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