Prescribing Rules 💊

Essential prescribing rules and guidelines for NCHDs. Medication safety, documentation requirements, and prescribing best practices in Irish hospitals.

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📋 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.

Add to Tasks

📝 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.