Advanced Pharmacotherapeutics
for Prescribers (1st Edition)
◍ Prescription writing: required pt and prescriber info. Answer: Patient's
name and full address
Date of prescription
Prescriber's full name, address, and phone number
Prescriber's DEA # if controlled substance
◍ Prescription writing: required drug info. Answer: Name (don't
abbreviate)
Strength and vehicle
Dosage
Route of administration
Directions (Sig) for taking the med: frequency, timing, details specific to
drug
Amount to be dispensed
Refills
◍ Critical Rx Information? Answer: DAW vs generic, refill #, dose
form, length of therapy/quantity, pt Ax, date of Rx, route, signature,
DEA #
,◍ "Rational" Prescribing Process, WHO. Answer: Choose a rational
treatment
Selection of P-drugs (Personal drugs)
Treating the pt (select, Rx, monitor)
Keeping up-to-date
◍ What are P-drugs? Answer: P(ersonal) drugs - those that you are
going to prescribe regularly and with which you become familiar
◍ Steps of Rational Prescribing. Answer: Define the pt's problem
Specify the therapeutic objective
Choose Tx
Verify: efficacy, safety, suitability, cost
Start Tx (write a clear Rx)
Educate! Give inform instructions, warnings
Monitor treatment
◍ What is DAW in prescribing? Answer: Dispense as written
◍ "Rights" of a prescription. Answer: Patient
Medication
Dose
Route
Dose schedule
,Does this make sense for this drug, patient, situation?
◍ Pharmacokinetics. Answer: How the body affects a drug
◍ Pharmacodynamics. Answer: How a drug affects the body - effects
that occur at the cellular and systemic levels
◍ Pharmacogenomics. Answer: General study of how one's individual
genetic variation affects drug behavior
◍ Four components of pharmacokinetics. Answer: ADME - absorption,
distribution, metabolism, excretion
◍ Absorption. Answer: How (well) does the body uptake the drug?
◍ Distribution. Answer: Transportation of the drug to the site of action
How (well) is the drug carried to the site of action?
◍ Elimination. Answer: How (well) is the drug cleared from the body?
◍ All types of absorption are affected by.... Answer: Drug properties
(molecular weight, lipid solubility) pKa, drug formulation, disintegration
time, dissolution rate)
, ◍ Enteral Absorption - GI tract - affected by? (4 things). Answer: Blood
flow to area of absorption
First pass effect
Cellular membrane permeability (passive vs. active)
GI motility (absence/presence of food in stomach, other drugs)
◍ Parenteral Absorption - affected by? (2 things). Answer: Blood flow
to area of absorption
Cell membrane permeability (passive vs. active transport)
◍ Bioavailability. Answer: Percentage of a drug that reaches the
systemic circulation
Ex: IV route = 100% bioavailability
◍ First pass effect. Answer: PO drug that is absorbed in the GI tract and
metabolized via liver before reaching systemic circulation
◍ Distribution is dependent upon... (3 things). Answer: Route of
administration
Blood flow
Solubility of drug (lipid/water)
◍ In what forms can the drug circulate?
In what form can a drug affect the body? What is that dependent on?
Answer: Can be free, bound to protein, or stored in tissue in equilibrium
for Prescribers (1st Edition)
◍ Prescription writing: required pt and prescriber info. Answer: Patient's
name and full address
Date of prescription
Prescriber's full name, address, and phone number
Prescriber's DEA # if controlled substance
◍ Prescription writing: required drug info. Answer: Name (don't
abbreviate)
Strength and vehicle
Dosage
Route of administration
Directions (Sig) for taking the med: frequency, timing, details specific to
drug
Amount to be dispensed
Refills
◍ Critical Rx Information? Answer: DAW vs generic, refill #, dose
form, length of therapy/quantity, pt Ax, date of Rx, route, signature,
DEA #
,◍ "Rational" Prescribing Process, WHO. Answer: Choose a rational
treatment
Selection of P-drugs (Personal drugs)
Treating the pt (select, Rx, monitor)
Keeping up-to-date
◍ What are P-drugs? Answer: P(ersonal) drugs - those that you are
going to prescribe regularly and with which you become familiar
◍ Steps of Rational Prescribing. Answer: Define the pt's problem
Specify the therapeutic objective
Choose Tx
Verify: efficacy, safety, suitability, cost
Start Tx (write a clear Rx)
Educate! Give inform instructions, warnings
Monitor treatment
◍ What is DAW in prescribing? Answer: Dispense as written
◍ "Rights" of a prescription. Answer: Patient
Medication
Dose
Route
Dose schedule
,Does this make sense for this drug, patient, situation?
◍ Pharmacokinetics. Answer: How the body affects a drug
◍ Pharmacodynamics. Answer: How a drug affects the body - effects
that occur at the cellular and systemic levels
◍ Pharmacogenomics. Answer: General study of how one's individual
genetic variation affects drug behavior
◍ Four components of pharmacokinetics. Answer: ADME - absorption,
distribution, metabolism, excretion
◍ Absorption. Answer: How (well) does the body uptake the drug?
◍ Distribution. Answer: Transportation of the drug to the site of action
How (well) is the drug carried to the site of action?
◍ Elimination. Answer: How (well) is the drug cleared from the body?
◍ All types of absorption are affected by.... Answer: Drug properties
(molecular weight, lipid solubility) pKa, drug formulation, disintegration
time, dissolution rate)
, ◍ Enteral Absorption - GI tract - affected by? (4 things). Answer: Blood
flow to area of absorption
First pass effect
Cellular membrane permeability (passive vs. active)
GI motility (absence/presence of food in stomach, other drugs)
◍ Parenteral Absorption - affected by? (2 things). Answer: Blood flow
to area of absorption
Cell membrane permeability (passive vs. active transport)
◍ Bioavailability. Answer: Percentage of a drug that reaches the
systemic circulation
Ex: IV route = 100% bioavailability
◍ First pass effect. Answer: PO drug that is absorbed in the GI tract and
metabolized via liver before reaching systemic circulation
◍ Distribution is dependent upon... (3 things). Answer: Route of
administration
Blood flow
Solubility of drug (lipid/water)
◍ In what forms can the drug circulate?
In what form can a drug affect the body? What is that dependent on?
Answer: Can be free, bound to protein, or stored in tissue in equilibrium
