hazards of drug administration/prescribing errors

Question 1

what are the principles of prescribing

Answer 1

dentists are independent prescribers upon graduation, and must have an understanding of the patients medical history

NHS primary care medicines are listed in the BNF

do not prescribe for yourself

do not prescribe for anyone u are close with

remote prescribing only if there is no other viable option

Question 2

what are the possible hazards of drug administration

Answer 2

side effects
allergies
drug interactions
acute toxic reactions
death

Question 3

what are side effects

Answer 3

unintended effects of drug administration, that are usually negative but can be beneficial

Question 4

how does the British national formulary categorise side effects

Answer 4

in terms of probability:
- common/very common
- uncommon
- rare/very rare
- frequency unknown

Question 5

describe drug allergies

Answer 5

immune system reacts to the drugs, common symptoms including
- rashes
- itching skin and eyes
- runny nose
- coughing and wheezing
- nausea

Question 6

which drugs commonly cause allergic reactions

Answer 6

penicillin
NSAIDS
anticonvulsants

Question 7

describe anaphylaxis in relation to drug allergies

Answer 7

severe allergic reaction occurring rapidly after the exposure, needs urgent medical attention

Question 8

impact of anaphylaxis on central nervous system

Answer 8

• lightheadedness
• loss of consciousness
• confusion
• headache
• anxiety

Question 9

impact of anaphylaxis on respiratory system

Answer 9

shortness of breath
wheezes or stridor
hoarseness
pain with swallowing
cough

Question 10

impact of anaphylaxis on gastrointestinal tract

Answer 10

crampy abdominal pain
diarrhoea
vomiting

Question 11

describe impact of anaphylaxis on skin

Answer 11

hives
itchiness
flushig

Question 12

impact of anaphylaxis on heart and vasculature

Answer 12

fast or flow heart raet
low blood pressure

Question 13

what is a drug interaction

Answer 13

reaction between 2 or more drugs, or between drugs and food or drink supplements

Question 14

why are drug interactions unideal

Answer 14

they can affect how a drug works or cause unwanted side effects
can impact absorption, action or metabolism of other drugs

Question 15

examples of drug interactions

Answer 15

protein binding
drug metabolism

Question 16

what is drug toxicity

Answer 16

when a person has too much of a drug in their system leading to adverse effects

Question 17

what are factors that determine toxicity

Answer 17

chemical structure
absorption
bodys ability to metabolise and eliminate drugs

Question 18

what are acute toxic reactions

Answer 18

adverse effects of a substance that occurs following single exposure or multiple exposures in a short period of time

Question 19

why can acute toxic reactions be life threatening

Answer 19

can cause bone marrow suppression, hepatotoxicity, biliary stasis, acute nephrotoxicity

Question 20

how to prevent drug fatality

Answer 20

• safe prescribing
• treat the whole person, not just the condition or disease
• prescribe only when necessary
• use of drug must be justified
• consideration of risk vs benefit

Question 21

summarise what the BNF is

Answer 21

British national formulary, provides guidance on prescribing, dispensing, and administering medicine

Question 22

what is the DPF

Answer 22

dental practitioners formulary, provides guidance on drug management of dental and oral conditions

general guidance, medical emergencies, and other problems in dental practice

NHS dentists can only prescribe drugs listed in DPF

Question 23

what are the different prescription forms and when are they used

Answer 23

GP14 for primary care in Scotland

HBP - hospital based prescriptions for out patients

private, headed notepaper

Question 24

why would prescription pads be kept secure

Answer 24

to prevent misuse or theft

Question 25

everything to include on a prescription

Answer 25

Full name & address of patient
Age if under 12 years (age and date of birth of all patients preferable but not essential. If under 12 - age is essential – legal requirement for POM medication). CHI Number not essential but put it in if you have it.
Date (valid for 6 months)
Name & address of prescriber (stamp)
Status of prescriber
Signature of prescriber (in ink, computer generated signatures do not meet the legal requirement)
Name of drug/preparation written clearly and not abbreviated: Generic name
Form & strength of preparation
Dose & dose frequency; if the medicine is to be taken as required a minimum dose interval should be specified
Duration of treatment
Total quantity of drug e.g. SEND: 15 tablets
Instructions: How & when e.g. LABEL: one tablet to be taken three times daily for five days
Residual space on form – score out

Question 26

what must you conform to when writing a prescription

Answer 26

use ink, or type write
must be legible
no abbreviations
can prescribe more than one item per form
signed in ink

Question 27

how to give advice to patients being provided with prescriptions

Answer 27

give written instructions, as stressed patients may not remember the instructions

language and communication barriers may prevent proper understanding

contact number for the patient to get in touch if there are any issues

Question 28

what are typical patient instructions for a prescription

Answer 28

take drugs at the correct time and finish the course
unexpected reactions, stop and contact the prescriber
known side effects should be discussed
keep the medicines safe and away from children

Question 29

what is the most common prescribing error

Answer 29

when a different treatment would be a better option, not looking at local measures. basically making the decision to prescribe when its not required?

Question 30

what are the main prescribing errors

Answer 30

making a wrong decision to prescribe
prescribing the wrong drug
completing the prescription form incorrectly