wk 1- INTRO Flashcards
listed medicines what are they
-low risk
-long history of use
-assessed for quality and safety
-not assessed for efficacy
-most are complementary medicines
-not on formulary
example: vitamins, fish oil, supplements
registered medicines what are they
-assessed for safety, quality and effectiveness
-all prescription medicines
-most OTC
-some comlpementary medicines
-on formulary
example: analegesics, fungal cream, etc
podiatrist v ESM podiatrist drugs available for what in QLD
pod: (S2, 3, 4)
administer
1. S2
2. adrenaline (S4)- only for anaphylaxis in QLD
3. Local anaesthetic (S4)
- lidocaine
-bupivocaine
-prilocaine
-
purchase/possess
1. some locals
ESM pod:
prescribe, administer, purchase, possess, dispose of S2, 3, 4, 8
Dangers of overprescribing
- increased risk of ADEs
- regime problems/complexity
- cost
dangers of under prescribing
- suboptimal management
what body is responsible for scheduling of medicines and poisons and what level do they schedule on (national or state) and what are their functions
TGA therapeutic goods administration (SUSMP)
national level
-scheduling of medicines and poisons
-test the safety and quality of drugs (listed v registered medicines)
-international stewardship with global manufactors
-reporting ADRs
-new medications and therapeutic claims
what is a S8 drug in national prescribing formulary for podiatrists with ESM
oxycodone- strong opioid
for pod surgeon with ESM use only
benzodiazepines belong to what schedule?
some are S8 - pods dont have access to these
Pods have access to S4
- lorazapam
Pod surgeons have access to S4
-diazapam - restriction: single dose only
what schedule (s) do NSAIDs belong to
unscheduled, S2, S3, S4
S4- celecoxib, diclofenac, indometacin, ketorolac (pod surgeron only), meloxicam, sulindac
S2, 3, 4- naproxen, ibuprofen (pack size-number of tablets, dosage dependent, combination with another drug)
Adavantages and disadvantages about drugs becoming unscheduled medicines
advantages
1. convenience
2. cheaper (manufactoring)
disadvantages
1. Increased risk of ADRS
2. increased risk of overdose
3. no counselling
who in australia is responsible for determining if someone is qualified enough to become an endorsed prescriber
AHPRA
who in QLD is responsible for determining who can prescribe medicines?
Medicines and Poisons regulation 2021
what 2 things does a podiatrist need to prescribe
- endorsement from the board
- authroity from state legislation in which you practice (medicines and poisons regulation 2021)
discuss general considerations when prescribing a medicine to patient
- information gathering
-medical history,
-reconiliations,
-further assessments,
-adherence - decision making
-identify medical/medications related issues
-determine how well conditions are managed
-determine whether symptomatic treatment is required or disease modifying treatment
-consider drug/non drug interventions and if they are contraindicated in patient, condition, or medications
-select drug, route, form, dose, frequency and duration - communicate decision
-communicate in ambulatory setting (outcare)
-communicate in inpatient setting - monitor and review
-review symptoms, signs, adherence, patient outcome measures
general considerations with prescribing a medication
- thorough medication history
-concerned about drug -drug interactions using AUSDI to check if there is one and the degree of risk
-allergies to ensure its safe
-adherence - thorough medical history
-concerned about drug disease interactions - social
-cost: podiatrists are a private prescription (referrals-PBS-medications, medicare rebate-diagnostic tests)
before aware of concession prices and PBS safety net- private prescriptions dont count towards - state based legislation and what you’re authorised to prescribe
