PHARMACOLOGY

RATIONAL PRESCRIBINING & PRESCRIPTION WRITING

Edberto R. General, MD, FPCP, FPSEDM, FACE Aug/31/2021 Year 2 | Semester 1

Rational Prescribing & Prescription Writing o The more toxic the drug the greater the
importance of educational program.
Rational Prescribing o Ex Anti TB medications
1. Make a specific diagnosis. Physician’s Order Sheet
2. Consider the pathophysiologic implications of
the diagnosis. o Patient’s name
3. Select a therapeutic objective. o Name and strength of medication
4. Select a drug of choice. o Dose, route and frequency of administration
5. Determine the appropriate dosing regimen. o Duration?
6. Devise a plan for monitoring the drug’s action o Date
and determine endpoint of therapy. o Signature of prescriber
7. Plan a program of patient education.
A typical chart order might be as follows:

1. Make a specific diagnosis. 11/15/08

o Not to satisfy patient’s psychological need. 10:30 a.m.
o Diagnosis should be clear and be shared to
patients. (1) Ampicillin 500 mg IV q6h ´ 5 days
2. Consider the pathophysiologic implications of (2) Aspirin 0.6 g per rectum q6h prn temp over
the diagnosis 101
o Well, understood disorder → effective therapy.
[Signed] Janet B. Doe, MD
o Ex. Inflammatory process, bacterial infection
3. Select a therapeutic objective
o Relief of pain process → reduced inflammation
o Arrest of disease process.
4. Select a drug of choice
o Consider specific characteristics of patients.
o Consider clinical presentation.
o Ex. Ulcer disease, bleeding problem
5. Determine the appropriate dosing regimen
o Determined primarily by the pharmacokinetics
of the drug.
o Ex. knowledge of the elimination of the drug.
6. Devise a plan for monitoring the drug’s action
and determine endpoint of therapy
o Drug effects to be monitored.
o Signs and symptoms that patient should report.
o Duration of therapy should be made clear to
patients.
o Specify changes in patient’s condition.
o Ex. Rheumatoid arthritis / CAD -GI bleeding
o Major toxicities should be explained to patient.
7. Plan a program for patient’s education.
o Reinforce information to patient.

Transcribed by Grp 8: Regalado, Jasper G. 1|Page

 PHARMACOLOGY
RATIONAL PRESCRIBINING & PRESCRIPTION WRITING
Edberto R. General, MD, FPCP, FPSEDM, FACE Aug/31/2021 Year 2 | Semester 1

Approximate Conversions p after

pc after meals
o 1 grain (gr) = 0.065 grams (g), often rounded to PO by mouth
60 milligrams (mg) PR per rectum
o 15 gr = 1 g prn when needed
o 1 ounce (oz) by volume = 30 milliliters (mL) q every
o 1 teaspoonful (tsp) = 5 mL qam, om every morning
o 1 tablespoonful (tbsp) = 15 mL qd (do not use) every day (write “daily”)
o 1 quart (qt) = 1000 mL qh, q1h every hour
o 1 minim = 1 drop (gtt) q2h, q3h, etc every 2 hours, every 3 hours, etc

o 20 drops = 1 mL qhs every night at bedtime

o 2.2 pounds (lb) = 1 kilogram (kg) qid four times a day
qod (do not use) every other day
Abbreviations Used in Prescriptions and Chart Orders qs sufficient quantity
rept, repet may be repeated
Abbreviation Explanation Rx take
a before s without
ac before meals SC, SQ subcutaneous
agit shake, stir sid (veterinary) once a day
Aq water Sig, S label
Aq dest distilled water sos if needed
bid twice a day ss, ss one-half
c with stat at once
cap capsule sup, supp suppository
D5W, D5W dextrose 5% in water susp suspension
dil dissolve dilute tab tablet
disp, dis dispense tbsp, T (do not use) tablespoon (always write
elix elixir out “15 mL”)
ext extract tid three times a day
g gram Tr, tinct tincture
gr grain tsp (do not use) tablespoon (always write
gtt drops out “5 mL”)
h hour U (do not use) Units (always write out
hs at bedtime “units”)
IA intra-arterial vag vaginal
IM intramuscular i, ii, iii, iv, etc (do not use) one, two, three, four, etc.
IV intravenous (do not use) dram (in fluid measure
IVPB IV piggyback 3.7 mL)
kg kilogram (do not use) ounce (in fluid measure
mcg, mg (do not use) microgram (always write out “microgram”) 29.6 mL)
mEq, meq milliequivalent
mg milligram
no number Elements of Prescription
non rep do not repeat 1. Name of prescriber.
OD right eye 2. License classification.
OS, OL left eye 3. Address.
OTC over-the-counter 4. Office telephone number.
OU both eyes 5. Date the prescription was written.

Transcribed by Grp 8: Regalado, Jasper G. 2|Page

 PHARMACOLOGY
RATIONAL PRESCRIBINING & PRESCRIPTION WRITING
Edberto R. General, MD, FPCP, FPSEDM, FACE
6. Patient’s name.
7. Patient’s address.
8. Drug’s name.
9. Drug’s strength.
10. Quantity to be dispensed.
11. Dosage and complete directions for use
12. Refill information.
13. Waiver of the requirement for childproof
containers.
14. Additional labeling instructions.
15. Prescriber’s signature
16. – 17. Other identification data
Dosage and Complete Directions for Use
o The simpler the direction, the better.
o Instructions on how, when to take, duration and
purpose MUST be explained clearly to patients.
o “taken as directed “ XXX
o It is always safer to write out the direction without
abbreviating.
Transcribed by Grp 8: Regalado, Jasper G.
Aug/31/2021 Year 2 | Semester 1
Omissions of Information
o Instructions to “resume pre-op meds”.
o Continue present IV fluids.
o Continue eye drops.
o Failure to discontinue old medications.
o Failure to specify strength or notation of medicines.
o As needed orders.
Prescription Errors
o Omissions of needed information.
o Poor prescription writing.
o Error of drug dose and timing.
o Inappropriate prescription of drugs.
Poor Prescription Writing
o Illegible handwriting.
o Misplaced or ambiguous decimal point.
o “U” as abbreviation for units.
o Using “ug” for micrograms.
o Drug specifying only the number of dosage units.
ex. drugs in ampules
o “OD” abbreviation.
o Use of QD or Q.D.
o Use of acronym or abbreviations of drugs. ex ASA
o Unclear handwriting is dangerous. ex
acetazolamide, acetohexamide; methotrexate,
metolazone
Inappropriate Drug Prescriptions
o Failure to recognize contraindications.
▪ Ex. pioglitazone in congestive heart failure.
o Failure to obtain information about other drugs the
patient is taking.
▪ Ex. omeprazole and pantoprazole
o Failure to recognize possible physicochemical
incompatibilities between drugs.
▪ Ex. levothyroxine and ferrous sulfate
o Contraindications to drugs in the presence of
other diseases.
▪ Ex. metformin and renal failure
3|Page
 PHARMACOLOGY
RATIONAL PRESCRIBINING & PRESCRIPTION WRITING
Edberto R. General, MD, FPCP, FPSEDM, FACE Aug/31/2021 Year 2 | Semester 1

PRACTICE

Find the error here….

Transcribed by Grp 8: Regalado, Jasper G. 4|Page

 PHARMACOLOGY
RATIONAL PRESCRIBINING & PRESCRIPTION WRITING
Edberto R. General, MD, FPCP, FPSEDM, FACE Aug/31/2021 Year 2 | Semester 1

Transcribed by Grp 8: Regalado, Jasper G. 5|Page