Pharmacotherapeutics for Advanced Practice A Practical Approach THIRD EDITION

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rescriber’s Name, Address, and Phone Number The next components are the name, address, and phone number of the prescriber and the collaborating physician if required by state law or regulations. ... This enables the pharma- cist to contact the prescriber if there is a question about the prescription. Name of Drug Of course, the name of the drug is the most essential part of the prescription. Ideally, the generic name (with the trade or brand name in parentheses) is used. The name must be leg- ible to avoid errors in filling the prescription correctly. For instance, some drugs have names that are commonly confused or misread, such as Norvasc and Navane, Prilosec and Prozac, carboplatin and cisplatin, and Levoxine and Lanoxin. Severe problems may result if the wrong drug is supplied erroneously. Adding the diagnosis to the prescription, although optional, can help the pharmacist avoid misinterpreting the prescribed drug. Dose, Dosage Regimen, and Route of Administration The drug dose is essential because many drugs are available in various strengths. The dose is written in numerals. If the dose is a fraction of 1, it is written in decimal form with a zero to the left of the decimal point (e.g., 0.75). However, a whole number should not be followed by a decimal point (10.0 could be misinterpreted as 100). The numeric dose is followed by the correct metric specification such as milligram (mg), gram (g), milliliter (mL), or microgram (mcg). Many practitioners spell out microgram to avoid confusion with mil- ligram. Some drugs are manufactured in units that should be specified, and the term unit should be written out (insulin 10 units, not 10 U). Usually, the strength of drugs that are combination products or that are manufactured only in one strength do not need to be included. The route of the drug is specified as well. (Routes of administration are discussed in Chapter 3.) The prescription also specifies how frequently the drug is to be taken. A drug prescribed to be taken as needed is termed 11 a prn drug. For example, dosage frequency can be written as “prn every 4 hours” (or another appropriate interval) for the problem for which the drug is prescribed (e.g., “as needed for nausea”). It is good practice to write out the number (10–ten), especially with controlled substances. Any special instructions, such as “after meals,” “at bedtime,” or “with food,” also should be specified. If the dose is once a day it is safer practice to write out daily than to write OD because this can be confused with every other day. The prescription also includes the number of pills, vials, suppositories, or containers or amount in milliliters or ounces to be dispensed. Many prescription reimbursement or health care insurance programs allow only a 1-month supply to be dispensed at a time, so it is good practice to be knowledge- able about the rules of various prescription plans. The prescrip- tion indicates whether the prescription may be refilled and the number of refills permitted. When prescribing a new drug for a patient, the practi- tioner may want to consider prescribing just a few doses or a 7-day supply initially. Alternatively, samples may be provided, if allowed by law or regulations, to determine if the patient can tolerate the drug and if it is effective. When deciding on the number of refills, the practitioner may decide when the patient should return for a follow-up visit and allow just the number of refills that will take the patient until the next visit to ensure that the patient returns. Some drug prescriptions cannot be refilled. For all Schedule 2 drugs, for example, a new prescrip- tion must be written each time. Allowable Substitutions There are many generic equivalents for brand name drugs. Indication of whether a substitution is allowed is a part of the prescription. A generic drug substitute must have the same chemical composition and dosage as the brand name drug originally prescribed. In many states, a generic drug will automatically be substituted for a brand name drug. If there is a medical reason to require a brand name drug (that has a generic equivalent), “Brand Medically Necessary” must be written on the prescription. Prescriber’s Signature and License Number The signature of the prescriber is required. It should be legible and should be the person’s legal signature. The license number of the prescriber or the collaborating physician is required on the prescription. In some instances, the DEA number of the prescriber is also required, especially when prescribing between states or prescribing a controlled substance. Figure 1-2 illustrates a blank prescription and a completed prescription. Each state has specific requirements for components on a printed prescription. The practitioner must be in compliance with state regulations and may prescribe only in the state in which he [Show More]

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