Beruflich Dokumente
Kultur Dokumente
Prescription order
Superscription
Inscription
Subscription
Signa or Sig
XXXXX M.D
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Phone -----------
Name__________ Age ___________
Address ________ weight _________
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R
Losartan 50 mg tablets
Dispense # 30
Avoid abbreviation
OD = once a day
BD OR BID = twice a day
TD OR TID = thrice a day
QD or QID = four times a day
QS = quantity sufficient [total dose]
Prescription order is written in ink esply prescriptions for drugs under Controlled Substance Act
Date is important
Prescription order for opioid broughjt 2 weeks after the date is not valid
Controlled substance: dated, signed on, day issued, rtefills
Non CS : one month refill / till next visit
No refills – 0
Brand name
MfR’s Proprietary name
Trade name
Trade mark
Generic name
US adopted name
Medical Errors
Approx 50000 deaths annually
3% in hospital, pediatric, neonatal, intensive care units
Minimize medication order errors
Proper communication with patient, pharmacist & other Health Care
professionals
Compliance
Extent to which the patient follows a regimen prescribed by health care
professionals
Patient is final & most important determinant of successful therapy regiment
Compliance, adherence, therapeutic alliance, concordance [agreement]
Doctor – Patient interaction
Doctor as a medical expert has a therapeutic goal
Patient is an expert on himself, his beliefs, values & life styles
Goals may differ, but patient has last word
Therapeutic failure
Error in dosage
Error in schedule
Underuse
Overuse
Termination of therapy
Not refilling
Patient expectation
Clinical, interpersonal relation
Communication
Patient habits
Daily routines
Life style [nigjht shift]
Drug Advertisements
FDA permits print / TV advertising for even prescription drugs
Regardless of target audience
Ad to include effectiveness, side effects & contradictions
Ad to direct consumers to health care professionals
Print ad include risk related sections of package insert
Ad sometimes compromise physician’s ability to educate patients
Patients learn about drugs & interact with health care providers
Ads in print, TV, internet increased consumer demand
Increased number of prescription dispensing
Increased sales
Raised pharmaceutical costs to health insurers, Government, consumers
Patients’ counseling
Evidence based drug information service
Controlled Substances
To restrict to legitimate use
Federal controlled substance act [CSA]
Drug Enforcement Agency [DEA]
State & local acts also govern
Substances come under CSA are in 5 schedules
Schedule I
[Eg: Heroin, LSD, Methylene dioxy methamphetamine, Mescaline]
High potential for abuse
No medical use or not safe
Research use only
Schedule II
[Eg: Morphine, oxycodone, fentanyl, meperidine, d-amphetamine, cocaine,
amobarbital]
High potential for abuse
Medically used
Severe psychological or physical dependence
presigned blanks, oral orders [except emergency], refills not allowed
Schedule III
[Eg: anabolic steroids, nalorphine, ketamine, certain schedule II substances in
suppositories, mixtures, or in limited amounts]
Less potential for abuse
Medical use
Moderate to low physical dependence or high psychological dependence
telephonic orders, up to 5 refills allowed
Schedule IV
[Eg: alprazolam, phenobarb, meprobamate]
Less abuse potential
Medical use
Limited physical or psychological dependence
telephonic orders, up to 5 refills allowed
Schedule V
[Eg: buprenorphine, medication containing low doses of opioid plus a non-
narcotic ingredient [codeine, diphenoxylate, atropine]
Low abuse potential
Medical use
Some may be sold in limited amounts without prescription
no restriction on refills