Guide to Good Prescribing - A Practical Manual
(1994; 115 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentAcknowledgments
View the documentWhy you need this book
Open this folder and view contentsPart 1: Overview
Open this folder and view contentsPart 2: Selecting your P(ersonal) drugs
Close this folderPart 3: Treating your patients
View the documentChapter 6. STEP 1: Define the patient's problem
View the documentChapter 7. STEP 2: Specify the therapeutic objective
Close this folderChapter 8. STEP 3: Verify the suitability of your P-drug
View the documentStep 3A: Are the active substance and dosage form suitable for this patient?
View the documentStep 3B: Is the standard dosage schedule suitable for this patient?
View the documentStep 3C: Is the standard duration of treatment suitable for this patient?
View the documentChapter 9. STEP 4: Write a prescription
View the documentChapter 10. STEP 5: Give information, instructions and warnings
View the documentChapter 11. STEP 6: Monitor (and stop?) the treatment
Open this folder and view contentsPart 4: Keeping up-to-date
Open this folder and view contentsAnnexes
View the documentBack Cover
 

Chapter 8. STEP 3: Verify the suitability of your P-drug

After defining your therapeutic objective you should now verify whether your P-drug is suitable for the individual patient. You will remember that you have chosen your P-drugs for an imaginary, standard patient with a certain condition, using the criteria of efficacy, safety, convenience and cost. However, you cannot assume that this ‘first-choice’ treatment will always be suitable for everyone. ‘Cookbook’ medicine does not make for good clinical practice! You should therefore always verify whether your P-drug is suitable for this individual patient. The same applies when you practice within the limits of national treatment guidelines, a hospital formulary or departmental prescribing policies.

Chapter 5 explained the relationship between P-drug and P-treatment. In fact, you should define P-treatments for the most common problems you will encounter in practice; such P-treatments will frequently include non-drug treatment. However, as this manual is primarily concerned with the development of prescribing skills, from now on the focus will be on drug treatment, based on the use of P-drugs. Always keep in mind that many patients do not need drugs at all!

The starting point for this step is to look up your P-drugs (described in Part 2), or the treatment guideline that is available to you. In all cases you will need to check three aspects: (1) are the active substance and the dosage form suitable for this patient? (2) is the standard dosage schedule suitable? and (3) is the standard duration of treatment suitable? For each aspect, you have to check whether the proposed treatment is effective and safe. A check on effectiveness includes a review of the drug indication and the convenience of the dosage form. Safety relates to contraindications and possible interactions. Be careful with certain high risk groups.

Verify the suitability of your P-drug

A Active substance and dosage form
B Standard dosage schedule
C Standard duration of treatment

For each of these, check:

Effectiveness (indication, convenience)

Safety (contraindications, interactions, high risk groups)

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