Vol. 1 No. 2 (2002): Malaysian Journal of Pharmacy

Published: July 2002

In this issue:

  • Adverse effects of herbs and drug-herbal interactions
  • Noncompliance with prescription writing requirements and prescribing errors in an outpatient department

Supplement:

  • Proceedings of the Pharmacy Scientific Conference 2001

Noncompliance with Prescription Writing Requirements and Prescribing Errors in an Outpatient Department

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    Abstract

    New prescriptions received by an outpatient pharmacy department of a teaching hospital were audited retrospectively for noncompliance with prescription writing requirements as well as to identify the types of prescribing errors. Of the 397 prescriptions screened in a single day, 96.7% had one or more of the legal or procedural requirements missing. These errors of omission, included prescriptions without the patient’s age, date, clinic or department where the prescription was issued, route of administration, dose and frequency of the drug to be used, strength, dosage form and quantity of drug to be supplied. Additionally, there were errors of commission involving 8.4% of the prescribed drugs. A total of 39 drug-drug interactions were identified; 15 were classified as potentially hazardous but could be overcome with careful monitoring of the patients. The results of the present study show a low compliance rate to the legal and procedural requirements in prescription writing. This indicates a need for pharmacy and medical educators to further emphasize the importance of writing clear and complete prescriptions. It also calls for the implementation of educational and monitoring programmes to bring more awareness to all concerned so as to reduce the rate of noncompliance and hence minimize the occurrence of prescribing errors.

    Adverse Effects Of Herbs And Drug-Herbal Interactions

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      Abstract

      Many people have turned away from conventional medicines, with the belief that ‘natural’ substances like herbs are safer than synthetic substances. This belief is augmented by many other unwarranted claims such as herbal products do not contain chemicals while conventional medicines do, thus contributing to the latter’s side effects. The increasing use of herbal medicines has resulted in concern about the efficacy and safety of these products. Herbs can be hazardous in many ways. They may be intrinsically toxic or toxic when taken in combination with other preparations. Because herbal preparations are usually not evaluated for purity and consistency of active compounds, they often contain contaminants. Inclusion of incorrect but toxic species, allergens, pollen, insect parts, heavy metals such as lead, mercury and arsenic and scheduled poisons (drugs), whether intentional or unintentional, have been cited as the causes of herbal adverse reactions or toxicities. The increasing use of herbal medicines means that there is potential for more drug interactions, particularly between herbal products and conventional ‘Western’ medicines. Toxicity and drug-local herb interaction studies are scarcely conducted and therefore should be encouraged. Proper documentation of adverse effects of herbs should be initiated and patients should be asked about their use of herbal products in order to evaluate the potential of these products to interact with concurrent prescription medications. The public should be made aware of the adverse effects of herbal products.