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Welcome!
Prescription review
You will need access to BNF (NHS evidence or app)
You will also need access to Prescribing Skills iBooks 1 & 2
Refer to case studies from workshop 1 and prescription review in prescribing skills handbook
Aim & Outcomes
An introduction to prescription review
• Purpose of prescription review• Performing a prescription review (a-h)• Medications not to miss when reviewing a
prescription • Review case studies from workshop 1• Homework
A Check for allergies and intolerances
B Check the patient demographics
C Check the medicine indication
D Check medicine dose, frequency, duration and route
E Check for drug interactions
F Check for relevant co-morbidities
G Check the prescription is legible and complete
H Check how the patient is taking their medication
(iBook 1)
Prescription review
Practice points:
Some common medicines that you SHOULD NOT miss when reviewing a prescription
1. Medications that cause bleeding (Anticoagulants)2. Strong pain killers (Opioids)3. Medications that make you sleep (Sedatives)4. Insulin 5. Medications that need strict monitoring (TDM) 6. Medications that should not be omitted (AEDs, PD
medications, Antimicrobials)7. Medications that commonly interact (inducers/inhibitors)
Case study 1
Patient MH (Matthew Hale) 8yrs old
attends the surgical ward with his
mum for an elective tonsillectomy.
As the clerking doctor you are
required to undertake a prescription
review and prescribe any required
post-op analgesia on a hospital
prescription chart. Matthew is 30kg.
**CONFIDENTIAL**
Mr. Matthew Hale 8yrs
14 Tree Drive, Manchester M6
REPEAT PRESCRIPTION ORDER FORM -
Tick items required and post in order box
Phone orders 0161-256-****.
PLEASE ALLOW TWO WORKING DAYS BEFORE COLLECTION
Please note we are CLOSED Wednesdays 12:30 – 15:00 ---------------------------------------------
There are 3 items on this re-order form
1. SALBUTAMOL METERED 100MCG DOSE INHALER
INHALE TWO PUFFS FOUR TIMES A DAY AS REQUIRED FOR
ASTHMA
You may order 2 more.
2. BECLOMETASONE(CLENIL)50 METERED DOSE INHALER INHALE
TWO PUFFS TWICE A DAY FOR ASTHMA
You may order 2 more.
3. HYDROCORTISONE1%CREAM
APPLY TWICE A DAY TO HANDS FOR ECZEMA
You may order 2 more.
Case study 2
1. Review Mr RB’s prescription chart. Can you identify the medications that may pose a falls risk?
You are about to review Mr RB on your daily ward round. He has been admitted for a fall (mechanical). PMHx: Benign prostatic hyperplasia (BPH), Hypertension (HTN) and Atrial fibrillation (AF)
Case study 2
1. What additional questions, tests or observations would you ask/undertake?
2. Would you make any changes to Mr RBs prescription?
PC: admitted for a fall (mechanical)PMHx: Benign prostatic hyperplasia (BPH), Hypertension (HTN) and Atrial fibrillation (AF) DHx: amlodipine 5mg one tablet every morning, dabigatran 150mg one tablet 12-hourly, tamsulosin 400mcg one capsule every morning. Paracetamol and codeine when required.
Case study 3
Miss DH visits you at your GP practice for some more tramadol and a repeat prescription. Perform a prescription review and prescribe accordingly.
**CONFIDENTIAL**
Miss Dawn Hall 32yrs
3a Longsdale, Manchester M2
REPEAT PRESCRIPTION ORDER FORM
Tick items required and post in order box
Phone orders 0161-256-****.
PLEASE ALLOW TWO WORKING DAYS BEFORE COLLECTION. ---------------------------------------------
Please note we are CLOSED Wednesdays 12:30 – 15:00
There are 3 items on this re-order form
1. RANITIDINE 150MG TABLETS TAKE ONE TABLET TWICE A DAY
You may order 2 more.
2. GAVISCON ADVANCE LIQUID TAKE 10MLS WITH MEALS AS REQUIRED
You may order 2 more.
3. CO-CODAMOL 30/500 TABLETS
TAKE ONE OR TWO TABLETS UP TO FOUR TIMES A DAY WHEN
REQUIRED
You may order 2 more.
Pharmacy Stamp
Please don’t stamp over age box
Age Title, Forename, Surname & Address
Number of days’ treatmentN.B. Ensure dose is stated
Endorsements
Signature of Prescriber Date
ForDispenserNo. ofPrescns.on form
Xxxxx Health AuthorityDr AddressTown PostcodeTel: 00000 000 000
FP10NC0105
Pharmacy Stamp
Please don’t stamp over age box
Age Title, Forename, Surname & Address
Number of days’ treatmentN.B. Ensure dose is stated
Endorsements
Signature of Prescriber Date
ForDispenserNo. ofPrescns.on form
Xxxxx Health AuthorityDr AddressTown PostcodeTel: 00000 000 000
FP10NC0105
Pharmacy Stamp
Please don’t stamp over age box
Age
32yrsD.o.B.
Title, Forename, Surname & Address
Dawn Hall3a LongsdaleManchester M2
Number of days’ treatmentN.B. Ensure dose is stated
Endorsements Ranitidine 150mg tabletsTake one tablet twice a day 60 tablets
Gaviscon Advance liquidTake 5mls after meals when required150mls
Signature of Prescriber
P.JonesDate
Today
ForDispenserNo. ofPrescns.on form
Xxxxx Health AuthorityDr AddressTown PostcodeTel: 00000 000 000
FP10NC0105
Pharmacy Stamp
Please don’t stamp over age box
Age
32yrsD.o.B.
Title, Forename, Surname & Address
Dawn Hall3a LongsdaleManchester M2
Number of days’ treatmentN.B. Ensure dose is stated
Endorsements Paracetamol 500mg tabletsTake 1-2 tablets up to four times a day when required100 tablets
Tramadol 50mg capsulesTake 1-2 capsules up to four times a day when required 30 capsules
Signature of Prescriber
P.JonesDate
Today
ForDispenserNo. ofPrescns.on form
Xxxxx Health AuthorityDr AddressTown PostcodeTel: 00000 000 000
FP10NC0105
Prescription review
Further revision:- iBooks - PSA revision questions- Additional case studies, ask your tutors