While you will not be allowed to write a prescription during your medical assistant work, you do need to have a good understanding of common drugs, their use and handling, and regulations governing them. You may be required to administer certain medications to patients, as directed by a doctor or nurse practitioner, and to call in or otherwise communicate prescriptions and refills to a pharmacy. Here is what you’ll need to understand.
As a medical assistant, you will need to be familiar with multiple drug (both generic and brand) names, their general indications for use, how they are administered and stored as well as their common side effects and contraindications. In addition, you will need to be familiar with abbreviations commonly used in the medical chart and on prescriptions.
Each drug has a generic and brand name. For example, Lasix is the brand name for a generic drug called furosemide. Brand names are under patent for 20 years, so they may change. Generic names do not. Be aware of different drugs whose names sound similar. Examples include Zantac and Xanax or hydroxyzine and hydralazine. Be familiar with abbreviations used for administration, such as IM or PO, as well as those indicating dosing frequency, such as QD or TID.
Many times, all the information you need to know about a medication cannot be recalled by memory. You will need to use a reference source available to you in your workplace to recall a drug’s classification, contraindications, method of action, administration route, medication interactions, and possible adverse reactions. Examples of such resources include the Physician’s Desk Reference (PDR) as well as the drug’s package insert which can be found with any sample you may have of the drug.
All drugs belong to certain therapeutic classes that treat specific disease states or health problems. The generic names of these medications may end in the same suffix. For example, atorvastatin and simvastatin belong to the “statin” family used to treat hypercholesterolemia. You should also recognize the indications of each drug class. Examples include ACE inhibitors for hypertension and sulfonylureas for type 2 diabetes mellitus. Each class often demonstrates similar side effects, adverse reactions, and has the same contraindications.
The pharmacokinetics of a drug refers to the way it is absorbed, distributed, metabolized, and excreted from the body. Understanding of pharmacokinetics is helpful to optimize the usefulness and reduce potential harm of a drug. For example, oral drugs cannot be given to a patient who has trouble swallowing or is vomiting. A drug that is heavily metabolized in the liver should be used with caution in a patient with cirrhosis.
All drugs have requirements for proper storage that include temperature, humidity,ssssss and exposure to light. This ensures their potency at the time of use. When medications need to be disposed of, follow all facility guidelines regarding the disposal of sharps and needles.
Medications come in various forms. Examples include: pills, capsules, suppositories, troches, ointments, gels, and transdermal patches. Parenteral drugs for injection can come premixed for administration or must be prepared. You must be familiar with them and understand how to safely and correctly prepare them for administration.
Multidose vials can be used to provide medication to multiple patients. Care must be taken not to contaminate the remaining medication in the vial when withdrawing doses. Alcohol should be used to thoroughly clean the rubber stopper before drawing up medication.
Ampules provide a single dose of medication. They are scored at the neck which allow them to be broken and the drug to be drawn up into a syringe.
Unit doses are prepackaged, single doses of oral or injectable drug. They are dispensed sealed and once opened, ready to administer.
Prefilled cartridge-needle units are premixed, ready to inject vials with needles that attach to the vial when the unit is secured and locked into the plunger.
Some medications come in a powder form as they lose their potency quickly once mixed into solution. These medications usually come in single dose vials that will use a diluent, such as normal saline, for reconstitution.
As a member of the medical team, you will be involved in both the issuing and refilling of many prescription medications. As such, you must be aware of the regulations and documentation requirements involved to perform both tasks.
The FDA, or Food and Drug Administration regulates the distribution of both prescription and over-the-counter drugs. The DEA, or Drug Enforcement Agency, is the regulating body that sets all guidelines for the ordering, dispensing, documentation, and storage of all controlled substances. Also known as narcotics, these drugs have a high potential for abuse. These prescriptions can be issued either electronically or by hand. Oral prescriptions are allowed for certain classes only. There are limits to the quantity of drug that can be dispensed as well as the frequency of refills that can be given. Only a licensed practitioner with a valid DEA number may issue and sign an order for a controlled substance.
First and foremost, any order for a medication prescription needs to be written legibly. This prevents miscommunication of any of the information contained on the prescription. E-prescribing has helped immensely with this problem and is preferable to a handwritten order. Any prescription must include: the practitioner’s name, title and phone number, the patient’s name, the date the prescription was issued, the medication name, form and dosage, the instructions for its use, the amount to be dispensed, any refills allowed and the signature of the ordering practitioner.