Additional Information
Book Details
Abstract
The Unofficial Guide to Prescribing lays out the practical steps of how to assess, investigate and manage a patient, with a focus on what to prescribe and how to prescribe it. Its aim is to empower newly graduated junior doctors to excel at dealing with emergencies and handling complex prescribing scenarios.
Prescribing errors cost healthcare systems millions annually, so early training in prescribing has become an urgent priority of medical education and now forms an essential part of teaching and assessment.
The Unofficial Guide to Prescribing (from the same stable as The Unofficial Guide to Passing OSCEs) is a new book designed to address this requirement. It is written by junior doctors still close to the transition from theory to practice, overseen by a review panel of senior clinicians to ensure accuracy, and designed to help medical students practise and learn as much as possible about prescribing, in actual clinical scenarios, before they have to do it for real.
Each scenario is presented as you would see it in the hospital setting and covers:
- Initial step-by-step assessment of the patient: how to assess, assessment findings, and immediate management
- Initial investigations
- Initial management
- Reassessment
- Treatment
- Handing over the patient
- 'Prescribe' alerts throughout
- Written-up drug charts
- Blank drug charts for copying and practice
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| The Unofficial Guide to Prescribing | iii | ||
| Copyright Page | iv | ||
| Contents | v | ||
| Preface | vii | ||
| Acknowledgements | viii | ||
| Contributors | ix | ||
| Panel of reviewers | x | ||
| How to use this book | xi | ||
| Prescribing | xi | ||
| List of abbreviations | xvii | ||
| 1 Introduction to prescribing | 1 | ||
| The Characteristics of a Good Prescriber | 1 | ||
| Basic Principles of Clinical Pharmacology | 2 | ||
| Pharmacodynamics | 2 | ||
| Dose–response relationships | 3 | ||
| Agonists and antagonists | 4 | ||
| Efficacy and potency | 4 | ||
| Therapeutic index | 5 | ||
| Desensitization and withdrawal | 5 | ||
| Pharmacokinetics | 5 | ||
| Drug absorption | 5 | ||
| Drug distribution | 7 | ||
| Volume of distribution | 7 | ||
| Drug metabolism | 7 | ||
| Drug excretion | 7 | ||
| Concentration–time relationships | 8 | ||
| Repeated doses | 8 | ||
| Inter-Individual Variation | 9 | ||
| Adverse Drug Reactions | 10 | ||
| Definition | 10 | ||
| Prevalence | 11 | ||
| Frequency of ADRs | 11 | ||
| Classification | 11 | ||
| Reproductive ADRs | 13 | ||
| Detecting ADRs | 13 | ||
| Suspecting an ADR | 13 | ||
| Prevention of ADRs | 13 | ||
| Drug Interactions | 13 | ||
| Pharmacodynamic Interactions | 14 | ||
| Pharmacokinetic Interactions | 14 | ||
| Avoiding Drug Interactions | 14 | ||
| Medication Errors | 15 | ||
| Types and Causes of Prescribing Errors | 15 | ||
| Responding to Error | 15 | ||
| Prevention of Prescribing Errors | 16 | ||
| Rational Prescribing | 16 | ||
| Making a Diagnosis | 16 | ||
| Establishing the Therapeutic Goal | 16 | ||
| Choosing the Therapeutic Approach | 17 | ||
| Choosing a Drug | 17 | ||
| Choosing a Dosage Regimen | 17 | ||
| Writing a Prescription | 18 | ||
| Informing the Patient | 18 | ||
| Monitoring Treatment Effects | 18 | ||
| Stopping Drug Therapy | 18 | ||
| Prescribing for Patients with Special Requirements | 19 | ||
| Prescribing for Patients with Renal Disease | 19 | ||
| Prescribing for Patients with Hepatic Disease | 20 | ||
| Prescribing for Elderly Patients | 20 | ||
| Prescribing for Women who are Pregnant or BreastFeeding | 20 | ||
| Prescribing for Children | 21 | ||
| Getting Information about Medicines | 21 | ||
| British National Formulary (BNF) | 21 | ||
| Other Information Resources for Prescribers | 22 | ||
| Writing a Prescription | 23 | ||
| Hospital Prescribing | 23 | ||
| General Considerations before Prescribing | 23 | ||
| Writing the Prescription | 25 | ||
| Other Considerations after Prescribing | 27 | ||
| Hospital Discharge (‘to take out’) Medicines | 27 | ||
| General Practice Prescribing | 27 | ||
| Prescribing Intravenous (IV) Fluids | 28 | ||
| Normal Fluid Requirements | 28 | ||
| Making an Assessment of Fluid Requirements | 28 | ||
| Types of Fluids | 28 | ||
| Prescribing an IV Fluid | 29 | ||
| Monitoring Fluid Therapy | 29 | ||
| Potential Complications of Fluid Therapy | 29 | ||
| Monitoring Drug Therapy | 31 | ||
| Clinical and Surrogate Endpoints | 31 | ||
| Plasma Drug Concentration | 31 | ||
| Further reading and information | 32 | ||
| 2 Cardiology | 33 | ||
| Station 2.1: Acute pericarditis | 33 | ||
| Initial Assessment | 33 | ||
| Airway | 33 | ||
| Breathing | 33 | ||
| Circulation | 34 | ||
| Disability | 34 | ||
| Exposure | 34 | ||
| Initial Investigations | 34 | ||
| Initial Management | 35 | ||
| Reassessment | 35 | ||
| Definitive Treatment | 35 | ||
| Handing over the Patient | 35 | ||
| Station 2.2: Acute left ventricular failure | 38 | ||
| Initial Assessment | 38 | ||
| Airway | 38 | ||
| Breathing | 38 | ||
| Circulation | 38 | ||
| Disability | 39 | ||
| Exposure | 39 | ||
| Initial Investigations | 39 | ||
| Initial Management | 40 | ||
| Reassessment | 40 | ||
| Handing over the Patient to ITU | 41 | ||
| Definitive Management | 41 | ||
| Station 2.3: Acute coronary syndrome | 45 | ||
| Initial Assessment | 45 | ||
| Airway | 45 | ||
| Breathing | 45 | ||
| Circulation | 45 | ||
| Disability | 46 | ||
| Exposure | 46 | ||
| Initial Investigations | 46 | ||
| Initial Management | 47 | ||
| Reassessment | 47 | ||
| Handing over the Patient | 47 | ||
| Definitive Management | 48 | ||
| Station 2.4: Bradycardia | 52 | ||
| Initial Assessment | 52 | ||
| Airway | 52 | ||
| Breathing | 52 | ||
| Circulation | 52 | ||
| Disability | 52 | ||
| Exposure | 52 | ||
| Initial Investigations | 53 | ||
| Initial Management | 53 | ||
| Reassessment | 53 | ||
| Definitive Management | 54 | ||
| Handing over to the Ward Doctor | 54 | ||
| Station 2.5: Tachycardia | 56 | ||
| Initial Assessment | 56 | ||
| Airway | 56 | ||
| Breathing | 56 | ||
| Circulation | 56 | ||
| Disability | 56 | ||
| Exposure | 56 | ||
| Initial Investigations | 57 | ||
| Initial Management | 57 | ||
| Reassessment | 57 | ||
| Definitive Management | 58 | ||
| Handing over the Patient | 58 | ||
| Station 2.6: Warfarin prescribing | 60 | ||
| Background Information | 60 | ||
| Initiating Warfarin | 60 | ||
| Warfarin counselling | 61 | ||
| Starting warfarin in a hospitalized patient | 62 | ||
| Starting warfarin in the community | 63 | ||
| Adjusting maintenance warfarin dose | 64 | ||
| Management of over-coagulation | 64 | ||
| What should you do if a patient taking warfarin is bleeding? | 64 | ||
| Major bleeding (i.e. requiring hospitalisation and blood transfusion, potentially life-threatening) | 64 | ||
| Minor bleeding with INR > 8.0 | 64 | ||
| Minor bleeding INR 5.0–8.0 | 64 | ||
| No bleeding with INR > 8.0 | 64 | ||
| No bleeding with INR 5.0–8.0 | 64 | ||
| Additional example scenarios | 65 | ||
| References | 65 | ||
| 3 Respiratory medicine | 67 | ||
| Station 3.1: Acute exacerbation of asthma | 67 | ||
| Initial Assessment | 67 | ||
| Airway | 67 | ||
| Breathing | 67 | ||
| Circulation | 68 | ||
| Disability | 68 | ||
| Exposure | 68 | ||
| Initial Investigations | 68 | ||
| Initial Management | 69 | ||
| Reassessment | 70 | ||
| Definitive Management | 70 | ||
| Handing over the Patient | 70 | ||
| Station 3.2: Exacerbation of COPD | 73 | ||
| Initial Assessment | 73 | ||
| Airway | 73 | ||
| Breathing | 73 | ||
| Circulation | 73 | ||
| Disability | 73 | ||
| Exposure | 74 | ||
| Initial Investigations | 74 | ||
| Initial Management | 74 | ||
| Reassessment | 75 | ||
| Definitive Management | 75 | ||
| Handing over the Patient | 76 | ||
| Station 3.3: Community-acquired pneumonia (CAP) | 79 | ||
| Initial Assessment | 79 | ||
| Airway | 79 | ||
| Breathing | 79 | ||
| Circulation | 79 | ||
| Disability | 79 | ||
| Exposure | 79 | ||
| Initial Investigations | 80 | ||
| Initial Management | 80 | ||
| Reassessment | 81 | ||
| Definitive Management | 81 | ||
| Handing over the Patient | 81 | ||
| Station 3.4: Hospital-acquired pneumonia | 85 | ||
| Initial Assessment | 85 | ||
| Airway | 85 | ||
| Breathing | 85 | ||
| Circulation | 85 | ||
| Disability | 85 | ||
| Exposure | 85 | ||
| Initial Investigations | 86 | ||
| Initial Management | 86 | ||
| Reassessment | 87 | ||
| Definitive Management | 87 | ||
| Handing over the Patient | 87 | ||
| Station 3.5: Pulmonary embolism | 91 | ||
| Initial Assessment | 91 | ||
| Airway | 91 | ||
| Breathing | 91 | ||
| Circulation | 91 | ||
| Disability | 91 | ||
| Exposure | 91 | ||
| Initial Investigations | 92 | ||
| Initial Management | 93 | ||
| Reassessment | 93 | ||
| Definitive Management | 93 | ||
| Handing over the Patient | 93 | ||
| References | 94 | ||
| 4 Gastroenterology | 97 | ||
| Station 4.1: Severe ulcerative colitis | 97 | ||
| Initial Assessment | 97 | ||
| Airway | 97 | ||
| Breathing | 97 | ||
| Circulation | 98 | ||
| Disability | 98 | ||
| Exposure | 98 | ||
| Initial Investigations | 98 | ||
| Initial Management | 99 | ||
| Reassessment | 99 | ||
| Definitive Management | 100 | ||
| Handing over the Patient | 100 | ||
| Station 4.2: Spontaneous bacterial peritonitis | 104 | ||
| Initial assessment | 104 | ||
| Airway | 104 | ||
| Breathing | 104 | ||
| Circulation | 104 | ||
| Disability | 105 | ||
| Exposure | 105 | ||
| Initial Investigations | 105 | ||
| Initial Management | 106 | ||
| Reassessment | 107 | ||
| Handing over the Patient | 107 | ||
| Station 4.3: Paracetamol overdose | 111 | ||
| Initial Assessment | 111 | ||
| Airway | 111 | ||
| Breathing | 111 | ||
| Circulation | 111 | ||
| Disability | 111 | ||
| Exposure | 112 | ||
| Initial Investigations | 112 | ||
| Initial Management | 113 | ||
| N-Acetylcysteine (NAC) Administration | 113 | ||
| Monitoring for liver failure | 114 | ||
| Reassessment | 114 | ||
| Additional management | 114 | ||
| Handing over the Patient | 114 | ||
| Station 4.4: Abdominal sepsis | 116 | ||
| Initial Assessment | 116 | ||
| Airway | 116 | ||
| Breathing | 116 | ||
| Circulation | 116 | ||
| Disability | 116 | ||
| Exposure | 117 | ||
| Initial Investigations | 117 | ||
| Initial Management | 118 | ||
| Reassessment | 118 | ||
| Definitive Management | 118 | ||
| Handing over the Patient | 118 | ||
| Station 4.5: Acute upper GI bleed | 122 | ||
| Initial Assessment | 122 | ||
| Airway | 122 | ||
| Breathing | 122 | ||
| Circulation | 122 | ||
| Disability | 123 | ||
| Exposure | 123 | ||
| Initial Investigations | 123 | ||
| Initial Management for all Severe UGI Bleeds | 125 | ||
| Reassessment | 125 | ||
| Definitive Management for Oesophageal Variceal Bleeding | 125 | ||
| Handing over the Patient | 126 | ||
| References | 126 | ||
| 5 Neurology | 131 | ||
| Station 5.1: Meningitis | 131 | ||
| Initial Assessment | 131 | ||
| Airway | 131 | ||
| Breathing | 131 | ||
| Circulation | 132 | ||
| Disability | 132 | ||
| Exposure | 133 | ||
| Initial Investigations | 133 | ||
| Initial Management | 134 | ||
| Reassessment after Investigation Results | 135 | ||
| Interpreting lumbar puncture results | 135 | ||
| Handing over the Patient (in this case would likely be to intensive care) | 135 | ||
| Station 5.2: Seizures | 139 | ||
| Initial Assessment | 139 | ||
| Airway | 139 | ||
| Breathing | 139 | ||
| Circulation | 140 | ||
| Disability | 140 | ||
| Exposure | 140 | ||
| Initial Investigations | 140 | ||
| Initial Management | 141 | ||
| Reassessment once the Seizure has Stopped | 142 | ||
| Phenytoin therapy | 142 | ||
| Handing over the Patient | 143 | ||
| Station 5.3: Subarachnoid haemorrhage | 147 | ||
| Initial Assessment | 147 | ||
| Airway | 147 | ||
| Breathing | 147 | ||
| Circulation | 147 | ||
| Disability | 148 | ||
| Exposure | 148 | ||
| Initial Investigations | 148 | ||
| Initial Management | 149 | ||
| Management Following Diagnosis of Subarachnoid Haemorrhage | 150 | ||
| Care of a patient following subarachnoid haemorrhage | 150 | ||
| Fluid prescribing in patients with subarachnoid haemorrhage | 151 | ||
| Handing over the Patient | 151 | ||
| Station 5.4: Ischaemic stroke | 155 | ||
| Initial Assessment | 155 | ||
| Airway | 155 | ||
| Breathing | 155 | ||
| Circulation | 155 | ||
| Disability | 156 | ||
| Exposure | 156 | ||
| Initial Investigations | 156 | ||
| Initial Management | 157 | ||
| Care of a Patient Following an Acute Stroke | 158 | ||
| Handing over the Patient | 158 | ||
| Station 5.5: Myasthenia gravis | 162 | ||
| Initial Assessment | 162 | ||
| Airway | 162 | ||
| Breathing | 162 | ||
| Circulation | 162 | ||
| Disability | 163 | ||
| Exposure | 163 | ||
| Initial Investigations | 163 | ||
| Initial Management | 164 | ||
| Handing over the Patient | 165 | ||
| References | 165 | ||
| 6 Endocrinology | 171 | ||
| Station 6.1: Diabetic ketoacidosis | 171 | ||
| Initial Assessment | 171 | ||
| Airway | 171 | ||
| Breathing | 172 | ||
| Circulation | 172 | ||
| Disability | 172 | ||
| Exposure | 172 | ||
| Initial Investigations | 172 | ||
| Initial Management | 173 | ||
| Reassessment | 173 | ||
| Definitive Management | 174 | ||
| Handing over the Patient | 174 | ||
| Station 6.2: Hyperosmolar hyperglycaemic state (HHS) | 178 | ||
| Initial Assessment | 178 | ||
| Airway | 178 | ||
| Breathing | 178 | ||
| Circulation | 178 | ||
| Disability | 178 | ||
| Exposure | 178 | ||
| Initial Investigations | 179 | ||
| Initial Management | 180 | ||
| IV fluids | 180 | ||
| Reassessment | 180 | ||
| Definitive Management | 181 | ||
| Handing over the Patient | 181 | ||
| Station 6.3: Hypoglycaemia | 185 | ||
| Initial Assessment | 185 | ||
| Airway | 185 | ||
| Breathing | 185 | ||
| Circulation | 185 | ||
| Disability | 185 | ||
| Exposure | 186 | ||
| Initial Investigations | 186 | ||
| Initial Management | 187 | ||
| Reassessment | 187 | ||
| Definitive Management | 187 | ||
| Handing over the Patient | 187 | ||
| Station 6.4: Insulin prescribing | 189 | ||
| Types of Insulin | 189 | ||
| Scenario 1: Starting a Basal—Bolus | 189 | ||
| 7 Obstetrics and gynaecology | 227 | ||
| Station 7.1: Preterm labour | 227 | ||
| Initial Assessment | 227 | ||
| Airway, breathing, circulation | 227 | ||
| History | 228 | ||
| Examination | 228 | ||
| Initial Investigations | 228 | ||
| Management | 229 | ||
| Outcome | 229 | ||
| Handing over to the Night Team | 229 | ||
| Station 7.2: Bleeding in pregnancy | 232 | ||
| Initial Assessment | 232 | ||
| Airway | 232 | ||
| Breathing | 232 | ||
| Circulation | 232 | ||
| Disability | 233 | ||
| Exposure | 233 | ||
| Initial Investigations | 233 | ||
| Initial Management | 234 | ||
| Fluid resuscitation | 234 | ||
| Reduce the blood loss | 234 | ||
| Handing over the Patient | 235 | ||
| Station 7.3: Pre-eclampsia | 239 | ||
| Initial Assessment | 239 | ||
| Airway | 239 | ||
| Breathing | 239 | ||
| Circulation | 239 | ||
| Disability | 239 | ||
| Exposure | 240 | ||
| Initial Investigations | 240 | ||
| Diagnosis | 241 | ||
| Management | 241 | ||
| Antenatal corticosteroids | 243 | ||
| Symptom management | 243 | ||
| Fetal monitoring | 243 | ||
| Presenting your Findings to the On-Call Obstetric Consultant | 243 | ||
| Outcome | 243 | ||
| Station 7.4: Hyperemesis gravidarum | 246 | ||
| Initial Assessment Aims | 246 | ||
| History | 246 | ||
| Examination | 247 | ||
| Initial Investigations | 247 | ||
| Diagnosis | 247 | ||
| Initial Management | 247 | ||
| Rehydration | 248 | ||
| Antiemetics | 248 | ||
| Refeeding complications | 249 | ||
| Encourage oral intake | 250 | ||
| Return of normal metabolism | 250 | ||
| VTE prophylaxis | 250 | ||
| Handing over the Patient to Primary Care: Discharge Summary | 250 | ||
| Station 7.5: Urinary tract infection in pregnancy | 254 | ||
| Initial Assessment | 254 | ||
| History | 254 | ||
| Examination | 254 | ||
| Investigations | 255 | ||
| Management | 255 | ||
| Prescribing analgesia | 255 | ||
| Prescribing antibiotics | 255 | ||
| Referring the patient for specialist opinion–consultant microbiologist | 256 | ||
| References | 258 | ||
| 8 General surgery | 259 | ||
| Station 8.1: Venous thromboembolism (VTE) prophylaxis | 259 | ||
| Thromboprophylaxis | 259 | ||
| Assessment of venous thrombosis risk factors | 259 | ||
| General measures to reduce VTE risk | 260 | ||
| Mechanical thromboprophylaxis | 260 | ||
| Prescribing mechanical thromboprophylaxis | 260 | ||
| Contraindications to mechanical VTE prophylaxis | 260 | ||
| Pharmacological thromboprophalaxis | 260 | ||
| Risk of bleeding on VTE prophylaxis | 260 | ||
| Prescribing pharmacological thromboprophylaxis | 261 | ||
| Nicole’s Risk Factors and Bleeding Risk | 261 | ||
| Additional VTE prophylaxis examples: See prescribe boxes in margin (drug charts not shown) | 261 | ||
| Station 8.2: Acute pancreatitis | 264 | ||
| Initial Assessment | 264 | ||
| Airway | 264 | ||
| Breathing | 264 | ||
| Circulation | 264 | ||
| Disability | 265 | ||
| Exposure | 265 | ||
| Initial Investigations | 265 | ||
| Initial Management | 266 | ||
| Reassessment | 267 | ||
| Handing over the Patient | 267 | ||
| Station 8.3: Intestinal obstruction | 271 | ||
| Initial Assessment | 271 | ||
| Airway | 271 | ||
| Breathing | 271 | ||
| Circulation | 271 | ||
| Disability | 271 | ||
| Exposure | 272 | ||
| Initial Investigations | 272 | ||
| Initial Management | 273 | ||
| Reassessment | 273 | ||
| Handing over the Patient | 274 | ||
| Station 8.4: Diabetes in the surgical patient | 278 | ||
| Airway | 278 | ||
| Breathing | 278 | ||
| Circulation | 278 | ||
| Disability | 278 | ||
| Exposure | 279 | ||
| Initial Investigations | 279 | ||
| Initial Management | 280 | ||
| Reassessment | 281 | ||
| Handing over the Patient | 281 | ||
| Station 8.5: Postoperative fluid loss | 285 | ||
| Initial Assessment | 285 | ||
| Airway | 285 | ||
| Breathing | 285 | ||
| Circulation | 285 | ||
| Disability | 286 | ||
| Exposure | 286 | ||
| Initial Investigations | 286 | ||
| Initial Management | 287 | ||
| Reassessment | 287 | ||
| Handing over the Patient | 287 | ||
| References | 293 | ||
| 9 Paediatrics | 295 | ||
| Station 9.1: Acute bronchiolitis | 295 | ||
| Initial Assessment | 295 | ||
| Airway | 295 | ||
| Breathing | 295 | ||
| Circulation | 296 | ||
| Disability | 296 | ||
| Exposure | 296 | ||
| Initial Investigations | 296 | ||
| Initial Management | 297 | ||
| Reassessment | 298 | ||
| Handing over the Patient | 298 | ||
| Station 9.2: Respiratory distress in the newborn | 302 | ||
| Initial Assessment | 302 | ||
| Airway | 302 | ||
| Breathing | 302 | ||
| Circulation | 302 | ||
| Disability | 303 | ||
| Exposure | 303 | ||
| Initial Investigations | 303 | ||
| Initial Management | 304 | ||
| Reassessment | 304 | ||
| Handing over the Patient | 305 | ||
| Station 9.3: Viral-induced wheeze | 310 | ||
| Initial Assessment | 310 | ||
| Airway | 310 | ||
| Breathing | 310 | ||
| Circulation | 310 | ||
| Disability | 310 | ||
| Exposure | 311 | ||
| Initial Investigations | 311 | ||
| Initial Management | 311 | ||
| Reassessment | 312 | ||
| Handing over the Patient | 312 | ||
| Station 9.4: Infective exacerbation of cystic fibrosis | 315 | ||
| Initial Assessment | 315 | ||
| Airway | 315 | ||
| Breathing | 315 | ||
| Circulation | 315 | ||
| Disability | 316 | ||
| Exposure | 316 | ||
| Initial Investigations | 316 | ||
| Initial Management | 317 | ||
| Reassessment | 318 | ||
| Handing over the Patient | 318 | ||
| Station 9.5: Gastroenteritis | 322 | ||
| Initial Assessment | 322 | ||
| Airway | 322 | ||
| Breathing | 322 | ||
| Circulation | 322 | ||
| Disability | 322 | ||
| Exposure | 323 | ||
| Initial Investigations | 323 | ||
| Initial Management | 323 | ||
| Reassessment | 324 | ||
| Handing over the Patient | 324 | ||
| Station 9.6: Sickle cell chest crisis | 326 | ||
| Initial Assessment | 326 | ||
| Airway | 326 | ||
| Breathing | 326 | ||
| Circulation | 326 | ||
| Disability | 327 | ||
| Exposure | 327 | ||
| Initial Investigations | 327 | ||
| Initial Management | 328 | ||
| Reassessment | 328 | ||
| Handing over the Patient | 329 | ||
| Station 9.7: Idiopathic nephrotic syndrome | 333 | ||
| Initial Assessment | 333 | ||
| Airway | 333 | ||
| Breathing | 333 | ||
| Circulation | 333 | ||
| Disability | 334 | ||
| Exposure | 334 | ||
| Initial Investigations | 334 | ||
| Initial Management | 335 | ||
| Reassessment | 336 | ||
| Handing over the Patient | 336 | ||
| References | 336 | ||
| 10 Additional important scenarios | 339 | ||
| Station 10.1: Discharge prescribing | 339 | ||
| Prescribing Regular Medications | 339 | ||
| Prescribing PRN (As Required) Medication | 340 | ||
| Example | 340 | ||
| Prescribing Controlled Drugs | 340 | ||
| Station 10.2: Analgesia | 341 | ||
| Non-Opioids | 341 | ||
| Weak Opioids | 341 | ||
| Strong Opioids | 341 | ||
| Adjuvants | 341 | ||
| Prescribing Morphine | 341 | ||
| Station 10.3: Dealing with a medication error | 343 | ||
| Station 10.4: Reporting an adverse drug reaction | 344 | ||
| Medicines and Healthcare Products Regulatory Agency | 344 | ||
| Station 10.5: Blood product prescribing | 346 | ||
| Initial Assessment | 346 | ||
| Airway, breathing, circulation, disability, exposure | 346 | ||
| Initial Investigations | 346 | ||
| Initial Management | 347 | ||
| Blood Products that can be Prescribed | 348 | ||
| Less Commonly Prescribed Blood Products | 348 | ||
| Reassessment | 348 | ||
| Handing over the Patient | 348 | ||
| Station 10.6: Anaphylaxis | 352 | ||
| Initial Assessment | 352 | ||
| Airway | 352 | ||
| Breathing | 352 | ||
| Circulation | 352 | ||
| Disability | 352 | ||
| Exposure | 352 | ||
| Initial Investigations | 353 | ||
| Initial Management | 353 | ||
| Reassessment | 354 | ||
| Handing over the Patient | 354 | ||
| Station 10.7: Alcohol withdrawal | 358 | ||
| Initial Assessment | 358 | ||
| Airway | 358 | ||
| Breathing | 358 | ||
| Circulation | 358 | ||
| Disability | 358 | ||
| Exposure | 358 | ||
| Initial Investigations | 359 | ||
| Initial Management | 359 | ||
| Reassessment | 360 | ||
| Handing over the Patient | 360 | ||
| Station 10.8: Vancomycin and gentamicin prescribing | 364 | ||
| Vancomycin | 365 | ||
| Background information | 365 | ||
| 1. Initiating vancomycin | 365 | ||
| 2. Monitoring regimen | 365 | ||
| 3. Subsequent dose adjustments | 365 | ||
| Gentamicin | 366 | ||
| Background information | 366 | ||
| 1. Initiating gentamicin | 366 | ||
| 2. Monitoring regimen | 366 | ||
| 3. Subsequent dose adjustments | 366 | ||
| References | 367 | ||
| Index | 373 |