Introduction to Pharmacology writing a prescription

1. Introduction to Pharmacologywriting a prescription Dr. Alia Shatanawi 09-18-2012

2. Definition and Format A prescription is a written, verbal, or electronic order from a practitioner or designated agent to a pharmacist for a particular medication for a specific patient.

3. Writing PrescriptionsWho can write a Rx? • Practitioners • Physicians, veterinarians, dentists, podiatrists • Mid-level practitioners • nurse practitioners, physician assistants, optometrists, pharmacists

4. Definition and Format Sample of Generic Hospital Prescription Sample of Physician Specific Prescription

5. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug • Quantity of the drug • Directions for use • Intended use of the drug, unless practitioner feels indication is not in best interest of patient • Practitioner Name, Address, Telephone number

6. Contents of the Prescription • Date of the order

7. Contents of the Prescription • Date of the order • Patient Name and Address

8. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug

9. Sample Prescription- “Brand Necessary”

10. Contents of the Prescription • Name of the drug • Multiple drugs per prescription can add to confusion • KEEP IT SIMPLE

11. Look Alike/Sound Alike Names CASE # 1: Serzone (nefazodone) vs. Seroquel (quetiapine) (antidepressant) (antipsychotic) • Similar overlapping strengths (100 mg and 200 mg) • Similar dosage forms (tablets) • Similar dosing interval (BID) • Similar titration schedule • Often stocked in close proximity on pharmacy shelf Prescribing and dispensing errors have led to a number of adverse events (N/V, hallucinations, lethargy, seizures, death)

12. Contents of the Prescription • Name of the drug AVOID THE USE OF: • Abbreviations • Many drugs identified with abbreviations • EX: HCTZ for hydrochlorothiazide, MSO4 for morphine sulfate • Attempts to standardize abbreviations have been unsuccessful

13. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug

14. Contents of the Prescription • Strength of the drug • Decimal points • Avoid trailing zeros. EX. 5 mg vs. 5.0 mg; can be mistaken for 50 mg or 0.7 g vs. .70 g; can be mistaken for 70 g • Always use leading zeros. EX. 0.8 ml vs. .8 ml; can be mistaken for 8 ml

15. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug • Quantity of the drug

16. Contents of the Prescription • Quantity of the drug • Prescribe only necessary quantity • Write for specific quantities rather than time period (for example: dispense #30 vs. dispense for 1 month) • Calculate: quantity = frequency per day x treatment days • Writing out “Dispense # X” is helpful

17. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug • Quantity of the drug • Directions for use

18. Contents of the Prescription • Directions for use • Write out in full English or use Latin abbreviations • Latin abbreviations – more convenient, more potential for mistakes • Provide clear and specific directions • Avoid “Take as Directed.”

19. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug • Quantity of the drug • Directions for use • Intended use of the drug, unless practitioner feels indication is not in best interest of patient

20. Contents of the Prescription • Date of the order • Patient Name and Address • Name of the drug • Strength of the drug • Quantity of the drug • Directions for use • Intended use of the drug, unless practitioner feels indication is not in best interest of patient • Practitioner Name, Address, Telephone number

21. CASE #2 Poor handwriting contributed to a medication dispensing error that resulted in a patient with depression receiving the antianxiety agent Buspar 10 mg instead of Prozac 10 mg

22. CASE #3 A hypertensive patient accidentally received Vantin 200 mg instead of Vasotec 20 mg when a pharmacist misread this prescription

24. MAXIMIZE PATIENT SAFETY • ALWAYS write legibly. • ALWAYS space out words and numbers to avoid confusion. • ALWAYS complete medication orders. • AVOID abbreviations. • When in doubt, ask to verify.

25. List of dangerous abbreviations, acronyms, and symbols JCAHO MINIMUM REQUIRED LIST

26. List of additional dangerous abbreviations, acronyms, and symbols