Problems with orders for medication as needed.

The safety of an order for medication as needed depends on assumptions and knowledge that may or may not accompany that order. Physicians should consider carefully the need for prescribing potent medications on an as-needed basis for newly admitted patients, particularly if these patients have not been examined, their histories are unknown, and no diagnosis has been established. In addition, the language of such orders should leave as little as possible to chance. Interpretation of orders should not be left to the discretion of staff members who may be inexperienced in the administration of medications that require frequent monitoring and astute interpretation of side effects.