Introduction to Prescription Writing PDF

PHARMACOLOGY 08/20/2024 MOD 1: INTRODUCTION TO PRESCRIPTION WRITING...

PHARMACOLOGY 08/20/2024 MOD 1: INTRODUCTION TO PRESCRIPTION WRITING Maria Luisa D. Delacruz, MD Trans Group/s: CML I. PRESCRIPTION AND ITS RATIONAL PRINCIPLES To come up with the guidelines, a group of experts come together and decide which strategic treatment regimen A. PRESCRIPTION is best for a particular disease. A written order or instruction of a validly registered prescriber to a dispenser for the use of a specific D. RULES AND REGULATIONS THAT GOVERN drug product for a specific patient. PRESCRIBING ○ The prescribers are usually physicians but they could also be dentists and veterinary practitioners. III. RULES IN PRESCRIPTION WRITING It is a legal document, therefore the prescriber assumes full responsibility for the issued prescription. A. CORRECTNESS OF FORM The prescriber also takes full responsibility for the care and welfare of the patient. 1. LEGIBLE “There are no safe drugs, only safe prescribers/doctors” Ensure the successful and optimal use of drugs. “A legible handwriting speaks of the writer’s ○ Physicians must rely on unbiased sources when willingness to communicate”. seeking information about drugs that will influence It is the legal duty of a physician to write legibly and their prescribing habits. clearly to avoid medication errors. ○ Important to know your pharmacology. ○ Medication errors: any preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control B. RATIONAL PRINCIPLES IN PRESCRIBING of the health-care professional, patient, or consumer THE RULES OF RIGHTS ○ 1.3 million people are injured and approximately 7,000 deaths occur each year in the U.S. due to Right patient medication-related errors. ○ Drug-related morbidity and mortality is estimated to Right drug cost $177 billion in the U.S. Research says that illegibility of doctors’ handwriting Right dose/dosage regimen in medical prescriptions is often the cause of medication errors, according to Philippine Council for Right attitude Health Research and Development Some view the non-legible physician’s handwriting as a Right to informed consent “professional emblem” or a “harmless quirk.” ○ Even though it is stereotyped (as the saying “doctor kasi eh, kaya pangit talaga ang sulat”), the thing is, Right to refuse treatment a physician’s handwriting could actually damage a patient. Guided foremost by the Hippocratic oath ○ Many jokes have been made about doctor’s sloppy “Primum non no cere” = first do no harm penmanship, but illegibility is no laughing matter ○ In the U.S., “doctors’ sloppy handwriting kills more II. FACTORS TO CONSIDER FOR SAFE AND EFFECTIVE than 7,000 people annually”, according to a July PRESCRIBING PRACTICES 2006 report from the National Academy of Science - Institute of Medicine (NAS-IOM). Liability does NOT end when the prescription leaves A. INDIVIDUALIZE PATIENT THERAPY the doctor’s clinic as it may also be a cause of the No such thing as “de kahon” or a therapeutic regimen negligence of others. for a “common” patient”. ○ Example: If a pharmacist is going to dispense the ○ Thus, patient therapy should be individualized to doctor’s prescription and misreads what is written in be specific and appropriate for every patient. that prescription, that is likely to cause medication error. B. PRINCIPLES OF PHARMACOKINETICS AND PHARMACODYNAMICS Apply the things learned in class, especially the principles of pharmacokinetics and pharmacodynamics (drug-to-body and body-to-drug interaction). C. TREATMENT GUIDELINES FOR SPECIFIC DISEASES Get hold of treatment guidelines for specific diseases because these are evidence-based. Pharmacology- Mod # Topic Title 1 of 5 The use of trans, practice questions, and evals ratio must be used discreetly and social media/public exposure of the aforementioned shall be strictly prohibited.  ○ Can easily lead to dispensing errors or abuse of controlled substances 5. USE OF GENERIC NAME (R. A. 6675) Mandated by the Generics Act of 1988 There are three (3) names by which a drug is known enericname(brandnameascriptions & NAMES BY WHICH DRUGS ARE KNOWN Describes the drug by its specific chemical composition Unsuitable for prescribing Chemical name Example: N-acetyl-p-aminophenol (Paracetamol) A sample prescription. An example of how a prescription should NOT be written. Based on the chemical name Scientifically and internationally recognized active ingredient of the product Official or non-proprietary Another sample prescription. In this example, the physician name given by an official agency prescribed Avandia — an anti-diabetes drug. However, it was (e.g. WHO) read as Coumadin — an anticoagulant. Generic name Use is mandated by law in the Philippines (Generics Act of 1988) Example: Paracetamol (U.S.P) Acetaminophen (B.P.) Commercial property of a Another sample prescription. In this example, a prescription pharmaceutical company (e.g. for Isordil® (Isosorbide dinitrate) 20mg per 6 hours was Paracetamol is available as interpreted by the pharmacist and dispensed as Plendil® Biogesic, Tempra, Calpol, (Felodipine) 20mg per 6 hours. Plendil (which should only be Tylenol) taken once a day), if taken 4x a day, could lead to Also known as Proprietary Name hypotensive shock. Registered Trademark - ® ○ The symbol precedes or is 2. SIMPLE written after the trade name Use plain white bond paper (not colored paper) Trade name/ of a drug NO elaborate handwriting or designs brand name Name given to a drug to Use least frequent dosing if possible distinguish it as being a ○ The less frequent the drug is taken by the manufacturer’s product patient, the likelihood the patient is going to Manufacturer assumes quality adhere to the treatment. and consistency of the product ○ Multiple doses would likely decrease adherence to Drug industry spends enormous treatment. amount of money in its promotion Tie dosing regimens to scheduled daily activities, meals, that is why most branded drugs sleep/wake patterns are more expensive than Multiple drugs in a prescription creates confusion generic drugs ○ If you need to write several drugs in a prescription, they should be labelled appropriately. 5.1 Advantages of Using the Generic Name Physicians must write with deliberate care and leave a mark of his good judgment on the prescription. Universality ○ Proprietary names differ from country to country 3. NEAT AND CLEAN ○ A drug would only have one generic name ○ Avoids duplication NO scratches Clarity: gives informations to which class the drug NO erasures belongs Clean and clear → written clearly in a clean sheet of ○ Group similarities are immediately apparent paper Beta blockers ending with (–olol): Propranolol 4. WRITTEN IN INK Metoprolol Antibiotics ending with (-cillin): Use blue or blank ink only (no any other color) Belong to the Penicillin group A medico-legal document Economical: drugs that are available in their generic A contract between a physician and patient; thus, names are cheaper legally-binding Convenience: allows the pharmacist to supply whatever Erasures on a prescription are NOT allowed version of the drug is in stock ○ May indicate prescription fraud Pharmacology - Mod 1 Introduction to Prescription Writing 2 of 5 The use of trans, practice questions, and evals ratio must be used discreetly and social media/public exposure of the aforementioned shall be strictly prohibited.  ○ If there is a preferred trademark by a doctor, but 1. USE OF METRIC SYSTEM OF WEIGHTS AND when the patient goes to the pharmacy, the one that MEASURES is desired by the physician is not available. Weights: grams, milligrams, or micrograms ○ Since the generic name is known, the pharmacist Volume: milliliter (not cc), or liter can substitute another product supposedly with the same quality. If in this amount Write the following 5.2 Disadvantages of Using the Generic Name Difficult to spell or recall 1G gram ○ Example: Carboxymethylcysteine Branded names: Solmux, Loviscol