(BQ) Part 1 book Prescribing at a glance presentation of content: Basic principles of prescribing (Using the british national formulary, taking a medication history, reviewing current medicines,..), drug selection, prescribing for special groups.
Prescribing at a Glance Sarah Ross MBChB, FRCP, MD, MSc Clinical Pharmacology, MMed NHS Grampian/University of Aberdeen Aberdeen, UK This edition first published 2014 © 2014 John Wiley & Sons, Ltd Registered Office John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Offices 350 Main Street, Malden, MA 02148-5020, USA 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of Sarah Ross to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher Wiley also publishes its books in a variety of electronic formats Some content that appears in print may not be available in electronic books Designations used by companies to distinguish their products are often claimed as trademarks All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The publisher is not associated with any product or vendor mentioned in this book Limit of Liability/Disclaimer of Warranty: While the publisher and author(s) have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom If professional advice or other expert assistance is required, the services of a competent professional should be sought Library of Congress Cataloging-in-Publication Data is available 9781118257319 A catalogue record for this book is available from the British Library Cover image: Science Photo Library © Mark Thomas/Science Photo Library Cover design by Meaden Creative Set in 9.5/11.5pt MinionPro by Toppan Best-set Premedia Limited 1 2014 Contents Preface v How to use your textbook vi About the companion website ix Part Part Basic principles of prescribing 1 Drug selection 13 10 11 12 13 Part How to choose a drug 14 How to choose frequency 15 How to choose a dose 16 How to choose route of administration and formulation 18 How to choose duration of treatment, define treatment objectives and measure outcomes 20 Assessing suitability of treatment regimens for patients 21 Worked example 1: Chapters 6–11 22 Worked example 2: Chapters 6–11 23 Prescribing for special groups 25 14 15 16 17 18 Part Introduction: principles of good prescribing Revision: pharmacokinetics Using the British National Formulary Taking a medication history Reviewing current medicines 10 Prescribing Prescribing Prescribing Prescribing Prescribing in in in in in liver disease 26 renal disease 28 children 30 the elderly 32 pregnancy and breast feeding 34 Logistics of prescribing 37 19 20 21 22 23 24 How to write a drug prescription 38 Communicating with patients about medicines 40 Therapeutic drug monitoring 42 Dealing with adverse drug reactions 44 Avoiding drug interactions (drugs, food and alternative medicines) 46 Avoiding prescribing errors 48 iii Part Specific drug groups 51 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 Using drugs for the gastrointestinal system 52 Using drugs for the cardiovascular system I 54 Using drugs for the cardiovascular system II 56 Using drugs for the cardiovascular system III 58 Using drugs for the respiratory system 60 Using drugs for the neurological system I 62 Using drugs for the neurological system II 64 Using drugs for infection 66 Using drugs for the endocrine system I 68 Using drugs for the endocrine system II 70 How to use drugs for the musculoskeletal system 72 Using drugs in haematology and oncology 74 Using drugs in anaesthesia 76 An approach to common prescribing requests I 78 An approach to common prescribing requests II 80 Appendix Cross references to Prescribing Scenarios at a Glance 81 Index 82 iv Preface P rescribing is a core skill for all doctors, and increasingly for non-medical staff It is a difficult skill to learn A great deal of attention has been paid to prescribing skills in recent times, and the new Prescribing Safety Assessment has focussed minds on ensuring that new graduates are ready to prescribe safely I hope that this book will be helpful to students and doctors learning to prescribe As with many skills, practice is essential, and you should take every opportunity to plan the exact prescription of a drug for patients that you see Prescribing Scenarios at a Glance provides useful practical examples to work through that are referenced within this text This book has been written with new graduates embarking on the Foundation Programme in mind, and therefore focuses on mainly hospital-related prescribing; however, many of the principles extend to primary care situations A highly practical approach has been taken, but will not describe all possible ways to look at a prescribing problem Seek out the advice of experienced colleagues, whether doctors, nurses or pharmacists, who can provide guidance to the novice prescriber This book is deliberately concise, and may be supplemented by Medical Pharmacology at a Glance which gives a useful summary of drug mechanisms of action Acknowledgements Thanks to Dr Mary Joan Macleod for critical review and suggestions Further reading Joint Formulary Committee (2013) British National Formulary 66th ed British Medical Association and Royal Pharmaceutical Society of Great Britain, London Richards D, Coleman J, Reynolds J, Aronson J (2011) Oxford Handbook of Practical Drug Therapy Oxford University Press, Oxford Nicholson TRJ, Singer DRJ (eds) (2014) Pocket Prescriber CRC Press, London v Section not available in this digital edition vii Section not available in this digital edition viii Prescribing for special groups Part Chapters 14 15 16 17 18 Prescribing Prescribing Prescribing Prescribing Prescribing in in in in in liver disease 26 renal disease 28 children 30 the elderly 32 pregnancy and breast feeding 34 Don’t forget to visit the companion website for this book www.ataglanceseries.com/prescribing to some practice MCQs and case studies on these topics 25 26 Part Prescribing for special groups 14 Prescribing in liver disease Figure 14.1 Pharmacokinetic changes in liver disease Impaired distribution Impaired absorption Impaired metabolism Impaired excretion Table 14.1 Child-Pugh classification Score Bilirubin (micromol/L) 50 Albumin (g/L) >35 28–35 90