Guidance on prescribing Flashcards
Do biologics need to be prescribed by brand name and if so why?
> Yes and automatic substitution of brands at point of dispensing is not appropraite
Size, complexity and way they are produced can result in a degree of natural variability
What information is important when reporting adverse reaction to yellow card scheme for biologic meds?
Brand name and batch number
Is it appropriate to abbreviate titles of drugs?
No- in general should be written in full to avoid misinterpretation
Is it appropriate to use generic names in prescribing?
> Yes- and they should generally be used to allow any suitable product to be dispensed- saving delay
Unless there is difference in clinical effect between manufacturers and brand name is needed (e.g. Qvar vs Clenil)
When should an oral syringe be given?
When oral liquid med prescribed in doses other than multiples of 5–> if Rx in 5ml doses then spoon given
What constitutes a ‘sugar-free’ oral liquid prep?
> Liquids that don’t contain fructose, glucose sucrose
> Also those that have hydrogenated glucose syrup, mannitol, maltitol, sorbitol or xylitol
Why is the presence of benzyl alcohol in injections indicated in the BNF?
It has been associated with fatal toxic syndrome in preterm neonates
Why is the presence of polyoxyl castor oil in injections indicated in the BNF?
It has been associated with severe anaphylactoid reactions
Why is the presence of propylene glycol in oral or parenteral meds indicated in the BNF?
> It can cause adverse effects if elimination impaired e.g. renal failure, neonates, young children and slow metabolisers
Can also interact with disulfram and metronidazole
At what sodium level is a medicine considered ‘sodium-free’?
<1mmol per dose
At what sodium level is a medicine considered ‘high-sodium’?
> 17mmol per dose (this is about 20% of total daily recommended WHO amount)
What are the requirements if extemporaneous product needs to be made in absence of authorised product?
> Must be ‘freshly prepared’ (i.e. not more than 24hrs before use)
Should be used within 4 weeks if stored at 15-25C
Fresh clean water should be used (either from tap or boiled and cooled)
What do prescribers need to tell patients when given them meds that can impair driving?
> Let them know it will likely affect driving
Warn them of potentiating effects with alcohol
Advise them to carry evidence to show med was Rx and not illegal with instructions of how it’s taken
When can a med not be put in a child-resistance container?
> Med is in original packet
Patient won’t be able to open child resistant container
Specific request made not to have it in child-resistant container
No suitable container available
What is legally required to appear on dispensing label?
- Name of patient
- Name and address of pharmacy
- Date of dispensing
- Name of med
- Directions for use
- Precautions relating to use of med
