
This analysis may lead to different drug selections for different patients. A STEPS assessment ( Table 1 10 ) will balance the convenience, effectiveness, and benefit of each drug for a particular patient. Hydrochlorothiazide is the cheapest, but it does not carry the extra benefit of avoidance of diabetic complications. 11 However, metoprolol tartrate requires twice-daily dosing, which can affect adherence, and metoprolol succinate is typically more expensive. Metoprolol reduces blood pressure and diabetic complications. It also is more expensive than hydrochlorothiazide. Lisinopril offers both blood pressure control and prevention of diabetic complications, 11 but it is contraindicated if the patient is not using a reliable form of birth control. Except for metoprolol tartrate, all of these drugs can be administered once daily. Generic formulations of hydrochlorothiazide (Esidrix), lisinopril (Zestril), metoprolol succinate (Toprol XL), and metoprolol tartrate (Lopressor) are all potential P-drug medications. Get comprehensive drug information, including uses, side effects, and more.

The P-drug and STEPS approaches can be shown using the example of the woman with diabetes and the added diagnosis of hypertension presented in scenario 5. Discover a wide range of medications that begin with the letter A on WebMD. s Pill Identification Wizard uses drug pictures to help consumers identify pills by their appearance, using a database of over 10,000 images of prescription drugs. Monographs cover generic and brand name, drug class and mechanism, dosing, drug interactions, side effects,and use.
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Using prescribing software and having access to electronic drug references on a desktop or handheld computer can also improve the legibility and accuracy of prescriptions and help physicians avoid errors. Index of comprehensive articles on common prescription and OTC medications and drugs, a listing. These eight steps, along with ongoing self-directed learning, compose a systematic approach to prescribing that is efficient and practical for the family physician.
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The ChemIDplus data (which includes all of the data in the Drug Information Portal) is also available as a bulk download file through the NLM Data Distribution Program and will continue to be available after both sites are retired. The authors add two additional steps: (7) consider drug cost when prescribing and (8) use computers and other tools to reduce prescribing errors. Both ChemIDplus and the Drug Information Portal will remain available until they are retired in mid-December 2022. This six-step approach to prescribing suggests that the physician should (1) evaluate and clearly define the patient's problem (2) specify the therapeutic objective (3) select the appropriate drug therapy (4) initiate therapy with appropriate details and consider nonpharmacologic therapies (5) give information, instructions, and warnings and (6) evaluate therapy regularly (e.g., monitor treatment results, consider discontinuation of the drug).

A systematic approach advocated by the World Health Organization can help minimize poor-quality and erroneous prescribing.
