ESSENTIAL VS NON-ESSENTIAL MEDICATIONS GUIDE
Essential Prescription Medications
Definition
In this guideline, the word "essential" is used to describe medications for which there is a risk of harm to the patient if not taken. The triager should use their nursing judgment and critical thinking in deciding whether a medication is essential. All OTC medications are considered non-essential.
Here are some examples:
- Asthma meds (e.g., rescue inhalers)
- Blood Pressure meds
- Cardiac meds
- Diabetes meds (e.g., insulin)
- Seizure meds
These meds become essential depending on clinical circumstances. Here are some examples:
- Antibiotics (e.g., lost or spilled: early in treatment course, still symptomatic)
- Pain meds (e.g., for severe pain). Note: these patients will most likely need to be seen and re-evaluated.
Spilled or Lost Antibiotics
- Calls about spilled liquid antibiotics are not uncommon. Antibiotics can also be left at day care/school or at a hotel during travel.
- If the patient has completed 7 or more days of the antibiotic AND has been symptom free for over 24 hours, a refill is not needed.
- The 10 day rule for most infections (such as ear infections) is arbitrary and not based on medical research.
- The caller can be reassured that the 7 days of treatment is adequate for 10 day course of antibiotic. Caution: This rule only applies to antibiotics prescribed for a 10 day course. Longer courses of antibiotics for 14 or 21 days should be refilled.
- Some physicians may worry more about the Rheumatic Fever risk with Strep pharyngitis. This disease has become rare in developed countries and only one study supports the 10 day rule.
Non-Essential Prescription Medications
Here are some other examples:
- Allergy medications (e.g. Singulair)
- Birth control pills
- Cholesterol and lipid-lowering meds
- Constipation meds
- Epinephrine injectable (for future anaphylactic reactions)
- Emergency contraception (available OTC)
- Reflux medications
- Scalp ringworm medications (e.g. Griseofulvin)
- Steroids - Inhaled
- Steroids - Oral for prevention of future bouts of asthma or croup
- Topical agents (e.g., creams and ointments)
- Note: all OTC (non-prescription) meds are considered non-essential. Reason: can be purchased by caller. Requests for OTC meds should never be transferred to the PCP during after-hours.
