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Writing a Prescription. Writing a Prescription. Legible, please Treat zeros with respect use for 0.5mg but not for 5.0mg Write purpose of medication “for high blood pressure” Write as needed for what “prn for nausea”. Writing a Prescription. Confirm allergies
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Writing a Prescription • Legible, please • Treat zeros with respect • use for 0.5mg but not for 5.0mg • Write purpose of medication • “for high blood pressure” • Write as needed for what • “prn for nausea”
Writing a Prescription • Confirm allergies • Confirm dose if not absolutely 100% sure • Consider interactions • epocrates • warfarin • seizure meds • immunosuppressants
Writing a Prescription • Think about QTc • Pregnancy ? • Monitoring • Baseline (need creatinine before metformin, ALT before statin) • Later (need creatinine and K after Ace-i, drug levels for lithium)
Writing a Prescription • # pills acceptable for given insurance (only 30 for Medicaid, 30 or 90 for Wal-Mart $4) • Use generics whenever possible • Forgery issues • microprinting on WebCIS • write out numbers (# thirty) • no mistakes on controlled substances prescriptions
Narcotics • Schedule I: no medical use (heroin, LSD) • Schedule II: medical use, high abuse/addiction potential (morphine, oxycodone) • Schedule III: lower potential (codeine, hydrocodone) • Schedule IV: even lower potential (benzodiazepines, propoxyphene) • Schedule V: very low potential (codeine in cough syrup) • Keep records organized and detailed: • strength, how many, any refills, when/from whom can get more
Narcotics • Schedule I: no medical use (heroin, LSD) • Schedule II: medical use, high abuse/addiction potential (morphine, oxycodone) • Schedule III: lower potential (codeine, hydrocodone) • Schedule IV: even lower potential (benzodiazepines, propoxyphene) • Schedule V: very low potential (codeine in cough syrup) • Keep records organized and detailed: • strength, how many, any refills, when/from whom can get more
Narcotics • Schedule I: no medical use (heroin, LSD) • Schedule II: medical use, high abuse/addiction potential (morphine, oxycodone) • Schedule III: lower potential (codeine, hydrocodone) • Schedule IV: even lower potential (benzodiazepines, propoxyphene) • Schedule V: very low potential (codeine in cough syrup) • Keep records organized and detailed: • strength, how many, any refills, when/from whom can get more
Narcotics • Schedule I: no medical use (heroin, LSD) • Schedule II: medical use, high abuse/addiction potential (morphine, oxycodone) • Schedule III: lower potential (codeine, hydrocodone) • Schedule IV: even lower potential (benzodiazepines, propoxyphene) • Schedule V: very low potential (codeine in cough syrup) • Keep records organized and detailed: • strength, how many, any refills, when/from whom can get more