event data

MedWatch

purpose of a black box warning

To warn of serious or life-threatening risks

strategy to improve medication compliance

Refill reminders

check if a generic drug is therapeutically equivalent

Orange Book

High potential for abuse

No accepted medical use; lack of accepted safety as drug.

schedule 1

High potential for abuse

Current accepted medical use. Abuse may lead to psychological or physical dependence.

schedule 2

potential for abuse is Less than I or II

Current accepted medical use. Moderate or low potential for physical dependence and high potential for psychological dependence.

schedule 3

potential for abuse is Less than III

Current accepted medical use. Limited potential for dependence.

schedule 4

potential for abuse is Less than IV

Current accepted medical use. Limited dependence possible.

schedule 5

which drug cannot be refilled without a prescription or over the phone ?

Schedule II drugs

which scheduled drugs can be refilled up to 5 times within 6 months?

•Prescriptions of III, IV, and V can be refilled up to 5 times within 6 mo

what is the problem to with monitoring controlled substances?

Inadequate treatment for pain could be a problem

requirement for a legal prescription

Secure prescription form

organization regulating controlled substance scheduling

DEA

Orange Book provides

Therapeutic equivalence information

type of prescribing error

Omission of information

abbreviation prone to error

tbsp

strategy to improve compliance in elderly patients

Providing pill containers

drug scenario requiring 'Dispense as Written'

Life-threatening conditions

MedWatch used for

Reporting adverse drug events

VAERS monitors safety of

Vaccines

best defines 'noncompliance'

Adhering to therapy

Adhering to therapy

Following the prescribed treatment plan consistently.

Refilling medication early

Obtaining a refill of medication before the prescribed time.

Taking extra doses

Consuming more medication than prescribed.

Failing to take medication properly

Not following the prescribed instructions for medication use.

Drug interaction checks

E-prescribing feature that enhances safety by identifying potential drug interactions.

Black box warning

The FDA's strongest safety notice regarding medications.

Medicare drug pricing

Medicare cannot negotiate drug prices.

National Provider Identifier

Required for e-prescribing by the CMS agency.

Prescription cost increase

Marketing and regulation contribute to increased prescription costs.

Pharmacy benefit manager

System that may send refill reminders to patients.

Good prescription direction

Take as directed is NOT a good direction on a prescription.

Acronyms in prescriptions

Should be avoided because they are not understood by patients.

Decimal point error

0.1 mg written as .1 mg is a prescribing error related to decimal points.

Orange Book

Tool that helps identify if two drugs are interchangeable.

Vaccine adverse event reporting

Associated with the website vaers.hhs.gov.

Off-label prescription

Clinician-directed for unapproved condition is appropriate for off-label use.

Generic names benefit

Flexibility and savings are benefits of using generic names.

Life-saving drugs

Medication type that requires careful monitoring and may not be substituted.

Compliance assessment

Patients personal and social factors should be assessed before prescribing for compliance.

Medication reminder strategy

Setting alarms may help patients remember to take medications.

Good prescription components

A good prescription includes legible and complete info.