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Flashcards in Safe Prescribing 2 Deck (21)
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1

What are the 3 main sections of the BNF?

- Guidance on prescribing in palliative care and emergency treatment on poisoning
- Chapters on individual therapeutic areas e.g. infections. Individual drug monograms are contained within these chapters
- Appendices e.g. interactions, additives

2

What is a drug monograph?

- Dosing information
- Contains details about the indication for use of that drug
- Some drugs will have different doses for different indications

3

What can gabapentin be used for?

- Seizures (epilepsy)
- Neuropathic pain (not liscensed for this but can still be used)

4

What is amitriptyline licensed for and what else canit be used to treat?

- Licensed for both depression and nocturnal enuresis
- Can also be used for neuropathic pain and migraine prophylaxis

5

Why do you need to be careful when prescribing unlicensed medications?

- You then carry accountability for the prescription

6

Name some epilepsy drugs

- Carbamezipine
- Gabapentin
- Phenytoin

7

Give an example of a drug which can be given with a modified release?

Nifedipine (usually given 3x daily)
- Adalat LA is a formula to be given once daily
- Adalat Retard is given 2x daily

8

How can drug interactions be classified?

- Pharmacodynamic
- Pharmacokinetic

9

What does a pharmacodynamic drug interaction mean?

2 drugs which have an additive or antagonistic pharmacological effect

10

What does a pharmacokinetic drug interaction mean?

When a drug increases or decreases the amount of another drug available in the body by affecting the absorption, distribution, metabolism or excretion of the other drug

11

What does a black dot mean in the BNF?

Serious drug interaction

12

Sources of information regarding prescribing

- Local NHS trust formularies
- BNF
- Pharmacists
- Medicines information department
- EMC

13

What is the difference between qd in the US and UK?

US = once daily
UK = 4x daily

14

Where can you find information regarding dosing of different formulations of morphine in the BNF?

Palliative care section

15

Where can you find information regarding drug interactions, dosing in renal impairment and administration details of IV infusions of medicines?

Appendix

16

What is a presribing error?

The result of a prescribing decision or prescribing writing process that results in an unintentional but significant reduction in the probability of treatment being timely and effective or an increased risk of harm compared with the generally accepted practice

17

Classify the different types of prescribing errors

- Slips and lapses (accidently writing the wrong thing)
- Mistakes (writing the wrong thing not knowing the usual dose is something else)

18

What are the common causes of prescribing errors

- Inadequate knowledge of the patient and their clinical status
- Inadequate drug knowledge
- Calculation errors
- Illegible handwriting
- Drug name confusion
- Poor history taking

19

What are the 3 different stages of errors in terms of medications?

- Prescribing
- Dispensing
- Administration

20

What percentage of prescriptions are associated with error/

1.5%

21

Give some 'top tips' for prescribing (what should you always do/check)

- Check allergy status
- Legible pen
- Sign legibly to legalise
- Approved names of drugs
- Use BLOCK letters
- Sign/date and give reason for discontinuation
- No abbreviations (only GTN is acceptable)
- Write doses in full (e.g micro)
- Antibiotics - state review date or course length
- PRN medications: include max frqncy, mx no of doses in 24 hrs and the indication