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Drugs and Prescription Records: History, Laws, and Procedures

This chapter provides an overview of the history of drug laws, including the Harrison Narcotic Act, Volstead Act, Marijuana Tax Act, Food, Drug, and Cosmetic Act, and the Controlled Substances Act. It also covers the procedures and regulations involved in prescription handling, including drug references, understanding prescriptions, authorizing prescriptions, prescription abbreviations, and the role of the medical assistant in managing prescription drugs.

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Drugs and Prescription Records: History, Laws, and Procedures

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  1. Chapter 10 Drugs and Prescription Records

  2. Objectives • Review the learning and performance objectives for this chapter • By the end of this chapter, demonstrate the procedures in the textbook and the job skills in the workbook

  3. Heart of theHealth Care Professional • Service • Efficient handling of prescription refills will serve the patient in ways you may never fully realize.

  4. History of Drug Laws • The Harrison Narcotic Act – 1914 • Register doctors, pharmacists, vendors • Paperwork for all drug transactions • The Volstead Act – 1919 • National Prohibition Act • Prohibited Beverages > 0.5% Alcohol

  5. History of Drug Laws • The Marijuana Tax Act – 1937 • Transfer tax for marijuana sales • The Food, Drug, and Cosmetic Act - 1938 • Control of cosmetics and medical devices • First labeling of drugs • Premarket approval from the FDA • FDA: Food and Drug Administration

  6. History of Drug Laws • The Drug Enforcement Administration (DEA) • 1960s War on Drugs • U.S. Department of Justice • Regulates Dangerous Drugs • Regulates Potentially Abused Drugs

  7. History of Drug Laws • Watch the video scenario about the DEA and controlled substances • DEA & Controlled Substances

  8. History of Drug Laws • The Omnibus Budget Reconciliation Act (OBRA) – 1990 • Medicaid Pharmacy Programs/Providers • Prospective Drug Utilization Review • Patient Counseling Standards • Maintenance of Patient Records • Drug Use Review Board

  9. History of Drug Laws • Controlled Substances Act – 1970 • Limit/control access to intoxicating drugs • Schedule of controlled substances • Five levels based on potential for abuse • Schedule I: Highest potential • Schedule V: Lowest potential • Table 10-1

  10. History of Drug Laws • Controlled Substances Act – 1970 • Physician Narcotic License • Physicians required to register with DEA • Administer, prescribe, or dispense • The Compassionate Use Act • Possible clinical uses of cannabis

  11. Drug Names • Chemical name • Indicates chemical content • Brand name • Trademark indicating ownership • Generic name • Established, nonproprietary, official name • See Example 10-1

  12. Drug References • Physicians’ Desk Reference (PDR) • Pharmaceutical products • Prescription information • Use a PDR to spell and locate information • Procedure 10-1

  13. Drug References • Other drug reference books • Over-the-counter drugs (OTC) • PDR for nonprescription drugs • Labeling (Figure 10-4) • Word books • Helpful in spelling • Detailed drug information not included

  14. Understanding Prescriptions • Routes of administration • Table 10-2 • Components of a prescription • Prescription • An order to prepare medications

  15. Understanding Prescriptions • Components of a prescription • Physician/office information • Name and address • DEA narcotic number • Patient information • Name and address • Date

  16. Understanding Prescriptions • Components of a prescription • Superscription • Recipe/Rx • Inscription • Name of medication • Quantity • Dosage and strength

  17. Understanding Prescriptions • Components of a prescription • Subscription • Directions to the pharmacist • Signature • Instructions to the patient

  18. Understanding Prescriptions • Components of a prescription • Signature of physician • Number of refills • State prescription regulations • Other regulations in certain states

  19. Understanding Prescriptions

  20. Understanding Prescriptions • Authorizing prescriptions • Legal document • Electronic prescription programs • E-prescribing • Transmit electronically to pharmacy • Preprinted and duplicate prescriptions • Copy for the medical record

  21. Understanding Prescriptions • Prescription abbreviations • Table 10-3 • Common errors/dangerous abbreviations • Table 10-4 • Formatting errors • Read and interpret a written prescription • Procedure 10-2

  22. Prescription Drugs and the Role of the Medical Assistant • Pharmaceutical representatives • Schedule meetings • Drug classifications • Organize • Track expiration dates

  23. Prescription Drugs and the Role of the Medical Assistant • Medication instructions • Instruct patients • Learn drug categories • Table 10-5 • Medication schedule card (Figure 10-7) • Drug dispensing containers • Medication log (Figure 10-8)

  24. Prescription Drugs and the Role of the Medical Assistant • Medication refills • Obtain information from the patient • Charting prescriptions • Record medication • Patient’s chart • Medication log • Procedure 10-3

  25. Prescription Drugs and the Role of the Medical Assistant • Drug abuse prevention measures • Good documentation • Protecting prescription pads • Drug side effects and adverse reactions • Allergies • Alert tags • Figure 10-9

  26. Control and Storage of Drugs • Control and storage • Keep an inventory • Contact pharmaceutical representative • Lock up controlled substances • Check expiration dates

  27. Control and Storage of Drugs • Disposal of drugs • Uncontrolled substances • Discard as hazardous or medical waste • Controlled substances • Return processors • Follow federal, state, and local regulations

  28. Stop and Think • Determine correct medication • Review the scenario • What would you do to determine the correct medication? • What are some preventive measures to help avoid cases of mistaken drug identity?

  29. Stop and Think • Determine food and drug allergies • Review the scenario • What might the patient also be allergic to? • What should you say to Dr. Practon in this situation? • Are there additional questions you might ask the patient?

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