Prescribing

Question 1

What are the principles of good Rx? (10)

Answer 1

1. Reasons for prescribing,
2. Consider px’s medical Hx before prescribing.
3. Consider factors that might alter +/- of tx.
4. Select effective, safe and cost effective medicines.
5. Adhere to national guidances and local formularies where appropriate.
6. Write unambiguous legal Rx using correct documentation.
7. Monitor +/ADR of medicines.
8. Communicate and document Rx decision and reasons for them.
9. Prescribe within limitations of your knowledge, skills and experience.

Question 2

What are the principles of good ABx Rx? (8)

Answer 2

Infection site
Likely pathogens
Severity of illness
Drug interactions
Host factors (pregnancy, immunocompromised)
Allergies
ABx resistance
Hepatic/liver toxicity

Question 3

What is the CSM warning for quinolones? (3)

Answer 3

Can induce convulsions in px with/without Hx of convulsions, taking NSAIDs at the same time.
Tendon damage (including rupture) has been reported rarely in px receiving quinolones.
Tendon rupture occurs within 48 hrs of starting tx cases also reported several months after stopping.
- C/I in px with hx of tendon disorders.
- > 60 yrs
- Increased risk of CS.

Question 4

What are the factors to consider for meeting px’s ICE? (7)

Answer 4

Consent
S/E (short/long-term)
Monitoring
Follow up
How to seek advice/review decisions
Records

Question 5

Give e.g. of common excipients found in medicines. (2)

Answer 5

Gelatin
Lactose