Writing a prescription (pharmacology practical class)

MBBS Pharmacology Practical Class

1. Writing a Prescription (Pharmacology Practical Class) Dr. Pravin Prasad M.B.B.S., MD Clinical Pharmacology Lecturer, Lumbini Medical College 27 June, 2018 (13 Asar 2075), Wednesday

2. By the end of this class, MBBS Sem IV students will be able to: Identify the components of a prescription Appreciate the medico-legal aspect of different components of prescription Understand the common errors present in the prescriptions

3. Time to brainstorm!! IS PRESCRIPTION WRITING NECESSARY???

4. Prescription: Example Written order by a registered physician Directing the pharmacist To prepare or dispense pharmacological agents for the diagnosis, prevention or treatment of a disease.

5. Legal issues of Prescription writing

6. Legal issues of Prescription writing

7. Legal issues of Prescription writing

8. Writing a prescription: Preliminaries Make a specific diagnosis Consider the pathophysiologic implications of the diagnosis Select a specific therapeutic objective Select a drug of choice Determine the appropriate dosing regimen Devise a plan for monitoring the drug’s action and determine the end point for therapy

9. Components of Prescription

10. Elements of a Prescription: Superscript Prescriber related: Prescriber’s credential should be verifiable Should be available if any queries arises ALWAYS START ON A NEW SHEET

11. Elements of a Prescription: Superscript Date Signifies when was prescription written Patient related: Name, Age, Sex Weight Address

12. Elements of a Prescription: Inscription Body of Prescription: Medication name (Brand/generic) Medication strength (metric units) Dispensing quantity, dosage Direction for use

13. Elements of a Prescription: Subscription Advice: How and when to take medications Duration of therapy, purpose of medication Possible side effects, warnings Must be clear ad concise

14. Elements of a Prescription: Subscription Follow up: To come back or not to come back When to come back When to come earlier

15. Elements of a Prescription Prescriber’s identification: Prescriber’s signature Prescriber’s name Prescriber’s registration number

16. Prescription: What could possibly go wrong? Inappropriate drug prescription Failure to recognise contraindications imposed by co-morbidities Failure to illicit drug history of the patient Failure to realise Drug-drug interaction

17. Prescription: What could possibly go wrong? Omission of Information “Resume pre-op medication” “Continue present iv fluids” “Continue eye drops” “prn” authorization without clear instructions on what conditions will justify the use

18. Prescription: What could possibly go wrong? Poor prescription writing Illegible handwriting Ambigious decimal point, using “0” properly, using “/” Using “U” for units Prescribing doses in micrograms One ampoule of a drug when more than 1 size ampoules are available Confusing abbreviations

19. Conclusion Each component of prescription ensures that the drugs have be dispensed as desired Should be legible, unambiguous, dated, signed properly Contain sufficient information so that any possible errors could be discovered easily Poor prescription writing is one of the common cause of prescription errors!

20. Please don’t spoil your prescription ever… Thank you!!!