Rx writing Flashcards
Things to note when writing an Rx
- Reduce hypersensitivity reactions
- Review allergy history, document positive and negative
- Reduce drug and or supplement interactions
- Review patient’s medications and supplements
- Avoid drug contraindications
- Review patient medical history
- Acknowledge patient’s pregnancy status
- Know patient’s imsurance company’s formulary and co-pay
Prescription outline
Legal requirements for writing prescriptions
- Hand-written rx must be legible
- Must have at leat two patient identifiers(Name, DOB, Address)
- Federal law states mo dispensing without a Rx-not even samples
Specific criteria for generic medications
- Same active ingredient
- Same stability, purity, strength
- Same bioequivalency/bioavailability
- Same labeling regarding indications, warnings, precautions
- Same manufacturing quality
- Generic eye drops may differ in excipients(inactive ingredients)
Orphan drugs and orphan diseases
Guidelines on off-label prescribing
Off-label rx involves the use of drugs or medical devices in a non-FDA approved manner such as
clinical indication, mode of delivery or dosing schedule
- There are many ocular conditions that necessitate off-label rx
20% of prescriptions written in the US are off-label; this practice is particularly common with
children and pregnant women
-
- Off-label rx is a necessary part of medicine
Malpractice insurance may not cover off-label rx practices, however failure to use drugs/devices off-
label could be considered malpractice
- Physicians may prescribe any legally available medication
- Must fall within the scope of “practice of medicine”
- Must be in best interest of patient
- Use must be based on scientific rationale and sound medical evedence
- Must maintain accurate records of use and effects
- Not required to warn patient of off-label use
Prescription pad content
- Clinic name, phone & fax
- Doctors name and degree
- Clinic address
- Doctor’DEA and/or NPI number
- Doctors license number
- Patient info-at least two identifiers
- Date of prescription
- Drug info
- Drug trade/generic name
- Formulation
- Concentration/strength
- Patient instructions
- Dose
- Route of administration
- Frequency of administration
- Duration of use
- Indication for use if needed
- Dispensing instructions
- Quantity
- Size
- Volume
- Nr of repeats
- Generic options
- Signature
Prescribing of controlled substances
- DEA number required
- Only certain states allow optometrists to prescribe narcotics
- DEA registration is very expensive
*note: on a narcotic or controlled substance rx, there is a security feature as well as a “Void after”
date
DEA schedules
NPI number
10 digit number to identify prescriber
Assigned for life at no cost to providers
e-prescribing
Interpret:
sig: i tab po bid-qid for pain x 7days
take one tablet by mouth 2 to 4 times daily for pain for one week
Interpret:
DAW on a Rx
Dispense as written
Interpret on an RX:
Q101
Every 10 minutes
Patient education
