Chapter 4 Prescription Writing Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Prescription Writing A prescription is an order for a specific medication for a specific patient at a particular time, with appropriate instructions for how the patient is to use the prescribed medication. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Current Prescription Formatting Heading Name, address, and telephone number of the prescriber Name, address, age, and telephone number of the patient Date of the prescription Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Current Prescription Formatting Body The Rx symbol Name and dose size or concentration (liquids) of the drug Amount to be dispensed Directions to the patient Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Current Prescription Formatting Closing Prescriber’s signature Drug enforcement administration number if required Refill instructions Generic substitution instructions Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Drug Legislation The Food and Drug Act of 1906 Regulated interstate commerce of drugs The Harrison Narcotic Act of 1914 Provided federal control over narcotics and required the registration of all practitioners prescribing narcotics Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Drug Legislation The Food, Drug, and Cosmetic Act of 1938 Prohibited the interstate commerce of drugs that had not been proven to be safe The Durham-Humphrey Law of 1952 Requires that certain types of drugs be sold by prescription only Prescriptions can only be refilled if it is indicated on the prescription Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Drug Legislation The Kefauver-Harris Bill of 1962 Manufacturers were required to prove that drugs were effective and to follow the strict rules of drug testing. Adverse effects that occurred once the drug was marketed were to be reported to the FDA. Drug ingredients are to be listed by the generic name in labeling and advertising and to state adverse effects, contraindications, and drug efficacy. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Drug Legislation Drug Abuse Control Amendments of 1965 Required accounting for drugs with the potential for abuse Controlled Substance Act of 1970 Divided controlled substances into five schedules according to their abuse potential Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Controlled Substance Act of 1970 Requirements of the Act Prescriptions for a controlled substance require a Drug Enforcement Agency number. Schedules II-VI require a written prescription. Schedule II prescriptions must be signed in ink, no refills, phone-ins are emergency only. Schedules III-V can be telephoned in and can have 5 refills over 6 months. Several states require “duplicate” or “triplicate” prescription blanks for Schedule II drugs. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Scheduled Drugs Schedule I High potential for abuse No accepted medical use in the U.S. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11 Scheduled Drugs Schedule II High potential for abuse Accepted medical use in the U.S. with or without severe restrictions Abuse may lead to severe psychological or physical dependence Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Scheduled Drugs Schedule III Potential for abuse is less than I or II Accepted medical use in the U.S. Abuse may lead to moderate to low psychological dependence Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Scheduled Drugs Schedule IV Low potential for abuse relative to III Accepted medical use in the U.S. Abuse may lead to limited physical or psychological dependence relative to III Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Scheduled Drugs Schedule V Low potential for abuse relative to IV Accepted medical use in the U.S. Limited physical and psychological dependence relative to IV Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15