Prescribing

Question 1

What are the steps that must be done prior to writing a prescription?

Answer 1

Make a diagnosis
Make a therapeutic decision
Choose a medicine
Choose a dosing regimen

Question 2

What are the important things to think about when making a therapeutic decision?

Answer 2

Are current symptoms modifiable by symptomatic treatment or disease modifying treatment, ie. what the patient wants vs what you want

Question 3

What are the three things to consider when choosing a medicine?

Answer 3

Efficacy
Safety
Appropriateness

Question 4

What are some things to consider when determining safety?

Answer 4

Allergies, side effects, drug interactions, pregnancy

Question 5

What are some of the things to consider with appropriateness?

Answer 5

Can the patient afford it and what are the compliance issues?

Question 6

What are the two things to consider when choosing dosing regime?

Answer 6

Route of delivery

Choose the dose

Question 7

Which things are essential for a legal prescription?

Answer 7

Doctor's name
Signature
Physical address
MCNZ registration number
Contact phone number
Patient's name
Full residential address
Age if under 13

Question 8

What are the three parts of a prescription?

Answer 8

Recipe, Sigma and Mitte

Question 9

What is within the recipe?

Answer 9

Name of medicine
Formulation (caps, tabs, syrup)
Strength of medicine
Rx Amoxycillin 500mg tabs

Question 10

What is within sigma?

Answer 10

Instructions for patient
Sig: i t.d.s. p.o
t.d.s. = 3 times a day
o.d. =once daily
b.d.= twice daily
p.o= orally
p.r.=rectally
i.v.=intravenous

Question 11

What are the three steps to be done after writing a prescription?

Answer 11

Counsel the patient
Monitor response
Review the medicine

Question 12

How do you counsel the patient?

Answer 12

Info about how and when to take it but not too much information when they can’t assimilate knowledge

Question 13

What are the ways that the response is monitored?

Answer 13

Clinical response
Biomarkers
Drug concentration

Question 14

How do you review a medicine?

Answer 14

Efficacy (desired effects vs adverse effects)
Appropriateness (clinical changes, changes in medicines)
Patient view (patient understanding/concerns, and adherence)

Question 15

When is it most important to review medicines?

Answer 15

Long term conditions with multiple medicines

Question 16

What is in mitte?

Answer 16

Instructions for pharmacist
M: 7 days supply
max 3 months except the pill