Prescription reviews Flashcards
(38 cards)
What is a prescription review?
The process of systematically assessing a patient’s medications to ensure they are safe, effective, appropriate, and optimised for their health needs.
What are the Five ‘R’s of Prescribing?
- Right drug
- Right dose
- Right route
- Right frequency
- Right patient
What should be reviewed regarding the indication of a drug?
- Does the patient still need the drug?
- Has the condition changed?
- Is there a better alternative?
What patient-specific factors should be considered in a prescription review?
- Renal and hepatic function
- Pregnancy and breastfeeding
- Age-related changes
What are common drug interactions to check for?
- Warfarin + macrolide antibiotics = ↑ INR
- Multiple antihypertensives causing hypotension
What are some common prescription errors?
- Incorrect dosing
- Inappropriate drug choice
- Contraindicated medications
- Incorrect formulation or route
- Omissions
- Lack of necessary monitoring
What is one example of incorrect dosing?
Overdosing in renal impairment, such as morphine accumulation in CKD.
Name a contraindicated medication in asthma.
Beta-blockers can cause bronchospasm.
What should be done regarding teratogenic drugs during pregnancy?
STOP teratogenic drugs like warfarin and ACE inhibitors.
What is a critical action regarding prescribing in renal impairment?
Dose adjustments are required for drugs like digoxin and aminoglycosides.
What does the STOPP criteria refer to?
Medications to avoid in the elderly.
What should be monitored for patients on warfarin?
INR monitoring.
List the steps in a prescription review.
- Look at the full drug list
- Check for unnecessary medications
- Assess interactions and contraindications
- Check doses for renal/hepatic function
- Ensure correct formulations and routes
- Monitor high-risk drugs
- Assess adherence
- Deprescribe where appropriate
Fill in the blank: A prescription review helps identify drug interactions, inappropriate prescribing, errors, and opportunities for _______.
deprescribing
True or False: All medications should be continued indefinitely regardless of changes in the patient’s condition.
False
What is a common issue identified in an elderly patient with CKD?
Ramipril can risk worsening renal function.
What are the potential risks of prescribing naproxen in a patient with CKD?
Increased risk of GI bleed and nephrotoxicity.
What practical tips should be remembered for PSA exam questions?
- Check drug interactions in the BNF
- Adjust doses for renal/liver impairment
- Deprescribe where possible
- Know monitoring requirements for high-risk drugs
- Ensure appropriate antibiotic duration
What is a prescription review?
The process of systematically assessing a patient’s medications to ensure they are safe, effective, appropriate, and optimised for their health needs.
What are the Five ‘R’s’ of Prescribing?
- Right drug
- Right dose
- Right route
- Right frequency
- Right patient
What should be reviewed regarding the indication for a drug?
- Does the patient still need the drug?
- Has the condition changed?
- Is there a better alternative?
What patient-specific factors should be considered in a prescription review?
- Renal and hepatic function
- Pregnancy and breastfeeding
- Age-related changes
What should be checked for drug interactions and duplications?
- Common interactions
- Avoid polypharmacy where possible
What are the common prescription errors?
- Incorrect dosing
- Inappropriate drug choice
- Contraindicated medications
- Incorrect formulation or route
- Omissions
- Lack of necessary monitoring
