Rational Drug Selection and Prescription Writing Flashcards

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1
Q

Before prescribing make sure you document what: (4 things)

A

A documented provider-patient relationship, thorough H&P, a plan for drug monitoring and titration, and a note documented if any other providers were consulted

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2
Q

How does cost contribute?

A

contributes to non-adherance

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3
Q

How do guidelines contribute

A

when in doubt, follow guidelines set out by organizations. However, if you deviate from the standard of care you need to document why

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4
Q

How does availability contribute?

A

Know the facilities formularies and what Medicaid/Medicare will cover for patients

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5
Q

How do interactions contribute?

A

Monitor for polypharmacy.

Ask about all current drugs, OTC meds, and herbal preparations

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6
Q

How do side effects contribute?

A

Asses risk-benefit ratio.

Ask your patient if they have experience side effects after initiating, stopping, or adjusting the dose on a medication

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7
Q

How do allergies contribute?

A

Critical to determine the type of reaction and document in the chart

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8
Q

How does hepatic and renal function contribute?

A

Impaired hepatic/renal function could cause an overdose of a medication.
Many drugs have specialized dosing in these circumstances.
Important to know if you can adjust dose or if it is contraindicated.

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9
Q

How does ‘need for monitoring’ contribute?

A

Assess patients ability to adhere to medication regimen, attend lab draws, and reachability by phone before prescribing a medication that requires monitoring.
Ex: warfarin, lithium, opioids, immunosuppressants

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10
Q

Necessities on a prescription

A

Prescriber name, license number, and contact information
Prescriber DEA number, if applicable
Patient name and date of birth
Patient allergies
Name of medication
Indication of medication (e.g., atenolol for hypertension)
Medication strength (e.g., 25 mg, 500 mg/mL)
Dose of medication and frequency (e.g., 12.5 mg once daily)
Number of tablets/capsules to dispense
Number of refills

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11
Q

Limitations to telephone prescriptions

A

Schedule II meds cannot be prescribed or refilled by telephone unless it’s an emergency and only then for a small supply and written prescription must be presented to pharmacy within 7 days

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12
Q

Consider shorter refill time (1-3 mo) when:

A
  • newer medication for patient
  • changing dose or frequency
  • adding new medication to regimen
  • pt having undesired side effects
  • you need to see them again before refilling
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