Chapter 10 – Prescribing CPSA Station



Introduction

Many students seem incredibly worried about this part of the exam and subsequently large numbers seem to struggle to pass this section. I guess this isn’t hugely surprising as its the one task that students aren’t able to do ‘for real’ prior to the exam.

Our top tip is to imagine you are the pharmacist or person dispensing the prescription and what you would need to know to ensure that the medication was going in the right amount to the right person. The failure rate is usually for ‘silly’ reasons (forgetting to sign, miscalculation of drug dose, not reading far enough down the BNF).

Practicing using the BNF is very worthwhile prior to the exam. Get used to the format and the different sections and practice using the search function. The elearning safer prescribing modules on SCRIPT are also a good use of your time (and the pre and post module tests are good for AKT/SBA revision too). You may also be asked to prescribe intravenous (IV) fluids (NICE guidelines on maintenance fluids is a good source).

An FP10 is an outpatient prescription that is usually taken by the patient to a dispensing chemist for them to then use at home.

It needs to have all of the required demographic information to identify the patient:

  • Name
  • Address
  • Date of birth
  • NHS number

The actual prescription should tell the pharmacist everything they need to know about the required medication:

  • Name of drug
  • Dosage and frequency (often using the abbreviations below)
  • Total supply (number of daily doses x number of days

To complete the prescription you then need to sign it and add the date of writing (a prescription is valid for six months after the date of writing).

Prescribing in hospital really isn’t that different to outpatient prescribing, although will now often be done using an online system.

Most exams are yet to catch up with the modern online prescribing systems and you will therefore need to write them on paper.

The only key difference writing an inpatient prescription is to remember to indicate what times the medication will be given, and the route of administration.

RoutesTimings
PO/OODOnce daily
IVIntravenousOM / ManeOnce daily in the morning
IMIntramuscularON / NocteOnce daily in the evening
PR / PVRectally / VaginallyBDTwice daily
INHInhaledTDSThree times daily
NEBNebulisedQDSFour times daily
SCSubcutaneousX-hourlyDoses X hours apart
TOPTopicallyPRNAs required
StatImmediately


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