Pharmacology Flashcards
Are medication errors common or rare
Common
Are medication errors usually preventable
Yes
Which patients are most at risk for errors
Those undergoing cardiothoracic surgery, vascular surgery, or neurosurgery
Those with complex conditions
Those in the emergency room
Those looked after by inexperienced doctors
Older patients
Examples of cognitive errors
Incorrect Dx
Choosing the wrong medication
Factors that could increase the rate of medication errors
More rapid throughput of patients
New drug developments, extending medicines into new areas
Increasing complexity of medical care
Increased specialisation
Increased use of medicines generally
Sicker and older patients, more vulnerable to adverse effects
People related causes of medication errors
Fatigue Hunger Concentration Distraction Lack of training Lack of access to information Other factors
Common prescribing errors
Wrong drug (e.g. drugs that sound alike) Wrong dose Inappropriate Units Poor/illegible prescriptions Failure to take account of drug interactions Omission Wrong route/multiple routes (IV/SC?PO) Calculation errors (important in Paediatrics) Poor cross referencing Infusions with not enough details of diluent, rate etc. Poor cross-referencing between charts Once weekly drugs Multiple dose changes
What should you always check with a patient when prescribing
Age Weight Renal and hepatic function Concurrent disease Lab results Concurrent medicaitons Allergies Medical/surgical and FH Pregnancy
Is it okay to use abbreviations?
Don’t use abbreviations!!
Things to avoid when writing a prescription
DO NOT use abbreviations
Avoid decimal points if possible
Never leave a decimal point naked
Never use a terminal zero (e.g 1g not 1.0g)
Leave a space between drug name and dose
Don’t use trade names unless you have to
5Rs of medication error prevention
Right patient Right Drug Right dose Right route Right time
Which formularies can you refer to
National Formularies (e.g BNF) Grampian joint formulary WHO
Which organisation is responsible for licensing medications
MHRA
Medicines and Healthcare products Regulatory Agency
Role of MHRA
Ensures that human medicines meet acceptable standards on safety, quality and efficacy.
Ensures that the sometimes difficult balance between safety and effectiveness is achieved.
Role of Scottish Medicines Consortium
Provide advice to NHS Scotland regarding all new licenced medicines, new formulations of existing medicines and new indications for established products.
Before a medicine can be routinely prescribed in Scotland who has to accept it
SMC
Scottish Medicine Consortium
GMC guidance for unlicensed medication prescribing
“You should usually prescribe licensed medicines in accordance with the terms of their licence. However, you may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.”
What does the GMC expect when prescribing unlicensed medication
You to:
Carefully consider the Rx you prescribe
Be able to justify your decision
3 classes of medications according to Human Medicines Regulation 2012
Prescription only medication (POM)
Pharmacist (P) medicines
General sales list medicines (GSL)
What class of medication does new medicines have to be in the first instance
Prescription only
What are general sales list and pharmacy medicines collectively known as
Over the counter
Where can general sales list drugs be sold
Registered pharmacies
Also in other retail outlets
Example of general sales list medication
Paracetamol
Where can Pharmacy (P) medicine be sold
Sold from a registered pharmacy premises by a pharmacist or a person acting under the supervision of a pharmacist.
