prescription

Introduction

A formula (generally written) for the preparation & administration of any therapy or pharmaceutical agent.

* for hand written prescriptions given to patient, write out full name of medication and full description of method of administration i.e. nitroglycerin 0.4 mg sublingual as needed

Management

• prior to prescribing medication, ask
  • is the medication really necessary?
    • are there alternative nonpharmacologic treatments?
  • what are the therapeutic endpoints?
    • how will they be assessed?
  • do the benefits outweigh the risks?
  • is one medication being used to treat adverse effects of another?
  • is there 1 medication that can be used to treat 2 conditions?
  • are there potential drug-drug interactions or drug-disease interactions?
  • will the administration times coincide with those of current medications?
  • do the patient & caregiver understand
    • what the medication is for?
    • how to take the medication?
    • how long to take the medication?
    • when the medication should start to work?
    • possible adverse effects?
      • what to do in case of adverse effects?
• general principles
  • start with a low dose (if possible)
    • titrate upward as needed slowly
  • try not to start 2 medications at once
  • include the indication(s) for the prescription
  • use decision support to promote optimum selection of medication
• followup
  • medication reconciliation with each visit

Notes

• professional education, alerts of drug-disease interactions linked to the medical record & financial incentives reduce hospital admissions for GI bleeding & heart failure

More general terms

• pharmacology

More specific terms

• appropriate prescription
• geriatric prescribing context
• inappropriate prescription
• prescription for survivorship

Additional terms

• DEA controlled substance
• Medicare part D Prescription Drug Plan (PDP)
• medication reconciliation
• polypharmacy (unecessary drug prescription)
• prescribing practices