Prescription Writing Exercises for Thursday, May 1, 2008
Use the attached prescription blanks to write prescriptions for each of the following
patients:
1. Refill 50 year-old Henry Xia’s hydrochlorothiazide prescription for hypertension.
He takes 25 mg a day and gets a 3 month supply with enough refills for a year.
2. Prescribe antibiotic therapy for 14-month old Brandy Mitchell who has acute
otitis media. She weighs 10 kilograms and has no allergies. She has not had otitis
media previously and has no allergies. (What calculation is necessary for this
prescription? What special consideration is necessary for an infant?)
3. Prescribe antibiotic therapy for 5 year-old Jane Steed with acute sinusitis who has
a history of hives following prior penicillin use. She weighs 25 kilograms. (Which
antibiotics are safe to use in penicillin allergic patients?)
4. Give 74 year old Robert Popovich, a post-operative hip replacement patient with
no allergies, a hydrocodone/acetaminophen prescription to last for 5 days. (What
special number is needed to prescribe this medication?)
5. Prescribe triamcinolone cream for 40 year old Ismail Kahn who has eczema.
6. Prescribe alendronate for 52 year-old Nancy Kozlosky to combat her recently
diagnosed osteoporosis. She can get a 3 month supply. (What special instructions
are needed for alendronate?)
7. 32 year old Ivan O’Malley has new onset of type I diabetes mellitus. He wants to
take insulin and monitor his blood sugar. He weighs 100 kg. You elect to start
insulin glargine daily and insulin lispro 0.05 units per kilogram prior to each of 3
meals daily. Prescribe the insulins for 3 months with refills for another 9 months.
Prescribe the equipment and materials needed to monitor his blood sugar 4 times
a day for one month.
8. Prescribe 18 year old Ivan Gasnorski, who has left eye bacterial conjunctivitis,
combined polymyxin B and trimethoprim drops.
9. Prescribe azelastine nose spray and fluticasone nose spray for 28 year-old
Francoise Delorm who gets allergic rhinitis for 6 to 8 weeks each Spring and each
Fall.
10. 77 year-old Letitia Black has a urinary tract infection. She has a history of high
blood pressure, atrial fibrillation and iron deficiency anemia. Her current
medications are: warfarin 5 mg a day, iron 150mg twice a day, lisinopril 5 mg a
day, and acetaminophen 650 mg 4 times a day as needed for pain. The patient has
a history of penicillin-induced wheezing. Write a prescription for an appropriate
drug to treat her urinary tract infection.
Hints: For help with writing Rxs for specific diagnoses, go to Up-To-Date and look in the
treatment section for drugs of choice; for drug forms, check the Medical Letter, the online
hospital formulary (particularly Micromedex), or see sources like Goodman and Gilman
or the Tarascon Pocket Pharmacopoeia.
Order Writing Exercises for Thursday, May 1, 2008
I.
A. Write a set of admission orders for Philip Johnson, a 65 year old patient of
Dr. Mahoney’s, admitted to the hospital for evaluation of crushing
substernal chest pain of 1 hour’s duration that occurred yesterday afternoon
(12 hours ago). He comes in taking only prn acetaminophen and a daily
multivitamin. He has an LDL of 176 and an HDL of 37. BP is 135/75,
pulse is 88, respirations are 16, and temperature is 986 F (oral).
Examination including heart and lungs is normal.
B. Mr. Johnson is proven to have had a small myocardial infarction but is
clinically stable and refuses cardiac catheterization. Write a set of
discharge orders to include his medication
II.
Write a set of admissions orders for Ulam Watkins, a 68 year old patient of Dr.
Middleton’s, in previously good health who comes in with influenza, pneumonia
and dehydration. A one pack per day smoker, Mr. Watkins is vigorously
coughing. He has no allergies. On examination he has rales in the right lung base
and is wheezing diffusely. He is slightly cyanotic. BP = 110/60 lying and 95/60
sitting; P = 95; T = 102F (oral); respiratory rate = 24. The remainder of the
examination including cardiac and neurologic examinations is normal.
Hints: Many house staff manuals have guidelines for treatments of these types of
problems. Try the Washington Manual or go to Up-To-Date online for guidance.