Prescribing + PSA

Question 1

What must go on every prescription?

Answer 1

Patient details:
Name 
DOB
Patient number 
(Address)

Drug details: 
Drug name
Form e.g. 250mg tablets 
Dose e.g. 500mg every 6hrs 
Supply e.g. 80 tablets 
[no more items on script] 

Sign + date

(ANY MORE?)

Question 2

What additional things must go on a prescription for controlled drugs?

Answer 2

Total quantity of supply must be written in words and figures

Question 3

What is important when reviewing a morphine prescription?

Answer 3

If someone is not controlling their pain on their current doses of modified release + immediate release: need to sum the number of mg taking overall (immediate + modified) – this becomes the new background dose/modified release tablets + any additional

For immediate release – and the management of breakthrough pain: should be 1/6th the dose of the background dose

(if outpatient) Review in 1-2wks

Remember tolerance

Question 4

What is important when prescribing DOACs?

Answer 4

E.g. dobigatran, rivaroxaban, apixaban
Calculating risk of stroke – chadsvasc
Calculating risk of adverse bleeding – hasbled
Assessment of renal function with DOACs – creatinine clearance

Question 5

DO SOME CARDS ON GENERAL CAUTIONS AND CONTRAINDICATIONS FOR DIFFERENT CLASSES OF DRUGS

Answer 5

..

Question 6

What is the STOPP START Toolkit?

Answer 6

Screening tool for managing polypharmacy in the elderly

MORE

Question 7

HAVE A GENERAL UNDERSTANDING OF NORMAL DOSE RANGES FOR COMMON DRUGS

Answer 7

YOU MIGHT HAVE TO SPOT WHAT DRUG IS PRESCRIBED AT TOO HIGH OR LOW A DOSE

Question 8

What are some of the most typical prescribing scenarios?

Answer 8

ALL TAKEN FROM PAGES ON HANDBOOK:

Acute asthma attack, acute heart failure, depression, GORD, thromboprophylaxis, pain, infections, hypertension, hypercholesterolaemia, contraception and HRT

Gentamicin monitoring and dosing
Vancomycin monitoring and dosing
Digoxin monitoring
Lithium monitoring
Aminophyline infusion
Thyroxine dose adjustment
Post operative fluids
Simple pain relief
Conversion of short acting opiates to long acting opiates
Side effects of psychiatric drugs
Adjusting doses in renal impairment
Monitoring of therapeutic response to drugs ie symptoms, weight, blood results etc
Management of high INR with and without bleeding
Writing up blood products

Anticoagulation
Antibiotics
Insulin
Opiates
Fluids