Transcript DRUGS FOR TAKE - University of Bristol

DRUGS FOR TAKE
A Practical Guide to Prescribing
on Day 1!
Dr. Anna Crown
OBJECTIVES
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Identify sections of the drug chart
Prescribing abbreviations
When not to prescribe
Use of the BNF
Use of hospital protocols
Prescribe common / emergency Rx
THE DRUG CHART
• FRONT
– Patient details
– Allergies
– Once only medication
– Drug doses omitted
THE DRUG CHART
• MIDDLE
– Regular medication
• BACK
– As required medication
ABBREVIATIONS
• Route of administration
• Timing
WHEN NOT TO PRESCRIBE
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Prescribing is not the answer
You need to do something else first
You could do more harm than good
You feel it is not appropriate
USE THE BNF &
HOSPITAL PROTOCOLS
• Useful things in the BNF
• Hospital protocols
SIMPLE REMEDIES FOR
MINOR PROBLEMS
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Nausea
Constipation
Cough
Indigestion
Leg cramps
Insomnia
Agitation
TACKLING PAIN
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Regular analgesia
Regular paracetamol
Regular co-codamol 30:500
NSAIDS
Morphine
Other pains
JUGGLING BLOOD SUGARS
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Highs and lows
Type 1 or Type 2?
Adjusting insulin doses
Sliding scales
AVOIDING PROBLEMS
WITH ALCOHOLICS
• Enforced abstinence
• Forced feeding
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Wernicke’s encephalopathy: thiamine
DTs
Excess sodium
Hypoglycaemia
Seek advice
SCARY SITUATIONS
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What if you get there first?
Additional management
OSCEs
Doses
IV or IM
SCARY SITUATIONS
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Respiratory depression & pinpoint pupils
Severe heart failure
Myocardial infarction
Severe asthma
Hypoglycaemia
Possible meningococcal disease
Anaphylactic shock
Status epilepticus
SUMMARY - 1
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The drug chart
Prescribing abbreviations
When not to prescribe
The BNF
Hospital protocols
Simple remedies for minor problems
SUMMARY - 2
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Pain
Diabetes and the drug chart
Avoiding problems with alcoholics
Scary situations