Electronic Prescribing

Differential Diagnosis

Distinguishing between related concepts for electronic prescribing:

Benzodiazepines: Examples: lorazepam, diazepam, alprazolam, midazolam. Mechanism: Enhance GABA-A receptor, increased chloride conductance, CNS depression. Key side effects: Sedation; Respiratory depression.

Insulins: Examples: lispro (rapid), regular (short), NPH (intermediate), glargine (long). Mechanism: Replaces endogenous insulin, facilitates glucose uptake into cells. Key side effects: Hypoglycemia; Weight gain.

Related Procedures

Digital transmission of prescriptions from prescriber to pharmacy, including EPCS (Electronic Prescribing for Controlled Substances). E-prescribing and EPCS requirements tested on PTCB exam.

Related drug class: SSRIs includes sertraline, fluoxetine, escitalopram, paroxetine. Mechanism: Selectively inhibit serotonin reuptake in synaptic cleft, increase 5-HT activity.

Patient Communication

Clear communication about electronic prescribing with patients, families, and the healthcare team is essential. Use standardized handoff tools (SBAR) for shift changes and transfers. Verify understanding by asking the patient to repeat key information back to you.

Step-by-Step Procedure

Digital transmission of prescriptions from prescriber to pharmacy, including EPCS (Electronic Prescribing for Controlled Substances). E-prescribing and EPCS requirements tested on PTCB exam.

Related drug class: Fluoroquinolones includes ciprofloxacin, levofloxacin, moxifloxacin. Mechanism: Inhibit bacterial DNA gyrase and topoisomerase IV, bactericidal.

Documentation

Proper documentation of electronic prescribing follows facility policies and regulatory requirements. All entries must be dated, timed, and signed. Errors are corrected with a single line through the incorrect entry, initialed and dated. Never erase or cover with correction fluid.

Clinical Significance

Pharmacy technicians must understand how electronic prescribing connects to medication therapy. For example, Opioids (morphine, hydrocodone, oxycodone, fentanyl, codeine): Bind mu-opioid receptors for analgesia, euphoria, respiratory depression.

• Constipation (tolerance does NOT develop)
• Respiratory depression
• Dependence/addiction
• Naloxone reversal