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7 Deadly Sins for Prescribing

Posted Oct 03 2008 11:31am
Recently, many prescriptions are wrong, either entirely unnecessary or unnecessarily dangerous. Inappropriate prescribing is causing risks outweigh the benefits, thus conferring a negative health impact on the patient.

This post especially for doctors who prescribe, and pharmacists that should be the prescriptions: The 7 Deadly Sins for Prescribing. It's just a reminder for healthcare professionals to carry on their duty more carefully.


Sin #1: The “disease” for which a drug is prescribed is actually an adverse reaction to another drug.
Sometimes, doctors are unable to identify which 'disease' is caused by side effects of certain drugs, maybe due to lack of experience, or knowledge on drugs. Instead of lowering the dose of the offending drug or replacing it with a safer alternative, the doctor adds a second drug to the regimen to “treat” the adverse drug reaction caused by the first drug. Pharmacists play an important role here to help to doctor in identifying the 'diseases' caused by drugs.

Sin #2: A drug is used to treat a problem that, although in some cases susceptible to a pharmaceutical solution, should first be treated with commonsense lifestyle changes.
Doctors should recommend lifestyle changes as the first approach for some conditions like insomnia, high blood pressure and so on, rather than automatically reach for the prescription.

Sin #3: The medical problem is both self-limited and completely unresponsive to treatments such as antibiotics or does not merit treatment with certain drugs, and yet the doctor still prescribing drugs to 'treat' it.
This is seen most clearly with viral infections such as colds and bronchitis in otherwise healthy children or adults.

Sin #4: A drug is the preferred treatment for the medical problem, but instead of the safest, most effective—and often least expensive—treatment, the doctor recommends the much less preferable alternative (less or equal effective, but much more expensive).
This situation most likely when the doctor can get more incentive from the less preferable alternative.

Sin #5: Two drugs interact. Each on its own may be safe and effective, but together they can cause serious injury or death.
Pharmacists should help doctor to check out the serious drug-drug interaction.

Sin #6: Two or more drugs in the same therapeutic category are used, the additional one(s) not adding to the effectiveness of the first but clearly increasing the risk to the patient.
Again, the role of pharmacists is important for combat this problem.

Sin #7: The right drug is prescribed, but the dose is dangerously high.
This problem is seen most often in older adults, who cannot metabolize or excrete drugs as rapidly as younger people. This problem is also seen in small people who are usually prescribed the same dose as that prescribed to people weighing two to three times as much as they do.

For doctors, to prevent yourselves from sinning, should humbly consult pharmacists concerning drugs issues. Nowadays, healthcare professionals work as a team, no longer the traditional solo act. When necessary, doctors should consult dietitians, nutritionists, physiotherapists, and many other healthcare professionals, too.
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