Prescribing and Medicines
What this domain tests
This domain tests safe prescribing within your competence, legal prescription requirements, antibiotic stewardship, analgesic selection, drug interactions and local anaesthetic dose limits.
Core rules and concepts
- Prescribe only after an appropriate assessment; do not treat an unseen patient remotely.
- Check allergies, current medicines, pregnancy/lactation, renal or hepatic disease and interactions before prescribing.
- Use the dental formulary. Antibiotics are adjuncts for spreading infection or systemic involvement, not for pain, pulpitis or dry socket.
- A prescription must identify the patient, date, drug, form, strength, dose, frequency, quantity, directions and prescriber, with signature and registration number as required. Controlled drugs have additional legal requirements.
- Know local anaesthetic maximum doses, for example lidocaine with adrenaline and articaine, and calculate by body weight where appropriate.
Worked example
An adult with a fluctuant periapical swelling and fever needs urgent drainage. After checking a penicillin allergy, you prescribe amoxicillin 500 mg three times daily for five days as an adjunct, with analgesia and review. If penicillin-allergic, choose an appropriate alternative from the formulary. You record the allergy check, prescription and advice. Amoxicillin alone without drainage would be inadequate.
Traps that cost marks
Prescribing antibiotics for pain or pulpitis; missing a penicillin allergy; prescribing metronidazole with warfarin without checking; using unapproved abbreviations; failing to record the prescription; exceeding local anaesthetic dose limits; issuing a prescription without a diagnosis.