lecture 18 - clinical pharmacology and prescribing Flashcards
1
Q
define rational prescribing
A
selection of the most appropriate therapeutic regimen for a specific patient
2
Q
steps prior to writing a prescription
A
- make a diagnosis
- make a therapeutic decision
- choose a medicine
- choose a dosing regime
3
Q
in order to choose a medicine, you need to know
A
efficacy - (evidence, consider patient-related factors that affect efficacy)
safety - (contra-indications = allergies, organ function, drug interactions)
appropriateness - (affordability, dosing intervals)
4
Q
making a therapeutic decision
A
- know treatment goals, what patient wants
* symptomatic or disease-modifying treatment
5
Q
choosing a dosing regimen
A
- choose a delivery route (IV, depot, local delivery, skin patches, gels, oral tablets)
- choose dose (dose/response relationship, influence of disease states, interactions) e.g. population, group, individual
6
Q
legal requirements when writing a prescription
A
- doctor’s name and initial
- signature
- physical address
- MCNZ registration number
- contact phone number
- patient name
- patient full residential address
- age if under 13
7
Q
steps after writing the prescription
A
- counsel the patient
- monitor response
- review the medicine
8
Q
counsel the patient
A
- reasons for providing medicine
- benefits of treatment and when they should occur
- possible adverse effects
- possible interactions
9
Q
monitor response
A
- check for signs of undesirable outcomes
- measure for clinical end-point
- monitor using surrogate biomarker measures eg. blood tests, bone density, CD4 count
- drug concentration measured (no easily measured end-point)
10
Q
review
A
- assess appropriateness of medicine
- assess effectiveness of medicine
- consider patient view (adherence, understanding, concerns)
11
Q
steps involved in prescribing
A
- diagnosis
- therapy
- medicine
- dosing regimen
- prescribe
- communicate
- monitor
- review
