Prescribing Rules 💊
📋 Overview
- Safe prescribing is a vital skill for junior doctors.
- Ensure all prescriptions are legible, complete, and clinically appropriate.
- Always review allergies and interactions before prescribing.
⚠️ Key Principles
- Write legibly with clear dosage and frequency.
- Avoid unsafe abbreviations (e.g. use "units" not "U").
- Include indication for PRN medications.
- Document duration or review dates where appropriate.
✅ Practical Tips
- Double check patient identity and weight.
- Know which medications require TDM (e.g. vancomycin, gentamicin).
- Use hospital guidelines or consult pharmacy when unsure.
📝 Prescribing Rules & Abbreviations
📌 General Prescribing Rules
- Always write legibly and use black ink if writing by hand.
- Use generic names unless brand is specifically required.
- Clearly state the dose, route, and frequency.
- Include indications for PRN (as needed) medications.
- Always sign and date prescriptions.
- Avoid trailing zeros (e.g., 5.0mg ❌ → 5mg ✅).
- Avoid decimal doses <1mg — write in micrograms instead (e.g., 0.5 mg ❌ → 500 mcg ✅)
- State the maximum dose in 24h for PRN medications (especially opioids or benzos).
🔤 Common Abbreviations
| Abbreviation | Meaning |
|---|---|
| OD | Once daily |
| BD | Twice daily |
| TDS | Three times daily |
| QDS | Four times daily |
| PRN | As needed |
| STAT | Immediately (single dose) |
| PO | By mouth |
| IV | Intravenous |
| IM | Intramuscular |
| SC | Subcutaneous |
| PR | Per rectum |
📦 MDAs (Controlled Drugs)
- Prescribe on the MDA Kardex if required (e.g., morphine, oxycodone).
- Must include drug name, dose (in words and numbers), frequency, and route.
- Specify "as directed" or give clear dosing interval and indication.
- Prescriber must sign each entry, and administration requires double signing by nursing staff.
- Max 14 days on outpatient prescriptions for Schedule 2/3 drugs.
- Storage must be in locked cupboard; return/disposal by two staff.