Hazards of administration and prescribing errors Flashcards
(25 cards)
What are some hazards of drug administration
Allergy – mild
Allergy – severe – anaphylaxis
Drug interactions
Acute toxic reactions
Death
What is an allergy reaction and what drugs usually cause them
Reaction of the immune system
Common symptoms include:
Rash/ Hives
Itching of skin/ eyes
Runny nose/ Sneezing
Coughing/ wheezing
Nausea/ vomiting
E.g. Penicillin, NSAIDs, anticonvulsants
What is anaphylaxis
Severe and potentially life-threatening allergic reaction
Occurs rapidly after exposure to allergen
Urgent medical treatment is required- adrenaline!
What are some symptoms of anaphylaxis
Hives
swelling of eyes/tongus/throat
loss of conciousness
shortness of breath
loss of bladder control
fast or slow heart rate
What is a drug interaction
Drug interaction is a reaction between 2 or more drugs or between drugs and food/ drink/ supplement.
Drug interactions can affect how a drug works or cause unwanted side effects.
Drugs can interfere with the absorption, action or metabolism of other drugs.
What are examples of drug interactions
Protein binding – Warfarin & aspirin/NSAIDS
Drug metabolism – warfarin, simvastatin
Erythromycin
Fluconazole
Carbamazepine
What is drug toxicity
Drug toxicity is when a person has too much of a drug in their system leading to adverse effects
What determines the toxicity of the drug
Chemical structure
Absorption
Body’s ability to metabolise and eliminate drug (liver, kidney function, hydration)
Usually due to taking more than prescribed dose, or prescribed dose too high, can occur at therapeutic dose.
Threshold between therapeutic and toxic dose can be narrow.
What are acute toxic reactions
Adverse effects of a substance that occur following single exposure or multiple exposures in a short period of time
Potentially life threatening
What are examples of acute toxic reactions
Bone marrow suppression
Hepatotoxicity & biliary stasis
Acute nephrotoxicity
How can fatality using drugs be reduced
Safe prescribing
Treat the whole person – NOT just the condition or disease
Prescribe only when necessary
Use of drug must be justified
Consideration of Risk Vs Benefit
What medications can NHS primary care dentists prescribe
medicines listed in DPF
Is there a limit on what private or hospital based dentists can prescribe
Yes, only those in the BNF
When is remote prescribing allowed
When there is no other viable option
What is the BNF
Provides guidance on prescribing, dispensing and administering medicines
It details all medicines that are generally prescribed in the UK- Intended for use by prescribers in the NHS
What does DPF stand for
Dental Practitioners’ Formulary
What does the DPF provide
Guidance on drug management of dental and oral conditions
General guidance, medical emergencies and other problems in dental practice.
What prescription forms do primary care dentists in scotland use
GP14
What prescription forms do hospital based dentists use
HBP (hospital based prescriptions)
What information should be on a prescription
Full name & address of patient
Age if under 12 years (age and date of birth of all patients preferable but not essential. If under 12 - age is essential – legal requirement for POM medication). CHI Number not essential but put it in if you have it.
Date (valid for 6 months)
Name & address of prescriber (stamp)
Status of prescriber
Signature of prescriber (in ink, computer generated signatures do not meet the legal requirement)
Name of drug/preparation written clearly and not abbreviated: Generic name
Form & strength of preparation
Dose & dose frequency; if the medicine is to be taken as required a minimum dose interval should be specified
Duration of treatment
Total quantity of drug e.g. SEND: 15 tablets
Instructions: How & when e.g. LABEL: one tablet to be taken three times daily for five days
Residual space on form – score out
How should you write a prescription
Written in ink or type-written (PC-generated)
Must be legible
Do not use abbreviations
May prescribe more than one item per form
Must be signed in ink
Can more than one item be prescribed per prescription
Yes
How should advice for dosage and administration to patients be given
WRITTEN instructions
-stressed patients may not remember verbal instructions
-language barriers may be present
-contact number is useful incase the patient encounters any issues
What information should be included in advice/instructions
Take drugs at correct time and finish the course
Unexpected reactions: STOP! and contact prescriber
Known side-effects should be discussed e.g. Metronidazole and alcohol
Keep medicines safe: especially from children
