WHO/DAP/94.

11
Distr: General
Original: English

Guide to Good Prescribing

A practical manual

World Health Organization

Action Programme on Essential Drugs
Geneva
Guide to Good Prescribing

uthors
T. P. G. M. de Vries
1
R. H. Henning
2
H. V. Hogerzeil
2
D. A. Fresle

With contributions from F.M. Haaijer-Ruskamp and R.M. van Gilst

1

Department of Clinical Pharmacology, Faculty of Medicine, Univer

sity of
Groningen, The Netherlands (WHO Collaborating Centre for Pharmacother
apy
Teaching and Training)
2
WHO Action Programme on Essential Drugs, Geneva, Switzerland

Acknowledgments
The support of the following persons in reviewing earlier drafts of this book
is
gratefully acknowledged: S.R. Ahmad (Pakistan), A. Alwan (WHO), F.S.
Antezana (WHO), J.S. Bapna (India), W. Bender (Netherlands), L. Bero (USA
), S.
Berthoud (France), K. Besseghir (Iran), C. Boelen (WHO), P. BrudonJakobowicz
(WHO), P. Bush (USA), M.R. Couper (WHO), M. Das (Malaysia), C.T. Dollery
(United Kingdom), M.N.G. Dukes (Netherlands), J.F. Dunne (WHO), H. Fraser
(Barbados), M. Gabir (Sudan), B.B. Gaitonde (India), W. Gardjito (Indonesia)
,
M. Helling-Borda (WHO), A. Herxheimer (United Kingdom), J. IdnpnHeikkil (WHO), K.K. Kafle (Nepal), Q.L. Kintanar (Philippines), M.M. Kochen
(Germany), A.V. Kondrachine (WHO), C. Kunin (USA), R. Laing (Zimbabwe),
C.D.J. de Langen (Netherlands), V. Lepakhin (USSR), A. Mabadeje (Nigeria),
V.S. Mathur (Bahrain), E. Nangawe (Tanzania), J. Orley (WHO), M. Orme
(United Kingdom), A. Pio (WHO), J. Quick (USA), A. Saleh (WHO), B. Santos
o
(Indonesia), E. Sanz (Spain), F. Savage (WHO), A.J.J.A. Scherpbier (Netherla
nds),
F. Siem Tjam (WHO), F. Sjqvist (Sweden), A. Sitsen (Netherlands), A.J. Smi
th
(Australia), J.L. Tulloch (WHO), K. Weerasuriya (Sri Lanka), I. ZebrowskaLupina (Poland), Z. Ben Zvi (Israel).
The following persons gave invaluable assistance in field testing the draft,
and

their su Kafle (Nepal), A. Mabadeje (Nigeria), B. Santoso (Indonesia), A.J. Smith

pport is (Australia).
grateful
ly ackn Illustrations on p. 56, 72: B. Cornelius (with permission from Vademecum)
owledg ; p. 7:
ed: J.S. P. ten Have; annexes and cartoon on p. 22: T.P.G.M. de Vries.
Bapna (
India),
L. Bero
(USA),
K.K.

iii

Contents

able of contents

Why you need this book.................................................................................................

Part 1: Overview ..................................................................................................................... 6
Chapter 1: The process of rational treatment............................................................. 7
Part 2: Selecting your P(ersonal) drugs...............................................................................

17

Chapter 2: Introduction to P-drugs........................................................................... 19

Chapter 3: Example of selecting a P-drug: angina pectoris..................................... 21
Chapter 4: Guidelines for selecting P-drugs .............................................................. 29
Chapter 5: P-drug and P-treatment ........................................................................... 37
Part 3: Treating your patients ...............................................................................................

33

Chapter 6: STEP 1: Define the patient's problem ...................................................... 44

Chapter 7: STEP 2: Specify the therapeutic objective ............................................... 48
Chapter 8: STEP 3: Verify the suitability of your P-drug......................................... 51
Chapter 9: STEP 4: Write a prescription................................................................... 66
Chapter 10: STEP 5: Give information, instructions and warnings ...........................

72

Chapter 11: STEP 6: Monitor (and stop?) the treatment ............................................ 79

Part 4: Keeping up-to-date ....................................................................................................

85

Chapter 12: How to keep up-to-date about drugs ...................................................... 86

Annexes ..................................................................................................................................

96

Annex 1:

Essentials of pharmacology in daily practice......................................... 98

Annex 2:

Essential references................................................................................ 105

Annex 3:

How to explain the use of some dosage forms..................................... 108

Annex 4:

The use of injections.............................................................................. 123

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