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DRUGS FOR TAKE. A Practical Guide to Prescribing on Day 1! Dr. Anna Crown. OBJECTIVES. 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
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DRUGS FOR TAKE A Practical Guide to Prescribing on Day 1! Dr. Anna Crown
OBJECTIVES • 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 • 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 • Nausea • Constipation • Cough • Indigestion • Leg cramps • Insomnia • Agitation
TACKLING PAIN • Regular analgesia • Regular paracetamol • Regular co-codamol 30:500 • NSAIDS • Morphine • Other pains
JUGGLING BLOOD SUGARS • Highs and lows • Type 1 or Type 2? • Adjusting insulin doses • Sliding scales
AVOIDING PROBLEMS WITH ALCOHOLICS • Enforced abstinence • Forced feeding • Wernicke’s encephalopathy: thiamine • DTs • Excess sodium • Hypoglycaemia • Seek advice
SCARY SITUATIONS • What if you get there first? • Additional management • OSCEs • Doses • IV or IM
SCARY SITUATIONS • Respiratory depression & pinpoint pupils • Severe heart failure • Myocardial infarction • Severe asthma • Hypoglycaemia • Possible meningococcal disease • Anaphylactic shock • Status epilepticus
SUMMARY - 1 • The drug chart • Prescribing abbreviations • When not to prescribe • The BNF • Hospital protocols • Simple remedies for minor problems
SUMMARY - 2 • Pain • Diabetes and the drug chart • Avoiding problems with alcoholics • Scary situations