Medication prescriptions

Item 17 List any prescription or non-prescription medications the patient was teking when ihe vactine(s) was given. 

Over the next decade, seniors will spend 1.8 trillion on prescription medications. Medicare proposals to provide a drug benefit for seniors have been suggested to cost 400 billion over a 10-year period. Thus, the most elaborate of the current drug programs will pay only 22% of seniors drug costs. Enhanced use of pharmacoeconomic tenets to select appropriate therapy while considering cost and therapeutic benefits for seniors and others will become even more crucial for clinicians in the future. 

Do not take non-prescription medications or herbal/alternativa/complementary medicines without notifying your physician, pharmacist, and/or health care team members. 

A 51 -year-old woman presents to the emergency department complaining of abdominal pain for the past 3 days and dark tarry stools over the past 2 days. She states that she has never had these symptoms before and that she has been feeling weak and tired for the past 2 weeks. She denies having bright red blood in her stools or vomiting. She does not take any prescription medications and only takes extra-strength acetaminophen for occasional headaches. 

Obtain a history of prescription medication, over-the-counter medication, and dietary supplement use. 

Obtain a thorough history of prescription medication use, and determine what treatments have been helpful in the past, which treatments the patient is currently receiving, and previous side effects experienced. 

TABLE 38-2. Pharmacokinetics of Prescription Medications Used to Treat Insomnia... 

Practitioners must be diligent in reviewing all medications for potential DDIs. In addition to reviewing prescription medications, it is essential to question patients about the use... 

This chapter will cover the production of coffee, tea, and cocoa, which comprise the primary crops that account for the majority of worldwide caffeine consumption. Caffeine-containing crops and products comprise a large share of the international market and are primary commodities for many national economies.3 4 Trade of such products is also important in the understanding of availability, market demand, and overall exposure to caffeine from various sources. Information is presented to a lesser degree for soft drinks, many of which do contain caffeine and are consumed primarily in the industrialized nations. Another source of caffeine exposure which contributes less than any beverages and foods under consideration are prescription and non-prescription medications, which are described in lesser detail. 

Selected Prescription and Non-Prescription Medications Containing Caffeine... 

Dyes. Dose does not appear to be a factor in patient reaction to dyes. The mandatory labeling of the azo dye tartrazine (FD C yellow No. 5) in OTC and prescription medications [58] has focused the attention of pharmaceutical manufacturers and the consumer on the potential danger of dyes in susceptible individuals. 

Product labels may be incorrect, accidentally or intentionally. Herbs may be mislabeled accidentally because of misidentification or the wrong part of the plant was picked. Other products may be mislabeled intentionally—a ginseng label may not disclose that the product contains mandrake (scopolamine) or snakeroot (reserpine) because of the high cost of pure ginseng [34]. Some herbal products may not declare the addition of prescription medications such as corticosteroids. 

Garlic s proven mechanisms of action include (a) inhibition of platelet function, (b) increased levels of two antioxidant enzymes, catalase and glutathione peroxidase, and (c) inhibition of thiol enzymes such as coenzyme A and HMG coenzyme A reductase. Garlic s anti-hyperlipidemic effects are believed to be in part due to the HMG coenzyme A reductase inhibition since prescription medications for hyperlipidemia have that mechanism of action (statins). It is unknown whether garlic would have the same drug interactions, side effects, and need for precautions as the statins. 

Some precautions may be similar to precautions for prescription or non-prescription medications. Precautions for valerian are similar to those for... 

Dietary supplements may be less expensive than prescription medications. However, dietary supplements are not guaranteed to be equivalent in safety and efficacy. Unfortunately, many consumers believe that dietary supplements are as safe and effective as prescription medications. As pharmacists, our role is to educate patients on the fallacies of dietary supplements. 

What prescription and non-prescription medications are you currently taking ... 

Takeda s melatonin (MT1/MT2) receptor agonist ramelteon (11) was approved and launched in 2005 in the U.S., indicated for the treatment of primary insomnia characterized by difficulty with sleep onset. It is the first prescription medication for insomnia with a novel mechanism of action to reach the US market in 35 years. It is also the first and only prescription sleep medication that has not exhibited potential for abuse and dependence, and as such is not designated as a scheduled substance by the DEA. Moreover, ramelteon was also filed in late March 2007 in E.U. for primary insomnia. 

The interpretation of prescription medication orders is one of the most important requirements of professional pharmacy practice. According to the National Association of Boards of Pharmacy s (NABP s) Model State Pharmacy Act,... 

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. 

First, FDA has been conducting continuing research into how much and what kind of information patienfs gef about their prescriptions from pharmacies and physicians offices. Dafa from fhe lasf four patient surveys that have been conducted since 1992 are on FDA s website at www.fda.gov/cder/ddmac/research.htm. FDA has also completed research on how men and women perceive benefits and risks in patient labeling as a fxmc-tion of how the information is commxmicated. FDA hopes to use these data to better communicate prescription medication information and is preparing papers for publication based on e data from this study. 

Basara, L.R., The impact of a direct-to-consumer prescription medication advertising campaign on new prescription volume. Drug Inf. J., 30, 715-729,1996. 

For a detailed description of orlistat and its approved uses (or for any other prescription medication approved for sale in the United States), see The Physicians Desk Reference. 

Substance-Induced Mood Disorder. Many prescription medications and abused substances cause depression (see Table 3.5). This idea is not new. In fact, recognizing that certain medications cause depression has helped us to understand the biology of depression better. 

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