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Arresting the course of the disease process in rheumatoid arthritis is a different therapeutic goal, which might lead to consideration of other drug groups and prescriptions.Ĥ. In a patient with rheumatoid arthritis, relief of pain by reduction of the inflammatory process is one of the major therapeutic goals that identifies the drug groups that should be considered. Select a specific therapeutic objective: A therapeutic objective should be chosen for each of the pathophysiologic processes defined in the preceding step. Many pharmacies, websites, and disease-oriented public and private agencies (eg, Arthritis Foundation, American Heart Association, American Cancer Society, etc) provide information sheets suitable for patients.ģ. The patient should be provided with the appropriate level and amount of information about the pathophysiology. For example, increasing knowledge about the mediators of inflammation makes possible more effective use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other agents used in rheumatoid arthritis. Consider the pathophysiologic implications of the diagnosis: If the disorder is well understood, the prescriber is in a much better position to offer effective therapy. For example, in a patient with a probable diagnosis of rheumatoid arthritis, the diagnosis and the reasoning underlying it should be clear and should be shared with the patient.Ģ. A specific diagnosis, even if it is tentative, is required to move to the next step. Make a specific diagnosis: Prescriptions based merely on a desire to satisfy the patient’s psychological need for some type of therapy are often unsatisfactory and may result in adverse effects.

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Like any other process in health care, writing a prescription should be based on a series of rational steps.ġ. Finally, some of the social and economic factors involved in prescribing and drug use are described. The physical form of the prescription, common prescribing errors, and legal requirements that govern various features of the prescribing process are then discussed. In this chapter, a plan for prescribing is presented.

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When a patient comes for an office visit, the physician or other authorized health professional prescribes medications 67% of the time, and an average of one prescription is written per office visit because more than one prescription may be written at a single visit.

A written prescription is the prescriber’s order to prepare or dispense a specific treatment-usually medication-for a specific patient. In most cases, this requires the writing of a prescription. Of these options, drug therapy is by far the one most frequently chosen. Medication, surgery, psychiatric treatment, radiation, physical therapy, health education, counseling, further consultation (second opinions), and no therapy are some of the options available. Once a patient with a clinical problem has been evaluated and a diagnosis has been reached, the practitioner can often select from a variety of therapeutic approaches. Rational Prescribing & Prescription Writing Basic and Clinical Pharmacology, 13th Ed.

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