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Take the opportunity to build knowledge on prescription writing and even design a few prescriptions on this site. Discuss the different categories of prescriptions and the drugs that fall into these categories. A duplicate of each prescription or a record therof should be kept in tthe patient's chart or record.

A Written Prescription has several important components such as:
1. The patient's full name and address- This must also include their date of birth or age (especially for children under 12)
2. The licensed prescriber's information: Name, address with telephone number, their DEA # and the prescriber's signature.
3. The date the prescription was issued
4. The Superscription- is the symbol Rx Latin abbreviation for "recipe" meaning "to take"
5. The Inscription- The body of the prescription and contains information of the drug such as the name (either the proprietary name, the nonpropietary name, or both) , the amount or dosage, and the ingredients.
6. The Subscription- Contains the directions of the prescriber to the pharmacist. This usually contains Latin abbreviations and short-hand writing.Also including the quantity and dosage form of the drug, as well as the number of authorized refills on the prescription.
7. The Transcription- Is the prescriber's directions to the patient. It is indicated on the prescription as "Sig" or "Label". This portion of the prescription is intended for the patient's directions of use and should be written in English. Latin abbreviations should be avoided.
8. Labeling and Refills- Allows the patient to know the name of the drug and if the prescriber recommends refills.

Prescription Writing Sample:


Dr. Jane Smith
1234 Oak Lane Terrace
San Diego, CA 99217
951-987-6543

Date: March 9, 2009

Name: Emily Watson Age: 27
Address : 2459 N. Harbor Ave. San Diego, CA 92126 D.O.B: January 24, 1981


Rx:

Doxycycline 100 mg
Disp: #14
Sig: Take 1 capsule bid x 7 days

Refills: 0 Substitution Permissible
( note: if premade RX form denotes 0,1,2,3 you can cross out all but desired # to make difficult to alter.)
Dr. Jane Smith
DEA #: AN12543


The following rules are used for figuring out the dosage of a drug for children. Of these's rules Clark's rule is commonly used, Young's rule isn't widely suggested because of possible errors, and the surface area is most accurate.

1. Clark's rule- child's weight - lb or kg (actual weight not guesstimate)
150 lb or 70kg X adult dose = child's dose

Example: (80 lb child / 150 lb) X 250 mg adult dose = 133.3 but true amount is 133 mg

2. Young's rule- child's age (yrs) * adult dose = child's dose
child's age + 12 yrs

3. Surface area- patient's height and weight = adult dose
average adult surface area



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Categories of Prescriptions & Examples


SCHEDULE


CRITERIA


EXAMPLES OF DRUGS


I
High abuse potential, no currently accepted medical use, may lead to severe dependence
Research use only: heroin, lysergic acid diethylamide,marijuana, mescaline, methaqualone, peyote, psilocybin
II
High abuse potential, accepted medical use, may lead to severe dependence
Amphetamines, cocaine, codeine, dronabinol, meperidine, methadone, methylphenidate, morphine, oxycodone, pentobarbital, secobarbital


III
Abuse potential less than drugs in Schedules I or II, accepted medical use, moderate to low physical dependence liability, possibly high psychologic dependence
Benzphetamine, butabarbital, methyprylon, mixtures of codeine or hydrocodone with aspirin or acetaminophen,stanozolol
IV
Abuse potential less than drugs in Schedule III accepted medical use, low dependence liability


Phenobarbital, meprobamate, chlordiazepoxide, ethchlorvynol, diazepam, propoxyphene, chloral hydrate


V
Abuse potential less than drugs in Schedule IV accepted medical use, limited dependence liability


Cough preparations containing codeine or similar opioid derivatives



Dose response relationship- the relationship between the dose administered and the effects obtained. The dose effect relationship is not a linear function throughout the dose range. Since there are no effects at the minimum threshold you can't increase the effect of the dose. And with the ceiling effect even if a larger dose was given it the effects would remain the same because the maximum effect has already been achieved. The best dosage that can be achieved is in between the threshold and the ceiling.




The steps involved in proper prescribing:
1. Initial step before prescribing:


Patient identification

  • establish diagnosis: medical history, examination and tests
  • treatment plan
  • counseling
  • follow up care
2. Selection of therapy:

Therapeutic goal

  • Drug interactions
  • patient factors
  • cost
  • form of drug and availability
3. Write and present Rx

correct Rx form

  • Appropriate info on Rx (as listed above) such as patient identification, superscription, inscription, subscription, signa, signature lines, date, warnings, refills, signature and degree, prescriber info
4. Patient counseling

name of drug and what it is used for

  • method, quantity, timing and duration of use
  • How to handle unexpected reactions
  • what to do if a dose is missed
  • cost
  • storage
5. Follow up care:


FREQUENTLY USED ABBREVIATIONS

ad lib. = at pleasure
a.c. = before meals
aq. = water
b.i.d. = twice a day
caps = capsule
c = with
d. = a day, or daily
disp. = dispense
gtt. = drops
h. = hour
h.s = at bedtime
non rep. = do not repeat or refill
no. = number or amount
p.c. = after meals
p.r.n. = as needed
q.h. = every hour
q.4h. = every four hours
q.i.d. = four times a day
sig. = label or let it be labeled
stat. = immediately
tab. = tablet
t.i.d. = three times a day













  • expected result obtained?
  • no untoward reactions?

common medications used in dentistry: (alyssa)
-medications used to control pain and anxiety
-analgesics
-anesthetics
-medications to treat dental infections
-antibiotics
-antifungals
-other dental medications

This website discusses in detail each of there categories and gives examples of each.
http://www.rxlist.com/script/main/art.asp?articlekey=90999

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Dental Hygiene and Pharmacology

There are numerous reasons for dental hygienists to study Pharmacology. This is a process that needs to be continued throughout a professional's lifetime. New drugs are being introduced on a regular basis as well as the use of alternative therapies which can impact day to day life.
Prior to providing any care, a dental professional should review the medical history at the beginning of each appointment. One cannot assume that everything is the same even if only a few days have passed since the last appointment. Individuals may have visited their physician in the interim and drug therapies may have changed. They may have chosen to self medicate or even forgotten to take their medications.
In any case, the dental hygienist needs to be aware of the drugs that the patients are taking in order to prepare for possible medical emergencies, identify oral conditions that may be present as a result of the drugs which may be associated with antibiotics or a number of different drugs, determining the appropriate home care procedures as would be the case with a patient taking drugs that may cause xerostomia and even to plan the best time for appointments, such as would be the case with someone with insulin dependant diabetes.
Being knowledgeable about pharmacology permits the dental hygienist to intelligently discuss the drugs and associated effects with patients and other health care professionals. In the case where a particular medication is causing a condition such as hyperplasia, the dental hygienist needs to first recognize that the condition might be a result of the drug and then educate the patient about the contributing factors that may be exacerbating the undesirable effects of the drug. Also, the dental hygienist might be able to identify that another drug that does not cause the same negative effects which could be substituted. In this situation, it might be helpful to speak with the prescribing health care professional to investigate the possibility of changing the drug regimen.
Lastly, while providing oral health care, the dental hygienist may administer drugs that can either impact the efficacy of another drug or may be contraindicated by another drug or condition, or cause a medical emergency.



Prescriptions

Which brings us to prescription writing, Every state has their own requirements for prescriptions but most follow a similar format. There are two methods of describing the parts of a prescription. The first is as follows:
  • |||||||||| PRIMARY CARE ASSOCIATES ||
    |||||||||| 1234 Wellness Road · Resume Speed, Kansas · (913) 999-1212 ||
    |||||||||| ||
    || || Name || Priscilla Promiscuous || Date || 8/14/98 ||
    || || Address || 124 Red Light Lane || Age/Wt || __ ||
    |||||||||| ||
    |||||||||| ||




RX

Doxycycline 100 mg
  • Disp #14
  • Sig: Take 1 capsule bid x 7 days
  • ||^ || ||^ ||
  • ||^ || ||^ ||
  • ||^ || ||^ ||
  • || || || ||
The heading - Name, address and telephone number of prescriber, name, address, age and telephone number of the patient
  • Body -Rx, The name of the drug, amount to be dispensed, patient directions
  • Closing - Prescribers signature, DEA number, Refill instructions, If generic substitution permitted
The second method is a follows:
  • Superscription - Patient's name, address, age and date
  • Inscription - Name of the drug and the strength of the drug (i.e., 500 mg tablet)
  • Subscription - Direction to the pharmacist (dosage form and amount to be given -› Disp.)
  • Transcription - also referred to as the signa, Directions to the patient (Sig.)
  • Signature - Signature of the person prescribing the medication

Visit http://www2.kumc.edu/instruction/prescriptStuff/format.htm#components and identify the 3 separate sections of the prescription as described as method 1.
Abbreviations are very common in prescription writing. It is necessary to know the meaning of the abbreviations to avoid possible misuse of the drug. The laws governing the structure of the prescription and the abbreviations are to protect the public. On the website that you just visited, what was the issue that has been included into law in Texas and is being considered in other states?