Prescription Writing Flashcards
What is the purpose of a prescription
its the written direction for the preparation and administration of a medication for the treatment, prevention, or diagnosis of diseases
What was the purpose of the Durham-Humphrey Amendment of 1951
dividing medication into two categories
- safely used without medical supervision (OTC)
- only safely used with appropriate monitoring (prescription)
The responsibility for proper prescribing is upon the prescriber, but a corresponding responsibility rests with who
the pharmacist
True or False
The pharmacist has the responsibility to refuse a prescription that is unsafe or seems inappropriate
True
What is a prerequisite for a prescription
a legitimate patient-provider relationship including; chief complaint, diagnostic studies, history of present illness and diagnosis, medical history, and physical exam
What are some prescriptions not appropriate for a dentist to prescribe
birth control pills
anti-hypertensives
hypoglycemics
What is the Comprehensive Drug Abuse Control Act of 1970
It created a schedule for certain prescriptions, allowing for close tracking and supervision; dependent upon medical use and the ability to lead to psychological or physical dependence
What is the Drug Enforcement Agency
created in 1971 to coordinate all federal efforts related to drug abuse
This type of substance requires registration with the DEA and some individual states (not Ohio) may also require a separate registration
controlled substances
A DEA # is required for patient prescriptions for which schedule of medications
II, III, and IV
Which schedule of medication have a high abuse potential and have no accepted medical use
schedule I
What are some examples of schedule I drugs
heroin
LSD
Marijuana (in most states; Ohio)
Which schedule is there a high abuse potential/severe dependency risk physically and psychologically but is accepted for medical use
schedule II
What are some examples of schedule II drugs
oxycodone amphetamine (adderall) oxycodone preparations hydrocodone preparations (NEW Aug14)
Which schedule is there a moderate dependency risk
schedule III
What are some examples of schedule III drugs
Buprenophine (subutex)
codeine preparations; <90mg/dose
ketamine
Which schedule is there a lower dependency risk
schedule IV
What are some examples of schooled IV drugs
benzodiazepines; valium, xanax
darvocet
tramadol
Which schedule is there a limited abuse potential generally used for antidirrheal, antitussive, and analgesic purposes
Scheulde V
What is the “start talking” program
where narcotic prescribers communicate the risks of addiction with parents/guardians of minors (under 21)
This is required for state license registration
DEA registration number
What are the requirements of a prescription regarding the prescriber
name
professional title
address
telephone
What are the requirements of a prescription regarding the patient
full name
address
telephone
DOB
This is the traditional symbol for the prescription, used to align other parts of the prescription
“Rx”
superscription
This part of the prescription provides specific drug information for the preparation (and what)
inscription; drug name dose dose form manufactured vs. compounded
This part of the prescription provides the directions to the pharmacist
subscription;
quantity to be dispensed
any special compounding instruction
Why is it important to write in words the quantity of the prescription to be filled (i.e. twenty)
so that the patient cannot add an extra zero or such
This part of the prescription provides instructions to the patient
transcription; number of dosage units per dose route of administration frequency of dosing duration of dosing purpose of the medication special instruction precautions and warnings
This is important to ensure this is on the prescription
proper date; “dated as of and on the day when issued”
no post-dating
When are typical expirations dates for prescriptions
typically expire after one year
schedule II, III, IV and V expire at 6 months
What are the specifics about the “refillability” of schedule III and IV prescriptions
refillable up to 5 times in a 6 month period
valid 12 months from date of issue
may be faxed
may be given as a verbal or telephone prescription
What are the specifics about the “refillability” of schedule II prescriptions
not refillable
valid 6 months from date of issuance
must be signed by the practitioner
What are two characteristics of using abbreviations in prescription writing
use only standardized abbreviations
use latin abbreviations appropriately
What are four things to make sure you tell the patient
the name of the drug
the purpose of the drug
warn the patient of side effects
stress compliance and/or special concerns
It is important to check this for possible drug interactions
the patient’s current Rx list
What are two important things to verify
that the patient is not allergic to the prescription or related medications
that the prescription has been written correctly
What are eight things to keep in mind when prescribing
allergies drug interactions compliance weight metabolism organ systems (renal/hepatic)
What are characteristics of narcotic analgesics
the maximum recommended dose of narcotic may not be effective for certain individuals
What are three things to keep in mind regarding the patient and narcotic analgesics
patients managed for chronic pain
history of substance abuse/dependency
enzyme induction
What are characteristics of opioid analgesics
the maximum number of tables for an opioid combination is usually determined by the maximum dose of the non-opioid component; acetaminophen, aspirin, NSAIDs
For what time frame should narcotic analgesics be used for
a limited time only
If the patient calls to request a refill what should you do
they should be seen for re-evaluation to check for muscle pain, hematoma, and infection
