hazards of drug administration/prescribing errors Flashcards
what are the principles of prescribing
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
what are the possible hazards of drug administration
side effects
allergies
drug interactions
acute toxic reactions
death
what are side effects
unintended effects of drug administration, that are usually negative but can be beneficial
how does the British national formulary categorise side effects
in terms of probability:
- common/very common
- uncommon
- rare/very rare
- frequency unknown
describe drug allergies
immune system reacts to the drugs, common symptoms including
- rashes
- itching skin and eyes
- runny nose
- coughing and wheezing
- nausea
which drugs commonly cause allergic reactions
penicillin
NSAIDS
anticonvulsants
describe anaphylaxis in relation to drug allergies
severe allergic reaction occurring rapidly after the exposure, needs urgent medical attention
impact of anaphylaxis on central nervous system
- lightheadedness
- loss of consciousness
- confusion
- headache
- anxiety
impact of anaphylaxis on respiratory system
shortness of breath
wheezes or stridor
hoarseness
pain with swallowing
cough
impact of anaphylaxis on gastrointestinal tract
crampy abdominal pain
diarrhoea
vomiting
describe impact of anaphylaxis on skin
hives
itchiness
flushig
impact of anaphylaxis on heart and vasculature
fast or flow heart raet
low blood pressure
what is a drug interaction
reaction between 2 or more drugs, or between drugs and food or drink supplements
why are drug interactions unideal
they can affect how a drug works or cause unwanted side effects
can impact absorption, action or metabolism of other drugs
examples of drug interactions
protein binding
drug metabolism
what is drug toxicity
when a person has too much of a drug in their system leading to adverse effects
what are factors that determine toxicity
chemical structure
absorption
bodys ability to metabolise and eliminate drugs
what are acute toxic reactions
adverse effects of a substance that occurs following single exposure or multiple exposures in a short period of time
why can acute toxic reactions be life threatening
can cause bone marrow suppression, hepatotoxicity, biliary stasis, acute nephrotoxicity
how to prevent drug fatality
- 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
summarise what the BNF is
British national formulary, provides guidance on prescribing, dispensing, and administering medicine
what is the DPF
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
what are the different prescription forms and when are they used
GP14 for primary care in Scotland
HBP - hospital based prescriptions for out patients
private, headed notepaper
why would prescription pads be kept secure
to prevent misuse or theft
everything to include on a prescription
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
what must you conform to when writing a prescription
use ink, or type write
must be legible
no abbreviations
can prescribe more than one item per form
signed in ink
how to give advice to patients being provided with prescriptions
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
what are typical patient instructions for a prescription
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
what is the most common prescribing error
when a different treatment would be a better option, not looking at local measures. basically making the decision to prescribe when its not required?
what are the main prescribing errors
making a wrong decision to prescribe
prescribing the wrong drug
completing the prescription form incorrectly
