ordering & prescribing medications synchronous

synchronous material from lecture on 8/30

components of a drug regimen

• route of admin

• dose

• strength/concentration

• duration

• frequency

• indication (for as needed medications)

state laws for SPs and PAs when prescribing

in the state of pa, PA prescriptions must include:

• PA’s printed name and license number

• SP’s name and license number

• PA’s signature, followed by PA-C

• PA’s DEA number (if controlled substance)

how long can a PA prescribe an initial drug therapy for a schedule II controlled substance?

72 hours

can a PA prescribe a 30-day prescription if approved by the SO for ongoing therapy?

yes, MUST be noted on the prescription

prescribing resources

drug information databases

manufacturer website

FDA prescribing information

drug information databases

search for specific medication for quick prescribing references

won’t tell you what medication is better than another

ex. Micromedex, Lexicomp

manufacturer website

contains relevant safety and efficacy information and prescribing recommendations for brand name medications

can be a biased source

where to go if drug has just been released

FDA prescribing information

package insert

published after immediate approval→ may not always be up-to-date

cognitive process of prescribing

make a specific diagnosis → consider pathophysiologic implications of the diagnosis → select specific therapeutic objective(s) → select drug of choice → determine appropriate dosing regimen → create a monitoring plan (go back to goals of therapy)

common errors in prescribing practices

inappropriate drug selection or dose

inadequate pt education and acknowledgement of understanding

confusing or unnecessarily complex regimens

inappropriate drug selection or dose

based on:

• drug-drug interactions

• drug-disease interactions

• failure to collect OTC or herbal medication use

• missed dose adjustment in kidney or liver dysfunction

confusing or unnecessarily complex regimens

does the pt have to take multiple pills per dose, or is there a higher strength or extended release formulation available?

if IV fluids are administered too fast

fluid overload

infusion reactions

drug toxicity

flow rate

volume of fluid per unit of time

drip rate

drops of fluid administered per unit of time

1 kg

2.2 lbs