1. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 4 Prescription Writing

2. 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. 2

3. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 3

4. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Current Prescription Formatting  Body  The R x symbol  Name and dose size or concentration (liquids) of the drug  Amount to be dispensed  Directions to the patient 4

5. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Current Prescription Formatting  Closing  Prescriber’s signature  Drug enforcement administration number if required  Refill instructions  Generic substitution instructions 5

6. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 6

7. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 7

8. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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. 8

9. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 9

10. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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. 10

11. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Scheduled Drugs  Schedule I  High potential for abuse  No accepted medical use in the U.S. 11

12. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 12

13. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 13

14. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 14

15. Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 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 15