Named patient prescribing

A patient specific direction is the traditional prescription written by a doctor, dentist or other qualified prescriber for medicines fo be supplied or administered to a named patient. The majority of medicines are supplied or administered in this way. 

There are a number of criteria that must be met for supplementary prescribing to occur (www.dh.gov.uk/en/Publicationandstatistics/). For instance, the independent prescriber must be a doctor or dentist the supplementary prescriber must be from a professional group that is legally allowed to be a supplementary prescriber (such as radiographer, nurse, pharmacist, chiropodist, physiotherapist, optometrist) and there must a written CMP relating to a named patient and their specific condifion(s). 

One file for all Schedule II-V controlled substances. If this method is used, a prescription for a Schedule II-V controlled substance must be made readily retrievable by use of a red C stamp not less than 1 in. high. If a pharmacy has an electronic record keeping system for prescriptions which permits identification by prescription number and retrieval of original documents by the prescriber s name, patient s name, drug dispensed, and date filled, then the requirement to mark the hard copy prescription with a red C is waived. 

Constipation may occur as an adverse drug reaction. When the patient has constipation as an adverse reaction to another drug, the primary care provider may prescribe a stool softener or another laxative to prevent constipation during the drug therapy. Display 48-2 lists the names of some dm and drug classifications that may cause constipation. 

Insulin is ordered by die generic name (insulin zinc suspension, extended) or the trade (brand) name (Humulin U) (see the Summary Drug Table Insulin Preparations). The nurse must never substitute one brand of insulin for anodier unless the substitution is approved by the health care provider because some patients may be sensitive to changes in brands of insulin. In addition, it is important never to substitute one type of insulin for anodier. For example, do not use insulin zinc suspension instead of die prescribed protamine zinc insulin. 

There is no evidence that one LT4 product is better than another. However, given the likelihood that these products do have different bioavailabilities, patients should be maintained on the same LT4 product. Given the generic substitution regulations of most states, this is best accomplished by prescribing a brand-name product. The prescriber should not allow substitution in the way mandated by state regulations. 

Pharmacists receive prescriptions by telephone, fax, as written prescriptions from individual prescribers, practicing in a group, or hospitals and other institutions. Telephone orders are reduced to a written prescription (hard copy) by pharmacists. Generally, prescriptions include printed forms called prescription blanks which include the name, address, and telephone number of the prescriber a provision to write the name, address, age or date of birth of the patient and the I symbol. Medication orders are prescription equivalents which are written by practitioners (prescribers) in a hospital or a similar institution. Components of medication orders with appropriate examples are presented in the subsequent section. 

It is a legal requirement to affix a prescription label on the immediate container of prescription medications. The pharmacist is responsible for the accuracy of the label. It should bear the name, address, and the telephone number of the pharmacy, the date of dispensing, the prescription number, the prescriber s name, the name and address of the patient, and the directions for use of the medication. Some states require additional information. The name and strength of the medication, and the refill directions are also written frequently. The label for a sample prescription is in Figure 3.2. 

For all controlled drugs, prescriptions must be signed and dated by the prescriber and the following particulars included in the prescriber s own handwriting name and address of patient, form and strength of preparation as appropriate, total quantity in both words and figures and dose. 

Clause 18.1 does not prevent the provision of medical and educational goods and services which will enhance patient care or benefit the National Health Service. The provision of such goods or services must not be done in such a way as to be an inducement to prescribe, supply, administer, recommend or buy any medicine. They must not bear the name of any medicine but may bear a corporate name. 

Prescriptions Prescriptions for controlled substances must be written in ink and include the following Date name and address of the patient name, address, and DEA number of the physician. Oral prescriptions must be promptly committed to writing. Controlled substance prescriptions may not be dispensed or refilled more than 6 months after the date issued or be refilled more than 5 times. A written prescription signed by the physician is required for schedule II drugs. In case of emergency, oral prescriptions for schedule II substances may be filled however, the physician must provide a signed prescription within 72 hours. Schedule II prescriptions cannot be refilled. A triplicate order form is necessary for the transfer of controlled substances in schedule II. Forms are available for the individual prescriber at no charge from the DEA. 

Average number of medicines prescribed per patient encounter % medicines prescribed by generic name % encounters with an antibiotic prescribed % encounters with an injection prescribed... 

Tricyclic antidepressants are still prescribed today, but some patients experience side effects such as dry mouth, blurry vision, constipation, and other uncomfortable conditions. Other antidepressants have since been found that induce fewer side effects. One of the most popular is fluoxetine, which is marketed under the trade name Prozac. This drug, along with Zoloft and other antidepressants, are known to inhibit reuptake proteins specifically for serotonin. As a result, these drugs are called selective serotonin reuptake inhibitors, or SSRIs. Although some concerns have appeared because of a possible risk of suicide in young patients who take Prozac, these drugs are commonly prescribed and have proved highly effective in millions of patients. 

Derived from the alkaloid thebaine, oxycodone is a highly effective pain-reliever and prescribed to postsurgical patients, cancer patients, and others with severe pain. Oxycodone is sold under various trade names in combination with aspirin, including Per-codan , Endodan, and Roxipirin with acetaminophen it is marketed as Percocet , Endocet, and Roxicet. Oxycodone is also the main ingredient in OxyContin. The most frequent side effect of oxycodone is constipation, but naseua is also common. Oxycodone is highly abused in the United States. 

In the hospital setting, drugs are prescribed on a particular page of the patient s hospital chart called the physician s order sheet (POS) or chart order. The contents of that prescription are specified in the medical staff rules by the hospital s Pharmacy and Therapeutics Committee. The patient s name is typed or written on the form therefore, the orders consist of the name and strength of the medication, the dose, the route and frequency of administration, the date, other pertinent information, and the signature of the prescriber. If the duration of therapy or the number of doses is not specified (which is often the case), the medication is continued until the prescriber discontinues the order or until it is terminated as a matter of policy routine, eg, a stop-order policy. 

---