W7: Health Info Systems And Resources: The BNF, Drug Tariff, SPC, Newt guidelines Flashcards
What is a formulary?
Examples?
At basic, it is a list of medicines
BNF- British national formulary
BNFc- British national formulary for children
DPF and NPF
What are the definitions of:
Indications and dose?
Contraindication?
Caution?
-Why it is being used and the dose (amount)
-When not allowed to use it
-What to avoid
Everything that ends in …pril is an..
ACE inhibitor
What is the definition of Interaction?
‘An interaction occurs when the effects of one drug are changed by the presence of another drug, food, drink or by some other chemical agent.’
What is the role of a pharmacist with interactions?
ANTICIPATE interactions before they occur
RECOGNISE them if they occur
COUNSEL patients on their therapy
What information is in the BNF?
- Drugs – provides (almost) everything we need to
know about using a particular medicine - Summaries – gives an overview of how to treat
various different diseases and conditions - Medical devices – some information on various
“devices”, but more information on these in the Drug Tariff - Borderline substances – again, more info in Drug Tariff
- Guidance – useful section with lots of information ranging from adverse reactions reporting, through life support, prescribing in pregnancy and breast-feeding, how to legally write prescriptions, etc.
- Wound care – primarily dressings and bandages
- DPF and NPF – see drug tariff lecture
What is an interaction?
An interaction occurs when the effects of one drug are changed by the presence of another drug, food, drink or by some other chemical agent.
What is the nature of the interaction between
- Carbamazepine and Warfarin?
- What decision to make when both are prescribed together?
Carbamazepine decreases the effects of warfarin. Manufacturer advices monitor and adjust dose.
- We know that there are lots of interactions with warfarin
- Monitor the INR
- Adjust the dose of warfarin accordingly
What is the nature of the interaction between;
Clarithromycin and theophylline
- What decision to make when both are prescribed together?
Theophylline is predicted to cause hypo leukaemia when given with clarithromycin.
AND
Clarithromycin is predicted to increase the exposure to theophylline .
- Difficult decision to make
- Avoid if possible, but monitor closely if needed
- Withold/decrease theophylline dose
What is the nature of the interaction between;
Omeprazole and clopidogrel
- What decision to make when both are prescribed together?
Omeprazole is predicted to decrease the efficacy of clopidogrel. Manufacturer advises avoid.
- Don’t use this combination
- Use alternative to omeprazole
What’s in the Drug Tariff? (6)
- Basic prices of drugs – Part VIII
- The ‘Black List’ – Part XVIIIA
- DPF, NPF and NMIP – Part XVIIA, Part XVIIB(i), Part XVIIB(ii)
- Appliances – Parts IXA, IXB, IXC, IXR
- Fees paid to contractors – Part IIIA
- Prescription charges – Part XVI
What is allowed on an NHS Rx?
Drugs, foods, toiletries, cosmetics, appliances, incontinence appliances, stoma appliances, reagents
Generic vs branded names – what’s the difference?
Can blacklisted brands be prescribed?
- Generic name is the name of the active ingredient/s
- Brand name is a trademarked name given by the company marketing the drug
e.g. Brand: Calpol
Generic: Paracetamol
-Blacklisted brands can prescribed generically as long as the generic name isn’t also listed
What is the SLS list?
The selected list scheme.
*Some medicines that aren’t blacklisted can only be prescribed on the NHS in defined circumstances, e.g. for certain indications
Special Containers (for info)
Payment is based on the number of packs nearest to the quantity ordered:
- Examples
1. Glyceryl trinitrate sublingual tablets 500mcg x 140 Quantity to be dispensed, 100 tablets
- Betamethasone valerate 0.1% cream 50g
Quantity to be dispensed, 2 x 30g (= 60g)
