Prescribing 1 (Basics) Flashcards
(28 cards)
What is prescribing?
Advise and authorise the use of (a medicine or treatment) for someone, especially in writing.
What is dispensing?
Provision of drugs or medicines as set out properly on a lawful prescription. A prescription can only be filled, the drugs supplied, by a registered pharmacist, veterinarian, dentist or member of the medical profession.
What is prescription-only medicine?
Aprescriptiondrug (alsoprescription medicationor prescription medicine) is a pharmaceutical drug that legally requires amedical prescriptionto be dispensed.
What is over-the-counter medicine?
Drugs that can be obtained at a pharmacy without a prescription.
What are controlled drugs?
Controlled under the Misuse of Drugs legislation 2001 (and subsequent amendments). Stricter Legal controls apply to controlled medicines to:
- Prevent them being misused, being obtained illegally, causing harm
- Govern how controlled medicines canbe stored, produced, supplied, prescribed
What are pharmacy-only drugs?
Can be attained if approved by a pharmacist but not over the counter. No need for a prescription.
What is the BNF?
British National Formulary
Constantly updated
Good resource to find out common side effects - you are not expected to know the side effects and interactions of every drug.
What are the common drug presentations?
Tablets
Capsules
Caplets
Liquid - suspension and emulsions
What are tablets?
Solid unit dosage form of medicament or medicaments with or without excipientsand prepared either by molding or compression.
2/3 of all medications prescribed
Most are for oral use
What are capsules?
Medicine encapsulated in a relatively stable shell known as acapsule,
Can be seen as “better” by consumers
Led to Caplets (capsule shaped tablets) to foster the link in patients minds
Soft Shell usually oils or oil suspensions
What are suspensions?
Finely divided, undissolved drugs (powders for suspension) dispersed in liquid vehicles for oral or parenteral use.
Can be given in various ways
Will settle out over time
What are emulsions?
Lipid soluble drug dissolved in an inert lipid based substance
Can be given in various ways
What are the different drug administration methods?
Intramuscular injection - absorbed in capillaries of muscles
Subcutaneous injection - absorbed through subdermal layers
Intravenous
Inhaled - straight to the lungs
Topical - given onto the skin
Transcutaneous - absorbed slowly through the skin
Oral
Rectal e.g. supositories good blood supply
Vaginally
Buccal - through the oral muscosa e.g. anti-sickeness
Intraocular e.g. painkillers after surgery
Intranasal e.g. decongestants
Epidural - analgesia for surgery or childbirth
Spinal - surgery uses
Intraural - ear drops for ear infection
Intraosseous - into the bone marrow
Intrathecal - directly into an organ
Nebulised - drug into a mist which is inhaled
What factors determine which method of drug administration is used?
Acceptability for the patient The kind of drug Other drugs they are taking Speed of action Varies by patient e.g. age Varies by tolerability Appropriate delivery for the problem
What’s the difference between branded and generic drugs?
When first produced drugs are under patent protection
This supports the initial investment
After a time period the patent ends and other companies can produce a generic equivalent at lower cost.
What is a generic drug?
A generic drug is identical–or bioequivalent–to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.
Do not have to have the same non-active ingredients
Should we only used generics?
Drugs have specific licenses – sometimes the generics may not be licensed e.g. Pregabalin
Some drugs e.g. certain antiepileptics patients must be kept on their specific brand as issues with changing
Some brands are cheaper than other versions – inhalers most common
What are our responsibilities in prescription?
Is it appropriate? Patient vs. NHS - cost issues Consider holistic issues Safety Education
What factors must you consider when prescribing?
Local formulary Potential side effects Patient preference Past medical history Delivery method
What makes a good prescription?
In ink and legible
Avoid unnecessary decimal points
Use appropriate units and abbreviations
Dose and frequency must be stated
Names of drugs and preparations must be clear and not abbreviated
Directions ideally in English without abbreviation although some Latin allowed
What are Patient Group Directions?
Patient Group Directions (PGDs) are documents permitting the supply of prescription-only medicines (POMs) to groups of patients, without individual prescriptions. Healthcare workers using PGDs should be sufficiently trained to be able to supply and administer POMs
Who can give Patient Group Directions?
PGDs provide a legal framework that allows some registered health professionals to supply and/or administer a specified medicine(s) to a pre defined group of patients, without them having to see a doctor (or dentist). However, supplying and/or administering medicines under PGDs should be reserved for situations in which this offers an advantage for patient care, without compromising patient safety.
What are Patient Specific Directions?
A Patient Specific Direction is the traditional written (or electronic) instruction, signed by a doctor, dentist, or non-medical prescriber for medicines to be supplied and/or administered to a named patient after the prescriber has assessed the patient on an individual basis.
What are emergency exemptions to patient group directions or patient specific directions?
This list of medicines for use by parenteral administration (injection/infusion), are exempt from PGDs, prescriptions or PSDs when administered for the purpose of saving life in an emergency.
Doses are not specified in the legislation
e.g. adrenaline, glucose, antivenom
