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