General Points

Clinical Description

Consider each of the following general points before writing a prescription:

• Not all patients need a prescription for medicines. Non-medicine treatments and/or giving of simple advice may be more suitable in certain situations.
• Good therapeutics practice depends on:
• Accurate diagnosis, based on thorough history-taking, necessary careful physical examination and, if required, supporting laboratory testing and radiology services.
• Knowledge of the medicines available
• Careful selection of the appropriate medicines
• Correctly prescribing the selected medicines
• Ensuring that the patient understands fully how to use each prescribed medicine properly.
• Resist patient demand to prescribe injections or other expensive dosage forms.

e.g., capsules and oral liquids. Always try to explain to the patient that these may not represent the best form of treatment for the condition.

• In life threatening conditions, always prescribe the most effective medicine available irrespective of the cost or limited availability.
• To avoid possible confusion, always prescribe medicines by their generic name and not by the brand name e.g., diazepam (not Valium), paracetamol (not Panado) or abbreviations i.e., PCM.
• Avoid prescribing combination medicines unless they have a known significant therapeutic advantage over single ingredient preparations.
• When prescribing any medicine, always take into consideration factors suchas:
• Patient's age
• Patient's sex
• Patient's weight
• Co-morbidities
• Drug Interaction
• Side effects.

Pregnancy

• Breast-feeding
• The likely degree of patient compliance with treatment
• In all cases the likely benefit of any prescribed medication/s must be weighed against potential risks.
• Avoid overuse of symptomatic treatments for minor self- limiting conditions.
• Avoid multiple prescribing (polypharmacy), especially when the diagnosis is not clear.
• Whenever prescribing a particular medicine, care should be taken to avoid problems of interactions with other medicines, whether these are:
• Also prescribed at the same time
• Previously prescribed by another prescriber for the same or another condition and currently being taken by the patient
• Purchased or otherwise obtained by the patient for the purpose of self- medication.
• Before prescribing a medicine, always obtain other details of any medication currently being taken by the patient.
• Where a medicine interacts with alcohol (e.g., metronidazole, diazepam, anti- diabetic medicines, tricyclic antidepressants etc.) remember to counsel the patient to avoid taking alcoholic drinks during treatment and for at least 48 hours after completion of the course.