Drug Laws Flashcards
Writing a prescription should be based on what rational steps?
- Making a specific diagnosis
- Consider the pathophysiologic implication of the diagnosis
- Select a specific therapeutic objective
- Select a drug of choice
- Determine approx dosing regimen
- Devise plan for monitoring drug action and end point for therapy
- Plan program of pt education
What part of the hospital chart would a pt’s drugs be prescribed on?
Physician’s order sheet (POS) or chart order
What are the contents of a prescription on a POS designed by?
Medical staff rules by hospitals pharmacy and therapeutics committee
What does a hospital order for a drug consist of?
Name and strength of medication, dose, route and frequency of admin, date, pertinent info, signature of prescriber
What should be done if the duration of the drug therapy or number of doses isn’t specified?
Medication is continued until prescriber discontinues the order
Until it is terminated by policy routine = stop order
How is the strength of a solution measured?
Expressed as the quantity of solute in sufficient solvent to make 100 mL
What should the quantity of the medication prescribed reflect?
Duration of therapy, cost, need for clinic or physician contact, potential for abuse, potential for toxicity or overdose, and standard size consideration, repeat or refill
What should be considered in the use of the drug?
Drug specific, pt specific, simpler direction = better, fewer doses = better, pt noncompliance major cause of treatment failure
When writing for a controlled substance how must the number of the physical dose be written out?
Longhand
fourteen pills vs 14 pills
What are some common prescribing errors?
Omission of information
Poor prescription writing
Inappropriate drug prescriptions
What are the identification data used on a prescription?
Signature,
National Provider Identification (NPI)
Drug Enforcement Agency (DEA) number
State license number
What are the different ways a pt can commit non-compliance?
Fails to obtain medication
Fails to take medication as prescribed
Premature discontinuation
Taking the medication inappropriately
What are the two classes of drug which the US gov recognizes?
Over the counter (OTC)
Prescription (Rx)
How should instruction to take drugs be given?
How and when to take it, duration of therapy and purpose - should be written on the label
Who controls prescription drugs?
US FDA
What does a package insert include?
The official brochure stating the indications, contraindications, warning and dosing for the drug
What three things is a prescription?
The physician’s order in the pt’s chart
Written order to which the pharmacist refers when dispensing
Pt’s medication container with label affixed
What drugs does the fed gov and state impose special restrictions on?
Opioids Hallucinogens Stimulants Depressants Anabolic steroids
What was the Comprehensive Drug Abuse Prevention and Control Act of 1970 created for?
1960 inc in drug abuse
Classifies drugs with abuse potential in 5 schedules based on their potential for abuse and clinical use
Schedule I drugs
High abuse potential and no legitimate medical use and their distribution and possession are prohibited
Schedule II drugs
High abuse potential but a legitimate medical use and their distribution is highly controlled through requirements for inventories and records and through restrictions on prescriptions
Schedule III, IV and V drugs
Lower abuse potential and decreasingly fewer restrictions on distribution
What does the Controlled Drug Act do?
Requires prescribers and dispensers to register with the drug enforcement agency (DEA), pay and receive a personal registration number and keep a record of all controlled drugs
If you are prescribing a schedule II drug can you refill it?
No, but you can write multiple single prescriptions with time intervals in which they can be used
If a pt wants a specific brand name drug, how must it be written in a script to ensure they do not receive a generic?
“Dispense as written”
What is the generic version of valium?
Diazepam
Is it possible for pharmacists to substitute one therapeutic agent out for another if the effects are similar?
NO
In what ways are generics not as satisfactory as brand names?
Bioavailability - can vary
Drugs with a low therapeutic index, poor solubility or high ratio of inert ingredients to action drug content
What is an “A” coded drug in the orange book?
Products considered bioequivalent to a reference standard formulation of the same drug to all other versions
What is a “B” coded drug in the orange book?
Products not considered bioequivalent
1 grain =
.065 grams (60 mg)
15 gr =
1 g
1 ounce by volume =
30 milliliters (mL)
1 teaspoon (tsp) =
5 mL
1 tablespoon (tbsp) =
15 mL
1 quart (qt) =
1000 mL
1 minim =
1 drop (gtt)
20 drops =
1 mL
2.2 lbs =
1 kg
PO
By mouth
AC
Before meals
PC
After meals
Qd (so not use)
Everyday (just write daily)
bid
Twice a day
tid
Three times a day
qid
Four times a day
HS
At bedtime
prn
when needed
c (with a little line over the c)
with
s (with a little line over the s)
without
ss (with little line), ss (w/o little line)
One-half
